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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. When is the scar completely formed in an MI?
ASD
ASD - VSD - AV septal defect (endocardial cushion defect)
7 weeks
Atrial contraction

2. polypoid capillary hemangioma that can ulcerate and bleed
EKG
Aortic/pulmonic stenosis and mitral/tricuspid regurg
TAPVR
Pyogenic granuloma - associated with trauma and pregnancy

3. What channels do the the pacemaker cells lack?
Fast volatge gated Na channels
Total anomalous pulmonary trunk venous return
Decreased
Vasodilators

4. How does angiotensin II raise MAP
Myxoma
Total anomalous pulmonary trunk venous return
Vasocxn
Pulsus parvus and tardus - weak - can lead to syncope

5. Inspiration causes an increase in which sided heart sounds?
Sudden tensing of chordae tendinae
Right sided
Mitral>aortic>>tricuspid - high pressure valves affected most
Conduction delay through AV node - nl < 200 msec

6. fibrous plaques and atheromas in intima of arteries
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
...
Pos inotropy - exercise
Atherosclerosis

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

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8. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
Cardiac tamponde
2-4 day - early coag necrosis on the first day
Cyclophosphamide and corticosteroids

9. Central chemoreceptors do not respond directly to which parameter?
Inc interstitial osmotic pressure pulling fliud out of capillaries
P02
Age related calcifications or bicuspid aortic valve
Inc venous return exaccerbates pulm vasc congestion

10. What happens in phase 4 of the cardiac ventricular action potential?
The operating point of the heart
Total anomalous pulmonary trunk venous return
Resting potential high K perm
MI

11. What happens with a decrease of extracellular Na
Extracellular calcium - calcium induced calcium release
Increasing activity of Ca pump in SR
Late systolic crescendo murmur with a midsystolic click
Decrease in activity of Na/Ca exhanger and increase in contractility

12. What does HTN predispose to?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Holosystoiic
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

13. Irregularly irregular ECG - no p waves: dx and treatment
RV contraction (closed tricuspid valve bulding into atrium
3rd degree block - pacemaker - Lyme disease
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Dilated cardiomyopathy

14. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Yes
Mitral valve
Total anomalous pulmonary trunk venous return

15. Given P = QR - what factors influence resistance?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Inc venous return exaccerbates pulm vasc congestion
Proportional to viscosity and inversely proportional to the radius to the 4th power
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

16. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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17. congenital heart defect withdown syndrome
Decreases
Transfusion
ASD - VSD - AV septal defect (endocardial cushion defect)
MAP

18. What kind of infarct show ST depression
Adult type aortic coarctation
Kawasaki
Sturge weber - vasculitis of caps
Subendocardial

19. What masks atrial repolarization?
PDA
QRS complex
During diastole
Raynaud's

20. What is the definition of HTN?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Angiosarcoma
140/90
Hematocrit

21. What causes orthopnea?
Troponin I
Inc venous return exaccerbates pulm vasc congestion
Truncus - tet of fallot
Infective endocarditis

22. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Ventricular repolarization
Fluid movement through capillaries
Non

23. What is the cushing triad?
Indomethacin closes - and pge keeps it open
Venodilators (nitrogylcerine)
Persistant truncus arteriosus
HTN - bradycardia - and respiratory depression

24. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Crescendo - decrescendo systolic ejection murmur following ejection click
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
S. aureus
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

25. PCWP > LV diastolic pressure
Mitral stenosis
Tricuspid atresia - requires ASD and VSD
In parallel
Decreases

26. friction rub - 3-5 days post MI
SV/ EDV
Ventricles are depolarized
Postinfarction fibrinous pericarditis
The aortic before pulmonic - inspiration increases diff

27. coronary artery spasm - ST elevation
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Prinzmetal angina
Babies
During HF from microhemorrhages from inc pulm cap pressure

28. What are anitschkow's cells
Activated histiocytes
Torsades de pointes
Pyogenic granuloma - associated with trauma and pregnancy
Mitral and tricuspid closure

29. What does mitral prolapse predeispose to?
Varicose veins - thromboembolism rare
HypoK and bradycardia
LAD - V1- V2
Infective endocarditis

30. What causes the murmur heard in tricuspid regurg to enhance
Mean arterial pressure
In RA return (inspiration)
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Squat. Compression of femoral arteries - inc TPR - dec

31. Hyperplastic onion skinning
Pos inotropy - exercise
Ischemic heart dz - mitral valve prolapse - LV dilation
Wolff - Parkinson white syndrome
Arteriolosclerosis in malignant hypertension

32. What are the different etiologies of dialted cardiomyopathy
At least 55%
In HF
Ventricular depolarization - nl < 120 msec
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

33. In an EKG - What is the p wave?
Inc TPR and LA return (expiration)
Metastasis from melanoma or lymphoma
Atrial contraction
Kidney

34. When does extracellular calcium enter the cardiac muscle cells during contraction?
HTN - bradycardia - and respiratory depression
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Torsades de pointes
The plateau period

35. PROVe
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Left atrial pressure
Infective endocarditis
QRS complex

36. What does increasing intracellular Ca do?
Increase contractility
Decreases
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Adult type aortic coarctation

37. What are the four most common locations for atherosclerosis?
Decrease in activity of Na/Ca exhanger and increase in contractility
Aortic stenosis or LBBB
Non
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

38. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Can progess to V fib
Lymphangiosarcoma
Aortic and pulmonary closing
Increase - increase the chance the If are open

39. What causes the CO curve to shift downwards?
RV failure - in venous pressure
Neg inotropy - HF - narcotic overdose
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Kids

40. most common primary cardiac tumor in children - associated with tuberous sclerosis
CFX
Rhabdomyomas
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Increasing activity of Ca pump in SR

41. What are the systolic heart sounds
Increase - increase the chance the If are open
Coarcation of aorta
Aortic/pulmonic stenosis and mitral/tricuspid regurg
During diastole

42. In an anterolateral infarct - which artery is effected and which leads show Q waves
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Truncus - tet of fallot
LCX - V4- V6
CK- MB

43. In an EKG - What is the QT interval?
Mechanican contraction of the ventricles
Eccentric - concentric hypertrophy causes diastolic disfunction
Maintain blood flow to organ over wide range of perfussion pressures
Venodilators (nitrogylcerine)

44. Which enzymes are useful for diagnosing reinfarction
Mitral valve
CK- MB
Mitral>aortic>>tricuspid - high pressure valves affected most
PDA

45. What happens in phase 0 of the cardiac ventricular action potential?
Strawberry hemangioma
Rapid upstroke - voltage gated Na channels open
Vasocxn - while other tissues it causes vasodilation
Total anomalous pulmonary trunk venous return

46. What causes aortic stenosis
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Buerger's disease
Age related calcifications or bicuspid aortic valve
Aortic stenosis or LBBB

47. How are the sarcomeres added in eccentric hypertrophy?
In series
ASD
Isovolumetric contraction
Aortic/pulmonic stenosis and mitral/tricuspid regurg

48. When do you see extensive coagulative necrosis in an MI
Ventricular repolarization
2-4 day - early coag necrosis on the first day
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
RF

49. In an EKG - What is the PR interval?
Vasodilators - (hydrAlAzine)
Conduction delay through AV node - nl < 200 msec
Yes
Raynaud's

50. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
Tempral arteritis - may cause irreversible blindness
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Aortic/pulmonic regurg and mitral/tricuspid stenosis