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Cardiology
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Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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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. How do catecholamines increase contractility?
V fib
Increasing activity of Ca pump in SR
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Inc RA pressure - due to filling against closed tricupsid valve
2. What channels do the the pacemaker cells lack?
Fast volatge gated Na channels
Unstable/crescendo angina
2nd degree AV block - mobitz type 1
Atherosclerosis
3. What stimulates release of calcium from the SR?
MAP
Fetal right to left - neonate left to right leading to RVH and failure
Holosystoiic
Extracellular calcium - calcium induced calcium release
4. congenital heart defect with marfan's
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic insuffic - late
Coarcation of aorta
R to L shunt caused by stenoic pulmonic valve
5. What is the S1 sound?
Liver
Mitral and tricuspid closure
MAP
Patent ductus arteriosus - congenital rubella or prematurity
6. congenital heart defect withdown syndrome
Pulsus parvus and tardus - weak - can lead to syncope
Atherosclerosis
ASD - VSD - AV septal defect (endocardial cushion defect)
V fib
7. When is the scar completely formed in an MI?
Hypertrophied cardiomyopathy
RV contraction (closed tricuspid valve bulding into atrium
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
7 weeks
8. list the coronary vessels most likely to be occluded
Extracellular calcium - calcium induced calcium release
Atrial contraction
Fetal right to left - neonate left to right leading to RVH and failure
LAD > RCA > circumflex
9. Right to left shunts are more common in babies or kids?
Dec P02 - inc PC02 and dec pH
Kawasaki
HTN - bradycardia - and respiratory depression
Babies
10. Which class of drugs decreases afterload?
CO
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Vasodilators - (hydrAlAzine)
11. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
2-4 day - early coag necrosis on the first day
Subendocardial - fewer collaterals and higher pressure
Pulse pressure
12. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Subendocardial
Rhabdomyomas
LAD
13. prolonged PR interval
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
1st degree AV blodck
Varicose veins - thromboembolism rare
Mitral>aortic>>tricuspid - high pressure valves affected most
14. 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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15. tearing chest pain radiation to the back - associated with marfan
Aortic dilation - bicuspid aortic valve - RF -
Inc interstitial osmotic pressure pulling fliud out of capillaries
Arteriorles
Aortic disecction - intraluminal tear forming false lumen
16. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
Wolff - Parkinson white syndrome
C - ANCA
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
17. 2/3 diastolic + 1/3 systolic
MAP
Ventricular repolarization
Left atrial pressure
Gap junctions
18. moncekberg
...
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Inc RA pressure - due to filling against closed tricupsid valve
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
19. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
MAP
Increased SV
RCA - II - III - aVF
20. Wegener's tx
Cyclophosphamide and corticosteroids
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Patent ductus arteriosus - congenital rubella or prematurity
Mitral>aortic>>tricuspid - high pressure valves affected most
21. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
Mechanican contraction of the ventricles
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
5-10 days - macs have degraded structural components
EKG
22. If HR is too fast (V tach) what happens during diastole?
Vasocxn
Filling is incomplete and CO falls
Proportional to viscosity and inversely proportional to the radius to the 4th power
TAPVR
23. What does the LAD supply?
Cystic hygroma
Inc venous return exaccerbates pulm vasc congestion
Holosystoiic
Apex and anterior interventricular septum
24. How does aldosterone raise MAP
Wegener's
Adult type aortic coarctation
Filling is incomplete and CO falls
Inc blood volume
25. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
CHF
Posterior descending (80% off the RCA - 20% off the circumflex)
Aortic stenosis or LBBB
LCX - I - aVL
26. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
Volatage gated Ca channels
Temporal arteritis
Total anomalous pulmonary trunk venous return
27. What is a normal EF
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Ventricular depolarization - nl < 120 msec
Eccentric - concentric hypertrophy causes diastolic disfunction
At least 55%
28. What masks atrial repolarization?
Viridans streptococci
Inc blood volume
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
QRS complex
29. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
Fick principle
Atrial contraction
RF
30. Which bacteria causes endocarditis in the presence of colon cancer
3rd degree block - pacemaker - Lyme disease
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
S. bovis
31. What is indicated when CO and venous return are equal?
7 weeks
The operating point of the heart
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Squat. Compression of femoral arteries - inc TPR - dec
32. The carotid sinus transmits along which nerve?
Ventricular repolarization
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Glossopharyngeal to soliary nucleus of medulla
Acute thrombosis of coronary artery
33. Which organ has ht highest blood flow per gram of tissue
Atrial contraction
Kidney
Increase contractility
5-10 days - macs have degraded structural components
34. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Sturge weber - vasculitis of caps
In parallel
Polyarteritis nodosum
Adult type aortic coarctation
35. What are anitschkow's cells
Activated histiocytes
Increased SV
Glossopharyngeal to soliary nucleus of medulla
Cystic hygroma
36. Which enzymes are useful for diagnosing reinfarction
Transmural
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic stenosis or LBBB
CK- MB
37. machine murmer
PDA
Transposition of great vessels
Preload
Purkingee>atria>ventricles>AV node
38. Which bacteria can cause endocarditis from prosthetic valves?
Resting potential high K perm
Fluid movement through capillaries
S. epidermidis
1st degree AV blodck
39. Left to right shunts are more common in babies or kids?
EKG
Kids
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Venodilators (nitrogylcerine)
40. When does extracellular calcium enter the cardiac muscle cells during contraction?
The plateau period
Total anomalous pulmonary trunk venous return
Hypertrophied cardiomyopathy
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
41. In normal S2 splitting - which valve closes first? What increases it?
The aortic before pulmonic - inspiration increases diff
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
S. bovis
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
42. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
Ventricular repolarization
CHF
Takayasu's arteritis
43. What does hypoxia cause in the lung versus other tissues?
Unstable/crescendo angina
Vasocxn - while other tissues it causes vasodilation
Metastasis from melanoma or lymphoma
Preload
44. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Angiosarcoma
In HF
Failure of LV to in CO during exercise
No - no pressure gradient
45. What murmur is heard with aortic regurg?
Increase in Pc
Torsades de pointes
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Tricuspid atresia - requires ASD and VSD
46. How do beta blockers decrease contractility?
Greater ventricular EDV
Decrease in cAMP
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Squat. Compression of femoral arteries - inc TPR - dec
47. decrease stretch in baroreceptors leads to what response?
Increased efferent SANS and decreased efferent PANS
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
In RA return (inspiration)
Apex and anterior interventricular septum
48. What causes aortic regurg
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
140/90
Aortic dilation - bicuspid aortic valve - RF -
Prinzmetal angina
49. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Transfusion
Pulmonic stenosis and RBBB
50. Mitral stenosis is most often secondary to which condition?
Lymphangiosarcoma
Inc Kf - capillary perm
Mechanican contraction of the ventricles
RF
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