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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. What does the LAD supply?
Apex and anterior interventricular septum
Pyogenic granuloma - associated with trauma and pregnancy
Heart - 02 extraction is always around 100%
During diastole

2. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Lymphangiosarcoma
Persistant truncus arteriosus
P02
Fetal right to left - neonate left to right leading to RVH and failure

3. What is the classic X ray finding for tet of fallot?
Extracellular calcium - calcium induced calcium release
Pulmonary flow murmur and diastolic rumble
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Boot shaped heart

4. What is the formula for EF?
Increase in Pc
SV/ EDV
LAD - V1 - V4
Increase - increase the chance the If are open

5. What stimulates release of calcium from the SR?
Mitral stenosis
Extracellular calcium - calcium induced calcium release
EKG
Rhabdomyomas

6. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Myxomatous degeneration - RF - chordae rupture
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Right sided

7. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
Sudden tensing of chordae tendinae
Viridans streptococci
Fluid movement through capillaries

8. What is the result of not have fast sodium channels in pacemaker cells?
Medullary vasomotor center senses baroreceptors and JGA
Vasodilators
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
RV contraction (closed tricuspid valve bulding into atrium

9. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
TAPVR
Infective endocarditis
Chordae rupture - GN - suppurative pericarditis - emboli

10. coronary artery spasm - ST elevation
Prinzmetal angina
Increasing activity of Ca pump in SR
CHF
R to L shunt caused by stenoic pulmonic valve

11. What is sudden cardiac death most commonly due to...
CO
Increasing activity of Ca pump in SR
V fib arrhythima
Tempral arteritis - may cause irreversible blindness

12. What murmur is heard with aortic regurg?
SA>AV>bundle of His>ventricles
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Eccentric - concentric hypertrophy causes diastolic disfunction
Extracellular calcium - calcium induced calcium release

13. How do beta blockers decrease contractility?
Apex and anterior interventricular septum
If sodium channel
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Decrease in cAMP

14. What is the early and late lesion in rheumatic heart disease
In HF
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Mitral valve prolapse
Mitral valve

15. polypoid capillary hemangioma that can ulcerate and bleed
Mitral valve
Pyogenic granuloma - associated with trauma and pregnancy
Inc TPR and LA return (expiration)
Left sided

16. Where are pacemaker cells?
S. aureus
SA and AV nodes
Inc interstitial osmotic pressure pulling fliud out of capillaries
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

17. Which kind of infarct show ST elevation - and/or pathologic Q waves
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Transmural
LV failure - pulm venous distention transudation of fluid

18. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Neg inotropy - HF - narcotic overdose
Increase - increase the chance the If are open
ASD - VSD - AV septal defect (endocardial cushion defect)

19. What are aschoff bodies
Patent ductus arteriosus - congenital rubella or prematurity
Inc TPR and LA return (expiration)
Polyarteritis nodosum
Granuloma with giant cells

20. What causes orthopnea?
Inc venous return exaccerbates pulm vasc congestion
Atherosclerosis
Isovolumetric contraction
Neg inotropy - HF - narcotic overdose

21. What does the atria release in response to inc blood volume and atrial pressure
RCA - II - III - aVF
ANP
Activated histiocytes
Hyperlipidemia

22. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Aortic dilation - bicuspid aortic valve - RF -
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
The aortic before pulmonic - inspiration increases diff

23. In an EKG - What is the T wave?
Mitral and tricuspid closure
SA>AV>bundle of His>ventricles
Ventricular repolarization
LAD - V1 - V4

24. What does an isoelectric ST segment indicate?
Ventricles are depolarized
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
CHF
Atherosclerosis

25. 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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26. What causes hepatomegaly?
1st degree AV blodck
In RA return (inspiration)
Inc central venous pressure - inc resistance to portal flow
Neg inotropy - HF - narcotic overdose

27. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
140/90
Activated histiocytes
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

28. What is the time frame for arrhythmia risk in the evolution of MI
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
The first 4 days
Dilated cardiomyopathy
CFX

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

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30. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
Dec P02 - inc PC02 and dec pH
Stroke volume affected by contractility - afterload - and preload
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

31. What is a normal EF
P02
Persistant truncus arteriosus
Subendocardial - fewer collaterals and higher pressure
At least 55%

32. fibrous plaques and atheromas in intima of arteries
Troponin I
Atherosclerosis
Babies
LAD > RCA > circumflex

33. What do the starling forces determine
Purkingee>atria>ventricles>AV node
Fluid movement through capillaries
3rd degree block - pacemaker - Lyme disease
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

34. moncekberg
Dec plasma proteins
Patent ductus arteriosus - congenital rubella or prematurity
LAD - V1- V2
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

35. which ethnic groups have higher association with HTN?
Medullary vasomotor center senses baroreceptors and JGA
Black > white > asian
Unstable/crescendo angina
QRS complex

36. What is the most common cause of right heart failure
Left heart failure
EKG
Changes in CO as a function of preload
Cyclophosphamide and corticosteroids

37. What does HTN predispose to?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Conduction delay through AV node - nl < 200 msec
Changes in CO as a function of preload
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

38. Which murmur is heard with VSD?
Increase - increase the chance the If are open
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Holosystoiic
LAD - V1- V2

39. prolonged PR interval
1st degree AV blodck
CO
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Anterosuperior displacement of the infundibular septum

40. What are anitschkow's cells
Hemorrhage
Filling is incomplete and CO falls
Activated histiocytes
Aortic and pulmonary closing

41. Which bacteria causes endocarditis in the presence of colon cancer
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Pulse pressure
Increased efferent SANS and decreased efferent PANS
S. bovis

42. In an anterolateral infarct - which artery is effected and which leads show Q waves
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
LCX - V4- V6
The aortic before pulmonic - inspiration increases diff

43. What are the complications of atherosclerosis?
Myxoma
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Vasocxn - while other tissues it causes vasodilation
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

44. In the cardiac cycle - which period has the highest 02 consumption?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Takayasu's arteritis
Systolic dysfunction
Isovolumetric contraction

45. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Angiosarcoma
Increase intracellular Na - resulting in increased Ca
Glomus tumor
Kaposi's sarcoma

46. The carotid sinus transmits along which nerve?
Adult type aortic coarctation
Glossopharyngeal to soliary nucleus of medulla
Gap junctions
Afterload (proportional to peripheral resistance)

47. What causes the CO curve to shift upwards?
Pos inotropy - exercise
Maintain blood flow to organ over wide range of perfussion pressures
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Raynaud's

48. How are cadiac myocytes eltrically coupled?
Aortic insuffic - late
Rapid upstroke - voltage gated Na channels open
At least 55%
Gap junctions

49. What 4 things drive myocardial 02 demand?
No
Can progess to V fib
Myxoma
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

50. What are the systolic heart sounds
Holosystoiic
Purkingee>atria>ventricles>AV node
Aortic/pulmonic stenosis and mitral/tricuspid regurg
QRS complex