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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. Churg Strauss - presentation and test
Medullary vasomotor center senses baroreceptors and JGA
Granuloma with giant cells
During diastole
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

2. What causes aortic stenosis
TAPVR
Age related calcifications or bicuspid aortic valve
MI
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

3. What does the atria release in response to inc blood volume and atrial pressure
ANP
Left sided
Mean arterial pressure
Isovolumetric contraction

4. The 7 complications of MI

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5. absecnce of tricuspid valve - hypoplastic RV
Neg inotropy - HF - narcotic overdose
LAD - V1- V2
Black > white > asian
Tricuspid atresia - requires ASD and VSD

6. no change in PR interval followed by dropped beat
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)
Atrial contraction
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

7. bening capillary hemangioma of elderly - does not regress
Ventricles are depolarized
Chordae rupture - GN - suppurative pericarditis - emboli
MI
Cherry hemangioma

8. What does mitral prolapse predeispose to?
Increasing activity of Ca pump in SR
Vasocxn
Infective endocarditis
PDA

9. Which sympathetic receptors raise MAP
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
ANP
Mitral valve
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

10. In the cardiac cycle - which period has the highest 02 consumption?
Isovolumetric contraction
7 weeks
Fetal right to left - neonate left to right leading to RVH and failure
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

11. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
140/90
Vasodilators
10%
Angiosarcoma

12. Where is the most posterior portion of the heart and What can it cause?
Strawberry hemangioma
Total anomalous pulmonary trunk venous return
Varicose veins - thromboembolism rare
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

13. Central chemoreceptors do not respond directly to which parameter?
P02
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Adult type aortic coarctation
Can progess to V fib

14. When does EF decrease
Inc central venous pressure - inc resistance to portal flow
In HF
Ventricular repolarization
Stable angina

15. What happens in phase 3 of the cardiac ventricular action potential?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Inc venous return exaccerbates pulm vasc congestion
Afterload (proportional to peripheral resistance)
Resting potential high K perm

16. What does an isoelectric ST segment indicate?
Ventricles are depolarized
SV/ EDV
MI
Filling is incomplete and CO falls

17. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Temporal arteritis
Age related calcifications or bicuspid aortic valve
Non
Left atrial pressure

18. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Strawberry hemangioma
Wolff - Parkinson white syndrome
Late systolic crescendo murmur with a midsystolic click
Inc RA pressure - due to filling against closed tricupsid valve

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

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20. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Transposition of great vessels
Filling is incomplete and CO falls
Pulmonary flow murmur and diastolic rumble

21. Which class of drugs decrease the murmur heard in aortic regurg?
Late diastolic murmur following an opening snap
Vasodilators
Resting potential high K perm
Strawberry hemangioma

22. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
Lower right - MC - upper right - AO - upper right AC - lower left MO
Pulmonary flow murmur and diastolic rumble
LAD - V1 - V4

23. What does the LAD supply?
The aortic before pulmonic - inspiration increases diff
Mechanican contraction of the ventricles
Apex and anterior interventricular septum
Fluid movement through capillaries

24. What is the classic X ray finding for tet of fallot?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Boot shaped heart
Wegener's
Age related calcifications or bicuspid aortic valve

25. Left to right shunts are more common in babies or kids?
Changes in CO as a function of preload
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Kids
Temporal arteritis

26. What kind of infarct show ST depression
Inc Kf - capillary perm
Patent ductus arteriosus - congenital rubella or prematurity
Subendocardial
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

27. congenital heart defect withdown syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
LCX - V4- V6
Increase - increase the chance the If are open
Crescendo - decrescendo systolic ejection murmur following ejection click

28. What are the 5 T's of cyanoitc babies
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Crescendo - decrescendo systolic ejection murmur following ejection click
Age related calcifications or bicuspid aortic valve
Non

29. The cause of cardiac dilation?
Activated histiocytes
Atrial contraction
Greater ventricular EDV
Subendocardial - fewer collaterals and higher pressure

30. decrease stretch in baroreceptors leads to what response?
Atrial contraction
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Increased efferent SANS and decreased efferent PANS
Holosystolic - harsh sounding murmur - loudest over tricuspid area

31. What causes the cushing reflex and why
Group a beta hemolytic strep
Hematocrit
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

32. EDV is also known as
Squat. Compression of femoral arteries - inc TPR - dec
Kids
Preload
RV failure - in venous pressure

33. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
Takayasu's arteritis
2nd degree AV block - mobitz type 1
Increasing activity of Ca pump in SR

34. Which murmur do you hear in mitral stenosis?
Chordae rupture - GN - suppurative pericarditis - emboli
Late diastolic murmur following an opening snap
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Pulmonary flow murmur and diastolic rumble

35. What are the four most common locations for atherosclerosis?
Group a beta hemolytic strep
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Mitral valve

36. What is associated with paradoxical spliting of S2
Turners
Aortic stenosis or LBBB
Ischemic heart dz - mitral valve prolapse - LV dilation
Subendocardial

37. machine murmer
PDA
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
SA and AV nodes
Increase contractility

38. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Mitral>aortic>>tricuspid - high pressure valves affected most
In series
No
Sturge weber - vasculitis of caps

39. Do you see elevaged ASO titers in rheumatic heart disease
Yes
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Hemorrhage
If sodium channel

40. congenital heart defect with turner's
Stroke volume
Coarcation of aorta
P02
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

41. What causes the ejection click in the Cres - decres murmur?
Left atrial pressure
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Subendocardial
Aburpt halting of valve leaflets

42. What are the diastolic heart sounds?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Cardiac tamponde
Varicose veins - thromboembolism rare
Early deaths from myocarditis

43. serum marker for wegener's
C - ANCA
Myxomatous degeneration - RF - chordae rupture
Atrial contraction
Pulse pressure

44. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
V fib
MI

45. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Medullary vasomotor center senses baroreceptors and JGA
LCX - I - aVL
Rhabdomyomas
Hematocrit

46. What does increasing intracellular Ca do?
Decrease in cAMP
Black > white > asian
MI
Increase contractility

47. What are anitschkow's cells
Aburpt halting of valve leaflets
Microscopic polyangiitis - like wegener's without granulomas
Activated histiocytes
Takayasu's arteritis

48. What are the systolic heart sounds
Preload
The aortic before pulmonic - inspiration increases diff
Infective endocarditis
Aortic/pulmonic stenosis and mitral/tricuspid regurg

49. What masks atrial repolarization?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Wolff - Parkinson white syndrome
Decrease in activity of Na/Ca exhanger and increase in contractility
QRS complex

50. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
2nd degree AV block - mobitz type 1
Apex and anterior interventricular septum
Atrial contraction
Vagus to medulla