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Test your basic knowledge |
Cardiology
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Study First
Subject
:
health-sciences
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. What causes ankle - sacral edema - jugular venous distention
RF
RV failure - in venous pressure
Decreased
LAD > RCA > circumflex
2. Which bacteria can cause endocarditis from prosthetic valves?
ASD
Increasing activity of Ca pump in SR
S. epidermidis
Eisenmenger's syndrome
3. Restrictive cardiomyopathy causes
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Increase intracellular Na - resulting in increased Ca
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
MAP
4. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?
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5. What is the characteristic pulse in aortic stenosis?
3rd degree block - pacemaker - Lyme disease
Aortic insuffic - late
Inc RA pressure - due to filling against closed tricupsid valve
Pulsus parvus and tardus - weak - can lead to syncope
6. Mitral stenosis is most often secondary to which condition?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Vasocxn
RF
5-10 days - macs have degraded structural components
7. Which artery supplies the inferior portion of the left ventricle and posterior septum?
No
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Posterior descending (80% off the RCA - 20% off the circumflex)
Medullary vasomotor center senses baroreceptors and JGA
8. friction rub - 3-5 days post MI
Cardiac tamponde
Postinfarction fibrinous pericarditis
Proportional to viscosity and inversely proportional to the radius to the 4th power
CFX
9. fibrous plaques and atheromas in intima of arteries
Kidney
Stable angina
Cardiac tamponde
Atherosclerosis
10. Which area of the endocardium is especially vulnerable to infarction? Why?
Subendocardial - fewer collaterals and higher pressure
Apex and anterior interventricular septum
Pos inotropy - exercise
Decreased
11. Which lab value indicates blood viscosity?
LAD - V1- V2
Unstable/crescendo angina
Transposition of great vessels
Hematocrit
12. which heart valves are afected most in rheumatic heart diseease
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Aortic insuffic - late
LCX - V4- V6
Mitral>aortic>>tricuspid - high pressure valves affected most
13. What is the time frame for arrhythmia risk in the evolution of MI
Dilation
The first 4 days
Total anomalous pulmonary trunk venous return
Fetal right to left - neonate left to right leading to RVH and failure
14. What causes orthopnea?
Troponin I
Inc venous return exaccerbates pulm vasc congestion
Increase intracellular Na - resulting in increased Ca
LAD
15. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
The plateau period
Inc Kf - capillary perm
Eisenmenger's syndrome
Fick principle
16. What is the association with wide S2 splitting?
Pulmonic stenosis and RBBB
Metastasis from melanoma or lymphoma
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Heart - 02 extraction is always around 100%
17. Which organ has the largest arteriovenous difference
Heart - 02 extraction is always around 100%
Posterior descending (80% off the RCA - 20% off the circumflex)
Dec P02 - inc PC02 and dec pH
Extracellular calcium - calcium induced calcium release
18. When do coronary arteries fill?
Stroke volume
Decreases
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
During diastole
19. Inspiration causes an increase in which sided heart sounds?
Right sided
Hemorrhage
R to L shunt caused by stenoic pulmonic valve
Transmural
20. Which two mechanisms sense decrease MAP?
Preload
Inc venous return exaccerbates pulm vasc congestion
Medullary vasomotor center senses baroreceptors and JGA
QRS complex
21. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Preload
MAP
Fetal right to left - neonate left to right leading to RVH and failure
Decreases
22. Expiration causes an increase in which sided heart sounds
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Left sided
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
23. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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24. What are the 5 T's of cyanoitc babies
TAPVR
5-10 days - macs have degraded structural components
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
25. What happends in phase 1 of the ventricular cardiac action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Aortic stenosis or LBBB
Angiosarcoma
26. congenital heart defect with congenital rubella
Fluid movement through capillaries
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Septal defects - PDA - pulm art stenosis
RV contraction (closed tricuspid valve bulding into atrium
27. The carotid sinus transmits along which nerve?
Dec P02 - inc PC02 and dec pH
MI
RF
Glossopharyngeal to soliary nucleus of medulla
28. What 4 things drive myocardial 02 demand?
Arteriorles
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
2-4 day - early coag necrosis on the first day
Temporal arteritis
29. CO x Total peripheral resistance
2-4 day - early coag necrosis on the first day
Mean arterial pressure
SV/ EDV
Dressler's - autoimmune
30. What are common causes of mitral regurg?
Diastolic
Tempral arteritis - may cause irreversible blindness
Ischemic heart dz - mitral valve prolapse - LV dilation
If sodium channel
31. How does digitatlis increase contractility?
Posterior descending (80% off the RCA - 20% off the circumflex)
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Dressler's - autoimmune
Increase intracellular Na - resulting in increased Ca
32. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
RF
Resting potential high K perm
Viridans streptococci
Kawasaki
33. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
MI
Medullary vasomotor center senses baroreceptors and JGA
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Sturge weber - vasculitis of caps
34. Which kind of infarct show ST elevation - and/or pathologic Q waves
Aortic and pulmonary closing
Transmural
Patent ductus arteriosus - congenital rubella or prematurity
S. bovis
35. Why is contractility decreased in heart failure?
Cardiac tamponde
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Systolic dysfunction
Volatage gated Ca channels
36. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Aortic disecction - intraluminal tear forming false lumen
Kids
MI
Left heart failure
37. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Aortic disecction - intraluminal tear forming false lumen
Dec plasma proteins
Aortic dilation - bicuspid aortic valve - RF -
Microscopic polyangiitis - like wegener's without granulomas
38. What causes the CO curve to shift upwards?
Angiosarcoma
Persistant truncus arteriosus
Pos inotropy - exercise
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
39. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
LAD
SA and AV nodes
LAD > RCA > circumflex
40. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
V fib
Fast volatge gated Na channels
LV failure - pulm venous distention transudation of fluid
Liver
41. In an anterolateral infarct - which artery is effected and which leads show Q waves
3rd degree block - pacemaker - Lyme disease
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic and pulmonary closing
LCX - V4- V6
42. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Left sided
Unstable/crescendo angina
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Polyarteritis nodosum
43. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Cherry hemangioma
Left atrial pressure
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
44. polypoid capillary hemangioma that can ulcerate and bleed
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Septal defects - PDA - pulm art stenosis
Pyogenic granuloma - associated with trauma and pregnancy
Mitral>aortic>>tricuspid - high pressure valves affected most
45. When and why is the S3 sound heard?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Vagus to medulla
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
ANP
46. cavernous lymphangioma of the neck - associated with turner's
Cystic hygroma
Yes
Ventricular depolarization - nl < 120 msec
Cyclophosphamide and corticosteroids
47. benign cap hemangioma of infancy - spont regresses
Liver
Strawberry hemangioma
Acute thrombosis of coronary artery
Rhabdomyomas
48. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Pulmonic stenosis and RBBB
Aortic/pulmonic stenosis and mitral/tricuspid regurg
49. no relation between p waves and QRS intervals - treatment and predisposing factor
2-4 day - early coag necrosis on the first day
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
3rd degree block - pacemaker - Lyme disease
Mechanican contraction of the ventricles
50. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Left heart failure
Mitral stenosis
Stable angina
Sudden tensing of chordae tendinae
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