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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. no relation between p waves and QRS intervals - treatment and predisposing factor
3rd degree block - pacemaker - Lyme disease
...
Yes
MI

2. congenital heart defect with marfan's
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Preload
Aortic insuffic - late
Increased efferent SANS and decreased efferent PANS

3. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
Tricuspid atresia - requires ASD and VSD
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Myxoma

4. Which two mechanisms sense decrease MAP?
Transposition of great vessels
S. epidermidis
Medullary vasomotor center senses baroreceptors and JGA
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

5. which heart valves are afected most in rheumatic heart diseease
Coarcation of aorta
LAD - V1- V2
Mitral>aortic>>tricuspid - high pressure valves affected most
Hemorrhage

6. Which channel accounts for automaticity of the SA and AV nodes?
No - no pressure gradient
If sodium channel
Fick principle
Infective endocarditis

7. How are sarcomeres added in concentric hypertrophy?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
LAD - V1- V2
In parallel
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

8. clinical signs of cardiac tamponade
Indomethacin closes - and pge keeps it open
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
In parallel

9. moncekberg
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Inc RA pressure - due to filling against closed tricupsid valve
Persistant truncus arteriosus
Aortic insuffic - late

10. In an EKG - What is the QT interval?
LAD
Coarcation of aorta
Mechanican contraction of the ventricles
Left sided

11. In an inferior wall infarct - which artery is affected and which leads show Q waves
RCA - II - III - aVF
Patent ductus arteriosus - congenital rubella or prematurity
Preload
Apex and anterior interventricular septum

12. Which kind of infarct show ST elevation - and/or pathologic Q waves
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Boot shaped heart
S. aureus
Transmural

13. Which class of drugs decreases afterload?
Raynaud's
PDA
Vasodilators - (hydrAlAzine)
The plateau period

14. What channels do the the pacemaker cells lack?
HypoK and bradycardia
Infective endocarditis
Cyclophosphamide and corticosteroids
Fast volatge gated Na channels

15. in the JVP - What is the a wave?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Atrial contraction
Raynaud's
Stroke volume affected by contractility - afterload - and preload

16. no change in PR interval followed by dropped beat
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
No
Inc blood volume
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

17. CO x Total peripheral resistance
Myxomatous degeneration - RF - chordae rupture
Viridans streptococci
Mean arterial pressure
Increasing activity of Ca pump in SR

18. What kind of infarct show ST depression
Increased efferent SANS and decreased efferent PANS
If sodium channel
Subendocardial
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

19. What are the systolic heart sounds
Vasocxn - while other tissues it causes vasodilation
Conduction delay through AV node - nl < 200 msec
Aortic/pulmonic stenosis and mitral/tricuspid regurg
S. epidermidis

20. which medications are used to maintain patency or close the ductus arteriosus?
LCX - I - aVL
Mean arterial pressure
In parallel
Indomethacin closes - and pge keeps it open

21. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Increase - increase the chance the If are open
Strawberry hemangioma
Fetal right to left - neonate left to right leading to RVH and failure
Pos inotropy - exercise

22. Which bacteria causes endocarditis in the presence of colon cancer
Atherosclerosis
CFX
S. bovis
Left sided

23. Which murmur is heard with mitral prolapse?
Dilated cardiomyopathy
Preload
Late systolic crescendo murmur with a midsystolic click
Aortic/pulmonic regurg and mitral/tricuspid stenosis

24. 2/3 diastolic + 1/3 systolic
Pyogenic granuloma - associated with trauma and pregnancy
MAP
S. aureus
CO

25. What does the atria release in response to inc blood volume and atrial pressure
Purkingee>atria>ventricles>AV node
Vasodilators - (hydrAlAzine)
Angiosarcoma
ANP

26. What causes the murmur heard in tricuspid regurg to enhance
Dilation
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Inc central venous pressure - inc resistance to portal flow
In RA return (inspiration)

27. What causes aortic stenosis
Glomus tumor
Age related calcifications or bicuspid aortic valve
Inc blood volume
During diastole

28. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Mitral valve prolapse
Inc interstitial osmotic pressure pulling fliud out of capillaries
Infective endocarditis

29. tearing chest pain radiation to the back - associated with marfan
Aortic disecction - intraluminal tear forming false lumen
Boot shaped heart
Wolff - Parkinson white syndrome
Buerger's disease

30. in the JVP - What is the c wave?
Ventricles are depolarized
RV contraction (closed tricuspid valve bulding into atrium
Viridans streptococci
Varicose veins - thromboembolism rare

31. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Decreases
Posterior descending (80% off the RCA - 20% off the circumflex)
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Black > white > asian

32. MAP is also known as
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Afterload (proportional to peripheral resistance)
Decrease in cAMP
Volatage gated Ca channels

33. The carotid sinus transmits along which nerve?
Age related calcifications or bicuspid aortic valve
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Infective endocarditis
Glossopharyngeal to soliary nucleus of medulla

34. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Decrease in cAMP
The aortic before pulmonic - inspiration increases diff
Dilated cardiomyopathy
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

35. What do the carotid and aortic bodies respond to?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Dec P02 - inc PC02 and dec pH
Preload

36. What constitues the upstroke in pacemaker cells?
Medullary vasomotor center senses baroreceptors and JGA
Volatage gated Ca channels
RCA - II - III - aVF
2-4 day - early coag necrosis on the first day

37. Which class of drugs decrease the murmur heard in aortic regurg?
Aortic disecction - intraluminal tear forming false lumen
Vasodilators
Septal defects - PDA - pulm art stenosis
Maintain blood flow to organ over wide range of perfussion pressures

38. most common heart tumor
Fick principle
Myxomatous degeneration - RF - chordae rupture
Metastasis from melanoma or lymphoma
Unstable/crescendo angina

39. What happens with a decrease of extracellular Na
Decrease in activity of Na/Ca exhanger and increase in contractility
7 weeks
Atrial contraction
Non

40. What are the different etiologies of dialted cardiomyopathy
LAD - V1 - V4
Diastolic
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Increased SV

41. congenital heart defect in an infant with a diabetic mother?
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Mean arterial pressure
Transposition of great vessels
Kids

42. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
QRS complex
Lower right - MC - upper right - AO - upper right AC - lower left MO
At least 55%
Myxomatous degeneration - RF - chordae rupture

43. What is the most common cause of MI
Acute thrombosis of coronary artery
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Preload
Increase in Pc

44. In an EKG - What is the QRS complex?
Cardiac tamponde
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
3rd degree block - pacemaker - Lyme disease
Ventricular depolarization - nl < 120 msec

45. When do you find hemosiderin laden macrophages in the lungs?
Myxoma
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
During HF from microhemorrhages from inc pulm cap pressure
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

46. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Glossopharyngeal to soliary nucleus of medulla
Pyogenic granuloma - associated with trauma and pregnancy

47. fibrinous pericarditis several weeks post MI

48. What cardiac change occurs in pregnancy?
Anterosuperior displacement of the infundibular septum
Microscopic polyangiitis - like wegener's without granulomas
Mitral>aortic>>tricuspid - high pressure valves affected most
Increased SV

49. Wegener's presentation
Kids
Increase - increase the chance the If are open
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
5-10 days - macs have degraded structural components

50. What are the diastolic heart sounds?
Mitral stenosis
Eisenmenger's syndrome
Aortic/pulmonic regurg and mitral/tricuspid stenosis
LV failure - pulm venous distention transudation of fluid