Cardiology

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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2. in the JVP - What is the v wave?
Aortic and pulmonary closing
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Inc RA pressure - due to filling against closed tricupsid valve
Hematocrit


3. bening capillary hemangioma of elderly - does not regress
Conduction delay through AV node - nl < 200 msec
Raynaud's
Sudden tensing of chordae tendinae
Cherry hemangioma


4. What is the machine like murmur? What is the heart pathology and the predisposing causes
Fick principle
Sturge weber - vasculitis of caps
Fast volatge gated Na channels
Patent ductus arteriosus - congenital rubella or prematurity


5. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Can progess to V fib
Subendocardial
Libman - sacks endocarditis
Pulse pressure


6. Which class of drugs decrease the murmur heard in aortic regurg?
Vasodilators
Mitral stenosis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
P02


7. What is the result of not have fast sodium channels in pacemaker cells?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
ASD - VSD - AV septal defect (endocardial cushion defect)
Postinfarction fibrinous pericarditis
Systolic dysfunction


8. What is the classic X ray finding for tet of fallot?
Boot shaped heart
Atherosclerosis
Total anomalous pulmonary trunk venous return
Mitral valve


9. What are anitschkow's cells
Activated histiocytes
In RA return (inspiration)
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Buerger's disease


10. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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11. Which organ gets the largest share of systemic cardiac output
Late diastolic murmur following an opening snap
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
MI
Liver


12. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
Coarcation of aorta
The plateau period
Temporal arteritis


13. When do you see extensive coagulative necrosis in an MI
Increasing activity of Ca pump in SR
Lower right - MC - upper right - AO - upper right AC - lower left MO
Failure of LV to in CO during exercise
2-4 day - early coag necrosis on the first day


14. What happens in phase 0 of the cardiac ventricular action potential?
Rapid upstroke - voltage gated Na channels open
Lymphangiosarcoma
Lower right - MC - upper right - AO - upper right AC - lower left MO
Kaposi's sarcoma


15. What is indicated when CO and venous return are equal?
Inc central venous pressure - inc resistance to portal flow
The operating point of the heart
Coarcation of aorta
Preload


16. what percentage of HTN is secondary to renal disease?
10%
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Liver
Activated histiocytes


17. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?

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18. exaggerated decrease in pulse during inspiration.

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19. When do coronary arteries fill?
Ventricular repolarization
During diastole
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Ventricular depolarization - nl < 120 msec


20. What does an isoelectric ST segment indicate?
Ventricles are depolarized
Hemorrhage
Metastasis from melanoma or lymphoma
No


21. What does the LAD supply?
Microscopic polyangiitis - like wegener's without granulomas
Apex and anterior interventricular septum
Extracellular calcium - calcium induced calcium release
Chordae rupture - GN - suppurative pericarditis - emboli


22. What does the starling curve show?
Atrial contraction
The first 4 days
Systolic dysfunction
Changes in CO as a function of preload


23. absecnce of tricuspid valve - hypoplastic RV
Anterosuperior displacement of the infundibular septum
C - ANCA
Tricuspid atresia - requires ASD and VSD
Pulmonary flow murmur and diastolic rumble


24. Churg Strauss - presentation and test
Transfusion
Aortic and pulmonary closing
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Increase contractility


25. What is the definition of HTN?
S. epidermidis
Increase in Pc
140/90
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia


26. What is the association with wide S2 splitting?
Patent ductus arteriosus - congenital rubella or prematurity
During diastole
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Pulmonic stenosis and RBBB


27. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
140/90
LV failure - pulm venous distention transudation of fluid
The aortic before pulmonic - inspiration increases diff


28. In an EKG - What is the p wave?
In RA return (inspiration)
Inc Kf - capillary perm
Atrial contraction
Raynaud's


29. congenital heart defect with 22q11
Vasodilators - (hydrAlAzine)
Truncus - tet of fallot
During HF from microhemorrhages from inc pulm cap pressure
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD


30. What do the carotid and aortic bodies respond to?
Increase intracellular Na - resulting in increased Ca
Dec P02 - inc PC02 and dec pH
Arteriolosclerosis in malignant hypertension
Posterior descending (80% off the RCA - 20% off the circumflex)


31. What does FAN MY SKIN On Wednesday stand for?
Changes in CO as a function of preload
Stroke volume affected by contractility - afterload - and preload
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Mean arterial pressure


32. In what disease states is blood viscosity increased?
140/90
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aburpt halting of valve leaflets
Troponin I


33. What masks atrial repolarization?
QRS complex
Filling is incomplete and CO falls
Transmural
RCA


34. Which organ has the largest arteriovenous difference
Decreased
Heart - 02 extraction is always around 100%
Inc Kf - capillary perm
Failure of LV to in CO during exercise


35. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Lymphangiosarcoma
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
3rd degree block - pacemaker - Lyme disease
No - no pressure gradient


36. Where is the most posterior portion of the heart and What can it cause?
Early deaths from myocarditis
Diastolic
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction


37. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Decreases
SA and AV nodes
Fick principle
Truncus - tet of fallot


38. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Atherosclerosis
Varicose veins - thromboembolism rare


39. What causes the midsystolic click
Raynaud's
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
RV failure - in venous pressure
Sudden tensing of chordae tendinae


40. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
MI
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Inc interstitial osmotic pressure pulling fliud out of capillaries


41. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Troponin I
If sodium channel
Apex and anterior interventricular septum
In series


42. in the JVP - What is the c wave?
Aortic disecction - intraluminal tear forming false lumen
RV contraction (closed tricuspid valve bulding into atrium
Left atrial pressure
ASD - VSD - AV septal defect (endocardial cushion defect)


43. The 7 complications of MI

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44. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Proportional to viscosity and inversely proportional to the radius to the 4th power
Wolff - Parkinson white syndrome
Angiosarcoma
ANP


45. What murmur is heard with aortic regurg?
Conduction delay through AV node - nl < 200 msec
SV/ EDV
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure


46. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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47. Fatal arrhythmia
Activated histiocytes
V fib
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Sturge weber - vasculitis of caps


48. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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49. What causes the early cyanosis in Tet of Fallot?
Afterload (proportional to peripheral resistance)
MI
R to L shunt caused by stenoic pulmonic valve
Eisenmenger's syndrome


50. clinical signs of cardiac tamponade
Truncus - tet of fallot
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
During diastole
Atherosclerosis