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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. In an EKG - What is the T wave?
Temporal arteritis
Vagus to medulla
Ventricular repolarization
Babies

2. Which bacteria causes rheumatic heart disease
Acute thrombosis of coronary artery
Group a beta hemolytic strep
Angiosarcoma
Polyarteritis nodosum

3. Wegener's presentation
Henoch - Schlonlein purpura
Increase - increase the chance the If are open
Subendocardial
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

4. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
If sodium channel
Dressler's - autoimmune
Aortic disecction - intraluminal tear forming false lumen

5. which medications are used to maintain patency or close the ductus arteriosus?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Indomethacin closes - and pge keeps it open
Fick principle
No - no pressure gradient

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

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7. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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8. Wegener's tx
LAD > RCA > circumflex
Left atrial pressure
Cyclophosphamide and corticosteroids
Postinfarction fibrinous pericarditis

9. SV CAP means?
Vasocxn - while other tissues it causes vasodilation
Stroke volume affected by contractility - afterload - and preload
CFX
Pos inotropy - exercise

10. What is the definition of HTN?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
140/90
Pulmonic stenosis and RBBB

11. congenital heart defect in an infant with a diabetic mother?
Transposition of great vessels
Greater ventricular EDV
Can progess to V fib
Decrease in activity of Na/Ca exhanger and increase in contractility

12. Left to right shunts are more common in babies or kids?
Kids
RCA
CHF
HypoK and bradycardia

13. What is the difference between adult and infantile type aortic coarctation?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Transmural
Cystic hygroma
Neg inotropy - HF - narcotic overdose

14. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Increase contractility
Heart - 02 extraction is always around 100%
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

15. What causes the cushing reflex and why
SV/ EDV
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Resting potential high K perm
10%

16. congenital heart defect with marfan's
Increase in Pc
Kids
The first 4 days
Aortic insuffic - late

17. What does mitral prolapse predeispose to?
Myxomatous degeneration - RF - chordae rupture
Indomethacin closes - and pge keeps it open
Infective endocarditis
Atherosclerosis

18. What happends in phase 1 of the ventricular cardiac action potential?
Mean arterial pressure
Turners
The plateau period
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

19. What is the S1 sound?
Stroke volume
RV contraction (closed tricuspid valve bulding into atrium
Mitral and tricuspid closure
In HF

20. congenital heart defect withdown syndrome
Preload
Failure of LV to in CO during exercise
The aortic before pulmonic - inspiration increases diff
ASD - VSD - AV septal defect (endocardial cushion defect)

21. EDV is also known as
Preload
R to L shunt caused by stenoic pulmonic valve
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

22. What happens in phase 0 of the cardiac ventricular action potential?
Wolff - Parkinson white syndrome
In RA return (inspiration)
Rapid upstroke - voltage gated Na channels open
S. bovis

23. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
RF
Fick principle
Indomethacin closes - and pge keeps it open
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

24. What is the S2 sound?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Aortic and pulmonary closing
Increased SV
Troponin I

25. which ethnic groups have higher association with HTN?
CHF
Black > white > asian
Volatage gated Ca channels
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

26. Which channel accounts for automaticity of the SA and AV nodes?
ASD - VSD - AV septal defect (endocardial cushion defect)
In HF
Stroke volume
If sodium channel

27. What kind of dysfunction ensues in restrictive cardiomyopathy
Cyclophosphamide and corticosteroids
Age related calcifications or bicuspid aortic valve
Diastolic
Polyarteritis nodosum

28. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Volatage gated Ca channels
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Inc blood volume
Unstable/crescendo angina

29. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
CFX
Lower right - MC - upper right - AO - upper right AC - lower left MO
In RA return (inspiration)
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

30. congenital heart defect with turner's
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Pulse pressure
Coarcation of aorta

31. What is the danger of torsades to pointes?
Arteriolosclerosis in malignant hypertension
HypoK and bradycardia
Wegener's
Can progess to V fib

32. What 4 things drive myocardial 02 demand?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Wegener's
CO
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

33. which heart valves are afected most in rheumatic heart diseease
RV failure - in venous pressure
Mitral>aortic>>tricuspid - high pressure valves affected most
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Diastolic

34. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Patent ductus arteriosus - congenital rubella or prematurity
2nd degree AV block - mobitz type 1
Kaposi's sarcoma
Acute thrombosis of coronary artery

35. What causes tet of fallot?
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Pulmonary flow murmur and diastolic rumble
Buerger's disease
Anterosuperior displacement of the infundibular septum

36. What are the complications of atherosclerosis?
Late systolic crescendo murmur with a midsystolic click
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Pulmonic stenosis and RBBB

37. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Left sided
Subendocardial
Hemorrhage

38. What happens in phase 2 of the cardiac ventricular action potential?
Increase intracellular Na - resulting in increased Ca
Diastolic
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Mitral valve

39. Which artery supplies the SA and AV nodes?
2nd degree AV block - mobitz type 1
RCA
Boot shaped heart
Aortic/pulmonic stenosis and mitral/tricuspid regurg

40. What does FEVERSS stand for in rheumatic heart disease
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Atherosclerosis
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Dec P02 - inc PC02 and dec pH

41. How does digitatlis increase contractility?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Increase intracellular Na - resulting in increased Ca
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Boot shaped heart

42. What does HTN predispose to?
Systolic dysfunction
Inc RA pressure - due to filling against closed tricupsid valve
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

43. In an EKG - What is the PR interval?
Mechanican contraction of the ventricles
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Truncus - tet of fallot
Conduction delay through AV node - nl < 200 msec

44. tearing chest pain radiation to the back - associated with marfan
Purkingee>atria>ventricles>AV node
Atherosclerosis
Aortic disecction - intraluminal tear forming false lumen
2nd degree AV block - mobitz type 1

45. most common primary cardiac tumor in children - associated with tuberous sclerosis
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
C - ANCA
Ventricular depolarization - nl < 120 msec
Rhabdomyomas

46. The cause of cardiac dilation?
Dec P02 - inc PC02 and dec pH
Dilated cardiomyopathy
Cystic hygroma
Greater ventricular EDV

47. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Failure of LV to in CO during exercise
Henoch - Schlonlein purpura
RV contraction (closed tricuspid valve bulding into atrium
Ventricles are depolarized

48. What masks atrial repolarization?
QRS complex
Holosystoiic
Eccentric - concentric hypertrophy causes diastolic disfunction
Increase intracellular Na - resulting in increased Ca

49. What does TAPVR stand for
Decreased
Dilation
Total anomalous pulmonary trunk venous return
Anterosuperior displacement of the infundibular septum

50. no relation between p waves and QRS intervals - treatment and predisposing factor
P02
Mitral valve prolapse
3rd degree block - pacemaker - Lyme disease
Chordae rupture - GN - suppurative pericarditis - emboli