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Cardiology
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Subject
:
health-sciences
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. Which valve is most commonly involved in bacterial endocarditis?
Mitral valve
Atherosclerosis
QRS complex
P02
2. Where are pacemaker cells?
Adult type aortic coarctation
Resting potential high K perm
Failure of LV to in CO during exercise
SA and AV nodes
3. What happens in phase 3 of the cardiac ventricular action potential?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
...
Babies
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
4. Expiration causes an increase in which sided heart sounds
During diastole
Left sided
2-4 day - early coag necrosis on the first day
Vasocxn - while other tissues it causes vasodilation
5. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
In parallel
Inc Kf - capillary perm
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Stable angina
6. 2/3 diastolic + 1/3 systolic
During diastole
If sodium channel
MAP
Eisenmenger's syndrome
7. Which organ has ht highest blood flow per gram of tissue
Kidney
10%
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Greater ventricular EDV
8. What 4 things drive myocardial 02 demand?
Decreases
SV/ EDV
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Inc blood volume
9. CO x Total peripheral resistance
Mean arterial pressure
7 weeks
In RA return (inspiration)
Resting potential high K perm
10. Unilateral headache - jaw claudication - impaired vision
Myxomatous degeneration - RF - chordae rupture
CHF
Tempral arteritis - may cause irreversible blindness
Left sided
11. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Kaposi's sarcoma
Left atrial pressure
Inc venous return exaccerbates pulm vasc congestion
Hemorrhage
12. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
LV failure - pulm venous distention transudation of fluid
Mitral valve prolapse
During diastole
13. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Myxoma
Henoch - Schlonlein purpura
C - ANCA
Raynaud's
14. most common primary cardiac tumor in children - associated with tuberous sclerosis
Pulse pressure
Babies
Rhabdomyomas
Activated histiocytes
15. What does an isoelectric ST segment indicate?
Tricuspid atresia - requires ASD and VSD
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Subendocardial - fewer collaterals and higher pressure
Ventricles are depolarized
16. What is the association with wide S2 splitting?
Dilated cardiomyopathy
S. bovis
Pulmonic stenosis and RBBB
Squat. Compression of femoral arteries - inc TPR - dec
17. How are the sarcomeres added in eccentric hypertrophy?
2-4 day - early coag necrosis on the first day
In series
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
18. What are the complications from bacterial endocarditis?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Chordae rupture - GN - suppurative pericarditis - emboli
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Maintain blood flow to organ over wide range of perfussion pressures
19. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
3rd degree block - pacemaker - Lyme disease
No - no pressure gradient
Can progess to V fib
Group a beta hemolytic strep
20. cavernous lymphangioma of the neck - associated with turner's
Strawberry hemangioma
Aortic/pulmonic stenosis and mitral/tricuspid regurg
S. aureus
Cystic hygroma
21. 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
Kaposi's sarcoma
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Torsades de pointes
22. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Yes
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Troponin I
23. Which bacteria causes endocarditis in the presence of colon cancer
Mitral valve prolapse
LAD - V1 - V4
The plateau period
S. bovis
24. Exercise - overtransfusiion and excitiment causes and increase in...?
Coarcation of aorta
Preload
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Aortic stenosis or LBBB
25. list the coronary vessels most likely to be occluded
LAD > RCA > circumflex
Increase in Pc
In RA return (inspiration)
Dressler's - autoimmune
26. What does FEVERSS stand for in rheumatic heart disease
Unstable/crescendo angina
Polyarteritis nodosum
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
SV/ EDV
27. What are the 5 T's of cyanoitc babies
ANP
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Inc central venous pressure - inc resistance to portal flow
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
28. In an EKG - What is the QRS complex?
LAD
Ventricular depolarization - nl < 120 msec
Patent ductus arteriosus - congenital rubella or prematurity
LAD - V1- V2
29. In terms of starling forces - why does heart failure cause edema?
Increase in Pc
Strawberry hemangioma
RCA - II - III - aVF
Resting potential high K perm
30. What is the classic X ray finding for tet of fallot?
ANP
Tricuspid atresia - requires ASD and VSD
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Boot shaped heart
31. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Troponin I
No
Glomus tumor
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
32. what happens to capillaries in lymphatic blockage
Inc interstitial osmotic pressure pulling fliud out of capillaries
LCX - V4- V6
Wegener's
Mitral>aortic>>tricuspid - high pressure valves affected most
33. How does acidosis affect contractility?
Myxomatous degeneration - RF - chordae rupture
7 weeks
Decreased
Acute thrombosis of coronary artery
34. decrease stretch in baroreceptors leads to what response?
Activated histiocytes
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Increased efferent SANS and decreased efferent PANS
35. What are the different etiologies of dialted cardiomyopathy
Aortic/pulmonic stenosis and mitral/tricuspid regurg
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Black > white > asian
Unstable/crescendo angina
36. In what disease states is blood viscosity increased?
Inc venous return exaccerbates pulm vasc congestion
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Infective endocarditis
The aortic before pulmonic - inspiration increases diff
37. What are the systolic heart sounds
Ventricular repolarization
HTN - bradycardia - and respiratory depression
SV/ EDV
Aortic/pulmonic stenosis and mitral/tricuspid regurg
38. What is the cushing triad?
RV failure - in venous pressure
EKG
HTN - bradycardia - and respiratory depression
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
39. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Cystic hygroma
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
LAD - V1- V2
Medullary vasomotor center senses baroreceptors and JGA
40. Wegener's tx
Eccentric - concentric hypertrophy causes diastolic disfunction
Cyclophosphamide and corticosteroids
Inc venous return exaccerbates pulm vasc congestion
LAD
41. Which kind of infarct show ST elevation - and/or pathologic Q waves
Age related calcifications or bicuspid aortic valve
Subendocardial
Venodilators (nitrogylcerine)
Transmural
42. What murmur is heard with aortic regurg?
EKG
Truncus - tet of fallot
LV failure - pulm venous distention transudation of fluid
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
43. In an inferior wall infarct - which artery is affected and which leads show Q waves
1st degree AV blodck
RCA - II - III - aVF
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
44. Which class of drugs decrease preload
Venodilators (nitrogylcerine)
S. epidermidis
Cyclophosphamide and corticosteroids
Neg inotropy - HF - narcotic overdose
45. Wegener's presentation
Black > white > asian
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Inc blood volume
The plateau period
46. Which organ gets the largest share of systemic cardiac output
Liver
Can progess to V fib
RCA
During HF from microhemorrhages from inc pulm cap pressure
47. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Varicose veins - thromboembolism rare
Liver
Afterload (proportional to peripheral resistance)
48. Endothelial malignancy of the skin assocated with HHV-8 and HIV
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49. What does mitral prolapse predeispose to?
Infective endocarditis
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Increased SV
Kawasaki
50. What constitues the upstroke in pacemaker cells?
Aburpt halting of valve leaflets
R to L shunt caused by stenoic pulmonic valve
Volatage gated Ca channels
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
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