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Cardiology

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

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2. What cardiac change occurs in pregnancy?
Tempral arteritis - may cause irreversible blindness
Babies
Increased SV
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

3. stroke volume x HR =?
LV failure - pulm venous distention transudation of fluid
Transmural
Preload
CO

4. What is the S2 sound?
Aortic and pulmonary closing
Increase - increase the chance the If are open
Dec plasma proteins
Left atrial pressure

5. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
The operating point of the heart
Preload
No - no pressure gradient

6. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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7. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Hypertrophied cardiomyopathy
Kidney
MI
Rapid upstroke - voltage gated Na channels open

8. What does mitral prolapse predeispose to?
Neg inotropy - HF - narcotic overdose
LCX - V4- V6
Vasocxn - while other tissues it causes vasodilation
Infective endocarditis

9. congenital heart defect withdown syndrome
Ventricular depolarization - nl < 120 msec
ASD - VSD - AV septal defect (endocardial cushion defect)
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Pyogenic granuloma - associated with trauma and pregnancy

10. Central chemoreceptors do not respond directly to which parameter?
5-10 days - macs have degraded structural components
No - no pressure gradient
P02
Eisenmenger's syndrome

11. Inspiration causes an increase in which sided heart sounds?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Right sided
Patent ductus arteriosus - congenital rubella or prematurity
MI

12. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
CO
Sudden tensing of chordae tendinae
MI
Atherosclerosis

13. Restrictive cardiomyopathy causes
Mechanican contraction of the ventricles
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Purkingee>atria>ventricles>AV node
Increase - increase the chance the If are open

14. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
CHF
LAD - V1- V2
Myxoma
EKG

15. Which valve is most commonly involved in bacterial endocarditis?
Boot shaped heart
Left atrial pressure
SV/ EDV
Mitral valve

16. What causes the murmur heard in MR to enhance?
Inc TPR and LA return (expiration)
Buerger's disease
Kidney
Heart - 02 extraction is always around 100%

17. What causes the midsystolic click
Mean arterial pressure
Increasing activity of Ca pump in SR
Liver
Sudden tensing of chordae tendinae

18. What is the most common cause of MI
Posterior descending (80% off the RCA - 20% off the circumflex)
PDA
Acute thrombosis of coronary artery
Indomethacin closes - and pge keeps it open

19. What are the 5 T's of cyanoitc babies
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
The plateau period
Henoch - Schlonlein purpura

20. What is the characteristic pulse in aortic stenosis?
Pulsus parvus and tardus - weak - can lead to syncope
The plateau period
Angiosarcoma
P02

21. How do beta blockers decrease contractility?
Decrease in cAMP
P02
Total anomalous pulmonary trunk venous return
V fib arrhythima

22. congenital heart defect with congenital rubella
Chordae rupture - GN - suppurative pericarditis - emboli
Changes in CO as a function of preload
Buerger's disease
Septal defects - PDA - pulm art stenosis

23. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
In HF
Decrease in activity of Na/Ca exhanger and increase in contractility
Mitral>aortic>>tricuspid - high pressure valves affected most

24. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Stable angina
TAPVR
Infective endocarditis
Extracellular calcium - calcium induced calcium release

25. What is the time frame for arrhythmia risk in the evolution of MI
Aortic insuffic - late
In series
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
The first 4 days

26. disease of elastic arteries and large and medium sized muscular arteries
Early deaths from myocarditis
Neg inotropy - HF - narcotic overdose
Increase contractility
Atherosclerosis

27. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Strawberry hemangioma
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
S. aureus
Babies

28. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Metastasis from melanoma or lymphoma
Cardiac tamponde
Kawasaki

29. decrease stretch in baroreceptors leads to what response?
Varicose veins - thromboembolism rare
Stable angina
Group a beta hemolytic strep
Increased efferent SANS and decreased efferent PANS

30. What does the atria release in response to inc blood volume and atrial pressure
Inc RA pressure - due to filling against closed tricupsid valve
Extracellular calcium - calcium induced calcium release
ANP
Purkingee>atria>ventricles>AV node

31. with what heart sounds do ASD usually present?
C - ANCA
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Hemorrhage
Pulmonary flow murmur and diastolic rumble

32. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Purkingee>atria>ventricles>AV node
Ischemic heart dz - mitral valve prolapse - LV dilation
Subendocardial

33. When does EF decrease
LAD
In HF
Increased SV
Atherosclerosis

34. What is association with fixed S2 splitting - does not increase with inspiration
ASD
Aortic disecction - intraluminal tear forming false lumen
No
Adult type aortic coarctation

35. What does the starling curve show?
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Changes in CO as a function of preload
Lower right - MC - upper right - AO - upper right AC - lower left MO
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

36. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Eccentric - concentric hypertrophy causes diastolic disfunction
P02
Aortic/pulmonic stenosis and mitral/tricuspid regurg

37. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
5-10 days - macs have degraded structural components
Wegener's
...

38. What happens in phase 3 of the cardiac ventricular action potential?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
C - ANCA
Vasocxn - while other tissues it causes vasodilation
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

39. What does HTN predispose to?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Dilation
Ischemic heart dz - mitral valve prolapse - LV dilation

40. What happens in phase 2 of the cardiac ventricular action potential?
During HF from microhemorrhages from inc pulm cap pressure
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Dressler's - autoimmune
Chordae rupture - GN - suppurative pericarditis - emboli

41. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Right sided
Sturge weber - vasculitis of caps
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Vasodilators

42. most common primary cardiac tumor in children - associated with tuberous sclerosis
R to L shunt caused by stenoic pulmonic valve
Venodilators (nitrogylcerine)
RF
Rhabdomyomas

43. Which class of drugs decrease the murmur heard in aortic regurg?
Late diastolic murmur following an opening snap
Vasodilators
Wegener's
RCA - II - III - aVF

44. What is the S1 sound?
V fib arrhythima
Mitral and tricuspid closure
Black > white > asian
SA and AV nodes

45. When is the scar completely formed in an MI?
7 weeks
Gap junctions
Greater ventricular EDV
Inc blood volume

46. in the JVP - What is the v wave?
Rhabdomyomas
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Inc RA pressure - due to filling against closed tricupsid valve
Diastolic

47. What is the definition of HTN?
Extracellular calcium - calcium induced calcium release
140/90
Hematocrit
Subendocardial - fewer collaterals and higher pressure

48. PCWP > LV diastolic pressure
Arteriorles
Troponin I
Mitral stenosis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

49. What happens with a decrease of extracellular Na
Inc blood volume
Aortic disecction - intraluminal tear forming false lumen
Decrease in activity of Na/Ca exhanger and increase in contractility
ASD - VSD - AV septal defect (endocardial cushion defect)

50. Expiration causes an increase in which sided heart sounds
Pos inotropy - exercise
Non
Left sided
Yes