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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. Hyperplastic onion skinning
Systolic dysfunction
Coarcation of aorta
Arteriolosclerosis in malignant hypertension
Wegener's

2. What cardiac change occurs in pregnancy?
MAP
Volatage gated Ca channels
HypoK and bradycardia
Increased SV

3. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Heart - 02 extraction is always around 100%
LAD - V1- V2
Liver
Arteriolosclerosis in malignant hypertension

4. What is the cushing triad?
Viridans streptococci
Inc blood volume
In series
HTN - bradycardia - and respiratory depression

5. What does prolonged QT predispose to?
Transfusion
Total anomalous pulmonary trunk venous return
Torsades de pointes
In RA return (inspiration)

6. Which channel accounts for automaticity of the SA and AV nodes?
If sodium channel
Apex and anterior interventricular septum
LAD - V1 - V4
LAD > RCA > circumflex

7. Fatal arrhythmia
Increase in Pc
In series
V fib
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

8. What causes the CO curve to shift downwards?
Ventricular depolarization - nl < 120 msec
Lymphangiosarcoma
Metastasis from melanoma or lymphoma
Neg inotropy - HF - narcotic overdose

9. Which sympathetic receptors raise MAP
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Infective endocarditis
Posterior descending (80% off the RCA - 20% off the circumflex)
Holosystoiic

10. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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11. What are aschoff bodies
Unstable/crescendo angina
LAD > RCA > circumflex
Granuloma with giant cells
Decreases

12. What does mitral prolapse predeispose to?
Aortic dilation - bicuspid aortic valve - RF -
Infective endocarditis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Viridans streptococci

13. What causes the murmur heard in tricuspid regurg to enhance
7 weeks
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
In RA return (inspiration)
Sudden tensing of chordae tendinae

14. What does autoregulation do?
In RA return (inspiration)
Maintain blood flow to organ over wide range of perfussion pressures
Transposition of great vessels
Heart - 02 extraction is always around 100%

15. decrease stretch in baroreceptors leads to what response?
Increased efferent SANS and decreased efferent PANS
Right sided
Atrial contraction
SA and AV nodes

16. Mitral stenosis is most often secondary to which condition?
RF
Dressler's - autoimmune
Aburpt halting of valve leaflets
In series

17. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Wegener's
LAD - V1- V2
Stable angina
2-4 day - early coag necrosis on the first day

18. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Fick principle
Maintain blood flow to organ over wide range of perfussion pressures
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

19. How does digitatlis increase contractility?
Septal defects - PDA - pulm art stenosis
Metastasis from melanoma or lymphoma
EKG
Increase intracellular Na - resulting in increased Ca

20. What is the S2 sound?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
During diastole
Aortic and pulmonary closing

21. When do you find hemosiderin laden macrophages in the lungs?
Strawberry hemangioma
Unstable/crescendo angina
C - ANCA
During HF from microhemorrhages from inc pulm cap pressure

22. What is a normal EF
At least 55%
LCX - V4- V6
Proportional to viscosity and inversely proportional to the radius to the 4th power
Pulmonic stenosis and RBBB

23. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Pulse pressure
TAPVR
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
LAD

24. In an EKG - What is the QT interval?
Non
Mechanican contraction of the ventricles
MI
Aortic/pulmonic regurg and mitral/tricuspid stenosis

25. dyspnea - fatigue - edema and rales - multiple causes
CHF
No
Aortic and pulmonary closing
MI

26. What is the formula for EF?
CFX
Pos inotropy - exercise
SV/ EDV
Left heart failure

27. How does angiotensin II raise MAP
Turners
Fluid movement through capillaries
Vasocxn
Posterior descending (80% off the RCA - 20% off the circumflex)

28. How are sarcomeres added in concentric hypertrophy?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Inc Kf - capillary perm
3rd degree block - pacemaker - Lyme disease
In parallel

29. What causes aortic stenosis
Posterior descending (80% off the RCA - 20% off the circumflex)
Eisenmenger's syndrome
Age related calcifications or bicuspid aortic valve
SA and AV nodes

30. In an anterolateral infarct - which artery is effected and which leads show Q waves
Aortic and pulmonary closing
Non
LCX - V4- V6
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

31. 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
Dressler's - autoimmune
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

32. Exercise - overtransfusiion and excitiment causes and increase in...?
Pulsus parvus and tardus - weak - can lead to syncope
Preload
MAP
Lymphangiosarcoma

33. What supplies the posterior left ventricle?
Fetal right to left - neonate left to right leading to RVH and failure
CFX
P02
Decreases

34. Given P = QR - what factors influence resistance?
Kaposi's sarcoma
Proportional to viscosity and inversely proportional to the radius to the 4th power
Pulmonic stenosis and RBBB
Dec P02 - inc PC02 and dec pH

35. What does FEVERSS stand for in rheumatic heart disease
Subendocardial - fewer collaterals and higher pressure
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Mitral stenosis
Angiosarcoma

36. What causes ankle - sacral edema - jugular venous distention
RV failure - in venous pressure
EKG
Black > white > asian
Apex and anterior interventricular septum

37. congenital heart defect with 22q11
Boot shaped heart
Truncus - tet of fallot
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
The operating point of the heart

38. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
No
Late diastolic murmur following an opening snap
2-4 day - early coag necrosis on the first day

39. What does the atria release in response to inc blood volume and atrial pressure
In HF
The operating point of the heart
CHF
ANP

40. Which enzymes are useful for diagnosing reinfarction
Decreases
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
SA and AV nodes
CK- MB

41. What is the result of not have fast sodium channels in pacemaker cells?
In parallel
Mitral valve
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

42. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Viridans streptococci
Squat. Compression of femoral arteries - inc TPR - dec
Non
The first 4 days

43. PROVe
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Diastolic
Kids
Unstable/crescendo angina

44. Which class of drugs decrease preload
Strawberry hemangioma
Venodilators (nitrogylcerine)
LAD - V1- V2
Volatage gated Ca channels

45. What are the complications of atherosclerosis?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Cystic hygroma
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Myxoma

46. Which kind of infarct show ST elevation - and/or pathologic Q waves
LAD
Transmural
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Mitral and tricuspid closure

47. congenital heart defect with marfan's
Dec plasma proteins
Changes in CO as a function of preload
During diastole
Aortic insuffic - late

48. MAP is also known as
Afterload (proportional to peripheral resistance)
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
SA and AV nodes

49. Irregularly irregular ECG - no p waves: dx and treatment
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Atherosclerosis
Aortic/pulmonic regurg and mitral/tricuspid stenosis

50. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
S. epidermidis
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Viridans streptococci