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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 prolonged QT predispose to?
Mitral valve
Torsades de pointes
Changes in CO as a function of preload
Acute thrombosis of coronary artery

2. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Increased SV
Group a beta hemolytic strep
Eccentric - concentric hypertrophy causes diastolic disfunction
Hemorrhage

3. What happens in phase 3 of the cardiac ventricular action potential?
Turners
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Crescendo - decrescendo systolic ejection murmur following ejection click
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

4. exaggerated decrease in pulse during inspiration.

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5. benign cap hemangioma of infancy - spont regresses
During diastole
Dilated cardiomyopathy
Strawberry hemangioma
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

6. dyspnea - fatigue - edema and rales - multiple causes
Heart - 02 extraction is always around 100%
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
CHF
Liver

7. What causes aortic regurg
Subendocardial
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Mitral valve prolapse
Aortic dilation - bicuspid aortic valve - RF -

8. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Granuloma with giant cells
Increase in Pc
Prinzmetal angina

9. p - anca

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10. Wegener's tx
V fib
Cyclophosphamide and corticosteroids
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Septal defects - PDA - pulm art stenosis

11. What supplies the posterior left ventricle?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
CFX
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Pulmonic stenosis and RBBB

12. serum marker for wegener's
Filling is incomplete and CO falls
C - ANCA
PDA
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

13. congenital heart defect with congenital rubella
LAD - V1- V2
Acute thrombosis of coronary artery
Angiosarcoma
Septal defects - PDA - pulm art stenosis

14. What is the formula for EF?
C - ANCA
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
In series
SV/ EDV

15. absecnce of tricuspid valve - hypoplastic RV
No
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Tricuspid atresia - requires ASD and VSD
Myxoma

16. Wegener's presentation
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Tempral arteritis - may cause irreversible blindness
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

17. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
C - ANCA
Increase contractility
...

18. in the JVP - What is the a wave?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Troponin I
Atrial contraction
Holosystoiic

19. What does FEVERSS stand for in rheumatic heart disease
R to L shunt caused by stenoic pulmonic valve
Age related calcifications or bicuspid aortic valve
Truncus - tet of fallot
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

20. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Glossopharyngeal to soliary nucleus of medulla
LAD - V1- V2

21. decrease stretch in baroreceptors leads to what response?
5-10 days - macs have degraded structural components
Early deaths from myocarditis
Apex and anterior interventricular septum
Increased efferent SANS and decreased efferent PANS

22. What causes the CO curve to shift upwards?
Pos inotropy - exercise
Granuloma with giant cells
R to L shunt caused by stenoic pulmonic valve
Proportional to viscosity and inversely proportional to the radius to the 4th power

23. Which bacteria causes rheumatic heart disease
Group a beta hemolytic strep
Gap junctions
Tricuspid atresia - requires ASD and VSD
2-4 day - early coag necrosis on the first day

24. How does aldosterone raise MAP
Babies
Inc blood volume
Vasocxn - while other tissues it causes vasodilation
Early deaths from myocarditis

25. What is the cushing triad?
Dec plasma proteins
RCA
Increased SV
HTN - bradycardia - and respiratory depression

26. What is a normal EF
Cardiac tamponde
At least 55%
Neg inotropy - HF - narcotic overdose
Increasing activity of Ca pump in SR

27. In an EKG - What is the QT interval?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Mechanican contraction of the ventricles
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Aortic insuffic - late

28. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Arteriorles
The first 4 days
ANP

29. What do the carotid and aortic bodies respond to?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Dec P02 - inc PC02 and dec pH
Eisenmenger's syndrome

30. What are anitschkow's cells
Activated histiocytes
MI
Afterload (proportional to peripheral resistance)
Strawberry hemangioma

31. Which organ has ht highest blood flow per gram of tissue
Glossopharyngeal to soliary nucleus of medulla
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Kidney
Extracellular calcium - calcium induced calcium release

32. What does increasing intracellular Ca do?
Myxoma
Increase contractility
Increased efferent SANS and decreased efferent PANS
Pyogenic granuloma - associated with trauma and pregnancy

33. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Late systolic crescendo murmur with a midsystolic click
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Fick principle
Diastolic

34. What is the association with wide S2 splitting?
Sturge weber - vasculitis of caps
Arteriorles
Indomethacin closes - and pge keeps it open
Pulmonic stenosis and RBBB

35. most common heart tumor
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Metastasis from melanoma or lymphoma
QRS complex
Cyclophosphamide and corticosteroids

36. Where does coronary artery occlusion occur most commonly?
LV failure - pulm venous distention transudation of fluid
Mitral and tricuspid closure
LAD
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

37. Left to right shunts are more common in babies or kids?
Polyarteritis nodosum
Vasocxn
Rhabdomyomas
Kids

38. Which organ has the largest arteriovenous difference
MI
LCX - I - aVL
Heart - 02 extraction is always around 100%
Increase contractility

39. The 7 complications of MI

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40. What is association with fixed S2 splitting - does not increase with inspiration
Lymphangiosarcoma
ASD
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Stroke volume affected by contractility - afterload - and preload

41. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Aortic disecction - intraluminal tear forming false lumen
Hemorrhage
2-4 day - early coag necrosis on the first day
Fetal right to left - neonate left to right leading to RVH and failure

42. How do beta blockers decrease contractility?
Inc blood volume
Decrease in cAMP
During HF from microhemorrhages from inc pulm cap pressure
Pulse pressure

43. Which bacteria causes endocarditis in the presence of colon cancer
Holosystoiic
LAD
S. bovis
Raynaud's

44. polypoid capillary hemangioma that can ulcerate and bleed
Glossopharyngeal to soliary nucleus of medulla
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Pyogenic granuloma - associated with trauma and pregnancy
Volatage gated Ca channels

45. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?

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46. What happends in phase 1 of the ventricular cardiac action potential?
Ventricular repolarization
SA>AV>bundle of His>ventricles
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

47. What do the starling forces determine
Fluid movement through capillaries
Mitral>aortic>>tricuspid - high pressure valves affected most
Mean arterial pressure
Kawasaki

48. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
7 weeks
Activated histiocytes
No
Decreases

49. In normal S2 splitting - which valve closes first? What increases it?
The aortic before pulmonic - inspiration increases diff
In HF
Myxoma
Total anomalous pulmonary trunk venous return

50. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Boot shaped heart
Dressler's - autoimmune
Sturge weber - vasculitis of caps
CK- MB