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Cardiology
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Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
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. congenital heart defect in an infant with a diabetic mother?
Decrease in activity of Na/Ca exhanger and increase in contractility
Transposition of great vessels
Postinfarction fibrinous pericarditis
Increased efferent SANS and decreased efferent PANS
2. What is the association with wide S2 splitting?
LAD > RCA > circumflex
MAP
Dec P02 - inc PC02 and dec pH
Pulmonic stenosis and RBBB
3. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Ventricular repolarization
Tempral arteritis - may cause irreversible blindness
4. In an anterior wall infarct - which artery is effected and which leads show Q waves
S. epidermidis
Stroke volume
LAD - V1 - V4
Volatage gated Ca channels
5. How does digitatlis increase contractility?
Hemorrhage
Increase in Pc
Vasocxn
Increase intracellular Na - resulting in increased Ca
6. which ethnic groups have higher association with HTN?
Polyarteritis nodosum
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Increase intracellular Na - resulting in increased Ca
Black > white > asian
7. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Filling is incomplete and CO falls
Failure of LV to in CO during exercise
S. aureus
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
8. What happens in phase 0 of the cardiac ventricular action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
LAD - V1 - V4
Rapid upstroke - voltage gated Na channels open
Turners
9. What does mitral prolapse predeispose to?
Infective endocarditis
Wegener's
Septal defects - PDA - pulm art stenosis
Ischemic heart dz - mitral valve prolapse - LV dilation
10. What happens in phase 4 of the cardiac ventricular action potential?
Dec plasma proteins
Resting potential high K perm
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Inc TPR and LA return (expiration)
11. MAP is also known as
Kawasaki
Afterload (proportional to peripheral resistance)
Temporal arteritis
Decrease in activity of Na/Ca exhanger and increase in contractility
12. most common heart tumor
Metastasis from melanoma or lymphoma
Decrease in cAMP
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
13. Wegener's presentation
Vasocxn
Kawasaki
Extracellular calcium - calcium induced calcium release
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
14. CO x Total peripheral resistance
Inc interstitial osmotic pressure pulling fliud out of capillaries
Stroke volume
Mean arterial pressure
Lower right - MC - upper right - AO - upper right AC - lower left MO
15. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Increased SV
Increased efferent SANS and decreased efferent PANS
Dilated cardiomyopathy
Pulmonic stenosis and RBBB
16. What cardiac change occurs in pregnancy?
Increased SV
Inc Kf - capillary perm
The first 4 days
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
17. disease of elastic arteries and large and medium sized muscular arteries
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Atherosclerosis
Wegener's
Unstable/crescendo angina
18. Which murmur is heard with mitral prolapse?
Late systolic crescendo murmur with a midsystolic click
...
Preload
Early deaths from myocarditis
19. Given P = QR - what factors influence resistance?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Gap junctions
EKG
Myxoma
20. When do you see extensive coagulative necrosis in an MI
2-4 day - early coag necrosis on the first day
Fetal right to left - neonate left to right leading to RVH and failure
P02
Polyarteritis nodosum
21. Where are pacemaker cells?
2-4 day - early coag necrosis on the first day
SA and AV nodes
Mitral>aortic>>tricuspid - high pressure valves affected most
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
22. When does EF decrease
Troponin I
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
In HF
ANP
23. What causes the murmur heard in MR to enhance?
RF
Troponin I
Inc TPR and LA return (expiration)
Torsades de pointes
24. What are the four most common locations for atherosclerosis?
Dilated cardiomyopathy
During HF from microhemorrhages from inc pulm cap pressure
Inc venous return exaccerbates pulm vasc congestion
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
25. Wegener's tx
Unstable/crescendo angina
Cyclophosphamide and corticosteroids
Inc TPR and LA return (expiration)
Boot shaped heart
26. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
During HF from microhemorrhages from inc pulm cap pressure
Cardiac tamponde
Viridans streptococci
Vasocxn
27. fibrinous pericarditis several weeks post MI
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28. How do beta blockers decrease contractility?
The aortic before pulmonic - inspiration increases diff
Lower right - MC - upper right - AO - upper right AC - lower left MO
Decrease in cAMP
Eccentric - concentric hypertrophy causes diastolic disfunction
29. Right to left shunts are more common in babies or kids?
Vasocxn - while other tissues it causes vasodilation
Chordae rupture - GN - suppurative pericarditis - emboli
Mitral>aortic>>tricuspid - high pressure valves affected most
Babies
30. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Vasocxn - while other tissues it causes vasodilation
Dilation
Transfusion
Decrease in cAMP
31. congenital heart defect with marfan's
140/90
Stroke volume affected by contractility - afterload - and preload
Aortic insuffic - late
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
32. In the cardiac cycle - which period has the highest 02 consumption?
Right sided
Isovolumetric contraction
Increase in Pc
Apex and anterior interventricular septum
33. Which class of drugs decreases afterload?
Posterior descending (80% off the RCA - 20% off the circumflex)
Hyperlipidemia
Vasodilators - (hydrAlAzine)
Apex and anterior interventricular septum
34. fibrous plaques and atheromas in intima of arteries
Troponin I
Atherosclerosis
Increase contractility
Left heart failure
35. Where is the most posterior portion of the heart and What can it cause?
Myxoma
Can progess to V fib
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Decrease in activity of Na/Ca exhanger and increase in contractility
36. What is the early and late lesion in rheumatic heart disease
Mitral valve prolapse
Isovolumetric contraction
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
37. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Mitral valve prolapse
Increasing activity of Ca pump in SR
Fetal right to left - neonate left to right leading to RVH and failure
Turners
38. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
Ventricular repolarization
Posterior descending (80% off the RCA - 20% off the circumflex)
Aortic/pulmonic regurg and mitral/tricuspid stenosis
39. What is indicated when CO and venous return are equal?
7 weeks
Afterload (proportional to peripheral resistance)
The operating point of the heart
Eisenmenger's syndrome
40. What does prolonged QT predispose to?
Isovolumetric contraction
Torsades de pointes
Boot shaped heart
Coarcation of aorta
41. What does the starling curve show?
RCA - II - III - aVF
Failure of LV to in CO during exercise
Changes in CO as a function of preload
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
42. Which organ has ht highest blood flow per gram of tissue
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Kidney
Afterload (proportional to peripheral resistance)
Angiosarcoma
43. What are common causes of mitral regurg?
Atrial contraction
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Increasing activity of Ca pump in SR
Ischemic heart dz - mitral valve prolapse - LV dilation
44. list the coronary vessels most likely to be occluded
If sodium channel
Adult type aortic coarctation
LAD > RCA > circumflex
Tricuspid atresia - requires ASD and VSD
45. What does increasing intracellular Ca do?
Increase contractility
LAD
Transposition of great vessels
Vagus to medulla
46. Which channel accounts for automaticity of the SA and AV nodes?
Subendocardial - fewer collaterals and higher pressure
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Unstable/crescendo angina
If sodium channel
47. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Pulsus parvus and tardus - weak - can lead to syncope
Increase - increase the chance the If are open
Tempral arteritis - may cause irreversible blindness
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
48. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Ventricular depolarization - nl < 120 msec
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Volatage gated Ca channels
Stroke volume
49. cavernous lymphangioma of the neck - associated with turner's
Subendocardial - fewer collaterals and higher pressure
Libman - sacks endocarditis
Cystic hygroma
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
50. Unilateral headache - jaw claudication - impaired vision
ASD - VSD - AV septal defect (endocardial cushion defect)
LAD
Tempral arteritis - may cause irreversible blindness
Raynaud's
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