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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. Which murmur do you hear in mitral stenosis?
Late diastolic murmur following an opening snap
MAP
Coarcation of aorta
RCA

2. The aortic arch receptors transmit along which nerve?
Vagus to medulla
Total anomalous pulmonary trunk venous return
Age related calcifications or bicuspid aortic valve
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

3. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Viridans streptococci
Stable angina
Increased SV
Posterior descending (80% off the RCA - 20% off the circumflex)

4. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Myxoma
Indomethacin closes - and pge keeps it open
Mitral and tricuspid closure
Diastolic

5. PROVe
Fick principle
Vasodilators - (hydrAlAzine)
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Mean arterial pressure

6. What do patients die early from in rheumatic heart disease?
Early deaths from myocarditis
Buerger's disease
Glomus tumor
LAD - V1- V2

7. congenital heart defect with 22q11
Truncus - tet of fallot
HTN - bradycardia - and respiratory depression
Inc blood volume
Mitral and tricuspid closure

8. congenital heart defect with congenital rubella
Varicose veins - thromboembolism rare
Conduction delay through AV node - nl < 200 msec
Septal defects - PDA - pulm art stenosis
2nd degree AV block - mobitz type 1

9. What is a normal EF
Preload
Troponin I
During HF from microhemorrhages from inc pulm cap pressure
At least 55%

10. What constitues the upstroke in pacemaker cells?
Isovolumetric contraction
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Volatage gated Ca channels
Filling is incomplete and CO falls

11. In an acute MI - are there any visible changes via LM in the first 2-4 hours
LAD
LV failure - pulm venous distention transudation of fluid
No
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

12. disease of elastic arteries and large and medium sized muscular arteries
S. epidermidis
Activated histiocytes
Turners
Atherosclerosis

13. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
2nd degree AV block - mobitz type 1
Purkingee>atria>ventricles>AV node
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Persistant truncus arteriosus

14. How does acidosis affect contractility?
Raynaud's
No
Increased efferent SANS and decreased efferent PANS
Decreased

15. What is the S2 sound?
Kawasaki
No
Aortic and pulmonary closing
Holosystoiic

16. Which murmur is characteristic of mitral/tricuspid regurg?
5-10 days - macs have degraded structural components
Holosystoiic
S. aureus
Increase contractility

17. The carotid sinus transmits along which nerve?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Glossopharyngeal to soliary nucleus of medulla
Cardiac tamponde
Metastasis from melanoma or lymphoma

18. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Can progess to V fib
LCX - I - aVL
In series
RCA

19. bening capillary hemangioma of elderly - does not regress
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Ventricular repolarization
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Cherry hemangioma

20. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Increase - increase the chance the If are open
RCA
Septal defects - PDA - pulm art stenosis
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

21. Which murmur is heard with mitral prolapse?
During HF from microhemorrhages from inc pulm cap pressure
Hyperlipidemia
Increased SV
Late systolic crescendo murmur with a midsystolic click

22. What cardiac change occurs in pregnancy?
Extracellular calcium - calcium induced calcium release
Unstable/crescendo angina
Dilation
Increased SV

23. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Rapid upstroke - voltage gated Na channels open
LCX - I - aVL
TAPVR
QRS complex

24. most common heart tumor
Mitral stenosis
Truncus - tet of fallot
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Metastasis from melanoma or lymphoma

25. When do you find hemosiderin laden macrophages in the lungs?
Inc central venous pressure - inc resistance to portal flow
Increasing activity of Ca pump in SR
During HF from microhemorrhages from inc pulm cap pressure
Decreases

26. Which murmur is heard with VSD?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
TAPVR
2-4 day - early coag necrosis on the first day
Rapid upstroke - voltage gated Na channels open

27. What causes the cushing reflex and why
Eisenmenger's syndrome
Left atrial pressure
Cherry hemangioma
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

28. What other sign is often present with congenital long QT syndrome - why?
SA and AV nodes
During diastole
Increase - increase the chance the If are open
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

29. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Pulmonic stenosis and RBBB
V fib
Wolff - Parkinson white syndrome
Ventricles are depolarized

30. What channels do the the pacemaker cells lack?
Fast volatge gated Na channels
Vasocxn
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Vasodilators

31. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Pulmonary flow murmur and diastolic rumble
In RA return (inspiration)

32. When do coronary arteries fill?
Patent ductus arteriosus - congenital rubella or prematurity
Transfusion
Systolic dysfunction
During diastole

33. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Isovolumetric contraction
Viridans streptococci
Glomus tumor
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

34. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
In series
Fick principle
Babies
Inc central venous pressure - inc resistance to portal flow

35. EDV is also known as
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Preload
1st degree AV blodck
Isovolumetric contraction

36. Which bacteria can cause endocarditis from prosthetic valves?
S. epidermidis
Truncus - tet of fallot
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Stroke volume affected by contractility - afterload - and preload

37. What causes the midsystolic click
Sudden tensing of chordae tendinae
140/90
LV failure - pulm venous distention transudation of fluid
Pyogenic granuloma - associated with trauma and pregnancy

38. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Lymphangiosarcoma
Conduction delay through AV node - nl < 200 msec
Sturge weber - vasculitis of caps
Atrial contraction

39. Which enzymes are useful for diagnosing reinfarction
Resting potential high K perm
Fick principle
CK- MB
RV failure - in venous pressure

40. 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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41. Which sympathetic receptors raise MAP
Hypertrophied cardiomyopathy
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Late diastolic murmur following an opening snap
Glossopharyngeal to soliary nucleus of medulla

42. exaggerated decrease in pulse during inspiration.

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43. PCWP is an estimate of...
Inc RA pressure - due to filling against closed tricupsid valve
Left atrial pressure
LCX - I - aVL
Eisenmenger's syndrome

44. Why is contractility decreased in heart failure?
TAPVR
Decrease in cAMP
Systolic dysfunction
Eisenmenger's syndrome

45. Which channel accounts for automaticity of the SA and AV nodes?
Hypertrophied cardiomyopathy
If sodium channel
Libman - sacks endocarditis
Anterosuperior displacement of the infundibular septum

46. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Infective endocarditis
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
MI

47. p - anca

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48. EDV - ESV
Fick principle
If sodium channel
No
Stroke volume

49. What happens in phase 4 of the cardiac ventricular action potential?
Atherosclerosis
Resting potential high K perm
Neg inotropy - HF - narcotic overdose
RV contraction (closed tricuspid valve bulding into atrium

50. If HR is too fast (V tach) what happens during diastole?
Inc RA pressure - due to filling against closed tricupsid valve
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Filling is incomplete and CO falls
Unstable/crescendo angina