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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. Churg Strauss - presentation and test
Isovolumetric contraction
Septal defects - PDA - pulm art stenosis
Posterior descending (80% off the RCA - 20% off the circumflex)
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

2. EDV is also known as
Increase in Pc
Sudden tensing of chordae tendinae
CHF
Preload

3. What happens in phase 4 of the cardiac ventricular action potential?
Medullary vasomotor center senses baroreceptors and JGA
Fetal right to left - neonate left to right leading to RVH and failure
HypoK and bradycardia
Resting potential high K perm

4. Hyperplastic onion skinning
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Liver
Arteriolosclerosis in malignant hypertension
Dec plasma proteins

5. How does angiotensin II raise MAP
Vasocxn
Transfusion
Kidney
Persistant truncus arteriosus

6. fibrinous pericarditis several weeks post MI

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7. How does digitatlis increase contractility?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Increase intracellular Na - resulting in increased Ca
During diastole
In series

8. What is the most common cause of right heart failure
Left heart failure
In RA return (inspiration)
Vagus to medulla
Late diastolic murmur following an opening snap

9. What does prolonged QT predispose to?
Inc Kf - capillary perm
Torsades de pointes
LCX - I - aVL
SA and AV nodes

10. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
ANP
Volatage gated Ca channels
5-10 days - macs have degraded structural components
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

11. Why is contractility decreased in heart failure?
Yes
Systolic dysfunction
Gap junctions
Posterior descending (80% off the RCA - 20% off the circumflex)

12. In an EKG - What is the PR interval?
Kids
Pulsus parvus and tardus - weak - can lead to syncope
Conduction delay through AV node - nl < 200 msec
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

13. When does extracellular calcium enter the cardiac muscle cells during contraction?
Increased efferent SANS and decreased efferent PANS
Aortic insuffic - late
The plateau period
Aortic dilation - bicuspid aortic valve - RF -

14. 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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15. What is the cushing triad?
HTN - bradycardia - and respiratory depression
LV failure - pulm venous distention transudation of fluid
Hypertrophied cardiomyopathy
2-4 day - early coag necrosis on the first day

16. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Yes
Fetal right to left - neonate left to right leading to RVH and failure
In RA return (inspiration)
Gap junctions

17. Which artery supplies the SA and AV nodes?
Fluid movement through capillaries
Raynaud's
Mitral>aortic>>tricuspid - high pressure valves affected most
RCA

18. congenital heart defect with turner's
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
EKG
Coarcation of aorta
During HF from microhemorrhages from inc pulm cap pressure

19. coronary artery spasm - ST elevation
2nd degree AV block - mobitz type 1
2-4 day - early coag necrosis on the first day
Prinzmetal angina
Extracellular calcium - calcium induced calcium release

20. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Dilated cardiomyopathy

21. What is the classic X ray finding for tet of fallot?
In RA return (inspiration)
Boot shaped heart
Sudden tensing of chordae tendinae
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

22. What other syndrom is associated with infantile aortic coarctation
Turners
Fick principle
Myxoma
Vasodilators - (hydrAlAzine)

23. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Vasodilators - (hydrAlAzine)
Acute thrombosis of coronary artery
Myxoma
Angiosarcoma

24. stroke volume x HR =?
V fib
Squat. Compression of femoral arteries - inc TPR - dec
CO
Holosystolic - harsh sounding murmur - loudest over tricuspid area

25. What causes aortic regurg
Hypertrophied cardiomyopathy
Aortic dilation - bicuspid aortic valve - RF -
Pulse pressure
Preload

26. What cardiac change occurs in pregnancy?
SV/ EDV
During HF from microhemorrhages from inc pulm cap pressure
Increased SV
Extracellular calcium - calcium induced calcium release

27. which heart valves are afected most in rheumatic heart diseease
Kids
Mitral>aortic>>tricuspid - high pressure valves affected most
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

28. What does FEVERSS stand for in rheumatic heart disease
RCA - II - III - aVF
S. bovis
Anterosuperior displacement of the infundibular septum
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

29. What is the early and late lesion in rheumatic heart disease
CFX
Mitral valve prolapse
Pulsus parvus and tardus - weak - can lead to syncope
MI

30. CO x Total peripheral resistance
CFX
Metastasis from melanoma or lymphoma
Mean arterial pressure
In RA return (inspiration)

31. 2/3 diastolic + 1/3 systolic
Dec P02 - inc PC02 and dec pH
Glossopharyngeal to soliary nucleus of medulla
MAP
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

32. What is sudden cardiac death most commonly due to...
Granuloma with giant cells
Fick principle
HTN - bradycardia - and respiratory depression
V fib arrhythima

33. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Rapid upstroke - voltage gated Na channels open
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Boot shaped heart
Dec plasma proteins

34. Wegener's tx
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Kidney
Ventricular repolarization
Cyclophosphamide and corticosteroids

35. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Truncus - tet of fallot
Wolff - Parkinson white syndrome
LCX - V4- V6
No

36. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
S. aureus
Transfusion
Apex and anterior interventricular septum
Crescendo - decrescendo systolic ejection murmur following ejection click

37. Rank the pacemakers cells
Mitral>aortic>>tricuspid - high pressure valves affected most
Strawberry hemangioma
Raynaud's
SA>AV>bundle of His>ventricles

38. list the coronary vessels most likely to be occluded
LAD > RCA > circumflex
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Stroke volume
Patent ductus arteriosus - congenital rubella or prematurity

39. In an EKG - What is the QT interval?
Lymphangiosarcoma
Mechanican contraction of the ventricles
Atherosclerosis
Increase in Pc

40. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Unstable/crescendo angina
Vasocxn
Babies
Libman - sacks endocarditis

41. bening capillary hemangioma of elderly - does not regress
Patent ductus arteriosus - congenital rubella or prematurity
Pyogenic granuloma - associated with trauma and pregnancy
Cherry hemangioma
Right sided

42. Which channel accounts for automaticity of the SA and AV nodes?
Pulse pressure
Inc central venous pressure - inc resistance to portal flow
If sodium channel
During diastole

43. What is the progression of atherosclerosis?
Babies
Left atrial pressure
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
S. bovis

44. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
Ventricles are depolarized
Left heart failure
Kids

45. How does a patient with Tet of fallot learn to improve symptoms?
Dilated cardiomyopathy
Non
Squat. Compression of femoral arteries - inc TPR - dec
Filling is incomplete and CO falls

46. The cause of cardiac dilation?
Greater ventricular EDV
Ventricles are depolarized
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

47. Given P = QR - what factors influence resistance?
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
Stroke volume affected by contractility - afterload - and preload
Proportional to viscosity and inversely proportional to the radius to the 4th power

48. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Hematocrit
During diastole
2nd degree AV block - mobitz type 1
S. epidermidis

49. What stimulates release of calcium from the SR?
During HF from microhemorrhages from inc pulm cap pressure
Sudden tensing of chordae tendinae
Extracellular calcium - calcium induced calcium release
RF

50. What does the starling curve show?
Changes in CO as a function of preload
Fick principle
LAD > RCA > circumflex
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction