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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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1. clinical signs of cardiac tamponade
Right sided
Patent ductus arteriosus - congenital rubella or prematurity
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

2. What are anitschkow's cells
Activated histiocytes
RCA - II - III - aVF
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Left atrial pressure

3. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Increase intracellular Na - resulting in increased Ca
Atherosclerosis
Dilated cardiomyopathy
Boot shaped heart

4. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Systolic dysfunction
Turners
Coarcation of aorta
Hypertrophied cardiomyopathy

5. prolonged PR interval
1st degree AV blodck
Aortic and pulmonary closing
In RA return (inspiration)
ASD

6. What is the definition of HTN?
140/90
Infective endocarditis
Mitral valve
Tricuspid atresia - requires ASD and VSD

7. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
Libman - sacks endocarditis
In series
RV contraction (closed tricuspid valve bulding into atrium

8. absecnce of tricuspid valve - hypoplastic RV
Crescendo - decrescendo systolic ejection murmur following ejection click
Tricuspid atresia - requires ASD and VSD
Buerger's disease
Lower right - MC - upper right - AO - upper right AC - lower left MO

9. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Atherosclerosis
Henoch - Schlonlein purpura
2-4 day - early coag necrosis on the first day
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

10. most common heart tumor
Right sided
Metastasis from melanoma or lymphoma
Acute thrombosis of coronary artery
Systolic dysfunction

11. EDV - ESV
Stroke volume
Increase intracellular Na - resulting in increased Ca
Dilation
LAD - V1- V2

12. congenital heart defect with 22q11
Torsades de pointes
Myxoma
Truncus - tet of fallot
SA>AV>bundle of His>ventricles

13. which medications are used to maintain patency or close the ductus arteriosus?
Pulse pressure
Venodilators (nitrogylcerine)
Dec P02 - inc PC02 and dec pH
Indomethacin closes - and pge keeps it open

14. SV CAP means?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Decrease in activity of Na/Ca exhanger and increase in contractility
Stroke volume affected by contractility - afterload - and preload
Pulmonic stenosis and RBBB

15. Right to left shunts are more common in babies or kids?
Group a beta hemolytic strep
Isovolumetric contraction
Ventricular repolarization
Babies

16. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Coarcation of aorta
Dilation
Sturge weber - vasculitis of caps

17. Why is there edema after burns or during infection
Stroke volume
Inc Kf - capillary perm
Hemorrhage
Truncus - tet of fallot

18. In an inferior wall infarct - which artery is affected and which leads show Q waves
RCA - II - III - aVF
Mechanican contraction of the ventricles
Takayasu's arteritis
The first 4 days

19. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Viridans streptococci
Late diastolic murmur following an opening snap
Tricuspid atresia - requires ASD and VSD
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

20. in the JVP - What is the a wave?
Persistant truncus arteriosus
If sodium channel
Atrial contraction
Increased SV

21. What is the most common cause of MI
Acute thrombosis of coronary artery
S. bovis
Strawberry hemangioma
140/90

22. When does EF decrease
In HF
Pulmonic stenosis and RBBB
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Lymphangiosarcoma

23. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
The first 4 days
Ventricular repolarization

24. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Eccentric - concentric hypertrophy causes diastolic disfunction
Left heart failure

25. What are the four most common locations for atherosclerosis?
Systolic dysfunction
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Pulmonic stenosis and RBBB
Afterload (proportional to peripheral resistance)

26. The 7 complications of MI

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27. congenital heart defect withdown syndrome
Activated histiocytes
Prinzmetal angina
ASD - VSD - AV septal defect (endocardial cushion defect)
Greater ventricular EDV

28. which heart valves are afected most in rheumatic heart diseease
Mitral valve prolapse
Atherosclerosis
Mitral>aortic>>tricuspid - high pressure valves affected most
Septal defects - PDA - pulm art stenosis

29. How are cadiac myocytes eltrically coupled?
MI
Gap junctions
In series
ANP

30. What does an isoelectric ST segment indicate?
The plateau period
Kaposi's sarcoma
Ventricles are depolarized
Inc Kf - capillary perm

31. Which enzymes are useful for diagnosing reinfarction
Henoch - Schlonlein purpura
Eisenmenger's syndrome
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
CK- MB

32. How does acidosis affect contractility?
Decreased
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Eccentric - concentric hypertrophy causes diastolic disfunction
Dilated cardiomyopathy

33. Which bacteria causes rheumatic heart disease
1st degree AV blodck
Group a beta hemolytic strep
Holosystoiic
Pulsus parvus and tardus - weak - can lead to syncope

34. What kind of infarct show ST depression
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Inc Kf - capillary perm
Subendocardial

35. sawtooth wave

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36. moncekberg
Glomus tumor
Inc blood volume
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
In series

37. What causes hepatomegaly?
Systolic dysfunction
Glossopharyngeal to soliary nucleus of medulla
Inc central venous pressure - inc resistance to portal flow
Arteriolosclerosis in malignant hypertension

38. What is the S2 sound?
Sudden tensing of chordae tendinae
2nd degree AV block - mobitz type 1
Aortic and pulmonary closing
Atherosclerosis

39. Left to right shunts are more common in babies or kids?
Kids
Granuloma with giant cells
Late systolic crescendo murmur with a midsystolic click
Temporal arteritis

40. congenital heart defect in an infant with a diabetic mother?
HTN - bradycardia - and respiratory depression
Transposition of great vessels
Anterosuperior displacement of the infundibular septum
Cherry hemangioma

41. in the JVP - What is the v wave?
Tricuspid atresia - requires ASD and VSD
Mitral valve
Inc RA pressure - due to filling against closed tricupsid valve
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

42. What is the classic X ray finding for tet of fallot?
Prinzmetal angina
Kids
Activated histiocytes
Boot shaped heart

43. In an EKG - What is the p wave?
Atrial contraction
Mitral and tricuspid closure
Late systolic crescendo murmur with a midsystolic click
Aortic dilation - bicuspid aortic valve - RF -

44. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Stroke volume
ASD - VSD - AV septal defect (endocardial cushion defect)
Infective endocarditis

45. How does aldosterone raise MAP
Inc blood volume
Prinzmetal angina
Cardiac tamponde
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

46. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
LV failure - pulm venous distention transudation of fluid
Glomus tumor
Adult type aortic coarctation

47. What is associated with paradoxical spliting of S2
Decrease in cAMP
LAD - V1- V2
Stroke volume affected by contractility - afterload - and preload
Aortic stenosis or LBBB

48. Which artery supplies the inferior portion of the left ventricle and posterior septum?
At least 55%
ANP
Increase - increase the chance the If are open
Posterior descending (80% off the RCA - 20% off the circumflex)

49. Where is the most posterior portion of the heart and What can it cause?
Late diastolic murmur following an opening snap
Transfusion
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
LAD - V1- V2

50. What is the danger of torsades to pointes?
Can progess to V fib
MI
Turners
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical