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Cardiology

Instructions:

Answer 50 questions in 15 minutes.
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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. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Glossopharyngeal to soliary nucleus of medulla
TAPVR
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Aortic/pulmonic regurg and mitral/tricuspid stenosis

2. Left to right shunts are more common in babies or kids?
Boot shaped heart
Kids
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Dec plasma proteins

3. How do catecholamines increase contractility?
At least 55%
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Increasing activity of Ca pump in SR

4. What is the cushing triad?
Eisenmenger's syndrome
HTN - bradycardia - and respiratory depression
Increase intracellular Na - resulting in increased Ca
Inc blood volume

5. What is the result of not have fast sodium channels in pacemaker cells?
Eccentric - concentric hypertrophy causes diastolic disfunction
EKG
Temporal arteritis
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

6. in the JVP - What is the c wave?
Libman - sacks endocarditis
RV contraction (closed tricuspid valve bulding into atrium
Medullary vasomotor center senses baroreceptors and JGA
ASD - VSD - AV septal defect (endocardial cushion defect)

7. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
During diastole
1st degree AV blodck
Polyarteritis nodosum
Metastasis from melanoma or lymphoma

8. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Greater ventricular EDV
Sturge weber - vasculitis of caps
Glossopharyngeal to soliary nucleus of medulla
Fetal right to left - neonate left to right leading to RVH and failure

9. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Hyperlipidemia
Medullary vasomotor center senses baroreceptors and JGA
Torsades de pointes

10. Why is contractility decreased in heart failure?
Buerger's disease
Neg inotropy - HF - narcotic overdose
Systolic dysfunction
Transfusion

11. What murmur is heard with aortic regurg?
In parallel
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Boot shaped heart
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

12. What do the carotid and aortic bodies respond to?
Arteriorles
Dec P02 - inc PC02 and dec pH
Postinfarction fibrinous pericarditis
Mitral valve

13. How does a patient with Tet of fallot learn to improve symptoms?
Takayasu's arteritis
Vasodilators - (hydrAlAzine)
Squat. Compression of femoral arteries - inc TPR - dec
Wolff - Parkinson white syndrome

14. In terms of starling forces - why does heart failure cause edema?
V fib arrhythima
Vasocxn - while other tissues it causes vasodilation
Increase intracellular Na - resulting in increased Ca
Increase in Pc

15. Which bacteria can cause endocarditis from prosthetic valves?
Mitral stenosis
S. epidermidis
Tricuspid atresia - requires ASD and VSD
Inc blood volume

16. What are the complications from bacterial endocarditis?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Fick principle
Kawasaki
Chordae rupture - GN - suppurative pericarditis - emboli

17. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Stroke volume affected by contractility - afterload - and preload
Kaposi's sarcoma
Henoch - Schlonlein purpura
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

18. Right to left shunts are more common in babies or kids?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Vasocxn
10%
Babies

19. congenital heart defect in an infant with a diabetic mother?
Angiosarcoma
Kawasaki
Increase in Pc
Transposition of great vessels

20. no relation between p waves and QRS intervals - treatment and predisposing factor
Infective endocarditis
3rd degree block - pacemaker - Lyme disease
Cherry hemangioma
EKG

21. Which valve is most commonly involved in bacterial endocarditis?
MAP
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Afterload (proportional to peripheral resistance)
Mitral valve

22. What kind of infarct show ST depression
Subendocardial
Hemorrhage
Increased efferent SANS and decreased efferent PANS
Coarcation of aorta

23. dyspnea - fatigue - edema and rales - multiple causes
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Yes
CHF
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

24. What causes the early cyanosis in Tet of Fallot?
R to L shunt caused by stenoic pulmonic valve
Cardiac tamponde
Angiosarcoma
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

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 tet of fallot?
Ischemic heart dz - mitral valve prolapse - LV dilation
LAD - V1- V2
Anterosuperior displacement of the infundibular septum
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

27. In what disease states is blood viscosity increased?
Chordae rupture - GN - suppurative pericarditis - emboli
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Posterior descending (80% off the RCA - 20% off the circumflex)
Mitral valve prolapse

28. absecnce of tricuspid valve - hypoplastic RV
C - ANCA
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Tricuspid atresia - requires ASD and VSD
Aortic stenosis or LBBB

29. What is the formula for EF?
SV/ EDV
RF
Aortic dilation - bicuspid aortic valve - RF -
Increase - increase the chance the If are open

30. What is the gold standard for dx of MI in the first 6 hours
Decreased
Fast volatge gated Na channels
In parallel
EKG

31. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Decrease in cAMP
Lymphangiosarcoma
Boot shaped heart
During diastole

32. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
The aortic before pulmonic - inspiration increases diff
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Sudden tensing of chordae tendinae

33. Given P = QR - what factors influence resistance?
Proportional to viscosity and inversely proportional to the radius to the 4th power
Extracellular calcium - calcium induced calcium release
Increase contractility
Cherry hemangioma

34. In an EKG - What is the QT interval?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
HTN - bradycardia - and respiratory depression
Inc central venous pressure - inc resistance to portal flow
Mechanican contraction of the ventricles

35. What is the early and late lesion in rheumatic heart disease
Filling is incomplete and CO falls
10%
Buerger's disease
Mitral valve prolapse

36. What does TAPVR stand for
Posterior descending (80% off the RCA - 20% off the circumflex)
Total anomalous pulmonary trunk venous return
Arteriorles
Cardiac tamponde

37. Endothelial malignancy of the skin assocated with HHV-8 and HIV

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38. What causes aortic stenosis
Vasocxn
Age related calcifications or bicuspid aortic valve
Septal defects - PDA - pulm art stenosis
Polyarteritis nodosum

39. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
140/90
Increasing activity of Ca pump in SR
Angiosarcoma
Aortic stenosis or LBBB

40. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Increase - increase the chance the If are open
Kidney
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Pulmonic stenosis and RBBB

41. Fatal arrhythmia
ASD
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
V fib

42. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Arteriorles
Libman - sacks endocarditis
In parallel
Right sided

43. What other syndrom is associated with infantile aortic coarctation
Sudden tensing of chordae tendinae
Fick principle
Turners
1st degree AV blodck

44. Which lab value indicates blood viscosity?
In series
Hematocrit
Diastolic
Stroke volume

45. What is the progression of atherosclerosis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Myxoma
Extracellular calcium - calcium induced calcium release
Mitral valve prolapse

46. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Aortic stenosis or LBBB
Babies
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
LCX - I - aVL

47. Irregularly irregular ECG - no p waves: dx and treatment
Temporal arteritis
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Prinzmetal angina
Greater ventricular EDV

48. What do patients die early from in rheumatic heart disease?
Early deaths from myocarditis
Hypertrophied cardiomyopathy
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

49. When do you see extensive coagulative necrosis in an MI
Non
Systolic dysfunction
2-4 day - early coag necrosis on the first day
Aortic disecction - intraluminal tear forming false lumen

50. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Pyogenic granuloma - associated with trauma and pregnancy