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Cardiology

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. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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2. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Activated histiocytes
Vagus to medulla
Cardiac tamponde
Decreased

3. How do beta blockers decrease contractility?
Decrease in cAMP
V fib
Ventricular depolarization - nl < 120 msec
Decrease in activity of Na/Ca exhanger and increase in contractility

4. What causes tet of fallot?
SA and AV nodes
Mitral and tricuspid closure
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Anterosuperior displacement of the infundibular septum

5. When does extracellular calcium enter the cardiac muscle cells during contraction?
Conduction delay through AV node - nl < 200 msec
Decreases
Glomus tumor
The plateau period

6. What other sign is often present with congenital long QT syndrome - why?
Decreased
Fetal right to left - neonate left to right leading to RVH and failure
Changes in CO as a function of preload
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome

7. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Atherosclerosis
Vasocxn - while other tissues it causes vasodilation
Henoch - Schlonlein purpura

8. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Aortic/pulmonic stenosis and mitral/tricuspid regurg
2nd degree AV block - mobitz type 1
Turners
SA>AV>bundle of His>ventricles

9. What does an isoelectric ST segment indicate?
Ventricles are depolarized
10%
SV/ EDV
C - ANCA

10. Irregularly irregular ECG - no p waves: dx and treatment
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Systolic dysfunction
Myxomatous degeneration - RF - chordae rupture
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

11. What causes ankle - sacral edema - jugular venous distention
Tempral arteritis - may cause irreversible blindness
Subendocardial
Left heart failure
RV failure - in venous pressure

12. 2/3 diastolic + 1/3 systolic
Decreases
Postinfarction fibrinous pericarditis
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
MAP

13. What causes the cushing reflex and why
Septal defects - PDA - pulm art stenosis
Increased SV
Hemorrhage
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

14. Which valve is most commonly involved in bacterial endocarditis?
LCX - I - aVL
Activated histiocytes
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Mitral valve

15. What causes aortic stenosis
Yes
Inc blood volume
Stroke volume affected by contractility - afterload - and preload
Age related calcifications or bicuspid aortic valve

16. What are the systolic heart sounds
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Maintain blood flow to organ over wide range of perfussion pressures
Yes
Apex and anterior interventricular septum

17. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Cardiac tamponde
2-4 day - early coag necrosis on the first day
Stable angina
CO

18. What masks atrial repolarization?
LAD
Unstable/crescendo angina
Vasodilators
QRS complex

19. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Hypertrophied cardiomyopathy
Hyperlipidemia
Dec plasma proteins
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

20. PCWP is an estimate of...
Lymphangiosarcoma
Left atrial pressure
Aortic/pulmonic stenosis and mitral/tricuspid regurg
V fib

21. Which kind of infarct show ST elevation - and/or pathologic Q waves
Transmural
Extracellular calcium - calcium induced calcium release
Inc central venous pressure - inc resistance to portal flow
ASD

22. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
Atrial contraction
Increased efferent SANS and decreased efferent PANS
Aburpt halting of valve leaflets

23. Left to right shunts are more common in babies or kids?
Kids
Ventricular repolarization
Lower right - MC - upper right - AO - upper right AC - lower left MO
LAD - V1 - V4

24. When does EF decrease
Dec P02 - inc PC02 and dec pH
In HF
Right sided
Greater ventricular EDV

25. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Eisenmenger's syndrome
RV contraction (closed tricuspid valve bulding into atrium
MI

26. What causes the early cyanosis in Tet of Fallot?
S. aureus
Transmural
R to L shunt caused by stenoic pulmonic valve
SV/ EDV

27. What does T wave inversion indicated?
Turners
Increased efferent SANS and decreased efferent PANS
MI
Mean arterial pressure

28. What is the difference between adult and infantile type aortic coarctation?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Increase - increase the chance the If are open
Preload

29. What do patients die early from in rheumatic heart disease?
LAD > RCA > circumflex
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Early deaths from myocarditis
Fluid movement through capillaries

30. fibrinous pericarditis several weeks post MI

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31. Right to left shunts are more common in babies or kids?
Diastolic
Wegener's
Babies
Atherosclerosis

32. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
S. epidermidis
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
RV contraction (closed tricuspid valve bulding into atrium
Troponin I

33. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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34. What is the progression of atherosclerosis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Persistant truncus arteriosus
Libman - sacks endocarditis

35. Where is the most posterior portion of the heart and What can it cause?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Pulmonic stenosis and RBBB
Hyperlipidemia
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

36. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
S. bovis
Non
RF
Decrease in cAMP

37. failure of truncus arteriosus to divide?
Increase contractility
Persistant truncus arteriosus
RCA - II - III - aVF
Mitral and tricuspid closure

38. Where does coronary artery occlusion occur most commonly?
LAD
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
CO

39. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
SV/ EDV
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

40. How does digitatlis increase contractility?
Increase intracellular Na - resulting in increased Ca
S. epidermidis
Subendocardial - fewer collaterals and higher pressure
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

41. When do you find hemosiderin laden macrophages in the lungs?
The first 4 days
HypoK and bradycardia
Hyperlipidemia
During HF from microhemorrhages from inc pulm cap pressure

42. exaggerated decrease in pulse during inspiration.

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43. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
During diastole
Aburpt halting of valve leaflets
Strawberry hemangioma

44. How does angiotensin II raise MAP
Infective endocarditis
Activated histiocytes
Vasocxn
Glomus tumor

45. What does TAPVR stand for
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Total anomalous pulmonary trunk venous return
Mean arterial pressure

46. decrease stretch in baroreceptors leads to what response?
Increased efferent SANS and decreased efferent PANS
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Black > white > asian
Changes in CO as a function of preload

47. What other syndrom is associated with infantile aortic coarctation
ASD
Turners
Holosystolic - harsh sounding murmur - loudest over tricuspid area
During diastole

48. PCWP > LV diastolic pressure
Left atrial pressure
Mitral stenosis
Dressler's - autoimmune
Granuloma with giant cells

49. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
The first 4 days
Vasocxn
Decreases
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

50. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Total anomalous pulmonary trunk venous return