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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. What does the atria release in response to inc blood volume and atrial pressure
Inc venous return exaccerbates pulm vasc congestion
Changes in CO as a function of preload
ANP
Lymphangiosarcoma

2. The carotid sinus transmits along which nerve?
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Glossopharyngeal to soliary nucleus of medulla
Fast volatge gated Na channels

3. In an EKG - What is the QT interval?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Cyclophosphamide and corticosteroids
Postinfarction fibrinous pericarditis
Mechanican contraction of the ventricles

4. congenital heart defect withdown syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
Group a beta hemolytic strep
Cyclophosphamide and corticosteroids
Arteriorles

5. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Metastasis from melanoma or lymphoma
Changes in CO as a function of preload
Can progess to V fib

6. what percentage of HTN is secondary to renal disease?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Inc RA pressure - due to filling against closed tricupsid valve
Stroke volume affected by contractility - afterload - and preload
10%

7. SV CAP means?
Changes in CO as a function of preload
Arteriorles
Mitral>aortic>>tricuspid - high pressure valves affected most
Stroke volume affected by contractility - afterload - and preload

8. What masks atrial repolarization?
Late systolic crescendo murmur with a midsystolic click
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
QRS complex
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

9. Which murmur do you hear in mitral stenosis?
Eisenmenger's syndrome
Late diastolic murmur following an opening snap
During diastole
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

10. moncekberg
Troponin I
CHF
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

11. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
MI
Eccentric - concentric hypertrophy causes diastolic disfunction
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Septal defects - PDA - pulm art stenosis

12. PCWP is an estimate of...
Postinfarction fibrinous pericarditis
Left atrial pressure
Tricuspid atresia - requires ASD and VSD
CK- MB

13. What are the 5 T's of cyanoitc babies
Activated histiocytes
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Sudden tensing of chordae tendinae

14. How are cadiac myocytes eltrically coupled?
Mitral valve
Varicose veins - thromboembolism rare
If sodium channel
Gap junctions

15. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
ASD
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Angiosarcoma

16. Which two mechanisms sense decrease MAP?
No - no pressure gradient
Vasocxn - while other tissues it causes vasodilation
Medullary vasomotor center senses baroreceptors and JGA
Kids

17. What cardiac change occurs in pregnancy?
Vagus to medulla
ANP
Mitral and tricuspid closure
Increased SV

18. what happens to capillaries in lymphatic blockage
Proportional to viscosity and inversely proportional to the radius to the 4th power
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Inc interstitial osmotic pressure pulling fliud out of capillaries
Greater ventricular EDV

19. congenital heart defect in an infant with a diabetic mother?
Decrease in cAMP
RCA - II - III - aVF
Transposition of great vessels
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

20. What does TAPVR stand for
Total anomalous pulmonary trunk venous return
Myxoma
During diastole
Adult type aortic coarctation

21. 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
Dec P02 - inc PC02 and dec pH
Crescendo - decrescendo systolic ejection murmur following ejection click
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

22. in the JVP - What is the v wave?
Wegener's
Maintain blood flow to organ over wide range of perfussion pressures
Inc RA pressure - due to filling against closed tricupsid valve
Viridans streptococci

23. What are the complications from bacterial endocarditis?
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Chordae rupture - GN - suppurative pericarditis - emboli
7 weeks

24. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Decreases
Gap junctions
Total anomalous pulmonary trunk venous return
Glomus tumor

25. EDV - ESV
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Aortic dilation - bicuspid aortic valve - RF -
ASD - VSD - AV septal defect (endocardial cushion defect)
Stroke volume

26. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
SV/ EDV
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Angiosarcoma
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

27. The cause of cardiac dilation?
Hyperlipidemia
Dressler's - autoimmune
Greater ventricular EDV
Stable angina

28. Rank the pacemakers cells
SA>AV>bundle of His>ventricles
Pulsus parvus and tardus - weak - can lead to syncope
CFX
If sodium channel

29. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Dilation
Vagus to medulla
Posterior descending (80% off the RCA - 20% off the circumflex)
Right sided

30. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Lymphangiosarcoma
Strawberry hemangioma
Aortic/pulmonic stenosis and mitral/tricuspid regurg

31. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Crescendo - decrescendo systolic ejection murmur following ejection click
Libman - sacks endocarditis
1st degree AV blodck
Unstable/crescendo angina

32. When during cardiac nodal cells depolarize?
Arteriolosclerosis in malignant hypertension
Polyarteritis nodosum
SA and AV nodes
During diastole

33. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Inc Kf - capillary perm
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
MI
The operating point of the heart

34. How are sarcomeres added in concentric hypertrophy?
The aortic before pulmonic - inspiration increases diff
LCX - I - aVL
In parallel
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

35. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Aortic insuffic - late
Kaposi's sarcoma
Vasodilators - (hydrAlAzine)

36. How does angiotensin II raise MAP
Vasocxn
3rd degree block - pacemaker - Lyme disease
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Filling is incomplete and CO falls

37. The 7 complications of MI

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38. Where is the most posterior portion of the heart and What can it cause?
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Inc TPR and LA return (expiration)
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Dec P02 - inc PC02 and dec pH

39. What causes aortic stenosis
Age related calcifications or bicuspid aortic valve
No
Decreased
Changes in CO as a function of preload

40. What is the most common cause of right heart failure
Fetal right to left - neonate left to right leading to RVH and failure
Left heart failure
Right sided
Transmural

41. When is the scar completely formed in an MI?
PDA
LV failure - pulm venous distention transudation of fluid
S. bovis
7 weeks

42. In an EKG - What is the PR interval?
Extracellular calcium - calcium induced calcium release
Fetal right to left - neonate left to right leading to RVH and failure
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Conduction delay through AV node - nl < 200 msec

43. Right to left shunts are more common in babies or kids?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Babies
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

44. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Strawberry hemangioma
QRS complex

45. When does EF decrease
Crescendo - decrescendo systolic ejection murmur following ejection click
In HF
Rhabdomyomas
C - ANCA

46. The cause of dyspnea on exertion?
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Eisenmenger's syndrome
Failure of LV to in CO during exercise
Cardiac tamponde

47. What is the S2 sound?
Aortic and pulmonary closing
Decrease in cAMP
LCX - I - aVL
Indomethacin closes - and pge keeps it open

48. Which valve is most commonly involved in bacterial endocarditis?
Mitral valve
Increase intracellular Na - resulting in increased Ca
Group a beta hemolytic strep
Atrial contraction

49. Which artery supplies the SA and AV nodes?
ASD
Heart - 02 extraction is always around 100%
Increasing activity of Ca pump in SR
RCA

50. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
The operating point of the heart
Troponin I
Changes in CO as a function of preload
S. epidermidis