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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. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
Mitral>aortic>>tricuspid - high pressure valves affected most
RV contraction (closed tricuspid valve bulding into atrium
Proportional to viscosity and inversely proportional to the radius to the 4th power

2. Which bacteria causes rheumatic heart disease
Inc RA pressure - due to filling against closed tricupsid valve
Group a beta hemolytic strep
Dilated cardiomyopathy
Arteriorles

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

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4. SV CAP means?
Inc venous return exaccerbates pulm vasc congestion
Medullary vasomotor center senses baroreceptors and JGA
Lymphangiosarcoma
Stroke volume affected by contractility - afterload - and preload

5. What masks atrial repolarization?
QRS complex
In RA return (inspiration)
Afterload (proportional to peripheral resistance)
Aortic stenosis or LBBB

6. When do you find hemosiderin laden macrophages in the lungs?
Glossopharyngeal to soliary nucleus of medulla
During HF from microhemorrhages from inc pulm cap pressure
Increase in Pc
Volatage gated Ca channels

7. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Inc interstitial osmotic pressure pulling fliud out of capillaries
Conduction delay through AV node - nl < 200 msec
Septal defects - PDA - pulm art stenosis
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

8. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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9. What is the formula for EF?
SV/ EDV
Dec plasma proteins
140/90
Activated histiocytes

10. What kind of dysfunction ensues in restrictive cardiomyopathy
If sodium channel
Diastolic
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

11. PCWP > LV diastolic pressure
Cystic hygroma
Libman - sacks endocarditis
10%
Mitral stenosis

12. In an inferior wall infarct - which artery is affected and which leads show Q waves
Diastolic
V fib arrhythima
RCA - II - III - aVF
Inc TPR and LA return (expiration)

13. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Persistant truncus arteriosus
Patent ductus arteriosus - congenital rubella or prematurity
S. aureus
The first 4 days

14. What do the carotid and aortic bodies respond to?
Dec P02 - inc PC02 and dec pH
In series
In HF
Decreased

15. The cause of cardiac dilation?
Greater ventricular EDV
Inc central venous pressure - inc resistance to portal flow
Black > white > asian
Eisenmenger's syndrome

16. What does the U wave indicated?
Late diastolic murmur following an opening snap
Total anomalous pulmonary trunk venous return
Glossopharyngeal to soliary nucleus of medulla
HypoK and bradycardia

17. which medications are used to maintain patency or close the ductus arteriosus?
Arteriorles
Indomethacin closes - and pge keeps it open
Infective endocarditis
Inc blood volume

18. congenital heart defect with marfan's
V fib arrhythima
Systolic dysfunction
Aortic insuffic - late
Dressler's - autoimmune

19. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Libman - sacks endocarditis
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Holosystoiic

20. What is sudden cardiac death most commonly due to...
Gap junctions
Cystic hygroma
V fib arrhythima
Myxomatous degeneration - RF - chordae rupture

21. Where is the most posterior portion of the heart and What can it cause?
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Patent ductus arteriosus - congenital rubella or prematurity
Neg inotropy - HF - narcotic overdose
Strawberry hemangioma

22. The carotid sinus transmits along which nerve?
Systolic dysfunction
Proportional to viscosity and inversely proportional to the radius to the 4th power
Squat. Compression of femoral arteries - inc TPR - dec
Glossopharyngeal to soliary nucleus of medulla

23. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
Dec P02 - inc PC02 and dec pH
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Myxoma

24. absecnce of tricuspid valve - hypoplastic RV
LAD - V1- V2
Tricuspid atresia - requires ASD and VSD
In parallel
Increase intracellular Na - resulting in increased Ca

25. How do beta blockers decrease contractility?
SV/ EDV
Liver
Postinfarction fibrinous pericarditis
Decrease in cAMP

26. What is association with fixed S2 splitting - does not increase with inspiration
Heart - 02 extraction is always around 100%
Kidney
ASD
V fib arrhythima

27. What kind of infarct show ST depression
3rd degree block - pacemaker - Lyme disease
Subendocardial
140/90
Isovolumetric contraction

28. When is the scar completely formed in an MI?
7 weeks
Dec P02 - inc PC02 and dec pH
During HF from microhemorrhages from inc pulm cap pressure
P02

29. stroke volume x HR =?
CO
Dressler's - autoimmune
Babies
LAD - V1- V2

30. Wegener's presentation
Diastolic
Early deaths from myocarditis
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Decreases

31. How does angiotensin II raise MAP
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
Fluid movement through capillaries
Vasocxn

32. Mitral stenosis is most often secondary to which condition?
RF
ANP
Sturge weber - vasculitis of caps
Wegener's

33. Why is contractility decreased in heart failure?
EKG
RCA
Crescendo - decrescendo systolic ejection murmur following ejection click
Systolic dysfunction

34. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Inc interstitial osmotic pressure pulling fliud out of capillaries
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
2-4 day - early coag necrosis on the first day
Unstable/crescendo angina

35. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Late diastolic murmur following an opening snap
Myxoma
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

36. EDV - ESV
SV/ EDV
Stroke volume
Wegener's
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

37. In the cardiac cycle - which period has the highest 02 consumption?
During HF from microhemorrhages from inc pulm cap pressure
Ventricular depolarization - nl < 120 msec
Isovolumetric contraction
Kidney

38. CO x Total peripheral resistance
Kidney
Hemorrhage
Dilated cardiomyopathy
Mean arterial pressure

39. Left to right shunts are more common in babies or kids?
Aortic dilation - bicuspid aortic valve - RF -
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Prinzmetal angina
Kids

40. What is the most common cause of right heart failure
Left heart failure
Coarcation of aorta
In parallel
Late systolic crescendo murmur with a midsystolic click

41. What is the definition of HTN?
140/90
...
Fast volatge gated Na channels
In parallel

42. what percentage of HTN is secondary to renal disease?
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Metastasis from melanoma or lymphoma
10%
Eisenmenger's syndrome

43. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Microscopic polyangiitis - like wegener's without granulomas
140/90
Pulmonary flow murmur and diastolic rumble
Lower right - MC - upper right - AO - upper right AC - lower left MO

44. What causes the CO curve to shift downwards?
Rhabdomyomas
Kaposi's sarcoma
Aortic and pulmonary closing
Neg inotropy - HF - narcotic overdose

45. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Mitral>aortic>>tricuspid - high pressure valves affected most
Transfusion
In RA return (inspiration)
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

46. When do you see extensive coagulative necrosis in an MI
2-4 day - early coag necrosis on the first day
Total anomalous pulmonary trunk venous return
SA and AV nodes
Libman - sacks endocarditis

47. What causes the cushing reflex and why
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Polyarteritis nodosum
Aortic stenosis or LBBB
Increase contractility

48. exaggerated decrease in pulse during inspiration.

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49. Fatal arrhythmia
Acute thrombosis of coronary artery
V fib
Pulse pressure
ASD

50. Which murmur is characteristic of mitral/tricuspid regurg?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Atherosclerosis
Holosystoiic