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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 FEVERSS stand for in rheumatic heart disease
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Metastasis from melanoma or lymphoma
Left atrial pressure

2. In an EKG - What is the QT interval?
Early deaths from myocarditis
In RA return (inspiration)
Mechanican contraction of the ventricles
Ventricles are depolarized

3. What does the starling curve show?
Gap junctions
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Changes in CO as a function of preload
Vasodilators - (hydrAlAzine)

4. What is the S1 sound?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Dilated cardiomyopathy
Mitral and tricuspid closure
RCA

5. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
Preload
Yes
7 weeks

6. What causes the CO curve to shift downwards?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Failure of LV to in CO during exercise
Neg inotropy - HF - narcotic overdose
Conduction delay through AV node - nl < 200 msec

7. When is the scar completely formed in an MI?
Vagus to medulla
LAD - V1 - V4
7 weeks
Inc blood volume

8. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Transposition of great vessels
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Atherosclerosis

9. What does T wave inversion indicated?
Septal defects - PDA - pulm art stenosis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
MI
Subendocardial - fewer collaterals and higher pressure

10. In normal S2 splitting - which valve closes first? What increases it?
The aortic before pulmonic - inspiration increases diff
Glossopharyngeal to soliary nucleus of medulla
Squat. Compression of femoral arteries - inc TPR - dec
Fetal right to left - neonate left to right leading to RVH and failure

11. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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12. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
LCX - I - aVL
Left sided
Filling is incomplete and CO falls
Dilated cardiomyopathy

13. congenital heart defect with 22q11
Maintain blood flow to organ over wide range of perfussion pressures
Truncus - tet of fallot
Cardiac tamponde
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

14. In what disease states is blood viscosity increased?
Inc central venous pressure - inc resistance to portal flow
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Resting potential high K perm
Age related calcifications or bicuspid aortic valve

15. Wegener's tx
Atherosclerosis
Filling is incomplete and CO falls
Cyclophosphamide and corticosteroids
Increased SV

16. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Purkingee>atria>ventricles>AV node
LAD - V1 - V4
Polyarteritis nodosum
3rd degree block - pacemaker - Lyme disease

17. what conditions are associated with pulsus paradoxus
The aortic before pulmonic - inspiration increases diff
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
RV contraction (closed tricuspid valve bulding into atrium
Arteriorles

18. fibrinous pericarditis several weeks post MI

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19. CO x Total peripheral resistance
RCA
V fib
Mean arterial pressure
Pos inotropy - exercise

20. What does the atria release in response to inc blood volume and atrial pressure
LCX - V4- V6
PDA
ANP
V fib

21. What is the difference between adult and infantile type aortic coarctation?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

22. What is the definition of HTN?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
ANP
140/90
Holosystolic - harsh sounding murmur - loudest over tricuspid area

23. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Lymphangiosarcoma
S. bovis
Maintain blood flow to organ over wide range of perfussion pressures
Gap junctions

24. congenital heart defect withdown syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
Hypertrophied cardiomyopathy
Increase in Pc
Coarcation of aorta

25. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
CO
Stable angina
Persistant truncus arteriosus
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

26. In an anterior wall infarct - which artery is effected and which leads show Q waves
140/90
Vasodilators
Increase intracellular Na - resulting in increased Ca
LAD - V1 - V4

27. In an EKG - What is the p wave?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Atrial contraction
Gap junctions

28. What is the machine like murmur? What is the heart pathology and the predisposing causes
Inc Kf - capillary perm
Polyarteritis nodosum
In RA return (inspiration)
Patent ductus arteriosus - congenital rubella or prematurity

29. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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30. How do catecholamines increase contractility?
Hematocrit
Increasing activity of Ca pump in SR
Mean arterial pressure
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

31. What is sudden cardiac death most commonly due to...
V fib arrhythima
Left atrial pressure
LAD - V1 - V4
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

32. How does angiotensin II raise MAP
Subendocardial - fewer collaterals and higher pressure
Posterior descending (80% off the RCA - 20% off the circumflex)
Vasocxn - while other tissues it causes vasodilation
Vasocxn

33. cavernous lymphangioma of the neck - associated with turner's
Cystic hygroma
LCX - V4- V6
Unstable/crescendo angina
2nd degree AV block - mobitz type 1

34. What kind of infarct show ST depression
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Patent ductus arteriosus - congenital rubella or prematurity
Subendocardial
Late diastolic murmur following an opening snap

35. The aortic arch receptors transmit along which nerve?
During diastole
Vagus to medulla
Increase in Pc
Pulsus parvus and tardus - weak - can lead to syncope

36. When do you find hemosiderin laden macrophages in the lungs?
During HF from microhemorrhages from inc pulm cap pressure
Left atrial pressure
In parallel
Aortic dilation - bicuspid aortic valve - RF -

37. Mitral stenosis is most often secondary to which condition?
RF
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Libman - sacks endocarditis
Subendocardial

38. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
The operating point of the heart
Sturge weber - vasculitis of caps
Raynaud's
CO

39. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
At least 55%
TAPVR
Ischemic heart dz - mitral valve prolapse - LV dilation

40. How are the sarcomeres added in eccentric hypertrophy?
In series
Aortic dilation - bicuspid aortic valve - RF -
Vasodilators - (hydrAlAzine)
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

41. Which murmur is heard in aortic stenosis?
CK- MB
Eccentric - concentric hypertrophy causes diastolic disfunction
Crescendo - decrescendo systolic ejection murmur following ejection click
The first 4 days

42. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Dilated cardiomyopathy
Cardiac tamponde
ANP
Wegener's

43. Which lab value indicates blood viscosity?
Greater ventricular EDV
Inc blood volume
Hematocrit
Non

44. What is indicated when CO and venous return are equal?
The operating point of the heart
Late diastolic murmur following an opening snap
Granuloma with giant cells
Atrial contraction

45. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
The plateau period
Afterload (proportional to peripheral resistance)
Transfusion
Hypertrophied cardiomyopathy

46. When does extracellular calcium enter the cardiac muscle cells during contraction?
10%
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
The plateau period
MI

47. What is the gold standard for dx of MI in the first 6 hours
EKG
Conduction delay through AV node - nl < 200 msec
Metastasis from melanoma or lymphoma
Age related calcifications or bicuspid aortic valve

48. bening capillary hemangioma of elderly - does not regress
Vagus to medulla
Fick principle
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Cherry hemangioma

49. What does the U wave indicated?
Preload
HypoK and bradycardia
Apex and anterior interventricular septum
The first 4 days

50. What does autoregulation do?
Pulse pressure
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
RV failure - in venous pressure
Maintain blood flow to organ over wide range of perfussion pressures