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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. tearing chest pain radiation to the back - associated with marfan
Infective endocarditis
Henoch - Schlonlein purpura
Subendocardial
Aortic disecction - intraluminal tear forming false lumen

2. PCWP > LV diastolic pressure
Mitral stenosis
Holosystoiic
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Truncus - tet of fallot

3. Unilateral headache - jaw claudication - impaired vision
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
HypoK and bradycardia
Tempral arteritis - may cause irreversible blindness
Left heart failure

4. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Left heart failure
Atrial contraction
QRS complex
Dec plasma proteins

5. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Infective endocarditis
Proportional to viscosity and inversely proportional to the radius to the 4th power
At least 55%

6. Which organ has the largest arteriovenous difference
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
The plateau period
Heart - 02 extraction is always around 100%
Diastolic

7. what happens to capillaries in lymphatic blockage
Inc interstitial osmotic pressure pulling fliud out of capillaries
Libman - sacks endocarditis
If sodium channel
Vagus to medulla

8. Which kind of infarct show ST elevation - and/or pathologic Q waves
Right sided
Transmural
LAD - V1 - V4
Arteriolosclerosis in malignant hypertension

9. Which murmur is characteristic of mitral/tricuspid regurg?
Holosystoiic
Isovolumetric contraction
No
RCA - II - III - aVF

10. What does HTN predispose to?
If sodium channel
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Infective endocarditis
Extracellular calcium - calcium induced calcium release

11. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Fick principle
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Hypertrophied cardiomyopathy

12. congenital heart defect in an infant with a diabetic mother?
Pyogenic granuloma - associated with trauma and pregnancy
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
If sodium channel
Transposition of great vessels

13. What are the complications from bacterial endocarditis?
CK- MB
Chordae rupture - GN - suppurative pericarditis - emboli
Isovolumetric contraction
Activated histiocytes

14. What does increasing intracellular Ca do?
Increase contractility
Greater ventricular EDV
Left sided
Transposition of great vessels

15. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Angiosarcoma
RCA
LCX - V4- V6
TAPVR

16. What does the LAD supply?
Apex and anterior interventricular septum
5-10 days - macs have degraded structural components
Pulsus parvus and tardus - weak - can lead to syncope
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

17. fibrinous pericarditis several weeks post MI

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18. What does the U wave indicated?
HypoK and bradycardia
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Afterload (proportional to peripheral resistance)
Glomus tumor

19. Which class of drugs decrease preload
Raynaud's
Venodilators (nitrogylcerine)
1st degree AV blodck
...

20. The cause of cardiac dilation?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Decrease in cAMP
Greater ventricular EDV
Libman - sacks endocarditis

21. What does T wave inversion indicated?
Transposition of great vessels
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
MI

22. How does a patient with Tet of fallot learn to improve symptoms?
Pyogenic granuloma - associated with trauma and pregnancy
Squat. Compression of femoral arteries - inc TPR - dec
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
CK- MB

23. When do you see extensive coagulative necrosis in an MI
Kaposi's sarcoma
2-4 day - early coag necrosis on the first day
Septal defects - PDA - pulm art stenosis
LAD - V1- V2

24. list the coronary vessels most likely to be occluded
Truncus - tet of fallot
LAD > RCA > circumflex
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
V fib

25. What is the classic X ray finding for tet of fallot?
Vasodilators
Boot shaped heart
Aortic and pulmonary closing
Lower right - MC - upper right - AO - upper right AC - lower left MO

26. What cardiac change occurs in pregnancy?
Resting potential high K perm
Increased SV
Fluid movement through capillaries
In RA return (inspiration)

27. What is the formula for EF?
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
SV/ EDV
The plateau period
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

28. What causes the murmur heard in MR to enhance?
Viridans streptococci
Inc TPR and LA return (expiration)
CHF
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

29. no relation between p waves and QRS intervals - treatment and predisposing factor
Late systolic crescendo murmur with a midsystolic click
S. aureus
3rd degree block - pacemaker - Lyme disease
ASD

30. Chronic mitral stenosis can lead to what changes in size of the LA
Dilation
Atrial contraction
Medullary vasomotor center senses baroreceptors and JGA
Increase contractility

31. In what disease states is blood viscosity increased?
LAD > RCA > circumflex
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Ventricles are depolarized
10%

32. Wegener's tx
Changes in CO as a function of preload
MI
Cyclophosphamide and corticosteroids
Afterload (proportional to peripheral resistance)

33. What causes the midsystolic click
Inc TPR and LA return (expiration)
Transposition of great vessels
2nd degree AV block - mobitz type 1
Sudden tensing of chordae tendinae

34. machine murmer
MI
PDA
Crescendo - decrescendo systolic ejection murmur following ejection click
Proportional to viscosity and inversely proportional to the radius to the 4th power

35. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Viridans streptococci
P02
SA>AV>bundle of His>ventricles
Anterosuperior displacement of the infundibular septum

36. disease of elastic arteries and large and medium sized muscular arteries
Right sided
Wolff - Parkinson white syndrome
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Atherosclerosis

37. Which channel accounts for automaticity of the SA and AV nodes?
If sodium channel
RV failure - in venous pressure
HTN - bradycardia - and respiratory depression
In parallel

38. sawtooth wave

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39. What kind of dysfunction ensues in restrictive cardiomyopathy
Prinzmetal angina
Medullary vasomotor center senses baroreceptors and JGA
Activated histiocytes
Diastolic

40. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Temporal arteritis
Buerger's disease
Lower right - MC - upper right - AO - upper right AC - lower left MO
...

41. When during cardiac nodal cells depolarize?
LCX - V4- V6
During diastole
Squat. Compression of femoral arteries - inc TPR - dec
Group a beta hemolytic strep

42. What stimulates release of calcium from the SR?
Vasodilators
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
CK- MB
Extracellular calcium - calcium induced calcium release

43. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Early deaths from myocarditis
Afterload (proportional to peripheral resistance)
Mean arterial pressure

44. What does FAN MY SKIN On Wednesday stand for?
Mean arterial pressure
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Metastasis from melanoma or lymphoma
Preload

45. Which murmur is heard with mitral prolapse?
Henoch - Schlonlein purpura
Mitral valve prolapse
Late systolic crescendo murmur with a midsystolic click
S. bovis

46. The 7 complications of MI

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47. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Aortic and pulmonary closing
MI
Lower right - MC - upper right - AO - upper right AC - lower left MO
Vagus to medulla

48. EDV - ESV
Increase - increase the chance the If are open
Stroke volume
Polyarteritis nodosum
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

49. What is a normal EF
At least 55%
Wolff - Parkinson white syndrome
Varicose veins - thromboembolism rare
CHF

50. In an anterior wall infarct - which artery is effected and which leads show Q waves
Preload
Volatage gated Ca channels
LAD - V1 - V4
Fetal right to left - neonate left to right leading to RVH and failure