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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?
Unstable/crescendo angina
Mitral and tricuspid closure
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
S. epidermidis

2. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Vasodilators - (hydrAlAzine)
Fick principle
Extracellular calcium - calcium induced calcium release
Transposition of great vessels

3. What constitues the upstroke in pacemaker cells?
Changes in CO as a function of preload
Volatage gated Ca channels
Systolic dysfunction
Pulmonary flow murmur and diastolic rumble

4. Which class of drugs decrease the murmur heard in aortic regurg?
Stroke volume affected by contractility - afterload - and preload
Tempral arteritis - may cause irreversible blindness
Indomethacin closes - and pge keeps it open
Vasodilators

5. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Subendocardial
Tricuspid atresia - requires ASD and VSD
Angiosarcoma
Sturge weber - vasculitis of caps

6. In an EKG - What is the PR interval?
Patent ductus arteriosus - congenital rubella or prematurity
Conduction delay through AV node - nl < 200 msec
P02
Chordae rupture - GN - suppurative pericarditis - emboli

7. CO x Total peripheral resistance
Mean arterial pressure
Extracellular calcium - calcium induced calcium release
Subendocardial
Filling is incomplete and CO falls

8. What does the U wave indicated?
C - ANCA
Glossopharyngeal to soliary nucleus of medulla
TAPVR
HypoK and bradycardia

9. exaggerated decrease in pulse during inspiration.

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10. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Metastasis from melanoma or lymphoma
2nd degree AV block - mobitz type 1
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

11. What causes the murmur heard in MR to enhance?
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Inc TPR and LA return (expiration)
Decreased
Left heart failure

12. In the cardiac cycle - which period has the highest 02 consumption?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Isovolumetric contraction
Wolff - Parkinson white syndrome
At least 55%

13. What is the formula for EF?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
SV/ EDV
Hypertrophied cardiomyopathy
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

14. What are the systolic heart sounds
Granuloma with giant cells
Lower right - MC - upper right - AO - upper right AC - lower left MO
S. epidermidis
Aortic/pulmonic stenosis and mitral/tricuspid regurg

15. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Dressler's - autoimmune
The first 4 days
LAD - V1- V2
Sudden tensing of chordae tendinae

16. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
No - no pressure gradient
Myxomatous degeneration - RF - chordae rupture
10%

17. The aortic arch receptors transmit along which nerve?
RCA
Vagus to medulla
Apex and anterior interventricular septum
Aortic dilation - bicuspid aortic valve - RF -

18. Which organ gets the largest share of systemic cardiac output
Coarcation of aorta
Left sided
Total anomalous pulmonary trunk venous return
Liver

19. MAP is also known as
Afterload (proportional to peripheral resistance)
In parallel
Transmural
V fib

20. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Fluid movement through capillaries
...
Acute thrombosis of coronary artery
RCA - II - III - aVF

21. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
Increase intracellular Na - resulting in increased Ca
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Fast volatge gated Na channels

22. What is the characteristic pulse in aortic stenosis?
Metastasis from melanoma or lymphoma
Gap junctions
Pulsus parvus and tardus - weak - can lead to syncope
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

23. Which murmur is characteristic of mitral/tricuspid regurg?
Kids
Holosystoiic
ASD
Afterload (proportional to peripheral resistance)

24. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
Preload
Aortic dilation - bicuspid aortic valve - RF -
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

25. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
Dec plasma proteins
Subendocardial
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

26. How does a patient with Tet of fallot learn to improve symptoms?
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Kids
Squat. Compression of femoral arteries - inc TPR - dec
ANP

27. When and why do you hear the S4 sound
No
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
In RA return (inspiration)
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

28. In an EKG - What is the QT interval?
Mechanican contraction of the ventricles
Buerger's disease
Coarcation of aorta
ASD - VSD - AV septal defect (endocardial cushion defect)

29. What causes the CO curve to shift upwards?
Indomethacin closes - and pge keeps it open
Hyperlipidemia
Dilation
Pos inotropy - exercise

30. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Transposition of great vessels
LAD - V1- V2
Glomus tumor
Changes in CO as a function of preload

31. Why is contractility decreased in heart failure?
Ventricular depolarization - nl < 120 msec
Systolic dysfunction
Libman - sacks endocarditis
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

32. How are the sarcomeres added in eccentric hypertrophy?
In series
P02
Hemorrhage
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

33. What is the most common cause of right heart failure
R to L shunt caused by stenoic pulmonic valve
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Kids
Left heart failure

34. Which murmur is heard with mitral prolapse?
Lymphangiosarcoma
The plateau period
Late systolic crescendo murmur with a midsystolic click
Rapid upstroke - voltage gated Na channels open

35. When is the scar completely formed in an MI?
7 weeks
MAP
LCX - I - aVL
Isovolumetric contraction

36. What causes the early cyanosis in Tet of Fallot?
Buerger's disease
Coarcation of aorta
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
R to L shunt caused by stenoic pulmonic valve

37. In an anterior wall infarct - which artery is effected and which leads show Q waves
Venodilators (nitrogylcerine)
LAD - V1 - V4
Activated histiocytes
SV/ EDV

38. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Increase in Pc
Temporal arteritis
TAPVR
Dilation

39. Which channel accounts for automaticity of the SA and AV nodes?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
If sodium channel
Aortic insuffic - late
Indomethacin closes - and pge keeps it open

40. What are aschoff bodies
Increased SV
Kidney
Granuloma with giant cells
Atrial contraction

41. What is the definition of HTN?
140/90
TAPVR
The first 4 days
LV failure - pulm venous distention transudation of fluid

42. fibrinous pericarditis several weeks post MI

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43. friction rub - 3-5 days post MI
HTN - bradycardia - and respiratory depression
Mechanican contraction of the ventricles
Isovolumetric contraction
Postinfarction fibrinous pericarditis

44. Where are pacemaker cells?
LCX - I - aVL
Polyarteritis nodosum
SA and AV nodes
LV failure - pulm venous distention transudation of fluid

45. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Septal defects - PDA - pulm art stenosis
Cherry hemangioma
Ischemic heart dz - mitral valve prolapse - LV dilation
Non

46. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
Total anomalous pulmonary trunk venous return
Early deaths from myocarditis
LAD - V1- V2

47. what happens to capillaries in lymphatic blockage
Heart - 02 extraction is always around 100%
Transmural
Mitral valve
Inc interstitial osmotic pressure pulling fliud out of capillaries

48. Which enzymes are useful for diagnosing reinfarction
Inc TPR and LA return (expiration)
CK- MB
C - ANCA
Arteriorles

49. Which artery supplies the inferior portion of the left ventricle and posterior septum?
RF
Activated histiocytes
Posterior descending (80% off the RCA - 20% off the circumflex)
Fast volatge gated Na channels

50. What do the carotid and aortic bodies respond to?
Dec P02 - inc PC02 and dec pH
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Holosystoiic