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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. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
3rd degree block - pacemaker - Lyme disease
Unstable/crescendo angina
Mitral>aortic>>tricuspid - high pressure valves affected most
Subendocardial
2. What causes hepatomegaly?
LAD - V1- V2
Dec P02 - inc PC02 and dec pH
Early deaths from myocarditis
Inc central venous pressure - inc resistance to portal flow
3. 2/3 diastolic + 1/3 systolic
MAP
Extracellular calcium - calcium induced calcium release
Age related calcifications or bicuspid aortic valve
Strawberry hemangioma
4. What does prolonged QT predispose to?
Torsades de pointes
Activated histiocytes
Rhabdomyomas
Atherosclerosis
5. When and why do you hear the S4 sound
Libman - sacks endocarditis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Vagus to medulla
Arteriolosclerosis in malignant hypertension
6. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Vasodilators - (hydrAlAzine)
Dec plasma proteins
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Henoch - Schlonlein purpura
7. list the coronary vessels most likely to be occluded
C - ANCA
Posterior descending (80% off the RCA - 20% off the circumflex)
Postinfarction fibrinous pericarditis
LAD > RCA > circumflex
8. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Fick principle
Prinzmetal angina
LCX - I - aVL
9. What is sudden cardiac death most commonly due to...
In RA return (inspiration)
V fib arrhythima
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Failure of LV to in CO during exercise
10. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Indomethacin closes - and pge keeps it open
Apex and anterior interventricular septum
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Viridans streptococci
11. congenital heart defect with marfan's
Turners
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Aortic insuffic - late
Pos inotropy - exercise
12. Which organ has the largest arteriovenous difference
R to L shunt caused by stenoic pulmonic valve
RV contraction (closed tricuspid valve bulding into atrium
Ventricular depolarization - nl < 120 msec
Heart - 02 extraction is always around 100%
13. What happens in phase 3 of the cardiac ventricular action potential?
Anterosuperior displacement of the infundibular septum
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Viridans streptococci
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
14. Where does coronary artery occlusion occur most commonly?
LAD
Mitral>aortic>>tricuspid - high pressure valves affected most
Mitral stenosis
Increasing activity of Ca pump in SR
15. What does TAPVR stand for
Systolic dysfunction
Decreased
Non
Total anomalous pulmonary trunk venous return
16. What does HTN predispose to?
SV/ EDV
Indomethacin closes - and pge keeps it open
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Aburpt halting of valve leaflets
17. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Purkingee>atria>ventricles>AV node
Troponin I
Stroke volume affected by contractility - afterload - and preload
CO
18. What is associated with paradoxical spliting of S2
140/90
Aortic stenosis or LBBB
Pulmonic stenosis and RBBB
Henoch - Schlonlein purpura
19. in the JVP - What is the v wave?
Babies
Inc RA pressure - due to filling against closed tricupsid valve
Venodilators (nitrogylcerine)
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
20. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
5-10 days - macs have degraded structural components
Left sided
Heart - 02 extraction is always around 100%
Changes in CO as a function of preload
21. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
In parallel
Dec plasma proteins
Hypertrophied cardiomyopathy
22. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
LAD - V1- V2
Late systolic crescendo murmur with a midsystolic click
MI
Inc Kf - capillary perm
23. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Cardiac tamponde
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Purkingee>atria>ventricles>AV node
Hypertrophied cardiomyopathy
24. Which murmur is heard with VSD?
Hemorrhage
Holosystolic - harsh sounding murmur - loudest over tricuspid area
In series
Inc interstitial osmotic pressure pulling fliud out of capillaries
25. SV CAP means?
Stroke volume affected by contractility - afterload - and preload
Kidney
Increase - increase the chance the If are open
Atherosclerosis
26. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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27. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
Diastolic
Pulmonic stenosis and RBBB
Can progess to V fib
28. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Glomus tumor
Increase contractility
Cardiac tamponde
Mechanican contraction of the ventricles
29. absecnce of tricuspid valve - hypoplastic RV
Anterosuperior displacement of the infundibular septum
Tricuspid atresia - requires ASD and VSD
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Fast volatge gated Na channels
30. What happens in phase 2 of the cardiac ventricular action potential?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Ischemic heart dz - mitral valve prolapse - LV dilation
Ventricular depolarization - nl < 120 msec
31. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
1st degree AV blodck
Vasodilators - (hydrAlAzine)
Varicose veins - thromboembolism rare
Dressler's - autoimmune
32. What causes ankle - sacral edema - jugular venous distention
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
RV failure - in venous pressure
Infective endocarditis
During HF from microhemorrhages from inc pulm cap pressure
33. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
ASD
LV failure - pulm venous distention transudation of fluid
Mitral stenosis
34. In an EKG - What is the T wave?
Strawberry hemangioma
Hyperlipidemia
Lower right - MC - upper right - AO - upper right AC - lower left MO
Ventricular repolarization
35. Expiration causes an increase in which sided heart sounds
Crescendo - decrescendo systolic ejection murmur following ejection click
Pyogenic granuloma - associated with trauma and pregnancy
Ischemic heart dz - mitral valve prolapse - LV dilation
Left sided
36. Which organ gets the largest share of systemic cardiac output
SA>AV>bundle of His>ventricles
If sodium channel
Increase intracellular Na - resulting in increased Ca
Liver
37. Right to left shunts are more common in babies or kids?
Yes
At least 55%
Babies
Late diastolic murmur following an opening snap
38. What does FEVERSS stand for in rheumatic heart disease
HTN - bradycardia - and respiratory depression
Myxoma
Wolff - Parkinson white syndrome
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
39. Irregularly irregular ECG - no p waves: dx and treatment
LAD
Ventricular depolarization - nl < 120 msec
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Mechanican contraction of the ventricles
40. The cause of dyspnea on exertion?
Conduction delay through AV node - nl < 200 msec
The operating point of the heart
Vasodilators - (hydrAlAzine)
Failure of LV to in CO during exercise
41. 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
1st degree AV blodck
Inc TPR and LA return (expiration)
Anterosuperior displacement of the infundibular septum
42. Endothelial malignancy of the skin assocated with HHV-8 and HIV
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43. What is the gold standard for dx of MI in the first 6 hours
Atrial contraction
Vasocxn
EKG
Lymphangiosarcoma
44. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Atherosclerosis
Myxoma
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Ischemic heart dz - mitral valve prolapse - LV dilation
45. When and why is the S3 sound heard?
Septal defects - PDA - pulm art stenosis
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
C - ANCA
46. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Prinzmetal angina
Lower right - MC - upper right - AO - upper right AC - lower left MO
Polyarteritis nodosum
Vasocxn
47. How does digitatlis increase contractility?
Persistant truncus arteriosus
Increase intracellular Na - resulting in increased Ca
Left atrial pressure
Greater ventricular EDV
48. In normal S2 splitting - which valve closes first? What increases it?
Libman - sacks endocarditis
Infective endocarditis
Arteriolosclerosis in malignant hypertension
The aortic before pulmonic - inspiration increases diff
49. What is the characteristic pulse in aortic stenosis?
Pyogenic granuloma - associated with trauma and pregnancy
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Dec P02 - inc PC02 and dec pH
Pulsus parvus and tardus - weak - can lead to syncope
50. systolic - diastolic
Vagus to medulla
Neg inotropy - HF - narcotic overdose
Pulse pressure
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn