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Cardiology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

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 class of drugs decreases afterload?
Can progess to V fib
Vasodilators - (hydrAlAzine)
Lower right - MC - upper right - AO - upper right AC - lower left MO
SA>AV>bundle of His>ventricles

2. What does the starling curve show?
If sodium channel
Inc central venous pressure - inc resistance to portal flow
Late diastolic murmur following an opening snap
Changes in CO as a function of preload

3. The 7 complications of MI

4. When do coronary arteries fill?
The aortic before pulmonic - inspiration increases diff
Hemorrhage
Inc Kf - capillary perm
During diastole

5. Left to right shunts are more common in babies or kids?
2-4 day - early coag necrosis on the first day
Cardiac tamponde
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Kids

6. What is the early and late lesion in rheumatic heart disease
Tricuspid atresia - requires ASD and VSD
Lymphangiosarcoma
Mitral valve prolapse
Atrial contraction

7. PCWP is an estimate of...
Left atrial pressure
Ventricular depolarization - nl < 120 msec
Atrial contraction
Eisenmenger's syndrome

8. p - anca

9. In an EKG - What is the PR interval?
Conduction delay through AV node - nl < 200 msec
Babies
Ventricular repolarization
Atrial contraction

10. The cause of dyspnea on exertion?
Wegener's
Failure of LV to in CO during exercise
Sturge weber - vasculitis of caps
CK- MB

11. CO x Total peripheral resistance
Dec P02 - inc PC02 and dec pH
Increase intracellular Na - resulting in increased Ca
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Mean arterial pressure

12. Which organ has ht highest blood flow per gram of tissue
Kawasaki
Kidney
Vasodilators
Arteriorles

13. What is the characteristic pulse in aortic stenosis?
R to L shunt caused by stenoic pulmonic valve
2-4 day - early coag necrosis on the first day
Pulsus parvus and tardus - weak - can lead to syncope
Chordae rupture - GN - suppurative pericarditis - emboli

14. machine murmer
Heart - 02 extraction is always around 100%
PDA
Hematocrit
Ventricles are depolarized

15. What masks atrial repolarization?
Preload
LAD
QRS complex
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

16. What happens in phase 4 of the cardiac ventricular action potential?
Resting potential high K perm
Decreases
Medullary vasomotor center senses baroreceptors and JGA
S. epidermidis

17. What kind of infarct show ST depression
Late diastolic murmur following an opening snap
Aortic disecction - intraluminal tear forming false lumen
Proportional to viscosity and inversely proportional to the radius to the 4th power
Subendocardial

18. What does mitral prolapse predeispose to?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
RF
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Infective endocarditis

19. Chronic mitral stenosis can lead to what changes in size of the LA
Ventricles are depolarized
SV/ EDV
Dilation
Dec plasma proteins

20. 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
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
CFX
Coarcation of aorta

21. What is a normal EF
No
Mitral and tricuspid closure
At least 55%
Total anomalous pulmonary trunk venous return

22. EDV is also known as
Preload
Ventricles are depolarized
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Extracellular calcium - calcium induced calcium release

23. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Rapid upstroke - voltage gated Na channels open
RV failure - in venous pressure
...
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

24. benign cap hemangioma of infancy - spont regresses
If sodium channel
Strawberry hemangioma
Preload
Boot shaped heart

25. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

26. PCWP > LV diastolic pressure
Mitral stenosis
Inc venous return exaccerbates pulm vasc congestion
Libman - sacks endocarditis
Preload

27. congenital heart defect in an infant with a diabetic mother?
Apex and anterior interventricular septum
Transposition of great vessels
Myxoma
P02

28. PROVe
EKG
Unstable/crescendo angina
Cyclophosphamide and corticosteroids
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

29. What causes the murmur heard in MR to enhance?
Changes in CO as a function of preload
Conduction delay through AV node - nl < 200 msec
Inc TPR and LA return (expiration)
LCX - I - aVL

30. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
Fetal right to left - neonate left to right leading to RVH and failure
Increased efferent SANS and decreased efferent PANS
Mitral>aortic>>tricuspid - high pressure valves affected most

31. no relation between p waves and QRS intervals - treatment and predisposing factor
Dilation
Sturge weber - vasculitis of caps
3rd degree block - pacemaker - Lyme disease
Preload

32. Which kind of infarct show ST elevation - and/or pathologic Q waves
Inc TPR and LA return (expiration)
Preload
Aortic disecction - intraluminal tear forming false lumen
Transmural

33. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Increased efferent SANS and decreased efferent PANS
No - no pressure gradient
Tempral arteritis - may cause irreversible blindness
Arteriorles

34. How does a patient with Tet of fallot learn to improve symptoms?
Squat. Compression of femoral arteries - inc TPR - dec
Glomus tumor
Non
Raynaud's

35. What is the formula for EF?
SV/ EDV
Group a beta hemolytic strep
Tempral arteritis - may cause irreversible blindness
RV contraction (closed tricuspid valve bulding into atrium

36. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Dilation
Lymphangiosarcoma
Purkingee>atria>ventricles>AV node
EKG

37. systolic - diastolic
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Pulse pressure
Cyclophosphamide and corticosteroids
Afterload (proportional to peripheral resistance)

38. What does TAPVR stand for
Vasocxn
Total anomalous pulmonary trunk venous return
Henoch - Schlonlein purpura
Can progess to V fib

39. sawtooth wave

40. What are common causes of mitral regurg?
Vasocxn - while other tissues it causes vasodilation
Increasing activity of Ca pump in SR
Ischemic heart dz - mitral valve prolapse - LV dilation
Troponin I

41. What happens in phase 0 of the cardiac ventricular action potential?
Takayasu's arteritis
Atrial contraction
Pyogenic granuloma - associated with trauma and pregnancy
Rapid upstroke - voltage gated Na channels open

42. dyspnea - fatigue - edema and rales - multiple causes
CHF
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Granuloma with giant cells
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

43. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Changes in CO as a function of preload
Dilated cardiomyopathy
Atrial contraction
Kawasaki

44. which ethnic groups have higher association with HTN?
Black > white > asian
Microscopic polyangiitis - like wegener's without granulomas
Transfusion
RF

45. What are the complications from bacterial endocarditis?
Postinfarction fibrinous pericarditis
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Chordae rupture - GN - suppurative pericarditis - emboli
Activated histiocytes

46. What does the U wave indicated?
Temporal arteritis
HypoK and bradycardia
Pulse pressure
Hyperlipidemia

47. no change in PR interval followed by dropped beat
Aburpt halting of valve leaflets
Aortic insuffic - late
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Pulse pressure

48. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
Pos inotropy - exercise
Posterior descending (80% off the RCA - 20% off the circumflex)
Dilated cardiomyopathy

49. congenital heart defect with 22q11
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Stable angina
Truncus - tet of fallot

50. Which enzymes are useful for diagnosing reinfarction
Unstable/crescendo angina
CK- MB
Fast volatge gated Na channels
Kussmaul's sign - cardiac tamponade - pulsus paradoxus