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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. congenital heart defect withdown syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
Decrease in activity of Na/Ca exhanger and increase in contractility
Mitral and tricuspid closure
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction

2. Restrictive cardiomyopathy causes
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Inc interstitial osmotic pressure pulling fliud out of capillaries
C - ANCA
TAPVR

3. What is the characteristic pulse in aortic stenosis?
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
ANP
Hemorrhage
Pulsus parvus and tardus - weak - can lead to syncope

4. How do beta blockers decrease contractility?
Decrease in cAMP
Temporal arteritis
Arteriorles
Atherosclerosis

5. Which organ gets the largest share of systemic cardiac output
Liver
LCX - V4- V6
Inc Kf - capillary perm
CFX

6. Do you see elevaged ASO titers in rheumatic heart disease
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Yes
Inc interstitial osmotic pressure pulling fliud out of capillaries
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

7. what happens to capillaries in lymphatic blockage
Isovolumetric contraction
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Inc interstitial osmotic pressure pulling fliud out of capillaries
Mean arterial pressure

8. What is the most common cause of MI
Acute thrombosis of coronary artery
Truncus - tet of fallot
Right sided
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

9. Which class of drugs decrease the murmur heard in aortic regurg?
Rapid upstroke - voltage gated Na channels open
Vasodilators
Troponin I
Atherosclerosis

10. How are cadiac myocytes eltrically coupled?
Pulse pressure
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Atherosclerosis
Gap junctions

11. The carotid sinus transmits along which nerve?
Sturge weber - vasculitis of caps
Dilation
Glossopharyngeal to soliary nucleus of medulla
HTN - bradycardia - and respiratory depression

12. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Aortic and pulmonary closing
Dilated cardiomyopathy
MI

13. What kind of dysfunction ensues in restrictive cardiomyopathy
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Diastolic
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Vasodilators

14. Where is the most posterior portion of the heart and What can it cause?
Increase contractility
Pulmonic stenosis and RBBB
Transfusion
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve

15. congenital heart defect with 22q11
CHF
R to L shunt caused by stenoic pulmonic valve
Truncus - tet of fallot
Septal defects - PDA - pulm art stenosis

16. What does an isoelectric ST segment indicate?
Mitral valve
RV failure - in venous pressure
Ventricles are depolarized
Pulse pressure

17. Which vessels account for the most total peripheral resistance
Posterior descending (80% off the RCA - 20% off the circumflex)
Arteriorles
Cardiac tamponde
Aburpt halting of valve leaflets

18. What 4 things drive myocardial 02 demand?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
S. bovis
7 weeks
Non

19. How are sarcomeres added in concentric hypertrophy?
MI
Pulsus parvus and tardus - weak - can lead to syncope
In parallel
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

20. clinical signs of cardiac tamponade
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Metastasis from melanoma or lymphoma
Black > white > asian
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

21. What does FEVERSS stand for in rheumatic heart disease
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Transposition of great vessels
Gap junctions

22. Exercise - overtransfusiion and excitiment causes and increase in...?
Dec P02 - inc PC02 and dec pH
Preload
No
RCA

23. What is the gold standard for dx of MI in the first 6 hours
Atrial contraction
Decreases
EKG
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

24. How does a patient with Tet of fallot learn to improve symptoms?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Cyclophosphamide and corticosteroids
Varicose veins - thromboembolism rare
Squat. Compression of femoral arteries - inc TPR - dec

25. which medications are used to maintain patency or close the ductus arteriosus?
Mitral>aortic>>tricuspid - high pressure valves affected most
Indomethacin closes - and pge keeps it open
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
No - no pressure gradient

26. What is the difference between adult and infantile type aortic coarctation?
Aortic and pulmonary closing
S. epidermidis
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Babies

27. Which channel accounts for automaticity of the SA and AV nodes?
Transmural
Henoch - Schlonlein purpura
LCX - I - aVL
If sodium channel

28. What is the definition of HTN?
Increasing activity of Ca pump in SR
10%
Septal defects - PDA - pulm art stenosis
140/90

29. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Pulse pressure
S. bovis
Sturge weber - vasculitis of caps

30. What masks atrial repolarization?
Atrial contraction
QRS complex
Torsades de pointes
CK- MB

31. When does extracellular calcium enter the cardiac muscle cells during contraction?
Total anomalous pulmonary trunk venous return
Glomus tumor
Wegener's
The plateau period

32. Mitral stenosis is most often secondary to which condition?
RF
R to L shunt caused by stenoic pulmonic valve
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Wegener's

33. What stimulates release of calcium from the SR?
In series
Medullary vasomotor center senses baroreceptors and JGA
Extracellular calcium - calcium induced calcium release
Holosystoiic

34. What happens in phase 3 of the cardiac ventricular action potential?
Cardiac tamponde
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
2nd degree AV block - mobitz type 1
Ventricular repolarization

35. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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36. Which murmur do you hear in mitral stenosis?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
In HF
Late diastolic murmur following an opening snap
Pulse pressure

37. polypoid capillary hemangioma that can ulcerate and bleed
Pyogenic granuloma - associated with trauma and pregnancy
Atherosclerosis
Pulmonary flow murmur and diastolic rumble
Squat. Compression of femoral arteries - inc TPR - dec

38. Where does coronary artery occlusion occur most commonly?
LAD
Decrease in cAMP
Increase - increase the chance the If are open
ASD - VSD - AV septal defect (endocardial cushion defect)

39. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Troponin I
Temporal arteritis
TAPVR
Subendocardial - fewer collaterals and higher pressure

40. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Angiosarcoma
The operating point of the heart
Decrease in cAMP

41. What happens with a decrease of extracellular Na
If sodium channel
Extracellular calcium - calcium induced calcium release
Mitral>aortic>>tricuspid - high pressure valves affected most
Decrease in activity of Na/Ca exhanger and increase in contractility

42. What does T wave inversion indicated?
MI
Rapid upstroke - voltage gated Na channels open
TAPVR
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

43. Which class of drugs decrease preload
5-10 days - macs have degraded structural components
S. epidermidis
Venodilators (nitrogylcerine)
2-4 day - early coag necrosis on the first day

44. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Transmural
Glomus tumor
Late systolic crescendo murmur with a midsystolic click
Troponin I

45. What murmur is heard with aortic regurg?
LV failure - pulm venous distention transudation of fluid
Mean arterial pressure
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Increase intracellular Na - resulting in increased Ca

46. fibrinous pericarditis several weeks post MI

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47. What is a normal EF
At least 55%
Decrease in activity of Na/Ca exhanger and increase in contractility
Ischemic heart dz - mitral valve prolapse - LV dilation
Aortic stenosis or LBBB

48. When does EF decrease
In HF
R to L shunt caused by stenoic pulmonic valve
Diastolic
Decrease in cAMP

49. 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
Inc Kf - capillary perm
Polyarteritis nodosum

50. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
Anterosuperior displacement of the infundibular septum
Raynaud's
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis