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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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1. Rank the pacemakers cells
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
SA>AV>bundle of His>ventricles
Dec P02 - inc PC02 and dec pH
Right sided

2. no change in PR interval followed by dropped beat
Vagus to medulla
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
LCX - V4- V6

3. What other syndrom is associated with infantile aortic coarctation
Atrial contraction
The aortic before pulmonic - inspiration increases diff
Left sided
Turners

4. What does FAN MY SKIN On Wednesday stand for?
Adult type aortic coarctation
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Atherosclerosis
The first 4 days

5. serum marker for wegener's
Vasodilators
C - ANCA
Maintain blood flow to organ over wide range of perfussion pressures
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

6. in the JVP - What is the v wave?
Resting potential high K perm
Cystic hygroma
Total anomalous pulmonary trunk venous return
Inc RA pressure - due to filling against closed tricupsid valve

7. What are aschoff bodies
RV failure - in venous pressure
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Granuloma with giant cells

8. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Hyperlipidemia
Vasodilators - (hydrAlAzine)
Decreases
2-4 day - early coag necrosis on the first day

9. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dilated cardiomyopathy
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Vagus to medulla
S. bovis

10. What happens with a decrease of extracellular Na
Indomethacin closes - and pge keeps it open
Dressler's - autoimmune
Decrease in activity of Na/Ca exhanger and increase in contractility
Acute thrombosis of coronary artery

11. Exercise - overtransfusiion and excitiment causes and increase in...?
Neg inotropy - HF - narcotic overdose
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Preload
V fib arrhythima

12. congenital heart defect in an infant with a diabetic mother?
LAD > RCA > circumflex
Transposition of great vessels
Inc TPR and LA return (expiration)
Truncus - tet of fallot

13. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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14. In an EKG - What is the T wave?
Chordae rupture - GN - suppurative pericarditis - emboli
Boot shaped heart
Ventricular repolarization
Indomethacin closes - and pge keeps it open

15. Restrictive cardiomyopathy causes
Mitral>aortic>>tricuspid - high pressure valves affected most
Lymphangiosarcoma
Glomus tumor
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

16. What is the early and late lesion in rheumatic heart disease
Mitral valve prolapse
Aortic insuffic - late
Increase in Pc
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

17. In an EKG - What is the QT interval?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Systolic dysfunction
Inc Kf - capillary perm
Mechanican contraction of the ventricles

18. What is the S2 sound?
EKG
Aortic and pulmonary closing
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

19. Which bacteria can cause endocarditis from prosthetic valves?
Purkingee>atria>ventricles>AV node
Granuloma with giant cells
S. epidermidis
During diastole

20. How does acidosis affect contractility?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Decreased
5-10 days - macs have degraded structural components
MI

21. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Septal defects - PDA - pulm art stenosis
Torsades de pointes
HTN - bradycardia - and respiratory depression

22. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Fick principle
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Proportional to viscosity and inversely proportional to the radius to the 4th power
Isovolumetric contraction

23. In the cardiac cycle - which period has the highest 02 consumption?
Cystic hygroma
Isovolumetric contraction
Inc RA pressure - due to filling against closed tricupsid valve
V fib

24. in the JVP - What is the a wave?
Transposition of great vessels
Atrial contraction
Early deaths from myocarditis
S. bovis

25. In an EKG - What is the QRS complex?
At least 55%
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
SA>AV>bundle of His>ventricles
Ventricular depolarization - nl < 120 msec

26. When do coronary arteries fill?
During diastole
LCX - I - aVL
Systolic dysfunction
Septal defects - PDA - pulm art stenosis

27. In an anterolateral infarct - which artery is effected and which leads show Q waves
Kawasaki
Babies
LCX - V4- V6
Buerger's disease

28. What does T wave inversion indicated?
Hypertrophied cardiomyopathy
MI
Decreased
Subendocardial

29. Hyperplastic onion skinning
HypoK and bradycardia
Arteriolosclerosis in malignant hypertension
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Conduction delay through AV node - nl < 200 msec

30. fibrinous pericarditis several weeks post MI

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31. no relation between p waves and QRS intervals - treatment and predisposing factor
Mean arterial pressure
10%
3rd degree block - pacemaker - Lyme disease
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

32. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Sudden tensing of chordae tendinae
TAPVR
Coarcation of aorta
S. epidermidis

33. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Mean arterial pressure
During HF from microhemorrhages from inc pulm cap pressure
Transfusion
CK- MB

34. How does aldosterone raise MAP
Inc blood volume
Afterload (proportional to peripheral resistance)
Sudden tensing of chordae tendinae
Aortic insuffic - late

35. What causes tet of fallot?
Left heart failure
No - no pressure gradient
Anterosuperior displacement of the infundibular septum
CK- MB

36. Which bacteria causes endocarditis in the presence of colon cancer
Total anomalous pulmonary trunk venous return
S. bovis
140/90
Aortic disecction - intraluminal tear forming false lumen

37. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Atherosclerosis
Transmural
Non

38. When does EF decrease
Coarcation of aorta
In HF
Babies
Temporal arteritis

39. what percentage of HTN is secondary to renal disease?
10%
Increased efferent SANS and decreased efferent PANS
Mitral and tricuspid closure
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

40. Which organ has ht highest blood flow per gram of tissue
Tempral arteritis - may cause irreversible blindness
Mitral valve prolapse
Kidney
Non

41. What is sudden cardiac death most commonly due to...
...
V fib arrhythima
Atherosclerosis
Cyclophosphamide and corticosteroids

42. benign cap hemangioma of infancy - spont regresses
During diastole
Non
Strawberry hemangioma
1st degree AV blodck

43. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Holosystoiic
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Babies
Eccentric - concentric hypertrophy causes diastolic disfunction

44. Unilateral headache - jaw claudication - impaired vision
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Tempral arteritis - may cause irreversible blindness
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

45. What other sign is often present with congenital long QT syndrome - why?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
In series
Prinzmetal angina
Septal defects - PDA - pulm art stenosis

46. What constitues the upstroke in pacemaker cells?
Diastolic
Right sided
Volatage gated Ca channels
Kidney

47. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
P02
Holosystoiic
Pyogenic granuloma - associated with trauma and pregnancy

48. What is the progression of atherosclerosis?
2nd degree AV block - mobitz type 1
Stroke volume
Inc blood volume
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

49. What is the most common cause of right heart failure
Transposition of great vessels
QRS complex
Left heart failure
R to L shunt caused by stenoic pulmonic valve

50. What do the carotid and aortic bodies respond to?
MI
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Tricuspid atresia - requires ASD and VSD
Dec P02 - inc PC02 and dec pH