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Cardiology

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Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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1. In an EKG - What is the QT interval?
Inc central venous pressure - inc resistance to portal flow
P02
Mechanican contraction of the ventricles
Volatage gated Ca channels

2. What is the gold standard for dx of MI in the first 6 hours
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Libman - sacks endocarditis
Failure of LV to in CO during exercise
EKG

3. what percentage of HTN is secondary to renal disease?
CK- MB
TAPVR
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
10%

4. What is a normal EF
Afterload (proportional to peripheral resistance)
Arteriorles
At least 55%
Kidney

5. PCWP is an estimate of...
Left atrial pressure
S. epidermidis
S. aureus
Increased efferent SANS and decreased efferent PANS

6. 2/3 diastolic + 1/3 systolic
No
Varicose veins - thromboembolism rare
MAP
Increase in Pc

7. Where are pacemaker cells?
Hyperlipidemia
The aortic before pulmonic - inspiration increases diff
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
SA and AV nodes

8. How does a patient with Tet of fallot learn to improve symptoms?
Left sided
Boot shaped heart
RV failure - in venous pressure
Squat. Compression of femoral arteries - inc TPR - dec

9. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
LCX - V4- V6
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

10. What is the classic X ray finding for tet of fallot?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Boot shaped heart
ANP
Total anomalous pulmonary trunk venous return

11. which medications are used to maintain patency or close the ductus arteriosus?
Anterosuperior displacement of the infundibular septum
Indomethacin closes - and pge keeps it open
If sodium channel
Inc interstitial osmotic pressure pulling fliud out of capillaries

12. Where does coronary artery occlusion occur most commonly?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Inc interstitial osmotic pressure pulling fliud out of capillaries
LAD
V fib arrhythima

13. What stimulates release of calcium from the SR?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Extracellular calcium - calcium induced calcium release
Troponin I
Increased efferent SANS and decreased efferent PANS

14. What happens in phase 2 of the cardiac ventricular action potential?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
140/90
LAD > RCA > circumflex
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

15. list the coronary vessels most likely to be occluded
Takayasu's arteritis
LAD > RCA > circumflex
Fetal right to left - neonate left to right leading to RVH and failure
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

16. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Atherosclerosis
Right sided
Truncus - tet of fallot
Sturge weber - vasculitis of caps

17. What does the LAD supply?
Apex and anterior interventricular septum
In RA return (inspiration)
HTN - bradycardia - and respiratory depression
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

18. What causes the CO curve to shift downwards?
Mean arterial pressure
Venodilators (nitrogylcerine)
Neg inotropy - HF - narcotic overdose
V fib

19. What is indicated when CO and venous return are equal?
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
1st degree AV blodck
SV/ EDV
The operating point of the heart

20. exaggerated decrease in pulse during inspiration.

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21. What does the starling curve show?
Acute thrombosis of coronary artery
Isovolumetric contraction
Changes in CO as a function of preload
Can progess to V fib

22. disease of elastic arteries and large and medium sized muscular arteries
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Atherosclerosis
Crescendo - decrescendo systolic ejection murmur following ejection click
Sturge weber - vasculitis of caps

23. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Pulmonic stenosis and RBBB
Vasodilators
Cardiac tamponde
During HF from microhemorrhages from inc pulm cap pressure

24. Which organ gets the largest share of systemic cardiac output
Glomus tumor
Liver
Isovolumetric contraction
During diastole

25. congenital heart defect with marfan's
Aortic insuffic - late
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Kaposi's sarcoma
ANP

26. Right to left shunts are more common in babies or kids?
Babies
Atherosclerosis
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Libman - sacks endocarditis

27. Which class of drugs decreases afterload?
Heart - 02 extraction is always around 100%
RV failure - in venous pressure
Holosystoiic
Vasodilators - (hydrAlAzine)

28. most common heart tumor
MI
Metastasis from melanoma or lymphoma
Turners
During diastole

29. What does FEVERSS stand for in rheumatic heart disease
ASD - VSD - AV septal defect (endocardial cushion defect)
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Granuloma with giant cells

30. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
During diastole
Left atrial pressure
Pulsus parvus and tardus - weak - can lead to syncope

31. Which enzymes are useful for diagnosing reinfarction
CK- MB
Inc venous return exaccerbates pulm vasc congestion
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Temporal arteritis

32. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Hematocrit
LV failure - pulm venous distention transudation of fluid

33. Which valve is most commonly involved in bacterial endocarditis?
RCA - II - III - aVF
Mitral valve
Increase in Pc
Aortic/pulmonic stenosis and mitral/tricuspid regurg

34. polypoid capillary hemangioma that can ulcerate and bleed
Increased SV
Pyogenic granuloma - associated with trauma and pregnancy
Lymphangiosarcoma
R to L shunt caused by stenoic pulmonic valve

35. PCWP > LV diastolic pressure
Mitral stenosis
Inc central venous pressure - inc resistance to portal flow
QRS complex
Subendocardial

36. dyspnea - fatigue - edema and rales - multiple causes
Kids
Angiosarcoma
CHF
Aortic/pulmonic regurg and mitral/tricuspid stenosis

37. What causes the murmur heard in tricuspid regurg to enhance
Mitral stenosis
Pulmonary flow murmur and diastolic rumble
In RA return (inspiration)
Truncus - tet of fallot

38. clinical signs of cardiac tamponade
Vagus to medulla
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Dilation
Extracellular calcium - calcium induced calcium release

39. Which murmur is heard with VSD?
Pulmonic stenosis and RBBB
1st degree AV blodck
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Transmural

40. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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41. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Early deaths from myocarditis
Wegener's
Dilation

42. When do coronary arteries fill?
The plateau period
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Henoch - Schlonlein purpura
During diastole

43. machine murmer
PDA
Changes in CO as a function of preload
Volatage gated Ca channels
RF

44. What are the complications from bacterial endocarditis?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
QRS complex
Chordae rupture - GN - suppurative pericarditis - emboli
Non

45. What happends in phase 1 of the ventricular cardiac action potential?
Aortic stenosis or LBBB
Fast volatge gated Na channels
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
EKG

46. congenital heart defect with 22q11
LAD > RCA > circumflex
Indomethacin closes - and pge keeps it open
Aortic insuffic - late
Truncus - tet of fallot

47. The aortic arch receptors transmit along which nerve?
Vagus to medulla
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Changes in CO as a function of preload
Granuloma with giant cells

48. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
HTN - bradycardia - and respiratory depression
S. epidermidis
Angiosarcoma

49. How does acidosis affect contractility?
Decreased
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Dilated cardiomyopathy
Mitral and tricuspid closure

50. In an EKG - What is the p wave?
Atrial contraction
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Late diastolic murmur following an opening snap
Fluid movement through capillaries

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Cardiology

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