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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 is the S1 sound?
HypoK and bradycardia
Atherosclerosis
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Mitral and tricuspid closure

2. In an EKG - What is the T wave?
Ventricular repolarization
Decreased
Hematocrit
Aortic disecction - intraluminal tear forming false lumen

3. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Mitral stenosis
Angiosarcoma
LCX - I - aVL
No - no pressure gradient

4. The cause of dyspnea on exertion?
3rd degree block - pacemaker - Lyme disease
Non
Fick principle
Failure of LV to in CO during exercise

5. with what heart sounds do ASD usually present?
Preload
TAPVR
Pulmonary flow murmur and diastolic rumble
Wegener's

6. Where does coronary artery occlusion occur most commonly?
No
LAD
In parallel
Dec plasma proteins

7. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
RF
Boot shaped heart
Polyarteritis nodosum
Decreases

8. Which vessels account for the most total peripheral resistance
Arteriorles
Aortic/pulmonic stenosis and mitral/tricuspid regurg
The aortic before pulmonic - inspiration increases diff
S. bovis

9. Hyperplastic onion skinning
RV failure - in venous pressure
LAD
Arteriolosclerosis in malignant hypertension
Inc blood volume

10. How does a patient with Tet of fallot learn to improve symptoms?
LV failure - pulm venous distention transudation of fluid
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Squat. Compression of femoral arteries - inc TPR - dec

11. Which class of drugs decrease preload
V fib
V fib arrhythima
Mitral>aortic>>tricuspid - high pressure valves affected most
Venodilators (nitrogylcerine)

12. What murmur is heard with aortic regurg?
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Kawasaki
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Conduction delay through AV node - nl < 200 msec

13. Which class of drugs decrease the murmur heard in aortic regurg?
Pulsus parvus and tardus - weak - can lead to syncope
Vasodilators
During diastole
Hypertrophied cardiomyopathy

14. What is the classic X ray finding for tet of fallot?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Boot shaped heart
MAP
Acute thrombosis of coronary artery

15. polypoid capillary hemangioma that can ulcerate and bleed
Stroke volume affected by contractility - afterload - and preload
Pyogenic granuloma - associated with trauma and pregnancy
Kidney
MI

16. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Right sided
Decreases
Persistant truncus arteriosus
2nd degree AV block - mobitz type 1

17. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Sturge weber - vasculitis of caps
Preload
Decreased

18. exaggerated decrease in pulse during inspiration.

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19. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Ventricles are depolarized
S. epidermidis
Troponin I
Atherosclerosis

20. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Non
S. bovis
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Aortic and pulmonary closing

21. When during cardiac nodal cells depolarize?
Mitral stenosis
During diastole
Takayasu's arteritis
During HF from microhemorrhages from inc pulm cap pressure

22. In an EKG - What is the QRS complex?
Acute thrombosis of coronary artery
Ventricular depolarization - nl < 120 msec
Stroke volume
Fick principle

23. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
140/90
LV failure - pulm venous distention transudation of fluid
Left heart failure

24. When does extracellular calcium enter the cardiac muscle cells during contraction?
Total anomalous pulmonary trunk venous return
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
The plateau period
Late diastolic murmur following an opening snap

25. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
MI
Varicose veins - thromboembolism rare
Fick principle
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

26. Which bacteria causes endocarditis in the presence of colon cancer
Troponin I
Vagus to medulla
Babies
S. bovis

27. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Kawasaki
Pos inotropy - exercise
Unstable/crescendo angina
Mechanican contraction of the ventricles

28. no change in PR interval followed by dropped beat
Stroke volume
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Troponin I
Stroke volume affected by contractility - afterload - and preload

29. What are anitschkow's cells
Activated histiocytes
LAD > RCA > circumflex
Arteriorles
Isovolumetric contraction

30. Which murmur is characteristic of mitral/tricuspid regurg?
Pulmonic stenosis and RBBB
Holosystoiic
Afterload (proportional to peripheral resistance)
HypoK and bradycardia

31. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Decreased
Turners
Vasodilators - (hydrAlAzine)

32. Given P = QR - what factors influence resistance?
If sodium channel
Proportional to viscosity and inversely proportional to the radius to the 4th power
Aburpt halting of valve leaflets
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

33. MAP is also known as
Afterload (proportional to peripheral resistance)
Tempral arteritis - may cause irreversible blindness
LCX - I - aVL
Stable angina

34. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Inc TPR and LA return (expiration)
The operating point of the heart
Eccentric - concentric hypertrophy causes diastolic disfunction
2nd degree AV block - mobitz type 1

35. What is the S2 sound?
ASD - VSD - AV septal defect (endocardial cushion defect)
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Aortic and pulmonary closing

36. Where are pacemaker cells?
Microscopic polyangiitis - like wegener's without granulomas
Chordae rupture - GN - suppurative pericarditis - emboli
Takayasu's arteritis
SA and AV nodes

37. Restrictive cardiomyopathy causes
Pulsus parvus and tardus - weak - can lead to syncope
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Infective endocarditis
Torsades de pointes

38. Which organ has the largest arteriovenous difference
Heart - 02 extraction is always around 100%
The first 4 days
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Transfusion

39. which heart valves are afected most in rheumatic heart diseease
In series
Inc interstitial osmotic pressure pulling fliud out of capillaries
Mitral>aortic>>tricuspid - high pressure valves affected most
Extracellular calcium - calcium induced calcium release

40. systolic - diastolic
Pulse pressure
Kawasaki
Glossopharyngeal to soliary nucleus of medulla
Kids

41. Which organ has ht highest blood flow per gram of tissue
Liver
Kidney
10%
HTN - bradycardia - and respiratory depression

42. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Eccentric - concentric hypertrophy causes diastolic disfunction
Neg inotropy - HF - narcotic overdose
Transmural

43. machine murmer
Can progess to V fib
PDA
If sodium channel
Fetal right to left - neonate left to right leading to RVH and failure

44. What is associated with paradoxical spliting of S2
Varicose veins - thromboembolism rare
Aortic stenosis or LBBB
Angiosarcoma
Atrial contraction

45. In normal S2 splitting - which valve closes first? What increases it?
Can progess to V fib
The aortic before pulmonic - inspiration increases diff
Myxomatous degeneration - RF - chordae rupture
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

46. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Mitral valve
5-10 days - macs have degraded structural components
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

47. Which kind of infarct show ST elevation - and/or pathologic Q waves
Conduction delay through AV node - nl < 200 msec
Transmural
Atherosclerosis
ASD - VSD - AV septal defect (endocardial cushion defect)

48. What kind of dysfunction ensues in restrictive cardiomyopathy
Greater ventricular EDV
Inc Kf - capillary perm
Diastolic
Vasodilators - (hydrAlAzine)

49. How does digitatlis increase contractility?
Fick principle
The plateau period
Ischemic heart dz - mitral valve prolapse - LV dilation
Increase intracellular Na - resulting in increased Ca

50. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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