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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 an isoelectric ST segment indicate?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Inc blood volume
Ventricles are depolarized
Holosystolic - harsh sounding murmur - loudest over tricuspid area

2. dyspnea - fatigue - edema and rales - multiple causes
Inc venous return exaccerbates pulm vasc congestion
CHF
SV/ EDV
Extracellular calcium - calcium induced calcium release

3. What is the cushing triad?
Squat. Compression of femoral arteries - inc TPR - dec
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
HTN - bradycardia - and respiratory depression
In series

4. What is the time frame for arrhythmia risk in the evolution of MI
CK- MB
Increase contractility
The first 4 days
Torsades de pointes

5. EDV is also known as
Preload
LAD
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
HypoK and bradycardia

6. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
In series
Volatage gated Ca channels
Dec P02 - inc PC02 and dec pH

7. Which lab value indicates blood viscosity?
Prinzmetal angina
Indomethacin closes - and pge keeps it open
Greater ventricular EDV
Hematocrit

8. What kind of dysfunction ensues in restrictive cardiomyopathy
Diastolic
Decreases
Aortic dilation - bicuspid aortic valve - RF -
Cyclophosphamide and corticosteroids

9. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Greater ventricular EDV
Pyogenic granuloma - associated with trauma and pregnancy
2nd degree AV block - mobitz type 1
Decreases

10. What is the formula for EF?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Varicose veins - thromboembolism rare
SV/ EDV
Cardiac tamponde

11. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Dressler's - autoimmune
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

12. Restrictive cardiomyopathy causes
Atrial contraction
Fick principle
Inc central venous pressure - inc resistance to portal flow
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

13. Central chemoreceptors do not respond directly to which parameter?
In RA return (inspiration)
Maintain blood flow to organ over wide range of perfussion pressures
P02
2nd degree AV block - mobitz type 1

14. How does acidosis affect contractility?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
V fib
Decreased
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

15. CO x Total peripheral resistance
Hyperlipidemia
Mean arterial pressure
Ventricular depolarization - nl < 120 msec
During diastole

16. Which bacteria causes rheumatic heart disease
Yes
Fick principle
S. aureus
Group a beta hemolytic strep

17. What supplies the posterior left ventricle?
Angiosarcoma
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
CFX
Stroke volume affected by contractility - afterload - and preload

18. What murmur is heard with aortic regurg?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Atrial contraction
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

19. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Hemorrhage
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

20. Irregularly irregular ECG - no p waves: dx and treatment
Lymphangiosarcoma
The first 4 days
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Liver

21. Which murmur is heard in aortic stenosis?
Takayasu's arteritis
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Crescendo - decrescendo systolic ejection murmur following ejection click
Glossopharyngeal to soliary nucleus of medulla

22. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
SA>AV>bundle of His>ventricles
Microscopic polyangiitis - like wegener's without granulomas
MAP

23. What is the most common cause of right heart failure
Subendocardial
Left heart failure
Angiosarcoma
Rapid upstroke - voltage gated Na channels open

24. with what heart sounds do ASD usually present?
Late systolic crescendo murmur with a midsystolic click
Pulmonary flow murmur and diastolic rumble
LAD - V1- V2
Aortic/pulmonic regurg and mitral/tricuspid stenosis

25. In an EKG - What is the QT interval?
Inc blood volume
Postinfarction fibrinous pericarditis
If sodium channel
Mechanican contraction of the ventricles

26. exaggerated decrease in pulse during inspiration.

27. What cardiac change occurs in pregnancy?
Chordae rupture - GN - suppurative pericarditis - emboli
Increased efferent SANS and decreased efferent PANS
Increased SV
Posterior descending (80% off the RCA - 20% off the circumflex)

28. serum marker for wegener's
C - ANCA
Increase in Pc
Increase - increase the chance the If are open
2nd degree AV block - mobitz type 1

29. in the JVP - What is the v wave?
Eccentric - concentric hypertrophy causes diastolic disfunction
Inc RA pressure - due to filling against closed tricupsid valve
In series
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

30. What is the characteristic pulse in aortic stenosis?
Pyogenic granuloma - associated with trauma and pregnancy
Arteriorles
Pulsus parvus and tardus - weak - can lead to syncope
During diastole

31. What happens with a decrease of extracellular Na
Can progess to V fib
Proportional to viscosity and inversely proportional to the radius to the 4th power
Vasodilators
Decrease in activity of Na/Ca exhanger and increase in contractility

32. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
The aortic before pulmonic - inspiration increases diff
Sturge weber - vasculitis of caps
MI
Vasodilators - (hydrAlAzine)

33. p - anca

34. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Purkingee>atria>ventricles>AV node
Mean arterial pressure
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

35. prolonged PR interval
Inc RA pressure - due to filling against closed tricupsid valve
C - ANCA
1st degree AV blodck
Preload

36. MAP is also known as
C - ANCA
Black > white > asian
Afterload (proportional to peripheral resistance)
...

37. What are the different etiologies of dialted cardiomyopathy
Torsades de pointes
Ventricular repolarization
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Subendocardial - fewer collaterals and higher pressure

38. In terms of starling forces - why does heart failure cause edema?
Neg inotropy - HF - narcotic overdose
Aortic disecction - intraluminal tear forming false lumen
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Increase in Pc

39. What does mitral prolapse predeispose to?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
PDA
Ischemic heart dz - mitral valve prolapse - LV dilation
Infective endocarditis

40. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Left heart failure
Hypertrophied cardiomyopathy
Cyclophosphamide and corticosteroids

41. How does angiotensin II raise MAP
During diastole
Stroke volume affected by contractility - afterload - and preload
Vasocxn
Dilation

42. congenital heart defect withdown syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
Troponin I
1st degree AV blodck
Stroke volume

43. what happens to capillaries in lymphatic blockage
Wegener's
Dressler's - autoimmune
Inc interstitial osmotic pressure pulling fliud out of capillaries
Dilation

44. Where does coronary artery occlusion occur most commonly?
R to L shunt caused by stenoic pulmonic valve
Fast volatge gated Na channels
LAD
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

45. Chronic mitral stenosis can lead to what changes in size of the LA
Myxoma
Dilation
SA and AV nodes
Rapid upstroke - voltage gated Na channels open

46. Endothelial malignancy of the skin assocated with HHV-8 and HIV

47. In an inferior wall infarct - which artery is affected and which leads show Q waves
RCA - II - III - aVF
Cherry hemangioma
Kids
Babies

48. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Viridans streptococci
No - no pressure gradient
RCA - II - III - aVF
HTN - bradycardia - and respiratory depression

49. in the JVP - What is the c wave?
Pulmonic stenosis and RBBB
Vagus to medulla
RV contraction (closed tricuspid valve bulding into atrium
Right sided

50. The aortic arch receptors transmit along which nerve?
1st degree AV blodck
Vagus to medulla
Neg inotropy - HF - narcotic overdose
Activated histiocytes