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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. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Lymphangiosarcoma
Truncus - tet of fallot
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

2. What causes ankle - sacral edema - jugular venous distention
Mitral>aortic>>tricuspid - high pressure valves affected most
RV failure - in venous pressure
Pos inotropy - exercise
Coarcation of aorta

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

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4. When is the scar completely formed in an MI?
Heart - 02 extraction is always around 100%
Glomus tumor
7 weeks
During diastole

5. cavernous lymphangioma of the neck - associated with turner's
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Fick principle
Decrease in activity of Na/Ca exhanger and increase in contractility
Cystic hygroma

6. What causes aortic stenosis
Age related calcifications or bicuspid aortic valve
Hemorrhage
Buerger's disease
Black > white > asian

7. what percentage of HTN is secondary to renal disease?
10%
Greater ventricular EDV
Rapid upstroke - voltage gated Na channels open
Anterosuperior displacement of the infundibular septum

8. What causes the midsystolic click
V fib
Sudden tensing of chordae tendinae
Late diastolic murmur following an opening snap
Myxoma

9. How do beta blockers decrease contractility?
Inc TPR and LA return (expiration)
HTN - bradycardia - and respiratory depression
Raynaud's
Decrease in cAMP

10. in the JVP - What is the v wave?
Inc RA pressure - due to filling against closed tricupsid valve
Inc interstitial osmotic pressure pulling fliud out of capillaries
Increase contractility
140/90

11. friction rub - 3-5 days post MI
Subendocardial - fewer collaterals and higher pressure
Stroke volume affected by contractility - afterload - and preload
Postinfarction fibrinous pericarditis
Pulse pressure

12. Which class of drugs decreases afterload?
Chordae rupture - GN - suppurative pericarditis - emboli
Vasodilators - (hydrAlAzine)
Aortic and pulmonary closing
If sodium channel

13. Which organ gets the largest share of systemic cardiac output
Liver
No
...
Eisenmenger's syndrome

14. When and why do you hear the S4 sound
Pulmonic stenosis and RBBB
The operating point of the heart
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Increase intracellular Na - resulting in increased Ca

15. p - anca

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16. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
2-4 day - early coag necrosis on the first day
TAPVR
Gap junctions

17. What is the classic X ray finding for tet of fallot?
Boot shaped heart
Kawasaki
CK- MB
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

18. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Rhabdomyomas
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Postinfarction fibrinous pericarditis

19. congenital heart defect withdown syndrome
SA>AV>bundle of His>ventricles
3rd degree block - pacemaker - Lyme disease
ASD - VSD - AV septal defect (endocardial cushion defect)
Pulse pressure

20. What cardiac change occurs in pregnancy?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Increased SV
During diastole
Apex and anterior interventricular septum

21. Which bacteria causes rheumatic heart disease
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Pulse pressure
Group a beta hemolytic strep
In RA return (inspiration)

22. What is the formula for EF?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Troponin I
SV/ EDV
Pos inotropy - exercise

23. most common heart tumor
EKG
Metastasis from melanoma or lymphoma
Takayasu's arteritis
Black > white > asian

24. stroke volume x HR =?
Metastasis from melanoma or lymphoma
CO
ANP
Volatage gated Ca channels

25. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Stroke volume affected by contractility - afterload - and preload
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
S. epidermidis

26. What does T wave inversion indicated?
MI
Acute thrombosis of coronary artery
Inc RA pressure - due to filling against closed tricupsid valve
Aortic/pulmonic stenosis and mitral/tricuspid regurg

27. What does the LAD supply?
Left atrial pressure
Apex and anterior interventricular septum
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Increase contractility

28. What does FAN MY SKIN On Wednesday stand for?
Venodilators (nitrogylcerine)
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Isovolumetric contraction
Pyogenic granuloma - associated with trauma and pregnancy

29. In an EKG - What is the QRS complex?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Increase - increase the chance the If are open
Ventricular depolarization - nl < 120 msec
Non

30. fibrinous pericarditis several weeks post MI

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31. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
In series
LAD - V1- V2
ANP
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

32. In an EKG - What is the QT interval?
Decrease in activity of Na/Ca exhanger and increase in contractility
Mechanican contraction of the ventricles
Boot shaped heart
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

33. When do coronary arteries fill?
Kaposi's sarcoma
CK- MB
During diastole
Postinfarction fibrinous pericarditis

34. failure of truncus arteriosus to divide?
Persistant truncus arteriosus
Increase intracellular Na - resulting in increased Ca
Subendocardial
Resting potential high K perm

35. Which murmur is heard with VSD?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Afterload (proportional to peripheral resistance)
Filling is incomplete and CO falls
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

36. What does the U wave indicated?
The plateau period
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
HypoK and bradycardia
Varicose veins - thromboembolism rare

37. Which enzymes are useful for diagnosing reinfarction
If sodium channel
Strawberry hemangioma
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
CK- MB

38. What is a normal EF
At least 55%
Truncus - tet of fallot
Dec plasma proteins
RF

39. Central chemoreceptors do not respond directly to which parameter?
LCX - V4- V6
Systolic dysfunction
Venodilators (nitrogylcerine)
P02

40. machine murmer
PDA
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
During diastole
SA and AV nodes

41. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Henoch - Schlonlein purpura
Purkingee>atria>ventricles>AV node
LAD
Stroke volume affected by contractility - afterload - and preload

42. Which valve is most commonly involved in bacterial endocarditis?
SA and AV nodes
Extracellular calcium - calcium induced calcium release
Mitral valve
Resting potential high K perm

43. What constitues the upstroke in pacemaker cells?
Polyarteritis nodosum
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Increase in Pc
Volatage gated Ca channels

44. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Preload
Libman - sacks endocarditis
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
S. aureus

45. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Medullary vasomotor center senses baroreceptors and JGA
Hemorrhage
Dec P02 - inc PC02 and dec pH
5-10 days - macs have degraded structural components

46. what happens to capillaries in lymphatic blockage
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Total anomalous pulmonary trunk venous return
Inc interstitial osmotic pressure pulling fliud out of capillaries
Purkingee>atria>ventricles>AV node

47. In an anterior wall infarct - which artery is effected and which leads show Q waves
Age related calcifications or bicuspid aortic valve
Microscopic polyangiitis - like wegener's without granulomas
RCA - II - III - aVF
LAD - V1 - V4

48. What does TAPVR stand for
Total anomalous pulmonary trunk venous return
If sodium channel
Raynaud's
Activated histiocytes

49. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
Early deaths from myocarditis
3rd degree block - pacemaker - Lyme disease
Septal defects - PDA - pulm art stenosis

50. What supplies the posterior left ventricle?
Age related calcifications or bicuspid aortic valve
CFX
...
Aburpt halting of valve leaflets