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Test your basic knowledge |
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. When does EF decrease
Cystic hygroma
10%
In HF
Ventricles are depolarized
2. no relation between p waves and QRS intervals - treatment and predisposing factor
Proportional to viscosity and inversely proportional to the radius to the 4th power
3rd degree block - pacemaker - Lyme disease
HTN - bradycardia - and respiratory depression
Ischemic heart dz - mitral valve prolapse - LV dilation
3. What do patients die early from in rheumatic heart disease?
HTN - bradycardia - and respiratory depression
Pos inotropy - exercise
Early deaths from myocarditis
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
4. What causes the cushing reflex and why
Diastolic
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Kawasaki
Decreases
5. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Metastasis from melanoma or lymphoma
Troponin I
Aortic dilation - bicuspid aortic valve - RF -
Libman - sacks endocarditis
6. What channels do the the pacemaker cells lack?
Fast volatge gated Na channels
MI
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
No - no pressure gradient
7. When do coronary arteries fill?
Lymphangiosarcoma
Anterosuperior displacement of the infundibular septum
During diastole
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
8. Which organ has ht highest blood flow per gram of tissue
LCX - I - aVL
Posterior descending (80% off the RCA - 20% off the circumflex)
Dec plasma proteins
Kidney
9. What is the progression of atherosclerosis?
Maintain blood flow to organ over wide range of perfussion pressures
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
During HF from microhemorrhages from inc pulm cap pressure
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
10. The carotid sinus transmits along which nerve?
RV contraction (closed tricuspid valve bulding into atrium
Glossopharyngeal to soliary nucleus of medulla
Sudden tensing of chordae tendinae
ASD - VSD - AV septal defect (endocardial cushion defect)
11. no change in PR interval followed by dropped beat
Wegener's
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Cardiac tamponde
12. What causes the CO curve to shift upwards?
Pos inotropy - exercise
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Pyogenic granuloma - associated with trauma and pregnancy
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
13. Where is the most posterior portion of the heart and What can it cause?
R to L shunt caused by stenoic pulmonic valve
In RA return (inspiration)
Increase in Pc
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
14. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Aortic dilation - bicuspid aortic valve - RF -
RF
Glomus tumor
Decreased
15. Most common vasculitis affecting medium and large arteries
Temporal arteritis
Subendocardial
Vagus to medulla
Transmural
16. What causes the midsystolic click
Varicose veins - thromboembolism rare
Sudden tensing of chordae tendinae
Activated histiocytes
Changes in CO as a function of preload
17. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Polyarteritis nodosum
Early deaths from myocarditis
Adult type aortic coarctation
Dec P02 - inc PC02 and dec pH
18. What is the gold standard for dx of MI in the first 6 hours
Failure of LV to in CO during exercise
Ischemic heart dz - mitral valve prolapse - LV dilation
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
EKG
19. congenital heart defect with turner's
Cyclophosphamide and corticosteroids
Ischemic heart dz - mitral valve prolapse - LV dilation
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Coarcation of aorta
20. What do the starling forces determine
Can progess to V fib
Eisenmenger's syndrome
Increased SV
Fluid movement through capillaries
21. in the JVP - What is the v wave?
Cyclophosphamide and corticosteroids
Inc RA pressure - due to filling against closed tricupsid valve
Heart - 02 extraction is always around 100%
Pulse pressure
22. What is the most common cause of right heart failure
If sodium channel
Ischemic heart dz - mitral valve prolapse - LV dilation
Left heart failure
Changes in CO as a function of preload
23. What do the carotid and aortic bodies respond to?
Vasocxn - while other tissues it causes vasodilation
Cherry hemangioma
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Dec P02 - inc PC02 and dec pH
24. Which channel accounts for automaticity of the SA and AV nodes?
Inc Kf - capillary perm
If sodium channel
3rd degree block - pacemaker - Lyme disease
Vasodilators - (hydrAlAzine)
25. congenital heart defect with 22q11
Vasodilators - (hydrAlAzine)
During HF from microhemorrhages from inc pulm cap pressure
CFX
Truncus - tet of fallot
26. What causes orthopnea?
Indomethacin closes - and pge keeps it open
Inc venous return exaccerbates pulm vasc congestion
Liver
2nd degree AV block - mobitz type 1
27. What supplies the posterior left ventricle?
Group a beta hemolytic strep
Temporal arteritis
Torsades de pointes
CFX
28. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Atherosclerosis
7 weeks
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
S. aureus
29. What does the starling curve show?
Transmural
Right sided
Changes in CO as a function of preload
S. epidermidis
30. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Inc RA pressure - due to filling against closed tricupsid valve
Dec plasma proteins
Increase intracellular Na - resulting in increased Ca
Holosystoiic
31. systolic - diastolic
Arteriorles
Maintain blood flow to organ over wide range of perfussion pressures
Pulse pressure
Stable angina
32. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
Inc blood volume
Dec P02 - inc PC02 and dec pH
MAP
33. What does an isoelectric ST segment indicate?
Microscopic polyangiitis - like wegener's without granulomas
Dilation
Ventricles are depolarized
Inc RA pressure - due to filling against closed tricupsid valve
34. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
...
Truncus - tet of fallot
Sturge weber - vasculitis of caps
Changes in CO as a function of preload
35. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40
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36. Expiration causes an increase in which sided heart sounds
QRS complex
Preload
Left sided
Pulse pressure
37. Where does coronary artery occlusion occur most commonly?
Extracellular calcium - calcium induced calcium release
Preload
Apex and anterior interventricular septum
LAD
38. What causes the murmur heard in MR to enhance?
Angiosarcoma
Postinfarction fibrinous pericarditis
Atrial contraction
Inc TPR and LA return (expiration)
39. What is the definition of HTN?
10%
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Dec P02 - inc PC02 and dec pH
140/90
40. Which area of the endocardium is especially vulnerable to infarction? Why?
EKG
Subendocardial - fewer collaterals and higher pressure
Ventricles are depolarized
Inc TPR and LA return (expiration)
41. What causes aortic regurg
ASD
Pulsus parvus and tardus - weak - can lead to syncope
Aortic dilation - bicuspid aortic valve - RF -
Eccentric - concentric hypertrophy causes diastolic disfunction
42. failure of truncus arteriosus to divide?
Persistant truncus arteriosus
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Decreased
Greater ventricular EDV
43. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Vagus to medulla
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
LCX - I - aVL
44. What is the classic X ray finding for tet of fallot?
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Boot shaped heart
Septal defects - PDA - pulm art stenosis
Increasing activity of Ca pump in SR
45. What are the complications from bacterial endocarditis?
Transposition of great vessels
Chordae rupture - GN - suppurative pericarditis - emboli
Sturge weber - vasculitis of caps
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
46. Which murmur is heard with mitral prolapse?
Group a beta hemolytic strep
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Late systolic crescendo murmur with a midsystolic click
Can progess to V fib
47. 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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48. Irregularly irregular ECG - no p waves: dx and treatment
Rapid upstroke - voltage gated Na channels open
Holosystolic - harsh sounding murmur - loudest over tricuspid area
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Sudden tensing of chordae tendinae
49. How do beta blockers decrease contractility?
Myxomatous degeneration - RF - chordae rupture
Decrease in cAMP
Gap junctions
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
50. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Transfusion
Decreased
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