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Test your basic knowledge |
Cardiology
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
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. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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2. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Left sided
...
Activated histiocytes
3. How do beta blockers decrease contractility?
Mitral and tricuspid closure
Decrease in cAMP
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
4. When does extracellular calcium enter the cardiac muscle cells during contraction?
Rapid upstroke - voltage gated Na channels open
Late diastolic murmur following an opening snap
The plateau period
Varicose veins - thromboembolism rare
5. What are the complications of atherosclerosis?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic/pulmonic regurg and mitral/tricuspid stenosis
6. Which two mechanisms sense decrease MAP?
Medullary vasomotor center senses baroreceptors and JGA
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Vasodilators - (hydrAlAzine)
Lower right - MC - upper right - AO - upper right AC - lower left MO
7. When and why do you hear the S4 sound
Holosystoiic
Vagus to medulla
Strawberry hemangioma
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
8. Most common vasculitis affecting medium and large arteries
Filling is incomplete and CO falls
Mitral>aortic>>tricuspid - high pressure valves affected most
Temporal arteritis
Posterior descending (80% off the RCA - 20% off the circumflex)
9. Where is the most posterior portion of the heart and What can it cause?
Atherosclerosis
Kidney
MI
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
10. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Dilated cardiomyopathy
Black > white > asian
RF
11. What is the progression of atherosclerosis?
Cardiac tamponde
If sodium channel
Infective endocarditis
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
12. Which organ has ht highest blood flow per gram of tissue
Dressler's - autoimmune
Kidney
V fib arrhythima
Black > white > asian
13. What other sign is often present with congenital long QT syndrome - why?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Preload
S. bovis
Myxomatous degeneration - RF - chordae rupture
14. In the cardiac cycle - which period has the highest 02 consumption?
Raynaud's
Stroke volume affected by contractility - afterload - and preload
Isovolumetric contraction
RV contraction (closed tricuspid valve bulding into atrium
15. EDV - ESV
ASD - VSD - AV septal defect (endocardial cushion defect)
Atherosclerosis
Stroke volume
Tricuspid atresia - requires ASD and VSD
16. What is the definition of HTN?
140/90
In parallel
Ischemic heart dz - mitral valve prolapse - LV dilation
Atrial contraction
17. Which bacteria can cause endocarditis from prosthetic valves?
Isovolumetric contraction
S. epidermidis
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
In parallel
18. When do you find hemosiderin laden macrophages in the lungs?
Granuloma with giant cells
During HF from microhemorrhages from inc pulm cap pressure
Greater ventricular EDV
Patent ductus arteriosus - congenital rubella or prematurity
19. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Wolff - Parkinson white syndrome
LV failure - pulm venous distention transudation of fluid
Increase - increase the chance the If are open
20. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
S. bovis
TAPVR
Fast volatge gated Na channels
21. What do the carotid and aortic bodies respond to?
Dec P02 - inc PC02 and dec pH
Truncus - tet of fallot
Atherosclerosis
If sodium channel
22. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
CK- MB
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
RF
Troponin I
23. Unilateral headache - jaw claudication - impaired vision
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Tempral arteritis - may cause irreversible blindness
Angiosarcoma
Total anomalous pulmonary trunk venous return
24. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Preload
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Hypertrophied cardiomyopathy
HypoK and bradycardia
25. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
LCX - V4- V6
The plateau period
Posterior descending (80% off the RCA - 20% off the circumflex)
26. In terms of starling forces - why does heart failure cause edema?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
R to L shunt caused by stenoic pulmonic valve
Increase in Pc
Lower right - MC - upper right - AO - upper right AC - lower left MO
27. CO x Total peripheral resistance
Mean arterial pressure
CHF
Tricuspid atresia - requires ASD and VSD
Holosystolic - harsh sounding murmur - loudest over tricuspid area
28. failure of truncus arteriosus to divide?
Mitral>aortic>>tricuspid - high pressure valves affected most
Fetal right to left - neonate left to right leading to RVH and failure
Varicose veins - thromboembolism rare
Persistant truncus arteriosus
29. What are aschoff bodies
Granuloma with giant cells
Holosystoiic
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Subendocardial
30. What is the early and late lesion in rheumatic heart disease
Varicose veins - thromboembolism rare
Mitral valve prolapse
Atrial contraction
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
31. What happends in phase 1 of the ventricular cardiac action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Decrease in activity of Na/Ca exhanger and increase in contractility
The plateau period
Non
32. Which organ gets the largest share of systemic cardiac output
Dilated cardiomyopathy
Crescendo - decrescendo systolic ejection murmur following ejection click
Transmural
Liver
33. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
EKG
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Myxoma
Failure of LV to in CO during exercise
34. Where does coronary artery occlusion occur most commonly?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Vasocxn - while other tissues it causes vasodilation
LAD
Varicose veins - thromboembolism rare
35. Churg Strauss - presentation and test
Glomus tumor
CK- MB
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
36. When do coronary arteries fill?
Cyclophosphamide and corticosteroids
Arteriorles
During diastole
CFX
37. When do you see extensive coagulative necrosis in an MI
2-4 day - early coag necrosis on the first day
Kawasaki
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
HTN - bradycardia - and respiratory depression
38. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Age related calcifications or bicuspid aortic valve
RF
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Stable angina
39. Chronic mitral stenosis can lead to what changes in size of the LA
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Dilation
Crescendo - decrescendo systolic ejection murmur following ejection click
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
40. congenital heart defect with marfan's
Subendocardial
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Aortic insuffic - late
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
41. How does a patient with Tet of fallot learn to improve symptoms?
Kaposi's sarcoma
Turners
Squat. Compression of femoral arteries - inc TPR - dec
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
42. How does digitatlis increase contractility?
Decreased
Increase intracellular Na - resulting in increased Ca
In RA return (inspiration)
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
43. what conditions are associated with pulsus paradoxus
Wolff - Parkinson white syndrome
ASD
Cherry hemangioma
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
44. benign - painful - red - blue tumor under fingernails from smooth muscle cells
RV contraction (closed tricuspid valve bulding into atrium
Pulsus parvus and tardus - weak - can lead to syncope
Eisenmenger's syndrome
Glomus tumor
45. What is the classic X ray finding for tet of fallot?
Lymphangiosarcoma
Infective endocarditis
Strawberry hemangioma
Boot shaped heart
46. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Mitral and tricuspid closure
Dilation
Polyarteritis nodosum
47. 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
LAD - V1 - V4
Extracellular calcium - calcium induced calcium release
Mitral stenosis
48. clinical signs of cardiac tamponade
Torsades de pointes
Gap junctions
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
49. Which murmur is heard with mitral prolapse?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Late systolic crescendo murmur with a midsystolic click
ASD - VSD - AV septal defect (endocardial cushion defect)
Systolic dysfunction
50. What are common causes of mitral regurg?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Proportional to viscosity and inversely proportional to the radius to the 4th power
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Ischemic heart dz - mitral valve prolapse - LV dilation