Cardiology

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• 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. sawtooth wave

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2. What does the starling curve show?
Changes in CO as a function of preload
Buerger's disease
Afterload (proportional to peripheral resistance)
No - no pressure gradient


3. Which vessels account for the most total peripheral resistance
Metastasis from melanoma or lymphoma
Mitral valve
Aortic and pulmonary closing
Arteriorles


4. When do you see extensive coagulative necrosis in an MI
Non
Kidney
2-4 day - early coag necrosis on the first day
140/90


5. What stimulates release of calcium from the SR?
Adult type aortic coarctation
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Extracellular calcium - calcium induced calcium release
Inc venous return exaccerbates pulm vasc congestion


6. in the JVP - What is the c wave?
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Wolff - Parkinson white syndrome
Inc TPR and LA return (expiration)
RV contraction (closed tricuspid valve bulding into atrium


7. What are anitschkow's cells
Activated histiocytes
Left atrial pressure
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
SA and AV nodes


8. What causes ankle - sacral edema - jugular venous distention
Ischemic heart dz - mitral valve prolapse - LV dilation
Cystic hygroma
RV failure - in venous pressure
2nd degree AV block - mobitz type 1


9. most common heart tumor
Metastasis from melanoma or lymphoma
Increased efferent SANS and decreased efferent PANS
Pulse pressure
ASD


10. How does digitatlis increase contractility?
Increase intracellular Na - resulting in increased Ca
2-4 day - early coag necrosis on the first day
Raynaud's
Hyperlipidemia


11. In an EKG - What is the p wave?
Ventricles are depolarized
Transfusion
Atrial contraction
Prinzmetal angina


12. When do you find hemosiderin laden macrophages in the lungs?
Pulsus parvus and tardus - weak - can lead to syncope
During HF from microhemorrhages from inc pulm cap pressure
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Ischemic heart dz - mitral valve prolapse - LV dilation


13. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Pulse pressure
Transfusion
Late systolic crescendo murmur with a midsystolic click


14. What is the machine like murmur? What is the heart pathology and the predisposing causes
CK- MB
Patent ductus arteriosus - congenital rubella or prematurity
The operating point of the heart
Raynaud's


15. What are the complications of atherosclerosis?
Left sided
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Holosystolic - harsh sounding murmur - loudest over tricuspid area
CK- MB


16. What does TAPVR stand for
V fib arrhythima
Troponin I
Total anomalous pulmonary trunk venous return
Cystic hygroma


17. What is the classic X ray finding for tet of fallot?
Subendocardial - fewer collaterals and higher pressure
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Increase contractility
Boot shaped heart


18. In normal S2 splitting - which valve closes first? What increases it?
Persistant truncus arteriosus
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Wegener's
The aortic before pulmonic - inspiration increases diff


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

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20. What happens in phase 2 of the cardiac ventricular action potential?
Inc interstitial osmotic pressure pulling fliud out of capillaries
2-4 day - early coag necrosis on the first day
Medullary vasomotor center senses baroreceptors and JGA
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction


21. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
Vasodilators
Vasodilators - (hydrAlAzine)
R to L shunt caused by stenoic pulmonic valve


22. fibrinous pericarditis several weeks post MI

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23. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Transposition of great vessels
Left sided
Early deaths from myocarditis
Dec plasma proteins


24. What is the danger of torsades to pointes?
Can progess to V fib
Kawasaki
Systolic dysfunction
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)


25. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Septal defects - PDA - pulm art stenosis
Subendocardial
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Glomus tumor


26. What causes orthopnea?
Rhabdomyomas
Inc venous return exaccerbates pulm vasc congestion
Aortic insuffic - late
LCX - V4- V6


27. How does angiotensin II raise MAP
Inc RA pressure - due to filling against closed tricupsid valve
Transmural
Vasocxn
Conduction delay through AV node - nl < 200 msec


28. What causes the ejection click in the Cres - decres murmur?
Left sided
Aburpt halting of valve leaflets
Medullary vasomotor center senses baroreceptors and JGA
Fluid movement through capillaries


29. What does the atria release in response to inc blood volume and atrial pressure
ANP
Preload
Myxoma
ASD


30. What is the gold standard for dx of MI in the first 6 hours
Truncus - tet of fallot
Stroke volume
EKG
Septal defects - PDA - pulm art stenosis


31. Inspiration causes an increase in which sided heart sounds?
Decreased
Indomethacin closes - and pge keeps it open
No - no pressure gradient
Right sided


32. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Turners
The operating point of the heart


33. Which murmur is heard with mitral prolapse?
Anterosuperior displacement of the infundibular septum
Systolic dysfunction
Dilated cardiomyopathy
Late systolic crescendo murmur with a midsystolic click


34. What is the difference between adult and infantile type aortic coarctation?
Atrial contraction
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Transposition of great vessels
Increase - increase the chance the If are open


35. p - anca

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36. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
LAD
Preload
Hemorrhage
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli


37. What happens with a decrease of extracellular Na
EKG
Libman - sacks endocarditis
LV failure - pulm venous distention transudation of fluid
Decrease in activity of Na/Ca exhanger and increase in contractility


38. What does T wave inversion indicated?
ASD
MI
Ventricular depolarization - nl < 120 msec
MAP


39. What do the starling forces determine
Viridans streptococci
Persistant truncus arteriosus
Fluid movement through capillaries
ASD


40. What is the most common cause of MI
Acute thrombosis of coronary artery
Pyogenic granuloma - associated with trauma and pregnancy
Aortic disecction - intraluminal tear forming false lumen
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence


41. Expiration causes an increase in which sided heart sounds
Crescendo - decrescendo systolic ejection murmur following ejection click
Inc interstitial osmotic pressure pulling fliud out of capillaries
Left sided
1st degree AV blodck


42. 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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43. In an inferior wall infarct - which artery is affected and which leads show Q waves
Squat. Compression of femoral arteries - inc TPR - dec
Increased efferent SANS and decreased efferent PANS
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
RCA - II - III - aVF


44. MAP is also known as
Afterload (proportional to peripheral resistance)
Left atrial pressure
Tempral arteritis - may cause irreversible blindness
Pulse pressure


45. The aortic arch receptors transmit along which nerve?
Raynaud's
In parallel
Vagus to medulla
Acute thrombosis of coronary artery


46. what happens to capillaries in lymphatic blockage
Inc interstitial osmotic pressure pulling fliud out of capillaries
Angiosarcoma
7 weeks
Eisenmenger's syndrome


47. What is the cushing triad?
HTN - bradycardia - and respiratory depression
C - ANCA
Eccentric - concentric hypertrophy causes diastolic disfunction
Myxoma


48. What is a normal EF
At least 55%
Vasodilators - (hydrAlAzine)
Inc interstitial osmotic pressure pulling fliud out of capillaries
Dilation


49. Which organ gets the largest share of systemic cardiac output
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
HTN - bradycardia - and respiratory depression
Liver
Septal defects - PDA - pulm art stenosis


50. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Non
Increase - increase the chance the If are open
Greater ventricular EDV
Vasocxn