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Cardiology

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Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is the early and late lesion in rheumatic heart disease
Atrial contraction
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Mitral valve prolapse
Sudden tensing of chordae tendinae

2. dyspnea - fatigue - edema and rales - multiple causes
Cystic hygroma
CHF
Filling is incomplete and CO falls
Preload

3. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Glomus tumor
No - no pressure gradient
LV failure - pulm venous distention transudation of fluid

4. What is associated with paradoxical spliting of S2
Subendocardial - fewer collaterals and higher pressure
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
CK- MB
Aortic stenosis or LBBB

5. What are the complications from bacterial endocarditis?
Kawasaki
Strawberry hemangioma
Chordae rupture - GN - suppurative pericarditis - emboli
Failure of LV to in CO during exercise

6. EDV is also known as
Resting potential high K perm
No - no pressure gradient
Preload
Dressler's - autoimmune

7. When do you see extensive coagulative necrosis in an MI
2-4 day - early coag necrosis on the first day
Adult type aortic coarctation
Turners
SA>AV>bundle of His>ventricles

8. Which two mechanisms sense decrease MAP?
SV/ EDV
Medullary vasomotor center senses baroreceptors and JGA
RF
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

9. exaggerated decrease in pulse during inspiration.

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10. Which murmur do you hear in mitral stenosis?
Decrease in cAMP
C - ANCA
Late diastolic murmur following an opening snap
MAP

11. Which organ has ht highest blood flow per gram of tissue
During diastole
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Myxoma
Kidney

12. Which bacteria can cause endocarditis from prosthetic valves?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Cardiac tamponde
Transposition of great vessels
S. epidermidis

13. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Increase in Pc
C - ANCA
Increase - increase the chance the If are open
Kawasaki

14. What is association with fixed S2 splitting - does not increase with inspiration
ASD
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Increasing activity of Ca pump in SR
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

15. What other sign is often present with congenital long QT syndrome - why?
SV/ EDV
Increased SV
Squat. Compression of femoral arteries - inc TPR - dec
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

16. bening capillary hemangioma of elderly - does not regress
Dec plasma proteins
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Cherry hemangioma
Vasocxn - while other tissues it causes vasodilation

17. machine murmer
Late diastolic murmur following an opening snap
PDA
Cystic hygroma
Left atrial pressure

18. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
2nd degree AV block - mobitz type 1
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Dilated cardiomyopathy

19. What is the S1 sound?
Mitral and tricuspid closure
Coarcation of aorta
Gap junctions
Torsades de pointes

20. In an EKG - What is the PR interval?
Subendocardial - fewer collaterals and higher pressure
Group a beta hemolytic strep
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Conduction delay through AV node - nl < 200 msec

21. What supplies the posterior left ventricle?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
CFX
Eccentric - concentric hypertrophy causes diastolic disfunction

22. What is the formula for EF?
Cherry hemangioma
Resting potential high K perm
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
SV/ EDV

23. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Unstable/crescendo angina
Cystic hygroma
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
ANP

24. congenital heart defect withdown syndrome
Vagus to medulla
Inc interstitial osmotic pressure pulling fliud out of capillaries
ASD - VSD - AV septal defect (endocardial cushion defect)
140/90

25. What kind of infarct show ST depression
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Arteriolosclerosis in malignant hypertension
Subendocardial
Cherry hemangioma

26. What happens in phase 2 of the cardiac ventricular action potential?
Apex and anterior interventricular septum
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Ventricles are depolarized
Vasocxn - while other tissues it causes vasodilation

27. friction rub - 3-5 days post MI
Acute thrombosis of coronary artery
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Postinfarction fibrinous pericarditis
Arteriolosclerosis in malignant hypertension

28. What do patients die early from in rheumatic heart disease?
In RA return (inspiration)
Early deaths from myocarditis
Venodilators (nitrogylcerine)
Acute thrombosis of coronary artery

29. When during cardiac nodal cells depolarize?
Aburpt halting of valve leaflets
Arteriorles
During diastole
Pos inotropy - exercise

30. CO x Total peripheral resistance
The aortic before pulmonic - inspiration increases diff
Age related calcifications or bicuspid aortic valve
Mean arterial pressure
Unstable/crescendo angina

31. What other syndrom is associated with infantile aortic coarctation
Turners
Activated histiocytes
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

32. When is the scar completely formed in an MI?
7 weeks
LCX - I - aVL
Inc venous return exaccerbates pulm vasc congestion
Polyarteritis nodosum

33. PCWP > LV diastolic pressure
Ventricular repolarization
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Eisenmenger's syndrome
Mitral stenosis

34. what happens to capillaries in lymphatic blockage
RV failure - in venous pressure
Proportional to viscosity and inversely proportional to the radius to the 4th power
Failure of LV to in CO during exercise
Inc interstitial osmotic pressure pulling fliud out of capillaries

35. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Vasodilators
Dec P02 - inc PC02 and dec pH
During diastole

36. fibrinous pericarditis several weeks post MI

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37. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Stroke volume affected by contractility - afterload - and preload
RV failure - in venous pressure
Inc venous return exaccerbates pulm vasc congestion

38. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Can progess to V fib
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Failure of LV to in CO during exercise
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

39. What causes the murmur heard in tricuspid regurg to enhance
Inc RA pressure - due to filling against closed tricupsid valve
If sodium channel
Truncus - tet of fallot
In RA return (inspiration)

40. What murmur is heard with aortic regurg?
1st degree AV blodck
V fib arrhythima
RCA - II - III - aVF
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

41. The cause of dyspnea on exertion?
Preload
Failure of LV to in CO during exercise
Arteriolosclerosis in malignant hypertension
The aortic before pulmonic - inspiration increases diff

42. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Group a beta hemolytic strep
Myxoma
Left atrial pressure
Kaposi's sarcoma

43. What is the machine like murmur? What is the heart pathology and the predisposing causes
Crescendo - decrescendo systolic ejection murmur following ejection click
Patent ductus arteriosus - congenital rubella or prematurity
Vasodilators - (hydrAlAzine)
Babies

44. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
Hematocrit
Inc venous return exaccerbates pulm vasc congestion
RV contraction (closed tricuspid valve bulding into atrium

45. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
MI
Fluid movement through capillaries
Viridans streptococci
Indomethacin closes - and pge keeps it open

46. Why is contractility decreased in heart failure?
MI
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Systolic dysfunction
5-10 days - macs have degraded structural components

47. PROVe
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Black > white > asian

48. What is the characteristic pulse in aortic stenosis?
CFX
SA>AV>bundle of His>ventricles
Inc TPR and LA return (expiration)
Pulsus parvus and tardus - weak - can lead to syncope

49. What is the most common cause of MI
Acute thrombosis of coronary artery
CHF
Aortic stenosis or LBBB
LAD > RCA > circumflex

50. Which vessels account for the most total peripheral resistance
Fick principle
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Arteriorles
If sodium channel

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