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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 artery supplies the SA and AV nodes?
Wegener's
Increase - increase the chance the If are open
RCA
Truncus - tet of fallot

2. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Lower right - MC - upper right - AO - upper right AC - lower left MO
RCA
Inc central venous pressure - inc resistance to portal flow
S. aureus

3. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Can progess to V fib
Posterior descending (80% off the RCA - 20% off the circumflex)
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

4. What supplies the posterior left ventricle?
Dilated cardiomyopathy
Vasodilators
CO
CFX

5. PROVe
Pulse pressure
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Liver
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

6. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
Mitral valve prolapse
140/90
Vasodilators

7. What is the formula for EF?
SV/ EDV
Isovolumetric contraction
No
Non

8. Why is there edema after burns or during infection
Failure of LV to in CO during exercise
During HF from microhemorrhages from inc pulm cap pressure
Chordae rupture - GN - suppurative pericarditis - emboli
Inc Kf - capillary perm

9. Given P = QR - what factors influence resistance?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Systolic dysfunction
Stroke volume
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

10. Where does coronary artery occlusion occur most commonly?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
LAD
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Adult type aortic coarctation

11. Expiration causes an increase in which sided heart sounds
Vasocxn
Adult type aortic coarctation
Left sided
Fick principle

12. Which murmur do you hear in mitral stenosis?
Increased SV
Indomethacin closes - and pge keeps it open
Late diastolic murmur following an opening snap
Dressler's - autoimmune

13. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Libman - sacks endocarditis
MI
Transmural
Patent ductus arteriosus - congenital rubella or prematurity

14. When do you see extensive coagulative necrosis in an MI
Aortic stenosis or LBBB
2-4 day - early coag necrosis on the first day
Ischemic heart dz - mitral valve prolapse - LV dilation
PDA

15. What other sign is often present with congenital long QT syndrome - why?
Vasocxn - while other tissues it causes vasodilation
During diastole
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Conduction delay through AV node - nl < 200 msec

16. What does the starling curve show?
Vasocxn - while other tissues it causes vasodilation
Changes in CO as a function of preload
Extracellular calcium - calcium induced calcium release
Truncus - tet of fallot

17. dyspnea - fatigue - edema and rales - multiple causes
CHF
Decrease in activity of Na/Ca exhanger and increase in contractility
Kaposi's sarcoma
Can progess to V fib

18. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Pulmonic stenosis and RBBB
Ventricular repolarization
Dec P02 - inc PC02 and dec pH
LCX - I - aVL

19. What are aschoff bodies
No
CHF
Myxomatous degeneration - RF - chordae rupture
Granuloma with giant cells

20. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Unstable/crescendo angina
Turners
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
MAP

21. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Tricuspid atresia - requires ASD and VSD
Preload
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

22. 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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23. What is the S2 sound?
Fetal right to left - neonate left to right leading to RVH and failure
Aortic and pulmonary closing
The first 4 days
Pulmonic stenosis and RBBB

24. which ethnic groups have higher association with HTN?
Crescendo - decrescendo systolic ejection murmur following ejection click
During HF from microhemorrhages from inc pulm cap pressure
Preload
Black > white > asian

25. 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
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
EKG
Cyclophosphamide and corticosteroids

26. sawtooth wave

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27. The aortic arch receptors transmit along which nerve?
Vagus to medulla
SA>AV>bundle of His>ventricles
Preload
Left sided

28. congenital heart defect with congenital rubella
Septal defects - PDA - pulm art stenosis
Postinfarction fibrinous pericarditis
Mitral valve
During diastole

29. In an EKG - What is the QT interval?
SA and AV nodes
Mechanican contraction of the ventricles
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Torsades de pointes

30. The cause of cardiac dilation?
Increase in Pc
Left atrial pressure
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Greater ventricular EDV

31. What kind of infarct show ST depression
RF
Subendocardial
Atherosclerosis
Increase in Pc

32. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Mitral>aortic>>tricuspid - high pressure valves affected most
...
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Septal defects - PDA - pulm art stenosis

33. How does digitatlis increase contractility?
Inc central venous pressure - inc resistance to portal flow
Increase intracellular Na - resulting in increased Ca
Atherosclerosis
ANP

34. How are sarcomeres added in concentric hypertrophy?
Decreased
Dilated cardiomyopathy
In parallel
Varicose veins - thromboembolism rare

35. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Fluid movement through capillaries
Kidney
Libman - sacks endocarditis
S. aureus

36. What does an isoelectric ST segment indicate?
P02
Eisenmenger's syndrome
Liver
Ventricles are depolarized

37. What are the systolic heart sounds
Fetal right to left - neonate left to right leading to RVH and failure
Increased efferent SANS and decreased efferent PANS
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Aortic/pulmonic stenosis and mitral/tricuspid regurg

38. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Heart - 02 extraction is always around 100%
Angiosarcoma
Holosystolic - harsh sounding murmur - loudest over tricuspid area
The operating point of the heart

39. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Varicose veins - thromboembolism rare
Mitral stenosis
2nd degree AV block - mobitz type 1
Decrease in activity of Na/Ca exhanger and increase in contractility

40. What does the LAD supply?
Kawasaki
Microscopic polyangiitis - like wegener's without granulomas
Apex and anterior interventricular septum
Kidney

41. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Tempral arteritis - may cause irreversible blindness
LAD
The plateau period

42. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Prinzmetal angina
Posterior descending (80% off the RCA - 20% off the circumflex)
Glomus tumor
Adult type aortic coarctation

43. In an EKG - What is the p wave?
Atrial contraction
Varicose veins - thromboembolism rare
Pulsus parvus and tardus - weak - can lead to syncope
Lower right - MC - upper right - AO - upper right AC - lower left MO

44. What is the progression of atherosclerosis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
V fib
Hemorrhage
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

45. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
No - no pressure gradient
Kawasaki
Right sided
2nd degree AV block - mobitz type 1

46. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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47. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Resting potential high K perm
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Pulmonic stenosis and RBBB

48. fibrous plaques and atheromas in intima of arteries
Atherosclerosis
Vasodilators - (hydrAlAzine)
Kawasaki
CFX

49. Why is contractility decreased in heart failure?
Posterior descending (80% off the RCA - 20% off the circumflex)
S. bovis
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Systolic dysfunction

50. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
SV/ EDV
Pulse pressure
Turners