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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. The cause of dyspnea on exertion?
Coarcation of aorta
At least 55%
Failure of LV to in CO during exercise
Turners

2. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
2nd degree AV block - mobitz type 1
Cystic hygroma
Fetal right to left - neonate left to right leading to RVH and failure

3. PROVe
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Filling is incomplete and CO falls
Late diastolic murmur following an opening snap
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

4. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Angiosarcoma
During diastole
Fluid movement through capillaries
Adult type aortic coarctation

5. congenital heart defect with 22q11
Atherosclerosis
During diastole
Truncus - tet of fallot
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

6. cavernous lymphangioma of the neck - associated with turner's
Decreases
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
2nd degree AV block - mobitz type 1
Cystic hygroma

7. benign cap hemangioma of infancy - spont regresses
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Strawberry hemangioma
Tricuspid atresia - requires ASD and VSD

8. PCWP > LV diastolic pressure
7 weeks
Can progess to V fib
Stroke volume affected by contractility - afterload - and preload
Mitral stenosis

9. Which murmur is heard with mitral prolapse?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Patent ductus arteriosus - congenital rubella or prematurity
Late systolic crescendo murmur with a midsystolic click
Mitral valve

10. In terms of starling forces - why does heart failure cause edema?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
C - ANCA
Increase in Pc
Increase contractility

11. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Mitral valve
Hypertrophied cardiomyopathy
Lower right - MC - upper right - AO - upper right AC - lower left MO
Kaposi's sarcoma

12. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Glomus tumor
Raynaud's
Sturge weber - vasculitis of caps
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

13. What are the complications of atherosclerosis?
Atherosclerosis
Black > white > asian
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Systolic dysfunction

14. What causes aortic regurg
Left sided
Aortic dilation - bicuspid aortic valve - RF -
Transposition of great vessels
SA and AV nodes

15. Wegener's presentation
Tricuspid atresia - requires ASD and VSD
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Patent ductus arteriosus - congenital rubella or prematurity
Cyclophosphamide and corticosteroids

16. What masks atrial repolarization?
2nd degree AV block - mobitz type 1
QRS complex
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Kawasaki

17. What is the S2 sound?
Left heart failure
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic and pulmonary closing
Venodilators (nitrogylcerine)

18. sawtooth wave

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19. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Dec plasma proteins
S. epidermidis
Transfusion
Tempral arteritis - may cause irreversible blindness

20. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Activated histiocytes
Fetal right to left - neonate left to right leading to RVH and failure
Arteriolosclerosis in malignant hypertension
MI

21. Hyperplastic onion skinning
Early deaths from myocarditis
Vasodilators - (hydrAlAzine)
Arteriolosclerosis in malignant hypertension
Group a beta hemolytic strep

22. What is the time frame for arrhythmia risk in the evolution of MI
Transposition of great vessels
Metastasis from melanoma or lymphoma
The first 4 days
Granuloma with giant cells

23. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
CK- MB
Lymphangiosarcoma
Varicose veins - thromboembolism rare
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

24. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Inc venous return exaccerbates pulm vasc congestion
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Ventricular depolarization - nl < 120 msec
S. aureus

25. dyspnea - fatigue - edema and rales - multiple causes
S. bovis
Aortic stenosis or LBBB
CHF
Increase intracellular Na - resulting in increased Ca

26. Churg Strauss - presentation and test
Rhabdomyomas
Transposition of great vessels
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Activated histiocytes

27. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Lower right - MC - upper right - AO - upper right AC - lower left MO
Dilation
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

28. What are the systolic heart sounds
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Aburpt halting of valve leaflets
Ventricular repolarization
CO

29. What causes the ejection click in the Cres - decres murmur?
Troponin I
Postinfarction fibrinous pericarditis
Aburpt halting of valve leaflets
Tricuspid atresia - requires ASD and VSD

30. What causes orthopnea?
Libman - sacks endocarditis
Failure of LV to in CO during exercise
Metastasis from melanoma or lymphoma
Inc venous return exaccerbates pulm vasc congestion

31. most common heart tumor
Metastasis from melanoma or lymphoma
Troponin I
QRS complex
Myxoma

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

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33. polypoid capillary hemangioma that can ulcerate and bleed
Left atrial pressure
LV failure - pulm venous distention transudation of fluid
Mitral valve
Pyogenic granuloma - associated with trauma and pregnancy

34. prolonged PR interval
Fetal right to left - neonate left to right leading to RVH and failure
Purkingee>atria>ventricles>AV node
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
1st degree AV blodck

35. clinical signs of cardiac tamponade
Vasocxn - while other tissues it causes vasodilation
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Cystic hygroma
Group a beta hemolytic strep

36. What kind of infarct show ST depression
Subendocardial
Dressler's - autoimmune
...
3rd degree block - pacemaker - Lyme disease

37. p - anca

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38. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Rhabdomyomas
Angiosarcoma
2nd degree AV block - mobitz type 1
S. aureus

39. Which sympathetic receptors raise MAP
QRS complex
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Persistant truncus arteriosus
ASD - VSD - AV septal defect (endocardial cushion defect)

40. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
HTN - bradycardia - and respiratory depression
No - no pressure gradient
Rapid upstroke - voltage gated Na channels open
Pulmonary flow murmur and diastolic rumble

41. decrease stretch in baroreceptors leads to what response?
Kidney
Dilation
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Increased efferent SANS and decreased efferent PANS

42. What kind of dysfunction ensues in restrictive cardiomyopathy
Stable angina
Hematocrit
Diastolic
Fast volatge gated Na channels

43. no relation between p waves and QRS intervals - treatment and predisposing factor
V fib arrhythima
3rd degree block - pacemaker - Lyme disease
Atherosclerosis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

44. congenital heart defect with congenital rubella
RV failure - in venous pressure
The aortic before pulmonic - inspiration increases diff
S. aureus
Septal defects - PDA - pulm art stenosis

45. What is the most common cause of right heart failure
LAD - V1- V2
Vasodilators
Left heart failure
Dec plasma proteins

46. What do the starling forces determine
RV failure - in venous pressure
Fluid movement through capillaries
Glossopharyngeal to soliary nucleus of medulla
ASD - VSD - AV septal defect (endocardial cushion defect)

47. In an EKG - What is the T wave?
RCA - II - III - aVF
Hematocrit
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Ventricular repolarization

48. What causes tet of fallot?
Anterosuperior displacement of the infundibular septum
Increase - increase the chance the If are open
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Aortic dilation - bicuspid aortic valve - RF -

49. What does TAPVR stand for
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Inc central venous pressure - inc resistance to portal flow
Total anomalous pulmonary trunk venous return
Varicose veins - thromboembolism rare

50. In an EKG - What is the p wave?
Unstable/crescendo angina
Postinfarction fibrinous pericarditis
Late diastolic murmur following an opening snap
Atrial contraction