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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. congenital heart defect in an infant with a diabetic mother?
Takayasu's arteritis
Total anomalous pulmonary trunk venous return
Kaposi's sarcoma
Transposition of great vessels
2. What does increasing intracellular Ca do?
ANP
Granuloma with giant cells
Increase contractility
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
3. Which class of drugs decrease preload
Septal defects - PDA - pulm art stenosis
Coarcation of aorta
Inc blood volume
Venodilators (nitrogylcerine)
4. What is the definition of HTN?
140/90
Anterosuperior displacement of the infundibular septum
SA and AV nodes
Adult type aortic coarctation
5. What constitues the upstroke in pacemaker cells?
Holosystoiic
Volatage gated Ca channels
S. aureus
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
6. What causes the midsystolic click
Sudden tensing of chordae tendinae
Inc RA pressure - due to filling against closed tricupsid valve
Indomethacin closes - and pge keeps it open
Left sided
7. dyspnea - fatigue - edema and rales - multiple causes
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
CHF
Increasing activity of Ca pump in SR
8. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Increase - increase the chance the If are open
Hyperlipidemia
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Increased efferent SANS and decreased efferent PANS
9. Wegener's tx
MI
Cyclophosphamide and corticosteroids
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Left heart failure
10. 2/3 diastolic + 1/3 systolic
Troponin I
ASD - VSD - AV septal defect (endocardial cushion defect)
MAP
RF
11. What causes the ejection click in the Cres - decres murmur?
Aburpt halting of valve leaflets
Unstable/crescendo angina
Tricuspid atresia - requires ASD and VSD
In series
12. Which channel accounts for automaticity of the SA and AV nodes?
If sodium channel
Eisenmenger's syndrome
Afterload (proportional to peripheral resistance)
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
13. polypoid capillary hemangioma that can ulcerate and bleed
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Arteriolosclerosis in malignant hypertension
Fetal right to left - neonate left to right leading to RVH and failure
Pyogenic granuloma - associated with trauma and pregnancy
14. most common primary cardiac tumor in children - associated with tuberous sclerosis
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Rhabdomyomas
Mitral stenosis
15. In an anterior wall infarct - which artery is effected and which leads show Q waves
LAD - V1 - V4
Vasocxn - while other tissues it causes vasodilation
Stroke volume affected by contractility - afterload - and preload
Vasodilators - (hydrAlAzine)
16. Which area of the endocardium is especially vulnerable to infarction? Why?
ASD - VSD - AV septal defect (endocardial cushion defect)
Squat. Compression of femoral arteries - inc TPR - dec
Subendocardial - fewer collaterals and higher pressure
RF
17. fibrous plaques and atheromas in intima of arteries
Atherosclerosis
Hemorrhage
Left atrial pressure
In parallel
18. 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
Pulsus parvus and tardus - weak - can lead to syncope
Kaposi's sarcoma
Lymphangiosarcoma
19. PCWP > LV diastolic pressure
Age related calcifications or bicuspid aortic valve
Mitral stenosis
RCA - II - III - aVF
Failure of LV to in CO during exercise
20. no change in PR interval followed by dropped beat
ASD - VSD - AV septal defect (endocardial cushion defect)
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Heart - 02 extraction is always around 100%
V fib
21. In terms of starling forces - why does heart failure cause edema?
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Mitral stenosis
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Increase in Pc
22. How are the sarcomeres added in eccentric hypertrophy?
P02
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Patent ductus arteriosus - congenital rubella or prematurity
In series
23. The carotid sinus transmits along which nerve?
Inc venous return exaccerbates pulm vasc congestion
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Glossopharyngeal to soliary nucleus of medulla
EKG
24. When does EF decrease
Increased efferent SANS and decreased efferent PANS
In HF
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
25. What does the atria release in response to inc blood volume and atrial pressure
Vasocxn
ANP
Inc venous return exaccerbates pulm vasc congestion
LAD - V1- V2
26. What does the starling curve show?
Changes in CO as a function of preload
Pulmonic stenosis and RBBB
Purkingee>atria>ventricles>AV node
Hemorrhage
27. decrease stretch in baroreceptors leads to what response?
Liver
Increased efferent SANS and decreased efferent PANS
Mitral stenosis
Henoch - Schlonlein purpura
28. which ethnic groups have higher association with HTN?
Ventricles are depolarized
Cyclophosphamide and corticosteroids
Black > white > asian
Mitral>aortic>>tricuspid - high pressure valves affected most
29. with what heart sounds do ASD usually present?
Torsades de pointes
Pulmonary flow murmur and diastolic rumble
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Wolff - Parkinson white syndrome
30. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
Right sided
Inc blood volume
Neg inotropy - HF - narcotic overdose
31. What is the gold standard for dx of MI in the first 6 hours
During HF from microhemorrhages from inc pulm cap pressure
EKG
Acute thrombosis of coronary artery
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
32. How do beta blockers decrease contractility?
Decrease in cAMP
If sodium channel
During HF from microhemorrhages from inc pulm cap pressure
Buerger's disease
33. 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
Gap junctions
Ventricles are depolarized
Atherosclerosis
34. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Myxoma
Resting potential high K perm
LAD - V1- V2
10%
35. What is the early and late lesion in rheumatic heart disease
Late diastolic murmur following an opening snap
Takayasu's arteritis
Kaposi's sarcoma
Mitral valve prolapse
36. fibrinous pericarditis several weeks post MI
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37. The aortic arch receptors transmit along which nerve?
Vagus to medulla
The first 4 days
Turners
No
38. Which organ has ht highest blood flow per gram of tissue
Late systolic crescendo murmur with a midsystolic click
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Kidney
ASD
39. Irregularly irregular ECG - no p waves: dx and treatment
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Postinfarction fibrinous pericarditis
Kawasaki
40. Rank the pacemakers cells
Infective endocarditis
7 weeks
SA>AV>bundle of His>ventricles
Can progess to V fib
41. What are the 5 T's of cyanoitc babies
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Buerger's disease
LAD - V1- V2
42. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Inc central venous pressure - inc resistance to portal flow
Polyarteritis nodosum
LV failure - pulm venous distention transudation of fluid
43. What causes the CO curve to shift upwards?
Polyarteritis nodosum
MI
Pos inotropy - exercise
Inc central venous pressure - inc resistance to portal flow
44. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Troponin I
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Hypertrophied cardiomyopathy
Inc central venous pressure - inc resistance to portal flow
45. What other sign is often present with congenital long QT syndrome - why?
CK- MB
Ventricular depolarization - nl < 120 msec
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Maintain blood flow to organ over wide range of perfussion pressures
46. What is indicated when CO and venous return are equal?
Glomus tumor
Myxoma
Volatage gated Ca channels
The operating point of the heart
47. The cause of cardiac dilation?
Hematocrit
Decreased
Greater ventricular EDV
Can progess to V fib
48. Which enzymes are useful for diagnosing reinfarction
Rapid upstroke - voltage gated Na channels open
RV failure - in venous pressure
CK- MB
LCX - I - aVL
49. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Unstable/crescendo angina
Cardiac tamponde
Increase in Pc
LCX - V4- V6
50. What is the cushing triad?
MAP
The operating point of the heart
Microscopic polyangiitis - like wegener's without granulomas
HTN - bradycardia - and respiratory depression