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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. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
...
Varicose veins - thromboembolism rare
Decrease in cAMP
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral

2. no relation between p waves and QRS intervals - treatment and predisposing factor
3rd degree block - pacemaker - Lyme disease
Lower right - MC - upper right - AO - upper right AC - lower left MO
Apex and anterior interventricular septum
Cyclophosphamide and corticosteroids

3. What happends in phase 1 of the ventricular cardiac action potential?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Non
Temporal arteritis
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

4. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
LAD - V1- V2
TAPVR
Cherry hemangioma
Dilated cardiomyopathy

5. When does EF decrease
In HF
Late diastolic murmur following an opening snap
Left atrial pressure
S. aureus

6. Where does coronary artery occlusion occur most commonly?
The plateau period
Failure of LV to in CO during exercise
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
LAD

7. Which sympathetic receptors raise MAP
Filling is incomplete and CO falls
Adult type aortic coarctation
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
CO

8. What does TAPVR stand for
Angiosarcoma
Dilation
Takayasu's arteritis
Total anomalous pulmonary trunk venous return

9. what percentage of HTN is secondary to renal disease?
Strawberry hemangioma
Purkingee>atria>ventricles>AV node
10%
Hematocrit

10. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Kawasaki
Dilated cardiomyopathy
Inc interstitial osmotic pressure pulling fliud out of capillaries
Systolic dysfunction

11. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Temporal arteritis
RV contraction (closed tricuspid valve bulding into atrium
LAD - V1- V2
...

12. Which enzymes are useful for diagnosing reinfarction
Vasocxn - while other tissues it causes vasodilation
CK- MB
5-10 days - macs have degraded structural components
Early deaths from myocarditis

13. What are the four most common locations for atherosclerosis?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Proportional to viscosity and inversely proportional to the radius to the 4th power
TAPVR
V fib arrhythima

14. sawtooth wave

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15. What is the S2 sound?
Aortic and pulmonary closing
Extracellular calcium - calcium induced calcium release
Postinfarction fibrinous pericarditis
Can progess to V fib

16. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Strawberry hemangioma
Lymphangiosarcoma
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

17. p - anca

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18. What kind of infarct show ST depression
Subendocardial
In parallel
Raynaud's
ANP

19. cavernous lymphangioma of the neck - associated with turner's
Cystic hygroma
Maintain blood flow to organ over wide range of perfussion pressures
Transposition of great vessels
Atherosclerosis

20. If HR is too fast (V tach) what happens during diastole?
Eisenmenger's syndrome
Viridans streptococci
Filling is incomplete and CO falls
Transposition of great vessels

21. What is the classic X ray finding for tet of fallot?
140/90
S. aureus
Boot shaped heart
LAD - V1- V2

22. In an anterolateral infarct - which artery is effected and which leads show Q waves
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
LCX - V4- V6
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Patent ductus arteriosus - congenital rubella or prematurity

23. When do you see extensive coagulative necrosis in an MI
Strawberry hemangioma
Libman - sacks endocarditis
Posterior descending (80% off the RCA - 20% off the circumflex)
2-4 day - early coag necrosis on the first day

24. When and why is the S3 sound heard?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Ventricular depolarization - nl < 120 msec
3rd degree block - pacemaker - Lyme disease
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

25. What is the most common cause of right heart failure
Squat. Compression of femoral arteries - inc TPR - dec
Troponin I
LCX - I - aVL
Left heart failure

26. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Failure of LV to in CO during exercise
LAD - V1- V2

27. most common primary cardiac tumor in children - associated with tuberous sclerosis
Takayasu's arteritis
Rhabdomyomas
Pyogenic granuloma - associated with trauma and pregnancy
Arteriolosclerosis in malignant hypertension

28. What causes ankle - sacral edema - jugular venous distention
The first 4 days
Conduction delay through AV node - nl < 200 msec
RV failure - in venous pressure
Posterior descending (80% off the RCA - 20% off the circumflex)

29. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Kidney
Resting potential high K perm

30. PCWP > LV diastolic pressure
Mitral stenosis
Failure of LV to in CO during exercise
Truncus - tet of fallot
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

31. What causes the murmur heard in tricuspid regurg to enhance
Decreased
In RA return (inspiration)
Total anomalous pulmonary trunk venous return
Venodilators (nitrogylcerine)

32. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
CK- MB
Eccentric - concentric hypertrophy causes diastolic disfunction
The aortic before pulmonic - inspiration increases diff
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

33. Where are pacemaker cells?
Transposition of great vessels
SA and AV nodes
Neg inotropy - HF - narcotic overdose
Inc TPR and LA return (expiration)

34. Irregularly irregular ECG - no p waves: dx and treatment
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Pulmonary flow murmur and diastolic rumble
Dilation
Inc central venous pressure - inc resistance to portal flow

35. What causes hepatomegaly?
Increase in Pc
Inc central venous pressure - inc resistance to portal flow
PDA
Aortic dilation - bicuspid aortic valve - RF -

36. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
PDA
Lymphangiosarcoma
Non

37. What happens in phase 2 of the cardiac ventricular action potential?
Sturge weber - vasculitis of caps
P02
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Lymphangiosarcoma

38. What cardiac change occurs in pregnancy?
SA and AV nodes
Turners
C - ANCA
Increased SV

39. What does autoregulation do?
Non
Maintain blood flow to organ over wide range of perfussion pressures
Mitral and tricuspid closure
Increase intracellular Na - resulting in increased Ca

40. What causes the ejection click in the Cres - decres murmur?
Increased efferent SANS and decreased efferent PANS
Aburpt halting of valve leaflets
Angiosarcoma
Increase contractility

41. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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42. What causes aortic regurg
Pos inotropy - exercise
Atherosclerosis
Aortic dilation - bicuspid aortic valve - RF -
LCX - I - aVL

43. Most common vasculitis affecting medium and large arteries
Volatage gated Ca channels
Temporal arteritis
S. bovis
Ischemic heart dz - mitral valve prolapse - LV dilation

44. What channels do the the pacemaker cells lack?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Group a beta hemolytic strep
Fast volatge gated Na channels
Maintain blood flow to organ over wide range of perfussion pressures

45. Where is the most posterior portion of the heart and What can it cause?
Kaposi's sarcoma
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Indomethacin closes - and pge keeps it open

46. What supplies the posterior left ventricle?
CFX
Metastasis from melanoma or lymphoma
TAPVR
LV failure - pulm venous distention transudation of fluid

47. What does hypoxia cause in the lung versus other tissues?
Diastolic
Vasocxn - while other tissues it causes vasodilation
Fetal right to left - neonate left to right leading to RVH and failure
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

48. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Hypertrophied cardiomyopathy
V fib arrhythima
Purkingee>atria>ventricles>AV node
Cyclophosphamide and corticosteroids

49. What does FAN MY SKIN On Wednesday stand for?
Ventricular repolarization
Transmural
Preload
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

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

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