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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. How do beta blockers decrease contractility?
Pulsus parvus and tardus - weak - can lead to syncope
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Acute thrombosis of coronary artery
Decrease in cAMP

2. What is the characteristic pulse in aortic stenosis?
The aortic before pulmonic - inspiration increases diff
Pulsus parvus and tardus - weak - can lead to syncope
Mitral and tricuspid closure
Group a beta hemolytic strep

3. most common primary cardiac tumor in children - associated with tuberous sclerosis
Sturge weber - vasculitis of caps
Age related calcifications or bicuspid aortic valve
Rhabdomyomas
Atrial contraction

4. In an EKG - What is the p wave?
Atrial contraction
Cherry hemangioma
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Vasocxn - while other tissues it causes vasodilation

5. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
Failure of LV to in CO during exercise
During HF from microhemorrhages from inc pulm cap pressure
Pulmonary flow murmur and diastolic rumble

6. Which bacteria causes endocarditis in the presence of colon cancer
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
S. bovis
Hypertrophied cardiomyopathy

7. Restrictive cardiomyopathy causes
Greater ventricular EDV
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
S. epidermidis
V fib arrhythima

8. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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9. in the JVP - What is the c wave?
Left atrial pressure
RV contraction (closed tricuspid valve bulding into atrium
Coarcation of aorta
Lower right - MC - upper right - AO - upper right AC - lower left MO

10. fibrinous pericarditis several weeks post MI

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11. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
During diastole
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Non
Kawasaki

12. list the coronary vessels most likely to be occluded
Transposition of great vessels
The aortic before pulmonic - inspiration increases diff
Wolff - Parkinson white syndrome
LAD > RCA > circumflex

13. Fatal arrhythmia
Unstable/crescendo angina
V fib
SA and AV nodes
Rapid upstroke - voltage gated Na channels open

14. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Wolff - Parkinson white syndrome
Left heart failure
Mitral>aortic>>tricuspid - high pressure valves affected most

15. what happens to capillaries in lymphatic blockage
Inc interstitial osmotic pressure pulling fliud out of capillaries
Vagus to medulla
Varicose veins - thromboembolism rare
Troponin I

16. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Rhabdomyomas
Liver
S. bovis

17. What are the different etiologies of dialted cardiomyopathy
Dec plasma proteins
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Wolff - Parkinson white syndrome

18. What other syndrom is associated with infantile aortic coarctation
Liver
Fluid movement through capillaries
Turners
Vagus to medulla

19. Which two mechanisms sense decrease MAP?
In parallel
Medullary vasomotor center senses baroreceptors and JGA
Kids
Diastolic

20. The cause of dyspnea on exertion?
Failure of LV to in CO during exercise
Decrease in activity of Na/Ca exhanger and increase in contractility
RCA
Transposition of great vessels

21. Which class of drugs decrease the murmur heard in aortic regurg?
Mitral valve prolapse
RV contraction (closed tricuspid valve bulding into atrium
Septal defects - PDA - pulm art stenosis
Vasodilators

22. which heart valves are afected most in rheumatic heart diseease
SV/ EDV
Mitral>aortic>>tricuspid - high pressure valves affected most
S. aureus
Inc Kf - capillary perm

23. What other sign is often present with congenital long QT syndrome - why?
Mitral>aortic>>tricuspid - high pressure valves affected most
Henoch - Schlonlein purpura
7 weeks
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

24. Central chemoreceptors do not respond directly to which parameter?
Changes in CO as a function of preload
Atherosclerosis
P02
Vasodilators

25. When during cardiac nodal cells depolarize?
Henoch - Schlonlein purpura
Holosystoiic
Greater ventricular EDV
During diastole

26. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Rhabdomyomas
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Mitral>aortic>>tricuspid - high pressure valves affected most

27. When does extracellular calcium enter the cardiac muscle cells during contraction?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Holosystoiic
7 weeks
The plateau period

28. Which bacteria causes rheumatic heart disease
S. bovis
Group a beta hemolytic strep
Pyogenic granuloma - associated with trauma and pregnancy
LAD

29. What are the complications from bacterial endocarditis?
Postinfarction fibrinous pericarditis
Atrial contraction
Chordae rupture - GN - suppurative pericarditis - emboli
Left heart failure

30. moncekberg
Filling is incomplete and CO falls
7 weeks
Pulse pressure
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

31. Inspiration causes an increase in which sided heart sounds?
SA and AV nodes
Aortic disecction - intraluminal tear forming false lumen
R to L shunt caused by stenoic pulmonic valve
Right sided

32. systolic - diastolic
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Increasing activity of Ca pump in SR
Pulse pressure
Mitral>aortic>>tricuspid - high pressure valves affected most

33. Which valve is most commonly involved in bacterial endocarditis?
10%
Dec P02 - inc PC02 and dec pH
Mitral valve
Increasing activity of Ca pump in SR

34. What can cause mitral prolapse?
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Myxomatous degeneration - RF - chordae rupture
7 weeks
Cardiac tamponde

35. What are the diastolic heart sounds?
Aortic and pulmonary closing
Cardiac tamponde
Dilated cardiomyopathy
Aortic/pulmonic regurg and mitral/tricuspid stenosis

36. Which organ has the largest arteriovenous difference
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Heart - 02 extraction is always around 100%
S. epidermidis

37. What does FROM JANE stand for in bacterial endocarditis?

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38. In an anterior wall infarct - which artery is effected and which leads show Q waves
Mitral stenosis
Systolic dysfunction
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
LAD - V1 - V4

39. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
ANP
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Lymphangiosarcoma
Medullary vasomotor center senses baroreceptors and JGA

40. In terms of starling forces - why does heart failure cause edema?
CHF
Increase in Pc
Early deaths from myocarditis
5-10 days - macs have degraded structural components

41. What masks atrial repolarization?
QRS complex
The operating point of the heart
Neg inotropy - HF - narcotic overdose
Inc Kf - capillary perm

42. What happens in phase 3 of the cardiac ventricular action potential?
Atherosclerosis
Dec plasma proteins
Heart - 02 extraction is always around 100%
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

43. The cause of cardiac dilation?
Mean arterial pressure
Greater ventricular EDV
Purkingee>atria>ventricles>AV node
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

44. 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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45. What does TAPVR stand for
Turners
Cystic hygroma
Heart - 02 extraction is always around 100%
Total anomalous pulmonary trunk venous return

46. What supplies the posterior left ventricle?
Henoch - Schlonlein purpura
CFX
Mitral>aortic>>tricuspid - high pressure valves affected most
Dressler's - autoimmune

47. What happens with a decrease of extracellular Na
Systolic dysfunction
Atherosclerosis
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Decrease in activity of Na/Ca exhanger and increase in contractility

48. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Prinzmetal angina
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

49. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Maintain blood flow to organ over wide range of perfussion pressures
2nd degree AV block - mobitz type 1
Increased SV
2-4 day - early coag necrosis on the first day

50. What is the classic X ray finding for tet of fallot?
Arteriorles
Boot shaped heart
Posterior descending (80% off the RCA - 20% off the circumflex)
Dilated cardiomyopathy