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Cardiology
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Subject
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health-sciences
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. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Myxoma
Stable angina
CK- MB
2. What is the S2 sound?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Tempral arteritis - may cause irreversible blindness
Hematocrit
Aortic and pulmonary closing
3. Churg Strauss - presentation and test
In HF
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Changes in CO as a function of preload
4. Mitral stenosis is most often secondary to which condition?
RF
Fick principle
Early deaths from myocarditis
Atherosclerosis
5. What happens with a decrease of extracellular Na
Decrease in activity of Na/Ca exhanger and increase in contractility
LAD
Transmural
Decreased
6. What kind of dysfunction ensues in restrictive cardiomyopathy
Diastolic
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Fluid movement through capillaries
Mitral valve prolapse
7. When do coronary arteries fill?
RCA - II - III - aVF
Activated histiocytes
During diastole
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
8. Which vessels account for the most total peripheral resistance
SA and AV nodes
Cardiac tamponde
Arteriorles
Atherosclerosis
9. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
ASD
Squat. Compression of femoral arteries - inc TPR - dec
Wolff - Parkinson white syndrome
Eccentric - concentric hypertrophy causes diastolic disfunction
10. serum marker for wegener's
C - ANCA
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Transposition of great vessels
MI
11. What does FAN MY SKIN On Wednesday stand for?
Decreases
Vasocxn
Failure of LV to in CO during exercise
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
12. Which class of drugs decrease the murmur heard in aortic regurg?
Dressler's - autoimmune
Decrease in activity of Na/Ca exhanger and increase in contractility
Vasodilators
Truncus - tet of fallot
13. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Neg inotropy - HF - narcotic overdose
Fick principle
Fetal right to left - neonate left to right leading to RVH and failure
Myxoma
14. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Varicose veins - thromboembolism rare
Atherosclerosis
Increase intracellular Na - resulting in increased Ca
15. When does EF decrease
S. bovis
Indomethacin closes - and pge keeps it open
Cyclophosphamide and corticosteroids
In HF
16. with what heart sounds do ASD usually present?
V fib arrhythima
C - ANCA
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Pulmonary flow murmur and diastolic rumble
17. What causes the CO curve to shift downwards?
S. epidermidis
Neg inotropy - HF - narcotic overdose
Rapid upstroke - voltage gated Na channels open
No - no pressure gradient
18. What is the most common cause of MI
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Acute thrombosis of coronary artery
Purkingee>atria>ventricles>AV node
Transmural
19. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
RV failure - in venous pressure
Stable angina
Increased SV
V fib
20. disease of elastic arteries and large and medium sized muscular arteries
Arteriolosclerosis in malignant hypertension
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Atherosclerosis
Vasocxn
21. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Lymphangiosarcoma
Strawberry hemangioma
Decreases
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
22. In what disease states is blood viscosity increased?
Kids
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
TAPVR
Holosystolic - harsh sounding murmur - loudest over tricuspid area
23. What are common causes of mitral regurg?
Cyclophosphamide and corticosteroids
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
EKG
Ischemic heart dz - mitral valve prolapse - LV dilation
24. Most common vasculitis affecting medium and large arteries
Purkingee>atria>ventricles>AV node
Proportional to viscosity and inversely proportional to the radius to the 4th power
Temporal arteritis
Hemorrhage
25. What is the classic X ray finding for tet of fallot?
Boot shaped heart
Dilated cardiomyopathy
Resting potential high K perm
Septal defects - PDA - pulm art stenosis
26. EDV is also known as
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Transmural
Preload
27. What causes the murmur heard in tricuspid regurg to enhance
Decreased
Boot shaped heart
In RA return (inspiration)
5-10 days - macs have degraded structural components
28. What does mitral prolapse predeispose to?
Kawasaki
Filling is incomplete and CO falls
Glossopharyngeal to soliary nucleus of medulla
Infective endocarditis
29. What causes the early cyanosis in Tet of Fallot?
R to L shunt caused by stenoic pulmonic valve
RV contraction (closed tricuspid valve bulding into atrium
Vasocxn - while other tissues it causes vasodilation
Glossopharyngeal to soliary nucleus of medulla
30. Chronic mitral stenosis can lead to what changes in size of the LA
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Dilation
MI
Diastolic
31. Where does coronary artery occlusion occur most commonly?
Inc Kf - capillary perm
Cherry hemangioma
In HF
LAD
32. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Wolff - Parkinson white syndrome
EKG
Arteriolosclerosis in malignant hypertension
Hemorrhage
33. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Total anomalous pulmonary trunk venous return
Can progess to V fib
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
34. What other sign is often present with congenital long QT syndrome - why?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Kidney
Arteriorles
Preload
35. What causes tet of fallot?
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Anterosuperior displacement of the infundibular septum
Mitral valve prolapse
P02
36. prolonged PR interval
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Troponin I
1st degree AV blodck
Myxoma
37. What is the formula for EF?
Holosystoiic
Heart - 02 extraction is always around 100%
Anterosuperior displacement of the infundibular septum
SV/ EDV
38. What happens in phase 4 of the cardiac ventricular action potential?
Resting potential high K perm
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Indomethacin closes - and pge keeps it open
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
39. In terms of starling forces - why does heart failure cause edema?
Dressler's - autoimmune
2-4 day - early coag necrosis on the first day
Maintain blood flow to organ over wide range of perfussion pressures
Increase in Pc
40. What are the complications from bacterial endocarditis?
Aortic stenosis or LBBB
Atrial contraction
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Chordae rupture - GN - suppurative pericarditis - emboli
41. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
Mitral valve prolapse
Afterload (proportional to peripheral resistance)
Kidney
42. In an anterolateral infarct - which artery is effected and which leads show Q waves
LCX - V4- V6
Hypertrophied cardiomyopathy
Neg inotropy - HF - narcotic overdose
The plateau period
43. What causes the ejection click in the Cres - decres murmur?
Ventricular repolarization
Mitral>aortic>>tricuspid - high pressure valves affected most
Subendocardial - fewer collaterals and higher pressure
Aburpt halting of valve leaflets
44. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Sturge weber - vasculitis of caps
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
45. SV CAP means?
Total anomalous pulmonary trunk venous return
Babies
Stroke volume affected by contractility - afterload - and preload
Metastasis from melanoma or lymphoma
46. What is association with fixed S2 splitting - does not increase with inspiration
ASD
Increase in Pc
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Aortic/pulmonic stenosis and mitral/tricuspid regurg
47. What kind of infarct show ST depression
LAD
Left atrial pressure
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Subendocardial
48. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Lymphangiosarcoma
Acute thrombosis of coronary artery
Polyarteritis nodosum
Late diastolic murmur following an opening snap
49. What murmur is heard with aortic regurg?
3rd degree block - pacemaker - Lyme disease
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Hemorrhage
Left heart failure
50. What is the time frame for arrhythmia risk in the evolution of MI
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
ASD - VSD - AV septal defect (endocardial cushion defect)
The first 4 days
Dilated cardiomyopathy
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