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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. congenital heart defect with congenital rubella
P02
Arteriorles
Septal defects - PDA - pulm art stenosis
Mitral valve prolapse

2. What happens in phase 3 of the cardiac ventricular action potential?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Ventricles are depolarized
The plateau period
Eccentric - concentric hypertrophy causes diastolic disfunction

3. What is the gold standard for dx of MI in the first 6 hours
Purkingee>atria>ventricles>AV node
EKG
Myxoma
Aburpt halting of valve leaflets

4. What causes the ejection click in the Cres - decres murmur?
SA and AV nodes
HTN - bradycardia - and respiratory depression
RCA
Aburpt halting of valve leaflets

5. What is the most common cause of right heart failure
Posterior descending (80% off the RCA - 20% off the circumflex)
Hemorrhage
Left heart failure
Isovolumetric contraction

6. no relation between p waves and QRS intervals - treatment and predisposing factor
S. aureus
3rd degree block - pacemaker - Lyme disease
In HF
Mitral valve prolapse

7. What does prolonged QT predispose to?
Failure of LV to in CO during exercise
Torsades de pointes
Persistant truncus arteriosus
Mechanican contraction of the ventricles

8. What causes hepatomegaly?
ASD
Lymphangiosarcoma
Myxomatous degeneration - RF - chordae rupture
Inc central venous pressure - inc resistance to portal flow

9. Which organ has the largest arteriovenous difference
SV/ EDV
Extracellular calcium - calcium induced calcium release
Granuloma with giant cells
Heart - 02 extraction is always around 100%

10. Which lab value indicates blood viscosity?
At least 55%
RCA
Hematocrit
Aortic disecction - intraluminal tear forming false lumen

11. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
LAD - V1- V2
Systolic dysfunction
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Changes in CO as a function of preload

12. How does a patient with Tet of fallot learn to improve symptoms?
Squat. Compression of femoral arteries - inc TPR - dec
Angiosarcoma
Decrease in cAMP
Transfusion

13. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
Gap junctions
Eisenmenger's syndrome
PDA

14. How are cadiac myocytes eltrically coupled?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
The first 4 days
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Gap junctions

15. What supplies the posterior left ventricle?
Aortic and pulmonary closing
Takayasu's arteritis
MI
CFX

16. in the JVP - What is the a wave?
Atrial contraction
S. bovis
Extracellular calcium - calcium induced calcium release
SA>AV>bundle of His>ventricles

17. coronary artery spasm - ST elevation
ASD
Dilated cardiomyopathy
Prinzmetal angina
Chordae rupture - GN - suppurative pericarditis - emboli

18. What does mitral prolapse predeispose to?
MI
Persistant truncus arteriosus
Postinfarction fibrinous pericarditis
Infective endocarditis

19. disease of elastic arteries and large and medium sized muscular arteries
Arteriolosclerosis in malignant hypertension
Mean arterial pressure
Atherosclerosis
Filling is incomplete and CO falls

20. What channels do the the pacemaker cells lack?
Fast volatge gated Na channels
Mechanican contraction of the ventricles
Decreased
...

21. What is the progression of atherosclerosis?
Libman - sacks endocarditis
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
HypoK and bradycardia
Cherry hemangioma

22. In an EKG - What is the p wave?
Ventricular depolarization - nl < 120 msec
Raynaud's
Varicose veins - thromboembolism rare
Atrial contraction

23. How does digitatlis increase contractility?
Cyclophosphamide and corticosteroids
Increase intracellular Na - resulting in increased Ca
Volatage gated Ca channels
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

24. What cardiac change occurs in pregnancy?
Tempral arteritis - may cause irreversible blindness
Babies
Greater ventricular EDV
Increased SV

25. Which channel accounts for automaticity of the SA and AV nodes?
PDA
Strawberry hemangioma
If sodium channel
LCX - V4- V6

26. How does angiotensin II raise MAP
Vasocxn
Troponin I
CO
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

27. Which two mechanisms sense decrease MAP?
Ischemic heart dz - mitral valve prolapse - LV dilation
CO
Medullary vasomotor center senses baroreceptors and JGA
Volatage gated Ca channels

28. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
1st degree AV blodck
Squat. Compression of femoral arteries - inc TPR - dec

29. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
V fib
Aortic stenosis or LBBB
Volatage gated Ca channels

30. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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31. failure of truncus arteriosus to divide?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
HTN - bradycardia - and respiratory depression
V fib
Persistant truncus arteriosus

32. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Septal defects - PDA - pulm art stenosis
Dec plasma proteins
TAPVR

33. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
S. bovis
Inc RA pressure - due to filling against closed tricupsid valve
Inc interstitial osmotic pressure pulling fliud out of capillaries
LV failure - pulm venous distention transudation of fluid

34. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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35. What are the systolic heart sounds
Ventricles are depolarized
Microscopic polyangiitis - like wegener's without granulomas
Atherosclerosis
Aortic/pulmonic stenosis and mitral/tricuspid regurg

36. What is associated with paradoxical spliting of S2
Torsades de pointes
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Aortic stenosis or LBBB
Hematocrit

37. Expiration causes an increase in which sided heart sounds
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Arteriorles
Mitral and tricuspid closure
Left sided

38. Which murmur is heard with VSD?
RCA - II - III - aVF
Holosystolic - harsh sounding murmur - loudest over tricuspid area
MI
During diastole

39. no change in PR interval followed by dropped beat
Group a beta hemolytic strep
Ventricles are depolarized
140/90
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

40. sawtooth wave

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41. Which murmur is heard in aortic stenosis?
Liver
Crescendo - decrescendo systolic ejection murmur following ejection click
Viridans streptococci
Ischemic heart dz - mitral valve prolapse - LV dilation

42. What are the complications of atherosclerosis?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Takayasu's arteritis
Vasodilators

43. What is the S1 sound?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Atrial contraction
Mitral and tricuspid closure
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

44. what conditions are associated with pulsus paradoxus
Subendocardial
MI
Vasodilators - (hydrAlAzine)
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

45. What causes the murmur heard in MR to enhance?
During diastole
1st degree AV blodck
Coarcation of aorta
Inc TPR and LA return (expiration)

46. What does HTN predispose to?
Unstable/crescendo angina
Kaposi's sarcoma
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

47. Which artery supplies the SA and AV nodes?
RCA
In series
In RA return (inspiration)
At least 55%

48. What kind of dysfunction ensues in restrictive cardiomyopathy
Total anomalous pulmonary trunk venous return
Diastolic
ASD
Lymphangiosarcoma

49. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
If sodium channel
...
SA and AV nodes
Unstable/crescendo angina

50. When does EF decrease
Septal defects - PDA - pulm art stenosis
Subendocardial
In HF
SA and AV nodes