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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. What is indicated when CO and venous return are equal?
The operating point of the heart
Aburpt halting of valve leaflets
Inc RA pressure - due to filling against closed tricupsid valve
Kaposi's sarcoma

2. PROVe
Inc central venous pressure - inc resistance to portal flow
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
CFX
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

3. What is the characteristic pulse in aortic stenosis?
MAP
Pulsus parvus and tardus - weak - can lead to syncope
During diastole
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

4. most common heart tumor
Metastasis from melanoma or lymphoma
Gap junctions
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Torsades de pointes

5. EDV - ESV
Stroke volume
Buerger's disease
RCA
2nd degree AV block - mobitz type 1

6. What is associated with paradoxical spliting of S2
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
7 weeks
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Aortic stenosis or LBBB

7. How does acidosis affect contractility?
Decreased
Late systolic crescendo murmur with a midsystolic click
Aortic and pulmonary closing
Libman - sacks endocarditis

8. When do you find hemosiderin laden macrophages in the lungs?
During HF from microhemorrhages from inc pulm cap pressure
Babies
SA>AV>bundle of His>ventricles
Ventricles are depolarized

9. How are the sarcomeres added in eccentric hypertrophy?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
If sodium channel
In series
Left heart failure

10. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
Cyclophosphamide and corticosteroids
Pulse pressure
Transfusion

11. Why is there edema after burns or during infection
Fick principle
Inc Kf - capillary perm
Early deaths from myocarditis
Unstable/crescendo angina

12. In an EKG - What is the QT interval?
RCA - II - III - aVF
Mechanican contraction of the ventricles
MAP
Inc interstitial osmotic pressure pulling fliud out of capillaries

13. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
Mitral>aortic>>tricuspid - high pressure valves affected most
Inc Kf - capillary perm
SV/ EDV

14. What are the complications from bacterial endocarditis?
Chordae rupture - GN - suppurative pericarditis - emboli
Afterload (proportional to peripheral resistance)
Angiosarcoma
Atherosclerosis

15. what conditions are associated with pulsus paradoxus
Takayasu's arteritis
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
No - no pressure gradient
Dec plasma proteins

16. Which artery supplies the SA and AV nodes?
RCA
HypoK and bradycardia
Isovolumetric contraction
Wolff - Parkinson white syndrome

17. failure of truncus arteriosus to divide?
Vasodilators - (hydrAlAzine)
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Resting potential high K perm
Persistant truncus arteriosus

18. Why is contractility decreased in heart failure?
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Activated histiocytes
Systolic dysfunction

19. What causes the midsystolic click
Sudden tensing of chordae tendinae
Angiosarcoma
SV/ EDV
Coarcation of aorta

20. Do you see elevaged ASO titers in rheumatic heart disease
Patent ductus arteriosus - congenital rubella or prematurity
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Yes
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

21. Which organ has the largest arteriovenous difference
Heart - 02 extraction is always around 100%
Stable angina
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Right sided

22. What does FROM JANE stand for in bacterial endocarditis?

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23. How does aldosterone raise MAP
Inc blood volume
Crescendo - decrescendo systolic ejection murmur following ejection click
In parallel
Pulse pressure

24. What murmur is heard with aortic regurg?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
RCA
P02

25. Which channel accounts for automaticity of the SA and AV nodes?
If sodium channel
Decreases
Turners
Mitral valve

26. What is the early and late lesion in rheumatic heart disease
Pulsus parvus and tardus - weak - can lead to syncope
Neg inotropy - HF - narcotic overdose
QRS complex
Mitral valve prolapse

27. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Infective endocarditis
Angiosarcoma
Resting potential high K perm
Pulsus parvus and tardus - weak - can lead to syncope

28. When and why is the S3 sound heard?
Strawberry hemangioma
Lower right - MC - upper right - AO - upper right AC - lower left MO
Decrease in activity of Na/Ca exhanger and increase in contractility
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

29. What do the carotid and aortic bodies respond to?
Dec P02 - inc PC02 and dec pH
...
Ventricular depolarization - nl < 120 msec
R to L shunt caused by stenoic pulmonic valve

30. bening capillary hemangioma of elderly - does not regress
Decrease in cAMP
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Cherry hemangioma
Takayasu's arteritis

31. Which bacteria can cause endocarditis from prosthetic valves?
Liver
CHF
LAD - V1 - V4
S. epidermidis

32. Hyperplastic onion skinning
Non
Arteriolosclerosis in malignant hypertension
Kidney
Increase contractility

33. Right to left shunts are more common in babies or kids?
Myxomatous degeneration - RF - chordae rupture
Wegener's
Babies
Left sided

34. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 1
Infective endocarditis
Troponin I
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

35. In an anterolateral infarct - which artery is effected and which leads show Q waves
CFX
Black > white > asian
LCX - V4- V6
LAD > RCA > circumflex

36. In what disease states is blood viscosity increased?
Persistant truncus arteriosus
During HF from microhemorrhages from inc pulm cap pressure
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Inc venous return exaccerbates pulm vasc congestion

37. In terms of starling forces - why does heart failure cause edema?
Mitral and tricuspid closure
Filling is incomplete and CO falls
Increase in Pc
At least 55%

38. disease of elastic arteries and large and medium sized muscular arteries
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Atherosclerosis
Myxoma
The aortic before pulmonic - inspiration increases diff

39. What does prolonged QT predispose to?
S. bovis
Torsades de pointes
Postinfarction fibrinous pericarditis
Aburpt halting of valve leaflets

40. What kind of infarct show ST depression
At least 55%
Subendocardial
Increase in Pc
CK- MB

41. When do coronary arteries fill?
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Mechanican contraction of the ventricles
During diastole
10%

42. stroke volume x HR =?
Pyogenic granuloma - associated with trauma and pregnancy
Vasocxn - while other tissues it causes vasodilation
CO
Mean arterial pressure

43. exaggerated decrease in pulse during inspiration.

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44. no relation between p waves and QRS intervals - treatment and predisposing factor
Buerger's disease
Vasodilators
Group a beta hemolytic strep
3rd degree block - pacemaker - Lyme disease

45. Which bacteria causes endocarditis in the presence of colon cancer
Libman - sacks endocarditis
Lymphangiosarcoma
Non
S. bovis

46. list the coronary vessels most likely to be occluded
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Extracellular calcium - calcium induced calcium release
LAD > RCA > circumflex
Yes

47. What is the most common cause of MI
Ventricular repolarization
Atherosclerosis
Acute thrombosis of coronary artery
Aortic/pulmonic stenosis and mitral/tricuspid regurg

48. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Increase in Pc
Troponin I
Fluid movement through capillaries
Isovolumetric contraction

49. When do you see extensive coagulative necrosis in an MI
2-4 day - early coag necrosis on the first day
Cystic hygroma
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
LAD - V1- V2

50. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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