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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. cavernous lymphangioma of the neck - associated with turner's
Fluid movement through capillaries
CHF
Cystic hygroma
S. aureus

2. What is a normal EF
At least 55%
Pulse pressure
Pyogenic granuloma - associated with trauma and pregnancy
MI

3. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Pulmonic stenosis and RBBB
Decreases
Inc Kf - capillary perm
Ventricular depolarization - nl < 120 msec

4. Which bacteria causes rheumatic heart disease
MI
Group a beta hemolytic strep
Temporal arteritis
Granuloma with giant cells

5. What does increasing intracellular Ca do?
Afterload (proportional to peripheral resistance)
Fluid movement through capillaries
Boot shaped heart
Increase contractility

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

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7. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Arteriorles
Eisenmenger's syndrome
Glomus tumor
Holosystoiic

8. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Ventricles are depolarized
Mitral valve

9. What is the cushing triad?
HTN - bradycardia - and respiratory depression
Arteriorles
Cardiac tamponde
Myxoma

10. benign cap hemangioma of infancy - spont regresses
Dressler's - autoimmune
Strawberry hemangioma
In parallel
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

11. What does the atria release in response to inc blood volume and atrial pressure
Cardiac tamponde
Systolic dysfunction
In series
ANP

12. Expiration causes an increase in which sided heart sounds
Kawasaki
Glossopharyngeal to soliary nucleus of medulla
HTN - bradycardia - and respiratory depression
Left sided

13. What do patients die early from in rheumatic heart disease?
V fib
Arteriorles
Postinfarction fibrinous pericarditis
Early deaths from myocarditis

14. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Transfusion
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Isovolumetric contraction

15. Where are pacemaker cells?
Vasodilators - (hydrAlAzine)
Mitral valve
Raynaud's
SA and AV nodes

16. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Acute thrombosis of coronary artery
Arteriolosclerosis in malignant hypertension
CK- MB
Wolff - Parkinson white syndrome

17. Why is contractility decreased in heart failure?
Systolic dysfunction
Inc TPR and LA return (expiration)
Left heart failure
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

18. What is the definition of HTN?
140/90
Increase in Pc
RV contraction (closed tricuspid valve bulding into atrium
Lower right - MC - upper right - AO - upper right AC - lower left MO

19. Which channel accounts for automaticity of the SA and AV nodes?
If sodium channel
Diastolic
Coarcation of aorta
Glossopharyngeal to soliary nucleus of medulla

20. Which two mechanisms sense decrease MAP?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
ANP
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Medullary vasomotor center senses baroreceptors and JGA

21. What are the 5 T's of cyanoitc babies
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
No
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
ASD - VSD - AV septal defect (endocardial cushion defect)

22. PCWP > LV diastolic pressure
LAD - V1 - V4
Mitral stenosis
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
MI

23. In an EKG - What is the PR interval?
Conduction delay through AV node - nl < 200 msec
Cardiac tamponde
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
The plateau period

24. congenital heart defect with marfan's
Pulmonary flow murmur and diastolic rumble
Vasodilators - (hydrAlAzine)
Lower right - MC - upper right - AO - upper right AC - lower left MO
Aortic insuffic - late

25. What is the danger of torsades to pointes?
Can progess to V fib
Pulse pressure
Takayasu's arteritis
Sudden tensing of chordae tendinae

26. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Yes
Lymphangiosarcoma
Polyarteritis nodosum
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

27. sawtooth wave

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28. Why is there edema after burns or during infection
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Stroke volume affected by contractility - afterload - and preload
Inc Kf - capillary perm
SA and AV nodes

29. most common heart tumor
Metastasis from melanoma or lymphoma
LAD - V1 - V4
Right sided
Mitral valve prolapse

30. What causes hepatomegaly?
Fluid movement through capillaries
Inc central venous pressure - inc resistance to portal flow
Sudden tensing of chordae tendinae
Conduction delay through AV node - nl < 200 msec

31. In an EKG - What is the p wave?
Rhabdomyomas
Fluid movement through capillaries
Atrial contraction
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

32. What are the complications from bacterial endocarditis?
Decreases
Rapid upstroke - voltage gated Na channels open
Chordae rupture - GN - suppurative pericarditis - emboli
Indomethacin closes - and pge keeps it open

33. 2/3 diastolic + 1/3 systolic
Vasodilators
MAP
Henoch - Schlonlein purpura
Hyperlipidemia

34. What is the result of not have fast sodium channels in pacemaker cells?
Takayasu's arteritis
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Unstable/crescendo angina
ANP

35. What happends in phase 1 of the ventricular cardiac action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Inc RA pressure - due to filling against closed tricupsid valve
Left heart failure
R to L shunt caused by stenoic pulmonic valve

36. Which class of drugs decreases afterload?
Angiosarcoma
Vasodilators - (hydrAlAzine)
Late systolic crescendo murmur with a midsystolic click
Stroke volume affected by contractility - afterload - and preload

37. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
TAPVR
P02
Acute thrombosis of coronary artery

38. fibrinous pericarditis several weeks post MI

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39. stroke volume x HR =?
Truncus - tet of fallot
Early deaths from myocarditis
CO
MI

40. In an EKG - What is the QRS complex?
RF
Failure of LV to in CO during exercise
7 weeks
Ventricular depolarization - nl < 120 msec

41. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Mitral>aortic>>tricuspid - high pressure valves affected most
Lower right - MC - upper right - AO - upper right AC - lower left MO
CK- MB

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

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43. How does angiotensin II raise MAP
Vasocxn
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
No - no pressure gradient
10%

44. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Unstable/crescendo angina
RCA - II - III - aVF
Decrease in activity of Na/Ca exhanger and increase in contractility

45. PROVe
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Yes
Apex and anterior interventricular septum

46. congenital heart defect withdown syndrome
Granuloma with giant cells
Dec plasma proteins
ASD - VSD - AV septal defect (endocardial cushion defect)
Maintain blood flow to organ over wide range of perfussion pressures

47. What constitues the upstroke in pacemaker cells?
Increasing activity of Ca pump in SR
LCX - I - aVL
Volatage gated Ca channels
Arteriorles

48. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
Atrial contraction
3rd degree block - pacemaker - Lyme disease
Afterload (proportional to peripheral resistance)

49. When does extracellular calcium enter the cardiac muscle cells during contraction?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Vasocxn - while other tissues it causes vasodilation
The plateau period
MAP

50. What cardiac change occurs in pregnancy?
Wegener's
Early deaths from myocarditis
Sudden tensing of chordae tendinae
Increased SV