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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. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Kawasaki
Sturge weber - vasculitis of caps
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

2. in the JVP - What is the c wave?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
RV contraction (closed tricuspid valve bulding into atrium
Stroke volume
Changes in CO as a function of preload

3. What does increasing intracellular Ca do?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Tempral arteritis - may cause irreversible blindness
Increase contractility

4. What does FAN MY SKIN On Wednesday stand for?
Torsades de pointes
Group a beta hemolytic strep
Wegener's
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

5. What do the starling forces determine
Fluid movement through capillaries
Atrial contraction
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

6. When do coronary arteries fill?
During diastole
Aortic and pulmonary closing
Fluid movement through capillaries
If sodium channel

7. benign cap hemangioma of infancy - spont regresses
Strawberry hemangioma
Holosystoiic
Transposition of great vessels
Prinzmetal angina

8. What is the progression of atherosclerosis?
Pos inotropy - exercise
SV/ EDV
Unstable/crescendo angina
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

9. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
Holosystoiic
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
5-10 days - macs have degraded structural components
Systolic dysfunction

10. What is the classic X ray finding for tet of fallot?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Atherosclerosis
Pos inotropy - exercise
Boot shaped heart

11. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Yes
Black > white > asian
The aortic before pulmonic - inspiration increases diff

12. stroke volume x HR =?
Right sided
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
CO
Dilation

13. EDV - ESV
Troponin I
Decreases
Indomethacin closes - and pge keeps it open
Stroke volume

14. Which organ gets the largest share of systemic cardiac output
Liver
RCA
Arteriolosclerosis in malignant hypertension
Inc Kf - capillary perm

15. Which organ has the largest arteriovenous difference
Dec plasma proteins
CK- MB
Heart - 02 extraction is always around 100%
Fast volatge gated Na channels

16. Exercise - overtransfusiion and excitiment causes and increase in...?
The operating point of the heart
EKG
Preload
Kids

17. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Increase - increase the chance the If are open
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
In series
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

18. most common heart tumor
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Failure of LV to in CO during exercise
Inc central venous pressure - inc resistance to portal flow
Metastasis from melanoma or lymphoma

19. In an anterior wall infarct - which artery is effected and which leads show Q waves
Dressler's - autoimmune
LAD - V1 - V4
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Fast volatge gated Na channels

20. What happens in phase 4 of the cardiac ventricular action potential?
Decreases
Resting potential high K perm
Kaposi's sarcoma
Maintain blood flow to organ over wide range of perfussion pressures

21. In an EKG - What is the QT interval?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Decreased
Kawasaki
Mechanican contraction of the ventricles

22. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
Maintain blood flow to organ over wide range of perfussion pressures
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Changes in CO as a function of preload

23. What is the machine like murmur? What is the heart pathology and the predisposing causes
Patent ductus arteriosus - congenital rubella or prematurity
Turners
LCX - I - aVL
Pos inotropy - exercise

24. What are the systolic heart sounds
S. aureus
Systolic dysfunction
Aortic/pulmonic stenosis and mitral/tricuspid regurg
CO

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

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26. What is the time frame for arrhythmia risk in the evolution of MI
Transfusion
RV contraction (closed tricuspid valve bulding into atrium
Myxoma
The first 4 days

27. What causes the murmur heard in tricuspid regurg to enhance
Inc venous return exaccerbates pulm vasc congestion
In RA return (inspiration)
Stroke volume
LAD - V1 - V4

28. no relation between p waves and QRS intervals - treatment and predisposing factor
The plateau period
Conduction delay through AV node - nl < 200 msec
3rd degree block - pacemaker - Lyme disease
Troponin I

29. In an EKG - What is the PR interval?
Metastasis from melanoma or lymphoma
Conduction delay through AV node - nl < 200 msec
Increased SV
LAD

30. which medications are used to maintain patency or close the ductus arteriosus?
Increased efferent SANS and decreased efferent PANS
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Arteriolosclerosis in malignant hypertension
Indomethacin closes - and pge keeps it open

31. fibrinous pericarditis several weeks post MI

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32. What channels do the the pacemaker cells lack?
Metastasis from melanoma or lymphoma
Fast volatge gated Na channels
Pos inotropy - exercise
Lymphangiosarcoma

33. In an EKG - What is the T wave?
Fick principle
Fluid movement through capillaries
Viridans streptococci
Ventricular repolarization

34. What is the definition of HTN?
Henoch - Schlonlein purpura
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
140/90
Increased SV

35. What stimulates release of calcium from the SR?
CFX
10%
RV failure - in venous pressure
Extracellular calcium - calcium induced calcium release

36. What supplies the posterior left ventricle?
Failure of LV to in CO during exercise
HypoK and bradycardia
Ventricular depolarization - nl < 120 msec
CFX

37. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Rapid upstroke - voltage gated Na channels open
Stable angina

38. Why is contractility decreased in heart failure?
Systolic dysfunction
Septal defects - PDA - pulm art stenosis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Holosystoiic

39. What does hypoxia cause in the lung versus other tissues?
Vasocxn - while other tissues it causes vasodilation
Eccentric - concentric hypertrophy causes diastolic disfunction
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
S. epidermidis

40. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?

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41. Which two mechanisms sense decrease MAP?
Apex and anterior interventricular septum
Medullary vasomotor center senses baroreceptors and JGA
Dilation
Anterosuperior displacement of the infundibular septum

42. What is the gold standard for dx of MI in the first 6 hours
Stable angina
In HF
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
EKG

43. congenital heart defect with 22q11
Truncus - tet of fallot
Myxoma
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Kawasaki

44. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Rhabdomyomas
Purkingee>atria>ventricles>AV node
LAD
2-4 day - early coag necrosis on the first day

45. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Pulmonary flow murmur and diastolic rumble
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Posterior descending (80% off the RCA - 20% off the circumflex)

46. Given P = QR - what factors influence resistance?
Troponin I
Left heart failure
Proportional to viscosity and inversely proportional to the radius to the 4th power
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

47. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
Neg inotropy - HF - narcotic overdose
Mitral and tricuspid closure
Fetal right to left - neonate left to right leading to RVH and failure

48. Right to left shunts are more common in babies or kids?
Babies
R to L shunt caused by stenoic pulmonic valve
Medullary vasomotor center senses baroreceptors and JGA
Cystic hygroma

49. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
TAPVR
Prinzmetal angina
CHF
Cyclophosphamide and corticosteroids

50. CO x Total peripheral resistance
1st degree AV blodck
Stroke volume affected by contractility - afterload - and preload
Mean arterial pressure
Infective endocarditis