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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. In what disease states is blood viscosity increased?
Wolff - Parkinson white syndrome
Heart - 02 extraction is always around 100%
Greater ventricular EDV
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

2. which ethnic groups have higher association with HTN?
Black > white > asian
Conduction delay through AV node - nl < 200 msec
Raynaud's
Aburpt halting of valve leaflets

3. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
QRS complex
Fick principle
Aortic/pulmonic regurg and mitral/tricuspid stenosis

4. What channels do the the pacemaker cells lack?
Stroke volume affected by contractility - afterload - and preload
ANP
Activated histiocytes
Fast volatge gated Na channels

5. moncekberg
Vagus to medulla
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Purkingee>atria>ventricles>AV node
Pulmonic stenosis and RBBB

6. How are the sarcomeres added in eccentric hypertrophy?
Increasing activity of Ca pump in SR
Pulmonary flow murmur and diastolic rumble
Decreased
In series

7. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Activated histiocytes
No
Left atrial pressure
Inc RA pressure - due to filling against closed tricupsid valve

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

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9. Where are pacemaker cells?
Isovolumetric contraction
SA and AV nodes
LAD > RCA > circumflex
In parallel

10. How does angiotensin II raise MAP
Truncus - tet of fallot
Vasocxn
Lower right - MC - upper right - AO - upper right AC - lower left MO
Dilated cardiomyopathy

11. cavernous lymphangioma of the neck - associated with turner's
Patent ductus arteriosus - congenital rubella or prematurity
Anterosuperior displacement of the infundibular septum
Cystic hygroma
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD

12. fibrinous pericarditis several weeks post MI

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13. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Resting potential high K perm
Left heart failure
Dilation

14. How does aldosterone raise MAP
Metastasis from melanoma or lymphoma
Inc blood volume
Boot shaped heart
Right sided

15. What is the definition of HTN?
Rhabdomyomas
Atherosclerosis
Vasocxn - while other tissues it causes vasodilation
140/90

16. Which kind of infarct show ST elevation - and/or pathologic Q waves
Granuloma with giant cells
Age related calcifications or bicuspid aortic valve
Transmural
SA and AV nodes

17. Most common vasculitis affecting medium and large arteries
Temporal arteritis
C - ANCA
Mechanican contraction of the ventricles
The first 4 days

18. What are aschoff bodies
Myxoma
Preload
Granuloma with giant cells
Babies

19. Inspiration causes an increase in which sided heart sounds?
1st degree AV blodck
PDA
Right sided
...

20. What causes the murmur heard in MR to enhance?
Temporal arteritis
Inc TPR and LA return (expiration)
Activated histiocytes
Pos inotropy - exercise

21. What are the diastolic heart sounds?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
SA and AV nodes
Hypertrophied cardiomyopathy
Mitral and tricuspid closure

22. Which bacteria causes rheumatic heart disease
In series
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Group a beta hemolytic strep
Inc interstitial osmotic pressure pulling fliud out of capillaries

23. What is the early and late lesion in rheumatic heart disease
Postinfarction fibrinous pericarditis
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Stroke volume affected by contractility - afterload - and preload
Mitral valve prolapse

24. How does digitatlis increase contractility?
S. epidermidis
Vasodilators - (hydrAlAzine)
Increase intracellular Na - resulting in increased Ca
Inc central venous pressure - inc resistance to portal flow

25. benign cap hemangioma of infancy - spont regresses
Microscopic polyangiitis - like wegener's without granulomas
Wolff - Parkinson white syndrome
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Strawberry hemangioma

26. What causes aortic stenosis
P02
In HF
Aortic stenosis or LBBB
Age related calcifications or bicuspid aortic valve

27. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Decreases
Inc interstitial osmotic pressure pulling fliud out of capillaries
Hypertrophied cardiomyopathy
S. aureus

28. 2/3 diastolic + 1/3 systolic
Takayasu's arteritis
MAP
Yes
If sodium channel

29. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Stroke volume
Increased efferent SANS and decreased efferent PANS
Inc TPR and LA return (expiration)
LCX - I - aVL

30. What are anitschkow's cells
Wegener's
Activated histiocytes
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Arteriolosclerosis in malignant hypertension

31. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Hemorrhage
Pulmonary flow murmur and diastolic rumble
Apex and anterior interventricular septum
Postinfarction fibrinous pericarditis

32. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Increased SV
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Kawasaki
Hyperlipidemia

33. Fatal arrhythmia
Transmural
V fib
Kaposi's sarcoma
Ventricular depolarization - nl < 120 msec

34. In an anterolateral infarct - which artery is effected and which leads show Q waves
The plateau period
Left atrial pressure
RV failure - in venous pressure
LCX - V4- V6

35. friction rub - 3-5 days post MI
Cardiac tamponde
Postinfarction fibrinous pericarditis
Mechanican contraction of the ventricles
Medullary vasomotor center senses baroreceptors and JGA

36. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
S. aureus
Holosystoiic
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Dilation

37. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
Babies
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Granuloma with giant cells
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

38. What are the four most common locations for atherosclerosis?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Kaposi's sarcoma
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Transfusion

39. disease of elastic arteries and large and medium sized muscular arteries
1st degree AV blodck
Preload
Atherosclerosis
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

40. 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
RCA - II - III - aVF
HypoK and bradycardia
Lymphangiosarcoma

41. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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42. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
Resting potential high K perm
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Age related calcifications or bicuspid aortic valve

43. What cardiac change occurs in pregnancy?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Increased SV
Ischemic heart dz - mitral valve prolapse - LV dilation
Changes in CO as a function of preload

44. The cause of dyspnea on exertion?
Truncus - tet of fallot
Preload
Fetal right to left - neonate left to right leading to RVH and failure
Failure of LV to in CO during exercise

45. How do beta blockers decrease contractility?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Decrease in cAMP
Early deaths from myocarditis
Ventricular repolarization

46. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

47. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Right sided
Dilated cardiomyopathy
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Kawasaki

48. Where does coronary artery occlusion occur most commonly?
Sudden tensing of chordae tendinae
LAD
Transmural
10%

49. stroke volume x HR =?
CO
Takayasu's arteritis
Turners
Group a beta hemolytic strep

50. What is the difference between adult and infantile type aortic coarctation?
Filling is incomplete and CO falls
Decrease in cAMP
Isovolumetric contraction
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus