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. Which artery supplies the SA and AV nodes?
Kids
Lower right - MC - upper right - AO - upper right AC - lower left MO
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
RCA


2. In an EKG - What is the p wave?
Atrial contraction
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Dilation
Boot shaped heart


3. What causes the murmur heard in MR to enhance?
Transmural
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Inc TPR and LA return (expiration)
In RA return (inspiration)


4. What causes orthopnea?
Inc venous return exaccerbates pulm vasc congestion
Gap junctions
Eccentric - concentric hypertrophy causes diastolic disfunction
In parallel


5. What is association with fixed S2 splitting - does not increase with inspiration
Posterior descending (80% off the RCA - 20% off the circumflex)
Increasing activity of Ca pump in SR
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
ASD


6. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
In HF
Henoch - Schlonlein purpura
Atherosclerosis


7. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Viridans streptococci
LV failure - pulm venous distention transudation of fluid
Kidney
Aburpt halting of valve leaflets


8. In an acute MI - are there any visible changes via LM in the first 2-4 hours
ANP
In HF
Systolic dysfunction
No


9. What does HTN predispose to?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Mitral and tricuspid closure
Varicose veins - thromboembolism rare
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection


10. fibrinous pericarditis several weeks post MI

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11. What causes ankle - sacral edema - jugular venous distention
Transmural
Right sided
2nd degree AV block - mobitz type 1
RV failure - in venous pressure


12. most common heart tumor
LAD
Left sided
Metastasis from melanoma or lymphoma
Group a beta hemolytic strep


13. Most common vasculitis affecting medium and large arteries
No
Temporal arteritis
EKG
Proportional to viscosity and inversely proportional to the radius to the 4th power


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

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15. In terms of starling forces - why does heart failure cause edema?
Mitral valve
Wolff - Parkinson white syndrome
Increase in Pc
Coarcation of aorta


16. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
Lower right - MC - upper right - AO - upper right AC - lower left MO
Extracellular calcium - calcium induced calcium release
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis


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

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18. Restrictive cardiomyopathy causes
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Failure of LV to in CO during exercise
At least 55%
Late diastolic murmur following an opening snap


19. What is sudden cardiac death most commonly due to...
Cardiac tamponde
TAPVR
V fib arrhythima
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved


20. Which murmur is characteristic of mitral/tricuspid regurg?
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Holosystoiic
5-10 days - macs have degraded structural components
SA and AV nodes


21. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
The first 4 days
PDA
Aortic stenosis or LBBB
Myxoma


22. What causes the CO curve to shift downwards?
Dec P02 - inc PC02 and dec pH
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Neg inotropy - HF - narcotic overdose
The aortic before pulmonic - inspiration increases diff


23. 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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24. What is the time frame for arrhythmia risk in the evolution of MI
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
The first 4 days
Left sided
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR


25. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
During HF from microhemorrhages from inc pulm cap pressure
CK- MB
Hemorrhage
Squat. Compression of femoral arteries - inc TPR - dec


26. Which class of drugs decrease the murmur heard in aortic regurg?
Afterload (proportional to peripheral resistance)
Postinfarction fibrinous pericarditis
Kaposi's sarcoma
Vasodilators


27. Central chemoreceptors do not respond directly to which parameter?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
P02
Adult type aortic coarctation
Changes in CO as a function of preload


28. Inspiration causes an increase in which sided heart sounds?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Afterload (proportional to peripheral resistance)
Right sided
Medullary vasomotor center senses baroreceptors and JGA


29. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Rapid upstroke - voltage gated Na channels open
Early deaths from myocarditis
Dilated cardiomyopathy


30. 2/3 diastolic + 1/3 systolic
Black > white > asian
Raynaud's
PDA
MAP


31. benign cap hemangioma of infancy - spont regresses
Strawberry hemangioma
Increasing activity of Ca pump in SR
Lower right - MC - upper right - AO - upper right AC - lower left MO
Left heart failure


32. In an EKG - What is the QT interval?
5-10 days - macs have degraded structural components
Myxoma
Wegener's
Mechanican contraction of the ventricles


33. Wegener's presentation
Increased SV
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
TAPVR
EKG


34. Which channel accounts for automaticity of the SA and AV nodes?
Neg inotropy - HF - narcotic overdose
Ischemic heart dz - mitral valve prolapse - LV dilation
PDA
If sodium channel


35. What are anitschkow's cells
Eisenmenger's syndrome
Activated histiocytes
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Fluid movement through capillaries


36. What happens with a decrease of extracellular Na
Stroke volume affected by contractility - afterload - and preload
Indomethacin closes - and pge keeps it open
PDA
Decrease in activity of Na/Ca exhanger and increase in contractility


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

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38. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Total anomalous pulmonary trunk venous return
Infective endocarditis
Dilated cardiomyopathy


39. PROVe
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Dressler's - autoimmune
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure


40. What masks atrial repolarization?
Buerger's disease
QRS complex
Kids
Isovolumetric contraction


41. What is the cushing triad?
HTN - bradycardia - and respiratory depression
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Mean arterial pressure
During diastole


42. fibrous plaques and atheromas in intima of arteries
In parallel
Pulse pressure
Polyarteritis nodosum
Atherosclerosis


43. dyspnea - fatigue - edema and rales - multiple causes
1st degree AV blodck
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
CHF
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open


44. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
MI
ASD
The aortic before pulmonic - inspiration increases diff


45. What is the characteristic pulse in aortic stenosis?
Transposition of great vessels
Pulsus parvus and tardus - weak - can lead to syncope
During diastole
TAPVR


46. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
...
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Dec plasma proteins
P02


47. How are cadiac myocytes eltrically coupled?
Troponin I
Varicose veins - thromboembolism rare
Gap junctions
Turners


48. which medications are used to maintain patency or close the ductus arteriosus?
Indomethacin closes - and pge keeps it open
The aortic before pulmonic - inspiration increases diff
Non
Gap junctions


49. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Ventricles are depolarized
Squat. Compression of femoral arteries - inc TPR - dec
LAD
Fick principle


50. What is the most common cause of MI
Acute thrombosis of coronary artery
Fick principle
Fast volatge gated Na channels
Dressler's - autoimmune