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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. no change in PR interval followed by dropped beat
Mechanican contraction of the ventricles
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

2. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
The aortic before pulmonic - inspiration increases diff
Decreases
Fast volatge gated Na channels
Adult type aortic coarctation

3. What does hypoxia cause in the lung versus other tissues?
Heart - 02 extraction is always around 100%
Posterior descending (80% off the RCA - 20% off the circumflex)
LCX - V4- V6
Vasocxn - while other tissues it causes vasodilation

4. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
LAD - V1- V2
The first 4 days
CK- MB
Inc interstitial osmotic pressure pulling fliud out of capillaries

5. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Pulmonary flow murmur and diastolic rumble
Cardiac tamponde
In HF

6. Mitral stenosis is most often secondary to which condition?
Purkingee>atria>ventricles>AV node
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
RF
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

7. What does mitral prolapse predeispose to?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Infective endocarditis
Patent ductus arteriosus - congenital rubella or prematurity
Unstable/crescendo angina

8. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Atherosclerosis

9. benign cap hemangioma of infancy - spont regresses
Atrial contraction
Preload
Neg inotropy - HF - narcotic overdose
Strawberry hemangioma

10. What causes orthopnea?
SV/ EDV
Increase intracellular Na - resulting in increased Ca
Inc venous return exaccerbates pulm vasc congestion
140/90

11. What does prolonged QT predispose to?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Torsades de pointes
Purkingee>atria>ventricles>AV node

12. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Decrease in cAMP
Increase - increase the chance the If are open
Conduction delay through AV node - nl < 200 msec
RF

13. What is the S1 sound?
Transposition of great vessels
Mitral and tricuspid closure
In HF
Mitral valve

14. What is the progression of atherosclerosis?
Apex and anterior interventricular septum
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Ischemic heart dz - mitral valve prolapse - LV dilation
Rapid upstroke - voltage gated Na channels open

15. When does extracellular calcium enter the cardiac muscle cells during contraction?
Buerger's disease
The plateau period
CO
Squat. Compression of femoral arteries - inc TPR - dec

16. 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

17. What is the result of not have fast sodium channels in pacemaker cells?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
If sodium channel
Babies
Cardiac tamponde

18. What does an isoelectric ST segment indicate?
Wolff - Parkinson white syndrome
RF
Ventricles are depolarized
Aortic disecction - intraluminal tear forming false lumen

19. Most common vasculitis affecting medium and large arteries
The first 4 days
Ventricular repolarization
Temporal arteritis
LAD > RCA > circumflex

20. What do the starling forces determine
Changes in CO as a function of preload
Fluid movement through capillaries
Indomethacin closes - and pge keeps it open
Decreases

21. Exercise - overtransfusiion and excitiment causes and increase in...?
Granuloma with giant cells
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
2nd degree AV block - mobitz type 1
Preload

22. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Mitral valve prolapse
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Holosystolic - harsh sounding murmur - loudest over tricuspid area

23. In an EKG - What is the QRS complex?
Late systolic crescendo murmur with a midsystolic click
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Ventricular depolarization - nl < 120 msec
QRS complex

24. What does increasing intracellular Ca do?
Increase contractility
Posterior descending (80% off the RCA - 20% off the circumflex)
Pyogenic granuloma - associated with trauma and pregnancy
During HF from microhemorrhages from inc pulm cap pressure

25. What are the complications of atherosclerosis?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Prinzmetal angina
Myxoma

26. 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
Lower right - MC - upper right - AO - upper right AC - lower left MO
Heart - 02 extraction is always around 100%
CHF

27. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Subendocardial
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Sturge weber - vasculitis of caps
Holosystoiic

28. What are the complications from bacterial endocarditis?
Chordae rupture - GN - suppurative pericarditis - emboli
Early deaths from myocarditis
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

29. Which murmur is heard with VSD?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Aortic stenosis or LBBB
Medullary vasomotor center senses baroreceptors and JGA
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

30. What cardiac change occurs in pregnancy?
Vasocxn - while other tissues it causes vasodilation
Increased SV
Ventricular depolarization - nl < 120 msec
SA and AV nodes

31. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Varicose veins - thromboembolism rare
Troponin I
Wolff - Parkinson white syndrome
In RA return (inspiration)

32. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Dilated cardiomyopathy
Libman - sacks endocarditis
Pos inotropy - exercise
Left heart failure

33. What is the classic X ray finding for tet of fallot?
Boot shaped heart
Subendocardial
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Aortic/pulmonic regurg and mitral/tricuspid stenosis

34. Where does coronary artery occlusion occur most commonly?
SV/ EDV
Increased efferent SANS and decreased efferent PANS
LAD
Strawberry hemangioma

35. Which area of the endocardium is especially vulnerable to infarction? Why?
Inc TPR and LA return (expiration)
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Yes
Subendocardial - fewer collaterals and higher pressure

36. friction rub - 3-5 days post MI
Dec plasma proteins
CK- MB
Postinfarction fibrinous pericarditis
2nd degree AV block - mobitz type 1

37. In an anterolateral infarct - which artery is effected and which leads show Q waves
SV/ EDV
Wolff - Parkinson white syndrome
LCX - V4- V6
Ventricles are depolarized

38. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
SV/ EDV
Inc central venous pressure - inc resistance to portal flow
TAPVR
Proportional to viscosity and inversely proportional to the radius to the 4th power

39. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Liver
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Eccentric - concentric hypertrophy causes diastolic disfunction

40. The aortic arch receptors transmit along which nerve?
Decreased
Afterload (proportional to peripheral resistance)
Inc central venous pressure - inc resistance to portal flow
Vagus to medulla

41. What kind of dysfunction ensues in restrictive cardiomyopathy
Viridans streptococci
Inc central venous pressure - inc resistance to portal flow
Diastolic
Activated histiocytes

42. Rank the pacemakers cells
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Increase intracellular Na - resulting in increased Ca
SA>AV>bundle of His>ventricles
Kawasaki

43. The cause of cardiac dilation?
During diastole
2-4 day - early coag necrosis on the first day
During HF from microhemorrhages from inc pulm cap pressure
Greater ventricular EDV

44. What causes the CO curve to shift downwards?
Neg inotropy - HF - narcotic overdose
Prinzmetal angina
Pulmonary flow murmur and diastolic rumble
Purkingee>atria>ventricles>AV node

45. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
Left heart failure
ASD
5-10 days - macs have degraded structural components

46. In the cardiac cycle - which period has the highest 02 consumption?
Age related calcifications or bicuspid aortic valve
Increase - increase the chance the If are open
No
Isovolumetric contraction

47. Which enzymes are useful for diagnosing reinfarction
CK- MB
Adult type aortic coarctation
Mitral and tricuspid closure
RCA

48. no relation between p waves and QRS intervals - treatment and predisposing factor
LCX - I - aVL
3rd degree block - pacemaker - Lyme disease
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

49. coronary artery spasm - ST elevation
Prinzmetal angina
Increased SV
At least 55%
S. bovis

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