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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. in the JVP - What is the c wave?
Pulmonic stenosis and RBBB
Babies
RV contraction (closed tricuspid valve bulding into atrium
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

2. Which two mechanisms sense decrease MAP?
Atherosclerosis
ASD - VSD - AV septal defect (endocardial cushion defect)
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Medullary vasomotor center senses baroreceptors and JGA

3. What do the starling forces determine
Fluid movement through capillaries
Venodilators (nitrogylcerine)
Cardiac tamponde
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

4. What happens in phase 2 of the cardiac ventricular action potential?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Medullary vasomotor center senses baroreceptors and JGA
Inc RA pressure - due to filling against closed tricupsid valve
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

5. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
CK- MB
LCX - V4- V6
Torsades de pointes

6. Which murmur is characteristic of mitral/tricuspid regurg?
The first 4 days
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Holosystoiic
Tricuspid atresia - requires ASD and VSD

7. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
Mitral valve prolapse
Troponin I
Wegener's

8. Given P = QR - what factors influence resistance?
Left sided
Proportional to viscosity and inversely proportional to the radius to the 4th power
2nd degree AV block - mobitz type 1
Liver

9. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Glomus tumor
Isovolumetric contraction

10. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

11. What other syndrom is associated with infantile aortic coarctation
Stroke volume
ASD - VSD - AV septal defect (endocardial cushion defect)
Turners
Vasocxn

12. sawtooth wave

13. How does digitatlis increase contractility?
Increase intracellular Na - resulting in increased Ca
MI
140/90
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

14. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Inc blood volume
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Mitral valve prolapse
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

15. When does EF decrease
Volatage gated Ca channels
In HF
Fetal right to left - neonate left to right leading to RVH and failure
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

16. in the JVP - What is the a wave?
Changes in CO as a function of preload
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Atrial contraction
During diastole

17. Which murmur is heard with mitral prolapse?
Late systolic crescendo murmur with a midsystolic click
Acute thrombosis of coronary artery
V fib
Subendocardial

18. What causes aortic stenosis
Apex and anterior interventricular septum
Failure of LV to in CO during exercise
Age related calcifications or bicuspid aortic valve
Mechanican contraction of the ventricles

19. The aortic arch receptors transmit along which nerve?
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Hyperlipidemia
Vagus to medulla
Vasodilators

20. What does an isoelectric ST segment indicate?
Myxomatous degeneration - RF - chordae rupture
No - no pressure gradient
Ventricles are depolarized
Boot shaped heart

21. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
3rd degree block - pacemaker - Lyme disease
Dilated cardiomyopathy
Decrease in cAMP
Rapid upstroke - voltage gated Na channels open

22. What causes the cushing reflex and why
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Purkingee>atria>ventricles>AV node
Posterior descending (80% off the RCA - 20% off the circumflex)

23. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
No
7 weeks
CO

24. clinical signs of cardiac tamponade
Mechanican contraction of the ventricles
Isovolumetric contraction
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Chordae rupture - GN - suppurative pericarditis - emboli

25. machine murmer
Can progess to V fib
SA and AV nodes
CFX
PDA

26. Why is there edema after burns or during infection
Crescendo - decrescendo systolic ejection murmur following ejection click
Inc Kf - capillary perm
Rapid upstroke - voltage gated Na channels open
Kaposi's sarcoma

27. When do you find hemosiderin laden macrophages in the lungs?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
ASD
Pulse pressure
During HF from microhemorrhages from inc pulm cap pressure

28. What is the most common cause of MI
Inc central venous pressure - inc resistance to portal flow
Aburpt halting of valve leaflets
Acute thrombosis of coronary artery
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

29. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Decrease in activity of Na/Ca exhanger and increase in contractility
MI
1st degree AV blodck
5-10 days - macs have degraded structural components

30. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Lymphangiosarcoma
Myxomatous degeneration - RF - chordae rupture
Increase - increase the chance the If are open
Cyclophosphamide and corticosteroids

31. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Neg inotropy - HF - narcotic overdose
Kawasaki
RF
Inc blood volume

32. What is associated with paradoxical spliting of S2
Aortic stenosis or LBBB
Arteriolosclerosis in malignant hypertension
Inc interstitial osmotic pressure pulling fliud out of capillaries
Persistant truncus arteriosus

33. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Turners
The aortic before pulmonic - inspiration increases diff
Failure of LV to in CO during exercise
Non

34. When is the scar completely formed in an MI?
Cherry hemangioma
7 weeks
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
V fib arrhythima

35. Expiration causes an increase in which sided heart sounds
Ischemic heart dz - mitral valve prolapse - LV dilation
C - ANCA
Left sided
Decreased

36. How are sarcomeres added in concentric hypertrophy?
RCA - II - III - aVF
In parallel
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
S. aureus

37. What 4 things drive myocardial 02 demand?
Filling is incomplete and CO falls
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Infective endocarditis

38. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
CO
Angiosarcoma
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Early deaths from myocarditis

39. no change in PR interval followed by dropped beat
RCA
Atherosclerosis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

40. fibrinous pericarditis several weeks post MI

41. Which enzymes are useful for diagnosing reinfarction
Inc blood volume
CK- MB
CFX
Kidney

42. Most common vasculitis affecting medium and large arteries
...
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Decrease in cAMP
Temporal arteritis

43. Which class of drugs decreases afterload?
Kidney
Fluid movement through capillaries
Vasodilators - (hydrAlAzine)
Aortic stenosis or LBBB

44. In an EKG - What is the PR interval?
Raynaud's
EKG
Conduction delay through AV node - nl < 200 msec
Inc venous return exaccerbates pulm vasc congestion

45. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Glomus tumor
Pulmonary flow murmur and diastolic rumble
MI

46. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Preload
At least 55%
LCX - I - aVL
Volatage gated Ca channels

47. Which area of the endocardium is especially vulnerable to infarction? Why?
Subendocardial - fewer collaterals and higher pressure
Cardiac tamponde
Dilation
RCA - II - III - aVF

48. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Wegener's
Resting potential high K perm
5-10 days - macs have degraded structural components
Henoch - Schlonlein purpura

49. Hyperplastic onion skinning
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Arteriolosclerosis in malignant hypertension
HypoK and bradycardia
Dec P02 - inc PC02 and dec pH

50. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
Metastasis from melanoma or lymphoma
Pulse pressure
Henoch - Schlonlein purpura