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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. Which vessels account for the most total peripheral resistance
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Arteriorles
Vasocxn - while other tissues it causes vasodilation
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

2. What is the time frame for arrhythmia risk in the evolution of MI
Cystic hygroma
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
CHF
The first 4 days

3. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Angiosarcoma
Early deaths from myocarditis
2nd degree AV block - mobitz type 1
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

4. Which class of drugs decreases afterload?
Vasodilators - (hydrAlAzine)
Purkingee>atria>ventricles>AV node
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

5. How does angiotensin II raise MAP
Holosystoiic
Vasocxn
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
LAD

6. What causes aortic stenosis
Arteriorles
Atrial contraction
Age related calcifications or bicuspid aortic valve
Mitral and tricuspid closure

7. What does an isoelectric ST segment indicate?
During diastole
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Ventricles are depolarized
RCA

8. What causes hepatomegaly?
Left sided
Venodilators (nitrogylcerine)
Inc Kf - capillary perm
Inc central venous pressure - inc resistance to portal flow

9. What does FROM JANE stand for in bacterial endocarditis?

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10. Which area of the endocardium is especially vulnerable to infarction? Why?
Fetal right to left - neonate left to right leading to RVH and failure
Subendocardial - fewer collaterals and higher pressure
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Ventricular depolarization - nl < 120 msec

11. What causes the murmur heard in MR to enhance?
Increase intracellular Na - resulting in increased Ca
Sturge weber - vasculitis of caps
Inc TPR and LA return (expiration)
Fick principle

12. In an EKG - What is the p wave?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Atrial contraction
LAD > RCA > circumflex
Wegener's

13. What is the most common cause of right heart failure
Left heart failure
Late diastolic murmur following an opening snap
Atrial contraction
Boot shaped heart

14. Unilateral headache - jaw claudication - impaired vision
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Myxomatous degeneration - RF - chordae rupture
Tempral arteritis - may cause irreversible blindness
Strawberry hemangioma

15. Wegener's tx
Early deaths from myocarditis
Aortic and pulmonary closing
Cyclophosphamide and corticosteroids
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

16. stroke volume x HR =?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
During diastole
CO
Hematocrit

17. What is the machine like murmur? What is the heart pathology and the predisposing causes
Mitral>aortic>>tricuspid - high pressure valves affected most
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Preload
Patent ductus arteriosus - congenital rubella or prematurity

18. What supplies the posterior left ventricle?
Resting potential high K perm
SV/ EDV
CFX
Increase in Pc

19. What happens in phase 2 of the cardiac ventricular action potential?
Left atrial pressure
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Fast volatge gated Na channels
Inc central venous pressure - inc resistance to portal flow

20. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Tempral arteritis - may cause irreversible blindness
5-10 days - macs have degraded structural components
Stroke volume affected by contractility - afterload - and preload

21. What are the systolic heart sounds
Patent ductus arteriosus - congenital rubella or prematurity
Heart - 02 extraction is always around 100%
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Right sided

22. Which bacteria causes endocarditis in the presence of colon cancer
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
S. bovis
Age related calcifications or bicuspid aortic valve
Increasing activity of Ca pump in SR

23. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
RF
R to L shunt caused by stenoic pulmonic valve
Atrial contraction
Decreases

24. Which organ has ht highest blood flow per gram of tissue
Stable angina
Kidney
Non
Buerger's disease

25. Restrictive cardiomyopathy causes
Cystic hygroma
Dec P02 - inc PC02 and dec pH
Increased SV
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

26. What is the S2 sound?
Decrease in activity of Na/Ca exhanger and increase in contractility
Holosystoiic
Aortic and pulmonary closing
Maintain blood flow to organ over wide range of perfussion pressures

27. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
ASD - VSD - AV septal defect (endocardial cushion defect)
Eccentric - concentric hypertrophy causes diastolic disfunction
Ischemic heart dz - mitral valve prolapse - LV dilation
Coarcation of aorta

28. decrease stretch in baroreceptors leads to what response?
Left heart failure
Increased efferent SANS and decreased efferent PANS
Conduction delay through AV node - nl < 200 msec
Heart - 02 extraction is always around 100%

29. What is the progression of atherosclerosis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Increasing activity of Ca pump in SR
Glomus tumor
Hypertrophied cardiomyopathy

30. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
During diastole
The plateau period
Volatage gated Ca channels

31. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Non
Filling is incomplete and CO falls

32. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Diastolic
Purkingee>atria>ventricles>AV node
RCA
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

33. Given P = QR - what factors influence resistance?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Persistant truncus arteriosus
In parallel
MI

34. What causes the murmur heard in tricuspid regurg to enhance
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Can progess to V fib
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
In RA return (inspiration)

35. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
TAPVR
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Lymphangiosarcoma
Aortic disecction - intraluminal tear forming false lumen

36. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
2nd degree AV block - mobitz type 1
Decreases
Inc blood volume

37. How does digitatlis increase contractility?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
SA>AV>bundle of His>ventricles
CO
Increase intracellular Na - resulting in increased Ca

38. Irregularly irregular ECG - no p waves: dx and treatment
Isovolumetric contraction
Raynaud's
Pulsus parvus and tardus - weak - can lead to syncope
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

39. Expiration causes an increase in which sided heart sounds
Ventricular depolarization - nl < 120 msec
Left sided
2-4 day - early coag necrosis on the first day
Mean arterial pressure

40. What kind of dysfunction ensues in restrictive cardiomyopathy
Diastolic
Temporal arteritis
Pulmonic stenosis and RBBB
Inc blood volume

41. no change in PR interval followed by dropped beat
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

42. most common primary cardiac tumor in children - associated with tuberous sclerosis
Rhabdomyomas
Angiosarcoma
Kawasaki
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

43. prolonged PR interval
Stable angina
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
1st degree AV blodck

44. Hyperplastic onion skinning
Lymphangiosarcoma
Mitral valve prolapse
Arteriolosclerosis in malignant hypertension
Increase intracellular Na - resulting in increased Ca

45. The cause of dyspnea on exertion?
Myxomatous degeneration - RF - chordae rupture
Adult type aortic coarctation
Kawasaki
Failure of LV to in CO during exercise

46. What does prolonged QT predispose to?
Inc RA pressure - due to filling against closed tricupsid valve
Extracellular calcium - calcium induced calcium release
Venodilators (nitrogylcerine)
Torsades de pointes

47. What is the result of not have fast sodium channels in pacemaker cells?
SV/ EDV
Aortic insuffic - late
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Black > white > asian

48. In an inferior wall infarct - which artery is affected and which leads show Q waves
RCA - II - III - aVF
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Neg inotropy - HF - narcotic overdose

49. moncekberg
During diastole
Resting potential high K perm
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Purkingee>atria>ventricles>AV node

50. The 7 complications of MI

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