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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. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Temporal arteritis
Arteriorles
Inc Kf - capillary perm
Dilated cardiomyopathy

2. Wegener's presentation
1st degree AV blodck
Myxoma
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
SV/ EDV

3. which ethnic groups have higher association with HTN?
LCX - I - aVL
Transmural
Black > white > asian
Ventricles are depolarized

4. In an EKG - What is the T wave?
Ventricular repolarization
Stroke volume
Cherry hemangioma
Right sided

5. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Eccentric - concentric hypertrophy causes diastolic disfunction
Babies
Ventricular depolarization - nl < 120 msec
Maintain blood flow to organ over wide range of perfussion pressures

6. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
Mitral>aortic>>tricuspid - high pressure valves affected most
Rapid upstroke - voltage gated Na channels open
In parallel

7. Which lab value indicates blood viscosity?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Takayasu's arteritis
Sturge weber - vasculitis of caps
Hematocrit

8. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Dilation
Ischemic heart dz - mitral valve prolapse - LV dilation
Non
Transmural

9. polypoid capillary hemangioma that can ulcerate and bleed
Infective endocarditis
Transfusion
Cherry hemangioma
Pyogenic granuloma - associated with trauma and pregnancy

10. What does the U wave indicated?
Pulmonic stenosis and RBBB
Ventricles are depolarized
Lymphangiosarcoma
HypoK and bradycardia

11. What is the time frame for arrhythmia risk in the evolution of MI
Strawberry hemangioma
The first 4 days
Early deaths from myocarditis
Stable angina

12. What do patients die early from in rheumatic heart disease?
Early deaths from myocarditis
LAD
Microscopic polyangiitis - like wegener's without granulomas
Late diastolic murmur following an opening snap

13. cavernous lymphangioma of the neck - associated with turner's
Crescendo - decrescendo systolic ejection murmur following ejection click
Prinzmetal angina
Cystic hygroma
CO

14. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Buerger's disease
QRS complex
Myxoma
Angiosarcoma

15. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Tricuspid atresia - requires ASD and VSD
Eisenmenger's syndrome
QRS complex

16. How are cadiac myocytes eltrically coupled?
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Vagus to medulla
Gap junctions
Changes in CO as a function of preload

17. Left to right shunts are more common in babies or kids?
Temporal arteritis
Filling is incomplete and CO falls
Kids
Lymphangiosarcoma

18. congenital heart defect with congenital rubella
Increased efferent SANS and decreased efferent PANS
Inc interstitial osmotic pressure pulling fliud out of capillaries
Turners
Septal defects - PDA - pulm art stenosis

19. What causes hepatomegaly?
Stroke volume affected by contractility - afterload - and preload
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Inc central venous pressure - inc resistance to portal flow

20. Churg Strauss - presentation and test
HTN - bradycardia - and respiratory depression
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Proportional to viscosity and inversely proportional to the radius to the 4th power
Viridans streptococci

21. What 4 things drive myocardial 02 demand?
No
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Aortic/pulmonic stenosis and mitral/tricuspid regurg

22. p - anca

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23. When does extracellular calcium enter the cardiac muscle cells during contraction?
Purkingee>atria>ventricles>AV node
Gap junctions
The plateau period
In RA return (inspiration)

24. What are the complications of atherosclerosis?
Transfusion
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Heart - 02 extraction is always around 100%
Can progess to V fib

25. Which class of drugs decreases afterload?
LAD > RCA > circumflex
Vasodilators - (hydrAlAzine)
Coarcation of aorta
Vasocxn

26. What stimulates release of calcium from the SR?
LAD > RCA > circumflex
Hemorrhage
Extracellular calcium - calcium induced calcium release
RF

27. PROVe
Stroke volume affected by contractility - afterload - and preload
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
1st degree AV blodck
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

28. What supplies the posterior left ventricle?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
CFX
During HF from microhemorrhages from inc pulm cap pressure
Kidney

29. Given P = QR - what factors influence resistance?
Acute thrombosis of coronary artery
Pulsus parvus and tardus - weak - can lead to syncope
Proportional to viscosity and inversely proportional to the radius to the 4th power
RCA

30. In an EKG - What is the QT interval?
Hemorrhage
Coarcation of aorta
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Mechanican contraction of the ventricles

31. What does an isoelectric ST segment indicate?
Stroke volume affected by contractility - afterload - and preload
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Ventricles are depolarized
Fast volatge gated Na channels

32. What other sign is often present with congenital long QT syndrome - why?
Early deaths from myocarditis
Heart - 02 extraction is always around 100%
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Viridans streptococci

33. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
Kaposi's sarcoma
Posterior descending (80% off the RCA - 20% off the circumflex)
Aortic dilation - bicuspid aortic valve - RF -

34. sawtooth wave

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35. fibrinous pericarditis several weeks post MI

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36. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Apex and anterior interventricular septum
Decreased
Lymphangiosarcoma
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

37. What is the definition of HTN?
Indomethacin closes - and pge keeps it open
140/90
SA and AV nodes
Changes in CO as a function of preload

38. benign cap hemangioma of infancy - spont regresses
Increasing activity of Ca pump in SR
Vasodilators
Strawberry hemangioma
Cyclophosphamide and corticosteroids

39. Expiration causes an increase in which sided heart sounds
LAD - V1 - V4
Squat. Compression of femoral arteries - inc TPR - dec
Left sided
Early deaths from myocarditis

40. When and why is the S3 sound heard?
Wegener's
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Viridans streptococci
Torsades de pointes

41. What is the formula for EF?
Rhabdomyomas
LCX - I - aVL
SV/ EDV
Henoch - Schlonlein purpura

42. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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43. Which valve is most commonly involved in bacterial endocarditis?
Arteriolosclerosis in malignant hypertension
Inc Kf - capillary perm
Mitral valve
Babies

44. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Glomus tumor
Fluid movement through capillaries
Sudden tensing of chordae tendinae
Dressler's - autoimmune

45. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
RV contraction (closed tricuspid valve bulding into atrium
Mitral valve prolapse
Sturge weber - vasculitis of caps

46. Which murmur is characteristic of mitral/tricuspid regurg?
QRS complex
Indomethacin closes - and pge keeps it open
Holosystoiic
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

47. Inspiration causes an increase in which sided heart sounds?
Patent ductus arteriosus - congenital rubella or prematurity
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Right sided
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

48. coronary artery spasm - ST elevation
Glossopharyngeal to soliary nucleus of medulla
Turners
Isovolumetric contraction
Prinzmetal angina

49. What kind of infarct show ST depression
Subendocardial
Aortic disecction - intraluminal tear forming false lumen
Right sided
RCA

50. What does FAN MY SKIN On Wednesday stand for?
LAD
Pyogenic granuloma - associated with trauma and pregnancy
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities