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Cardiology

Instructions:

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. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
Diastolic
Transmural
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

2. In the cardiac cycle - which period has the highest 02 consumption?
Isovolumetric contraction
During diastole
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Stroke volume affected by contractility - afterload - and preload

3. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Strawberry hemangioma
Vagus to medulla
Glossopharyngeal to soliary nucleus of medulla
Hemorrhage

4. Where are pacemaker cells?
LV failure - pulm venous distention transudation of fluid
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
SA and AV nodes
In RA return (inspiration)

5. What other syndrom is associated with infantile aortic coarctation
Arteriorles
V fib
Turners
Myxoma

6. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
Left heart failure
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Mitral valve prolapse

7. Irregularly irregular ECG - no p waves: dx and treatment
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Inc central venous pressure - inc resistance to portal flow
Aortic dilation - bicuspid aortic valve - RF -
S. epidermidis

8. What can cause mitral prolapse?
Systolic dysfunction
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Myxomatous degeneration - RF - chordae rupture
Fluid movement through capillaries

9. What causes the CO curve to shift upwards?
Ventricular depolarization - nl < 120 msec
No - no pressure gradient
Wegener's
Pos inotropy - exercise

10. What happens in phase 2 of the cardiac ventricular action potential?
Temporal arteritis
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Mechanican contraction of the ventricles
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

11. Which class of drugs decrease the murmur heard in aortic regurg?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
CHF
Vasodilators
Pulsus parvus and tardus - weak - can lead to syncope

12. Which organ gets the largest share of systemic cardiac output
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Viridans streptococci
Vasocxn - while other tissues it causes vasodilation
Liver

13. What is the difference between adult and infantile type aortic coarctation?
C - ANCA
Eccentric - concentric hypertrophy causes diastolic disfunction
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
LV failure - pulm venous distention transudation of fluid

14. What happens in phase 4 of the cardiac ventricular action potential?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Pyogenic granuloma - associated with trauma and pregnancy
Atrial contraction
Resting potential high K perm

15. What is sudden cardiac death most commonly due to...
Increase contractility
V fib arrhythima
LAD - V1- V2
MI

16. What are the four most common locations for atherosclerosis?
Group a beta hemolytic strep
LAD - V1 - V4
Conduction delay through AV node - nl < 200 msec
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

17. How does aldosterone raise MAP
Activated histiocytes
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Inc blood volume
At least 55%

18. exaggerated decrease in pulse during inspiration.

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19. cavernous lymphangioma of the neck - associated with turner's
MAP
Neg inotropy - HF - narcotic overdose
Adult type aortic coarctation
Cystic hygroma

20. How does angiotensin II raise MAP
Buerger's disease
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Vasocxn
140/90

21. When is the scar completely formed in an MI?
7 weeks
Eisenmenger's syndrome
Mean arterial pressure
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

22. In what disease states is blood viscosity increased?
CO
7 weeks
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

23. What is associated with paradoxical spliting of S2
Aortic disecction - intraluminal tear forming false lumen
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
CHF
Aortic stenosis or LBBB

24. What cardiac change occurs in pregnancy?
MI
Purkingee>atria>ventricles>AV node
Increased SV
Patent ductus arteriosus - congenital rubella or prematurity

25. PCWP is an estimate of...
Left atrial pressure
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Eccentric - concentric hypertrophy causes diastolic disfunction
Maintain blood flow to organ over wide range of perfussion pressures

26. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Pyogenic granuloma - associated with trauma and pregnancy
Dec plasma proteins
S. epidermidis
Gap junctions

27. which heart valves are afected most in rheumatic heart diseease
Ventricles are depolarized
Mitral>aortic>>tricuspid - high pressure valves affected most
Patent ductus arteriosus - congenital rubella or prematurity
LCX - I - aVL

28. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
During diastole
Vasodilators
Eisenmenger's syndrome

29. bening capillary hemangioma of elderly - does not regress
Increase in Pc
Cherry hemangioma
Patent ductus arteriosus - congenital rubella or prematurity
Gap junctions

30. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Torsades de pointes
Stable angina
Non

31. What 4 things drive myocardial 02 demand?
Resting potential high K perm
At least 55%
Eisenmenger's syndrome
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

32. How does a patient with Tet of fallot learn to improve symptoms?
Apex and anterior interventricular septum
Squat. Compression of femoral arteries - inc TPR - dec
Neg inotropy - HF - narcotic overdose
Pyogenic granuloma - associated with trauma and pregnancy

33. The aortic arch receptors transmit along which nerve?
Early deaths from myocarditis
Persistant truncus arteriosus
Vagus to medulla
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

34. Which murmur is characteristic of mitral/tricuspid regurg?
Holosystoiic
Vasocxn - while other tissues it causes vasodilation
10%
Increased SV

35. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Extracellular calcium - calcium induced calcium release
RCA - II - III - aVF
Hypertrophied cardiomyopathy
Cherry hemangioma

36. What masks atrial repolarization?
Decrease in cAMP
Strawberry hemangioma
QRS complex
Hemorrhage

37. How do catecholamines increase contractility?
Increasing activity of Ca pump in SR
Group a beta hemolytic strep
Takayasu's arteritis
RV contraction (closed tricuspid valve bulding into atrium

38. MAP is also known as
Afterload (proportional to peripheral resistance)
Proportional to viscosity and inversely proportional to the radius to the 4th power
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
LCX - I - aVL

39. congenital heart defect with marfan's
Aortic insuffic - late
Tempral arteritis - may cause irreversible blindness
Left heart failure
R to L shunt caused by stenoic pulmonic valve

40. Inspiration causes an increase in which sided heart sounds?
Chordae rupture - GN - suppurative pericarditis - emboli
ASD
Right sided
Inc venous return exaccerbates pulm vasc congestion

41. What causes the ejection click in the Cres - decres murmur?
Aburpt halting of valve leaflets
Posterior descending (80% off the RCA - 20% off the circumflex)
Late systolic crescendo murmur with a midsystolic click
Yes

42. Which lab value indicates blood viscosity?
Inc RA pressure - due to filling against closed tricupsid valve
Hematocrit
Vasodilators - (hydrAlAzine)
Stable angina

43. Why is there edema after burns or during infection
Aortic and pulmonary closing
LAD - V1- V2
Inc Kf - capillary perm
Atrial contraction

44. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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45. Which bacteria causes endocarditis in the presence of colon cancer
Metastasis from melanoma or lymphoma
S. bovis
Neg inotropy - HF - narcotic overdose
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

46. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Cystic hygroma
Wegener's
Purkingee>atria>ventricles>AV node
Mechanican contraction of the ventricles

47. What is the most common cause of right heart failure
Fick principle
Varicose veins - thromboembolism rare
Left heart failure
Proportional to viscosity and inversely proportional to the radius to the 4th power

48. The cause of dyspnea on exertion?
Failure of LV to in CO during exercise
Ventricular depolarization - nl < 120 msec
Filling is incomplete and CO falls
LAD - V1- V2

49. What does mitral prolapse predeispose to?
Infective endocarditis
At least 55%
If sodium channel
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

50. What does TAPVR stand for
Total anomalous pulmonary trunk venous return
Pos inotropy - exercise
Dressler's - autoimmune
Dec P02 - inc PC02 and dec pH