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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. p - anca

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2. in the JVP - What is the a wave?
Mean arterial pressure
Chordae rupture - GN - suppurative pericarditis - emboli
Dilated cardiomyopathy
Atrial contraction

3. Which murmur do you hear in mitral stenosis?
Group a beta hemolytic strep
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Late diastolic murmur following an opening snap
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

4. What kind of dysfunction ensues in restrictive cardiomyopathy
Neg inotropy - HF - narcotic overdose
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Diastolic
S. bovis

5. What channels do the the pacemaker cells lack?
Hypertrophied cardiomyopathy
Fast volatge gated Na channels
Activated histiocytes
Venodilators (nitrogylcerine)

6. What is the machine like murmur? What is the heart pathology and the predisposing causes
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Decreases
Patent ductus arteriosus - congenital rubella or prematurity
SA>AV>bundle of His>ventricles

7. congenital heart defect in an infant with a diabetic mother?
Transposition of great vessels
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Vagus to medulla

8. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Vasodilators
Black > white > asian
Cardiac tamponde
Cyclophosphamide and corticosteroids

9. EDV - ESV
V fib
At least 55%
RV contraction (closed tricuspid valve bulding into atrium
Stroke volume

10. What other syndrom is associated with infantile aortic coarctation
Turners
Babies
Liver
Decrease in cAMP

11. Rank the pacemakers cells
Filling is incomplete and CO falls
Henoch - Schlonlein purpura
LAD - V1 - V4
SA>AV>bundle of His>ventricles

12. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
Hematocrit
In RA return (inspiration)
Hypertrophied cardiomyopathy

13. What causes the CO curve to shift downwards?
Persistant truncus arteriosus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Neg inotropy - HF - narcotic overdose
Unstable/crescendo angina

14. exaggerated decrease in pulse during inspiration.

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15. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Crescendo - decrescendo systolic ejection murmur following ejection click
Afterload (proportional to peripheral resistance)
Left heart failure
Lymphangiosarcoma

16. what percentage of HTN is secondary to renal disease?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Ventricles are depolarized
C - ANCA
10%

17. in the JVP - What is the c wave?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
In RA return (inspiration)
The plateau period
RV contraction (closed tricuspid valve bulding into atrium

18. When is the scar completely formed in an MI?
Rapid upstroke - voltage gated Na channels open
Yes
7 weeks
LV failure - pulm venous distention transudation of fluid

19. friction rub - 3-5 days post MI
Inc TPR and LA return (expiration)
SV/ EDV
Postinfarction fibrinous pericarditis
CHF

20. In an EKG - What is the p wave?
Atrial contraction
Can progess to V fib
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

21. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Volatage gated Ca channels
Aortic disecction - intraluminal tear forming false lumen
Posterior descending (80% off the RCA - 20% off the circumflex)
Mechanican contraction of the ventricles

22. Which enzymes are useful for diagnosing reinfarction
CK- MB
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

23. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Age related calcifications or bicuspid aortic valve
Gap junctions
Mitral>aortic>>tricuspid - high pressure valves affected most
Adult type aortic coarctation

24. fibrinous pericarditis several weeks post MI

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25. In an anterolateral infarct - which artery is effected and which leads show Q waves
In parallel
LCX - V4- V6
Vasocxn - while other tissues it causes vasodilation
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

26. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
EKG
Aortic insuffic - late
LCX - I - aVL
Cystic hygroma

27. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
Myxomatous degeneration - RF - chordae rupture
CO
Subendocardial - fewer collaterals and higher pressure

28. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
5-10 days - macs have degraded structural components
Group a beta hemolytic strep
Angiosarcoma
Increase intracellular Na - resulting in increased Ca

29. with what heart sounds do ASD usually present?
LCX - I - aVL
Pulmonary flow murmur and diastolic rumble
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

30. Restrictive cardiomyopathy causes
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Aortic insuffic - late
Acute thrombosis of coronary artery

31. When and why is the S3 sound heard?
LV failure - pulm venous distention transudation of fluid
C - ANCA
Hemorrhage
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

32. What happens in phase 3 of the cardiac ventricular action potential?
Late systolic crescendo murmur with a midsystolic click
Rhabdomyomas
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Glomus tumor

33. stroke volume x HR =?
Increase in Pc
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
CO
Increase contractility

34. which heart valves are afected most in rheumatic heart diseease
LAD - V1- V2
Mitral>aortic>>tricuspid - high pressure valves affected most
LCX - V4- V6
In HF

35. which medications are used to maintain patency or close the ductus arteriosus?
Ventricular depolarization - nl < 120 msec
Indomethacin closes - and pge keeps it open
S. aureus
140/90

36. Inspiration causes an increase in which sided heart sounds?
Subendocardial - fewer collaterals and higher pressure
LCX - I - aVL
Pulmonary flow murmur and diastolic rumble
Right sided

37. moncekberg
Prinzmetal angina
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Transmural

38. What masks atrial repolarization?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
QRS complex
Posterior descending (80% off the RCA - 20% off the circumflex)
No - no pressure gradient

39. clinical signs of cardiac tamponade
V fib
Crescendo - decrescendo systolic ejection murmur following ejection click
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

40. no relation between p waves and QRS intervals - treatment and predisposing factor
Vasocxn
CFX
Glossopharyngeal to soliary nucleus of medulla
3rd degree block - pacemaker - Lyme disease

41. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Left heart failure
LCX - V4- V6
Vasocxn - while other tissues it causes vasodilation

42. What does the atria release in response to inc blood volume and atrial pressure
2nd degree AV block - mobitz type 1
Eccentric - concentric hypertrophy causes diastolic disfunction
ANP
Aortic stenosis or LBBB

43. serum marker for wegener's
C - ANCA
Pos inotropy - exercise
1st degree AV blodck
Kidney

44. Central chemoreceptors do not respond directly to which parameter?
10%
Hypertrophied cardiomyopathy
P02
Buerger's disease

45. polypoid capillary hemangioma that can ulcerate and bleed
TAPVR
Pyogenic granuloma - associated with trauma and pregnancy
PDA
Gap junctions

46. list the coronary vessels most likely to be occluded
LAD > RCA > circumflex
2-4 day - early coag necrosis on the first day
Late systolic crescendo murmur with a midsystolic click
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

47. Exercise - overtransfusiion and excitiment causes and increase in...?
Late diastolic murmur following an opening snap
Kaposi's sarcoma
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Preload

48. How are the sarcomeres added in eccentric hypertrophy?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
MI
During diastole
In series

49. congenital heart defect with congenital rubella
Total anomalous pulmonary trunk venous return
Increased efferent SANS and decreased efferent PANS
Septal defects - PDA - pulm art stenosis
Aortic disecction - intraluminal tear forming false lumen

50. EDV is also known as
SA>AV>bundle of His>ventricles
Aortic disecction - intraluminal tear forming false lumen
Apex and anterior interventricular septum
Preload