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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. benign cap hemangioma of infancy - spont regresses
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Strawberry hemangioma
5-10 days - macs have degraded structural components
Decreased

2. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Volatage gated Ca channels
Sturge weber - vasculitis of caps
Decrease in cAMP
LAD - V1- V2

3. What is the S1 sound?
Pulse pressure
Mitral and tricuspid closure
Acute thrombosis of coronary artery
Fluid movement through capillaries

4. Which murmur is heard with VSD?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
CFX
Myxoma
S. bovis

5. What is sudden cardiac death most commonly due to...
LAD - V1 - V4
CK- MB
S. bovis
V fib arrhythima

6. absecnce of tricuspid valve - hypoplastic RV
Stroke volume
Tricuspid atresia - requires ASD and VSD
Inc RA pressure - due to filling against closed tricupsid valve
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

7. Which vessels account for the most total peripheral resistance
Kawasaki
Troponin I
Arteriorles
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

8. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Mechanican contraction of the ventricles
Total anomalous pulmonary trunk venous return
Fick principle
Lower right - MC - upper right - AO - upper right AC - lower left MO

9. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
CHF
The plateau period

10. Wegener's tx
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Cyclophosphamide and corticosteroids
V fib arrhythima
Increase - increase the chance the If are open

11. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
Inc interstitial osmotic pressure pulling fliud out of capillaries
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

12. with what heart sounds do ASD usually present?
In series
140/90
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Pulmonary flow murmur and diastolic rumble

13. What does prolonged QT predispose to?
Rhabdomyomas
Torsades de pointes
Tempral arteritis - may cause irreversible blindness
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

14. Which kind of infarct show ST elevation - and/or pathologic Q waves
SV/ EDV
Transmural
ANP
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

15. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Inc TPR and LA return (expiration)
Transfusion

16. In an EKG - What is the QRS complex?
R to L shunt caused by stenoic pulmonic valve
Ventricular depolarization - nl < 120 msec
Eisenmenger's syndrome
2nd degree AV block - mobitz type 1

17. What other syndrom is associated with infantile aortic coarctation
Anterosuperior displacement of the infundibular septum
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Turners
Left sided

18. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Extracellular calcium - calcium induced calcium release
Resting potential high K perm
MI
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

19. in the JVP - What is the a wave?
Atrial contraction
Arteriolosclerosis in malignant hypertension
Decrease in activity of Na/Ca exhanger and increase in contractility
Aortic and pulmonary closing

20. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Libman - sacks endocarditis
During HF from microhemorrhages from inc pulm cap pressure
In HF
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

21. What causes the murmur heard in tricuspid regurg to enhance
Vasocxn
In RA return (inspiration)
SA>AV>bundle of His>ventricles
ANP

22. What does the LAD supply?
Dec plasma proteins
In parallel
Black > white > asian
Apex and anterior interventricular septum

23. Which channel accounts for automaticity of the SA and AV nodes?
Cystic hygroma
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
If sodium channel
Decrease in cAMP

24. What causes the murmur heard in MR to enhance?
Pos inotropy - exercise
Inc TPR and LA return (expiration)
HTN - bradycardia - and respiratory depression
Aortic stenosis or LBBB

25. What is association with fixed S2 splitting - does not increase with inspiration
ASD
1st degree AV blodck
HTN - bradycardia - and respiratory depression
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

26. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
If sodium channel
Atherosclerosis
Arteriorles

27. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
MI
Unstable/crescendo angina
Anterosuperior displacement of the infundibular septum
Crescendo - decrescendo systolic ejection murmur following ejection click

28. How are the sarcomeres added in eccentric hypertrophy?
During HF from microhemorrhages from inc pulm cap pressure
In series
Left sided
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

29. Which two mechanisms sense decrease MAP?
Medullary vasomotor center senses baroreceptors and JGA
Hematocrit
Fetal right to left - neonate left to right leading to RVH and failure
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

30. What does the starling curve show?
Medullary vasomotor center senses baroreceptors and JGA
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Babies
Changes in CO as a function of preload

31. When do you see extensive coagulative necrosis in an MI
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Fluid movement through capillaries
SV/ EDV
2-4 day - early coag necrosis on the first day

32. What causes aortic regurg
Kids
During diastole
Aortic dilation - bicuspid aortic valve - RF -
SV/ EDV

33. What is the result of not have fast sodium channels in pacemaker cells?
Troponin I
Ventricular depolarization - nl < 120 msec
Prinzmetal angina
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

34. What are the different etiologies of dialted cardiomyopathy
Dilated cardiomyopathy
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Wolff - Parkinson white syndrome
Atrial contraction

35. p - anca

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36. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
R to L shunt caused by stenoic pulmonic valve
RV contraction (closed tricuspid valve bulding into atrium
Lymphangiosarcoma
Pos inotropy - exercise

37. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Holosystoiic
CFX
Transfusion
Late systolic crescendo murmur with a midsystolic click

38. What do the carotid and aortic bodies respond to?
Glomus tumor
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Dec P02 - inc PC02 and dec pH

39. Which artery supplies the SA and AV nodes?
RCA
The first 4 days
MI
Kaposi's sarcoma

40. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Granuloma with giant cells
R to L shunt caused by stenoic pulmonic valve
LCX - I - aVL
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

41. bening capillary hemangioma of elderly - does not regress
CFX
RV failure - in venous pressure
Cherry hemangioma
Dec P02 - inc PC02 and dec pH

42. What is the time frame for arrhythmia risk in the evolution of MI
Late diastolic murmur following an opening snap
S. bovis
The first 4 days
Pulmonary flow murmur and diastolic rumble

43. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Maintain blood flow to organ over wide range of perfussion pressures
Venodilators (nitrogylcerine)
Dilated cardiomyopathy
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

44. In terms of starling forces - why does heart failure cause edema?
Venodilators (nitrogylcerine)
Medullary vasomotor center senses baroreceptors and JGA
Decreases
Increase in Pc

45. What does an isoelectric ST segment indicate?
Hypertrophied cardiomyopathy
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Fast volatge gated Na channels
Ventricles are depolarized

46. What are anitschkow's cells
Activated histiocytes
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
LAD - V1- V2
If sodium channel

47. What are the systolic heart sounds
Lymphangiosarcoma
Rapid upstroke - voltage gated Na channels open
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Aortic/pulmonic stenosis and mitral/tricuspid regurg

48. When is the scar completely formed in an MI?
Left heart failure
Ischemic heart dz - mitral valve prolapse - LV dilation
7 weeks
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

49. What constitues the upstroke in pacemaker cells?
Acute thrombosis of coronary artery
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Volatage gated Ca channels
Mitral valve

50. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
No - no pressure gradient
Decreases
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure