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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. tearing chest pain radiation to the back - associated with marfan
CFX
Aortic disecction - intraluminal tear forming false lumen
Increased SV
Increase intracellular Na - resulting in increased Ca

2. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
HTN - bradycardia - and respiratory depression
Viridans streptococci
Left heart failure
Libman - sacks endocarditis

3. In an anterior wall infarct - which artery is effected and which leads show Q waves
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
LAD - V1 - V4
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Conduction delay through AV node - nl < 200 msec

4. In an EKG - What is the QT interval?
Yes
Mechanican contraction of the ventricles
CO
Vasodilators - (hydrAlAzine)

5. In an inferior wall infarct - which artery is affected and which leads show Q waves
Metastasis from melanoma or lymphoma
RCA - II - III - aVF
Fast volatge gated Na channels
Aortic disecction - intraluminal tear forming false lumen

6. What do the starling forces determine
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Non
RV failure - in venous pressure
Fluid movement through capillaries

7. serum marker for wegener's
Heart - 02 extraction is always around 100%
C - ANCA
QRS complex
Boot shaped heart

8. Which area of the endocardium is especially vulnerable to infarction? Why?
...
Increase contractility
Subendocardial - fewer collaterals and higher pressure
Left heart failure

9. Which class of drugs decrease preload
Eisenmenger's syndrome
Venodilators (nitrogylcerine)
Inc RA pressure - due to filling against closed tricupsid valve
Heart - 02 extraction is always around 100%

10. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Unstable/crescendo angina
Inc TPR and LA return (expiration)
Eccentric - concentric hypertrophy causes diastolic disfunction
V fib

11. Central chemoreceptors do not respond directly to which parameter?
Henoch - Schlonlein purpura
Aburpt halting of valve leaflets
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
P02

12. What are the different etiologies of dialted cardiomyopathy
Mitral>aortic>>tricuspid - high pressure valves affected most
Systolic dysfunction
RV contraction (closed tricuspid valve bulding into atrium
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

13. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Subendocardial
Medullary vasomotor center senses baroreceptors and JGA
Metastasis from melanoma or lymphoma

14. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Apex and anterior interventricular septum
Strawberry hemangioma

15. congenital heart defect in an infant with a diabetic mother?
Atherosclerosis
Systolic dysfunction
Transposition of great vessels
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

16. fibrous plaques and atheromas in intima of arteries
Decrease in activity of Na/Ca exhanger and increase in contractility
Atherosclerosis
Mitral valve
Polyarteritis nodosum

17. sawtooth wave

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18. Irregularly irregular ECG - no p waves: dx and treatment
Cardiac tamponde
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
In parallel

19. What does hypoxia cause in the lung versus other tissues?
Postinfarction fibrinous pericarditis
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Vasocxn - while other tissues it causes vasodilation
P02

20. no relation between p waves and QRS intervals - treatment and predisposing factor
Takayasu's arteritis
Right sided
Aortic/pulmonic regurg and mitral/tricuspid stenosis
3rd degree block - pacemaker - Lyme disease

21. decrease stretch in baroreceptors leads to what response?
Increased SV
Increased efferent SANS and decreased efferent PANS
P02
Eccentric - concentric hypertrophy causes diastolic disfunction

22. What is the machine like murmur? What is the heart pathology and the predisposing causes
Arteriorles
Patent ductus arteriosus - congenital rubella or prematurity
Inc interstitial osmotic pressure pulling fliud out of capillaries
In series

23. In an EKG - What is the p wave?
Libman - sacks endocarditis
Liver
Atrial contraction
Torsades de pointes

24. When do coronary arteries fill?
Aortic and pulmonary closing
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
During diastole
CHF

25. What does the U wave indicated?
Hemorrhage
1st degree AV blodck
HypoK and bradycardia
Aortic stenosis or LBBB

26. How does angiotensin II raise MAP
Vasocxn
Wolff - Parkinson white syndrome
5-10 days - macs have degraded structural components
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

27. Which bacteria causes endocarditis in the presence of colon cancer
Kaposi's sarcoma
Henoch - Schlonlein purpura
Angiosarcoma
S. bovis

28. Which organ has the largest arteriovenous difference
LAD > RCA > circumflex
Heart - 02 extraction is always around 100%
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Pos inotropy - exercise

29. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
Left sided
5-10 days - macs have degraded structural components
Can progess to V fib

30. what percentage of HTN is secondary to renal disease?
HypoK and bradycardia
Wegener's
P02
10%

31. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Rapid upstroke - voltage gated Na channels open
Adult type aortic coarctation
Subendocardial - fewer collaterals and higher pressure
ANP

32. prolonged PR interval
Mitral valve
ANP
1st degree AV blodck
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

33. failure of truncus arteriosus to divide?
Stable angina
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Persistant truncus arteriosus
Apex and anterior interventricular septum

34. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Mean arterial pressure
MI
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Unstable/crescendo angina

35. What is the classic X ray finding for tet of fallot?
Boot shaped heart
SA and AV nodes
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

36. with what heart sounds do ASD usually present?
Vasodilators
5-10 days - macs have degraded structural components
Pulmonary flow murmur and diastolic rumble
Inc central venous pressure - inc resistance to portal flow

37. What is the early and late lesion in rheumatic heart disease
Mitral valve prolapse
LAD
Dilation
In parallel

38. What channels do the the pacemaker cells lack?
Early deaths from myocarditis
Temporal arteritis
Fast volatge gated Na channels
HypoK and bradycardia

39. What are the systolic heart sounds
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Changes in CO as a function of preload
Aburpt halting of valve leaflets

40. How do beta blockers decrease contractility?
Decrease in cAMP
Atherosclerosis
Decreased
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

41. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
LCX - I - aVL
Tempral arteritis - may cause irreversible blindness
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

42. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
No - no pressure gradient
Preload
Wegener's
Diastolic

43. Which murmur is characteristic of mitral/tricuspid regurg?
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Temporal arteritis
During diastole
Holosystoiic

44. What can cause mitral prolapse?
Vasodilators
1st degree AV blodck
Resting potential high K perm
Myxomatous degeneration - RF - chordae rupture

45. What does TAPVR stand for
Systolic dysfunction
Inc venous return exaccerbates pulm vasc congestion
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Total anomalous pulmonary trunk venous return

46. What are the complications from bacterial endocarditis?
Mitral and tricuspid closure
Inc blood volume
Chordae rupture - GN - suppurative pericarditis - emboli
Takayasu's arteritis

47. Which lab value indicates blood viscosity?
Mitral>aortic>>tricuspid - high pressure valves affected most
In series
Hematocrit
Squat. Compression of femoral arteries - inc TPR - dec

48. When does extracellular calcium enter the cardiac muscle cells during contraction?
No
The plateau period
7 weeks
Wolff - Parkinson white syndrome

49. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Decreases
Non
7 weeks
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

50. What cardiac change occurs in pregnancy?
RF
Decreases
Increased SV
Turners