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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. Which sympathetic receptors raise MAP
Filling is incomplete and CO falls
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Diastolic
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

2. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
RCA
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

3. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Mean arterial pressure
Right sided
Heart - 02 extraction is always around 100%
Myxoma

4. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
LAD - V1- V2
Angiosarcoma
Dilated cardiomyopathy
Persistant truncus arteriosus

5. What are anitschkow's cells
Gap junctions
S. aureus
Activated histiocytes
Inc RA pressure - due to filling against closed tricupsid valve

6. Which murmur is heard with VSD?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
HTN - bradycardia - and respiratory depression
Holosystolic - harsh sounding murmur - loudest over tricuspid area
TAPVR

7. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
QRS complex
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
The plateau period
Stable angina

8. Which murmur is heard with mitral prolapse?
2-4 day - early coag necrosis on the first day
Late systolic crescendo murmur with a midsystolic click
SV/ EDV
Mean arterial pressure

9. When do coronary arteries fill?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
PDA
During diastole
Henoch - Schlonlein purpura

10. What are the complications from bacterial endocarditis?
Cherry hemangioma
Chordae rupture - GN - suppurative pericarditis - emboli
Cardiac tamponde
Mitral>aortic>>tricuspid - high pressure valves affected most

11. Which artery supplies the SA and AV nodes?
RCA
Diastolic
Total anomalous pulmonary trunk venous return
Left heart failure

12. SV CAP means?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Hematocrit
Stroke volume affected by contractility - afterload - and preload
Mitral and tricuspid closure

13. How does acidosis affect contractility?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Temporal arteritis
Aortic disecction - intraluminal tear forming false lumen
Decreased

14. What is a normal EF
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
At least 55%
Coarcation of aorta
Hypertrophied cardiomyopathy

15. serum marker for wegener's
Myxomatous degeneration - RF - chordae rupture
C - ANCA
Granuloma with giant cells
The aortic before pulmonic - inspiration increases diff

16. What causes the ejection click in the Cres - decres murmur?
RV failure - in venous pressure
Aburpt halting of valve leaflets
Isovolumetric contraction
Squat. Compression of femoral arteries - inc TPR - dec

17. In an EKG - What is the PR interval?
HTN - bradycardia - and respiratory depression
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Decreases
Conduction delay through AV node - nl < 200 msec

18. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
The first 4 days
Pulsus parvus and tardus - weak - can lead to syncope
Changes in CO as a function of preload

19. p - anca

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20. Unilateral headache - jaw claudication - impaired vision
Rhabdomyomas
Maintain blood flow to organ over wide range of perfussion pressures
Tempral arteritis - may cause irreversible blindness
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

21. Most common vasculitis affecting medium and large arteries
CO
Heart - 02 extraction is always around 100%
Temporal arteritis
Turners

22. no change in PR interval followed by dropped beat
Diastolic
HypoK and bradycardia
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

23. What does the U wave indicated?
Right sided
Heart - 02 extraction is always around 100%
Patent ductus arteriosus - congenital rubella or prematurity
HypoK and bradycardia

24. Which murmur do you hear in mitral stenosis?
Late diastolic murmur following an opening snap
Polyarteritis nodosum
Subendocardial
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

25. What does hypoxia cause in the lung versus other tissues?
CHF
Vasocxn - while other tissues it causes vasodilation
Transmural
ANP

26. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Crescendo - decrescendo systolic ejection murmur following ejection click
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Fetal right to left - neonate left to right leading to RVH and failure

27. What causes the midsystolic click
Sudden tensing of chordae tendinae
In RA return (inspiration)
Inc central venous pressure - inc resistance to portal flow
1st degree AV blodck

28. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Left heart failure
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Boot shaped heart

29. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
If sodium channel
Indomethacin closes - and pge keeps it open
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

30. What causes the murmur heard in tricuspid regurg to enhance
Mitral stenosis
Granuloma with giant cells
LV failure - pulm venous distention transudation of fluid
In RA return (inspiration)

31. What is the definition of HTN?
140/90
R to L shunt caused by stenoic pulmonic valve
In HF
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

32. PCWP is an estimate of...
Left atrial pressure
No
P02
Rapid upstroke - voltage gated Na channels open

33. How are the sarcomeres added in eccentric hypertrophy?
Cyclophosphamide and corticosteroids
Preload
In series
LV failure - pulm venous distention transudation of fluid

34. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
Torsades de pointes
ASD
Polyarteritis nodosum

35. What does autoregulation do?
Systolic dysfunction
Maintain blood flow to organ over wide range of perfussion pressures
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Right sided

36. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Torsades de pointes
Eisenmenger's syndrome

37. What causes the CO curve to shift upwards?
CK- MB
Pos inotropy - exercise
Inc RA pressure - due to filling against closed tricupsid valve
Anterosuperior displacement of the infundibular septum

38. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Coarcation of aorta
Transfusion
Arteriolosclerosis in malignant hypertension
Inc TPR and LA return (expiration)

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

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40. What causes the cushing reflex and why
Inc Kf - capillary perm
Mitral>aortic>>tricuspid - high pressure valves affected most
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
MI

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

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42. The cause of dyspnea on exertion?
If sodium channel
Failure of LV to in CO during exercise
Aortic/pulmonic regurg and mitral/tricuspid stenosis
No - no pressure gradient

43. Which two mechanisms sense decrease MAP?
S. aureus
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Medullary vasomotor center senses baroreceptors and JGA
Inc RA pressure - due to filling against closed tricupsid valve

44. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
In RA return (inspiration)
S. aureus
Troponin I
Changes in CO as a function of preload

45. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Rapid upstroke - voltage gated Na channels open
During diastole
LAD - V1- V2

46. in the JVP - What is the v wave?
Inc RA pressure - due to filling against closed tricupsid valve
Mitral>aortic>>tricuspid - high pressure valves affected most
Left heart failure
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

47. benign cap hemangioma of infancy - spont regresses
In parallel
Strawberry hemangioma
Prinzmetal angina
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

48. Wegener's presentation
Inc TPR and LA return (expiration)
Decrease in activity of Na/Ca exhanger and increase in contractility
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Persistant truncus arteriosus

49. in the JVP - What is the c wave?
Tempral arteritis - may cause irreversible blindness
Ischemic heart dz - mitral valve prolapse - LV dilation
Libman - sacks endocarditis
RV contraction (closed tricuspid valve bulding into atrium

50. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
ANP
Filling is incomplete and CO falls
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence