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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. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Tempral arteritis - may cause irreversible blindness
Kawasaki
Angiosarcoma

2. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Greater ventricular EDV
Stroke volume affected by contractility - afterload - and preload
Decreases
Angiosarcoma

3. Which channel accounts for automaticity of the SA and AV nodes?
If sodium channel
Aortic insuffic - late
SV/ EDV
Aortic disecction - intraluminal tear forming false lumen

4. What are the systolic heart sounds
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Viridans streptococci
Transmural
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

5. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Cardiac tamponde
Apex and anterior interventricular septum
Transfusion
In series

6. no relation between p waves and QRS intervals - treatment and predisposing factor
P02
3rd degree block - pacemaker - Lyme disease
Inc Kf - capillary perm
CHF

7. congenital heart defect withdown syndrome
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Indomethacin closes - and pge keeps it open
Age related calcifications or bicuspid aortic valve
ASD - VSD - AV septal defect (endocardial cushion defect)

8. Which murmur is heard with VSD?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Unstable/crescendo angina
Hemorrhage
Aortic/pulmonic regurg and mitral/tricuspid stenosis

9. What is the result of not have fast sodium channels in pacemaker cells?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Angiosarcoma
Holosystoiic
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

10. Which enzymes are useful for diagnosing reinfarction
CK- MB
Activated histiocytes
Dilation
S. epidermidis

11. What stimulates release of calcium from the SR?
Extracellular calcium - calcium induced calcium release
Increase contractility
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Aortic dilation - bicuspid aortic valve - RF -

12. What constitues the upstroke in pacemaker cells?
Granuloma with giant cells
Vasocxn
Volatage gated Ca channels
S. bovis

13. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Subendocardial - fewer collaterals and higher pressure
Increase intracellular Na - resulting in increased Ca
Atherosclerosis

14. Inspiration causes an increase in which sided heart sounds?
LCX - V4- V6
Right sided
Cyclophosphamide and corticosteroids
2-4 day - early coag necrosis on the first day

15. Restrictive cardiomyopathy causes
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Babies
SA and AV nodes
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

16. tearing chest pain radiation to the back - associated with marfan
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Aortic disecction - intraluminal tear forming false lumen
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Inc central venous pressure - inc resistance to portal flow

17. Which artery supplies the SA and AV nodes?
Systolic dysfunction
V fib
RCA
Maintain blood flow to organ over wide range of perfussion pressures

18. When during cardiac nodal cells depolarize?
Neg inotropy - HF - narcotic overdose
EKG
During diastole
Babies

19. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Filling is incomplete and CO falls
MI
Viridans streptococci

20. Left to right shunts are more common in babies or kids?
Kids
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Fetal right to left - neonate left to right leading to RVH and failure

21. What is the most common cause of right heart failure
Atherosclerosis
Left heart failure
Microscopic polyangiitis - like wegener's without granulomas
Angiosarcoma

22. Fatal arrhythmia
The aortic before pulmonic - inspiration increases diff
V fib
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Inc central venous pressure - inc resistance to portal flow

23. How do catecholamines increase contractility?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Apex and anterior interventricular septum
Increasing activity of Ca pump in SR
TAPVR

24. What are the different etiologies of dialted cardiomyopathy
HTN - bradycardia - and respiratory depression
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
CHF
Aortic insuffic - late

25. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?

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26. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
The plateau period
Rapid upstroke - voltage gated Na channels open
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)

27. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Myxoma
HypoK and bradycardia
Non
Mitral valve

28. Which sympathetic receptors raise MAP
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Fast volatge gated Na channels
Glomus tumor

29. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Increased efferent SANS and decreased efferent PANS
PDA
Hemorrhage

30. absecnce of tricuspid valve - hypoplastic RV
Pyogenic granuloma - associated with trauma and pregnancy
Rapid upstroke - voltage gated Na channels open
Tempral arteritis - may cause irreversible blindness
Tricuspid atresia - requires ASD and VSD

31. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
At least 55%
Fetal right to left - neonate left to right leading to RVH and failure
LCX - V4- V6
LAD - V1 - V4

32. What are common causes of mitral regurg?
Ischemic heart dz - mitral valve prolapse - LV dilation
Systolic dysfunction
5-10 days - macs have degraded structural components
Arteriorles

33. dyspnea - fatigue - edema and rales - multiple causes
CHF
R to L shunt caused by stenoic pulmonic valve
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Hypertrophied cardiomyopathy

34. Unilateral headache - jaw claudication - impaired vision
Increase - increase the chance the If are open
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Increase contractility
Tempral arteritis - may cause irreversible blindness

35. What do the carotid and aortic bodies respond to?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
2-4 day - early coag necrosis on the first day
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Dec P02 - inc PC02 and dec pH

36. sawtooth wave

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37. which medications are used to maintain patency or close the ductus arteriosus?
Increase in Pc
Indomethacin closes - and pge keeps it open
Crescendo - decrescendo systolic ejection murmur following ejection click
Early deaths from myocarditis

38. In terms of starling forces - why does heart failure cause edema?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
R to L shunt caused by stenoic pulmonic valve
Increase in Pc
Fick principle

39. congenital heart defect with turner's
Arteriorles
If sodium channel
Coarcation of aorta
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

40. moncekberg
Tricuspid atresia - requires ASD and VSD
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Cherry hemangioma
Increase - increase the chance the If are open

41. machine murmer
Vasocxn
ASD
PDA
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

42. PCWP > LV diastolic pressure
Transmural
Arteriolosclerosis in malignant hypertension
Mitral stenosis
Prinzmetal angina

43. Which lab value indicates blood viscosity?
Pulmonary flow murmur and diastolic rumble
S. aureus
Hematocrit
Squat. Compression of femoral arteries - inc TPR - dec

44. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Acute thrombosis of coronary artery
In RA return (inspiration)
No
Pulse pressure

45. EDV is also known as
Proportional to viscosity and inversely proportional to the radius to the 4th power
Vasocxn - while other tissues it causes vasodilation
SA and AV nodes
Preload

46. What 4 things drive myocardial 02 demand?
Right sided
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Granuloma with giant cells
Aburpt halting of valve leaflets

47. What is the classic X ray finding for tet of fallot?
Buerger's disease
Stable angina
Boot shaped heart
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

48. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Aortic and pulmonary closing
Right sided

49. What causes the early cyanosis in Tet of Fallot?
Takayasu's arteritis
Pulmonic stenosis and RBBB
Systolic dysfunction
R to L shunt caused by stenoic pulmonic valve

50. When is the scar completely formed in an MI?
PDA
7 weeks
Atherosclerosis
Non