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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 the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
PDA
Takayasu's arteritis
Transfusion

2. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
MI
EKG
Glossopharyngeal to soliary nucleus of medulla
Kidney

3. CO x Total peripheral resistance
Mean arterial pressure
Right sided
Libman - sacks endocarditis
Crescendo - decrescendo systolic ejection murmur following ejection click

4. Where is the most posterior portion of the heart and What can it cause?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Inc Kf - capillary perm
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Polyarteritis nodosum

5. PCWP > LV diastolic pressure
Aortic stenosis or LBBB
Mitral stenosis
Cherry hemangioma
Inc blood volume

6. congenital heart defect with congenital rubella
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Torsades de pointes
Black > white > asian
Septal defects - PDA - pulm art stenosis

7. What causes the CO curve to shift downwards?
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Neg inotropy - HF - narcotic overdose
In HF

8. What causes the murmur heard in tricuspid regurg to enhance
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Decrease in activity of Na/Ca exhanger and increase in contractility
In RA return (inspiration)
CO

9. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Increased SV
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Dec plasma proteins
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

10. What are the systolic heart sounds
The aortic before pulmonic - inspiration increases diff
Mitral valve
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

11. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
LCX - V4- V6
Right sided
Late diastolic murmur following an opening snap
Angiosarcoma

12. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Holosystoiic
Increase - increase the chance the If are open
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

13. What are anitschkow's cells
RF
Aortic and pulmonary closing
Glomus tumor
Activated histiocytes

14. How are the sarcomeres added in eccentric hypertrophy?
Cystic hygroma
Aortic and pulmonary closing
In series
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block

15. What masks atrial repolarization?
Troponin I
QRS complex
Atrial contraction
Pyogenic granuloma - associated with trauma and pregnancy

16. failure of truncus arteriosus to divide?
Anterosuperior displacement of the infundibular septum
Persistant truncus arteriosus
Greater ventricular EDV
ASD - VSD - AV septal defect (endocardial cushion defect)

17. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Maintain blood flow to organ over wide range of perfussion pressures
Diastolic
S. aureus
The operating point of the heart

18. Why is contractility decreased in heart failure?
Inc TPR and LA return (expiration)
Systolic dysfunction
Lower right - MC - upper right - AO - upper right AC - lower left MO
Takayasu's arteritis

19. What does autoregulation do?
Maintain blood flow to organ over wide range of perfussion pressures
Mitral>aortic>>tricuspid - high pressure valves affected most
Ventricular repolarization
PDA

20. What is the machine like murmur? What is the heart pathology and the predisposing causes
Patent ductus arteriosus - congenital rubella or prematurity
V fib
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Torsades de pointes

21. In what disease states is blood viscosity increased?
Hematocrit
Pulse pressure
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
If sodium channel

22. bening capillary hemangioma of elderly - does not regress
2nd degree AV block - mobitz type 1
LAD - V1- V2
Resting potential high K perm
Cherry hemangioma

23. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
CO
P02
During HF from microhemorrhages from inc pulm cap pressure
Purkingee>atria>ventricles>AV node

24. Which organ gets the largest share of systemic cardiac output
Fluid movement through capillaries
In RA return (inspiration)
Dilated cardiomyopathy
Liver

25. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Decreases
In series
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Boot shaped heart

26. Central chemoreceptors do not respond directly to which parameter?
P02
RCA - II - III - aVF
7 weeks
Aortic disecction - intraluminal tear forming false lumen

27. How does digitatlis increase contractility?
Cherry hemangioma
Granuloma with giant cells
Increase intracellular Na - resulting in increased Ca
Increasing activity of Ca pump in SR

28. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Subendocardial - fewer collaterals and higher pressure
Pulsus parvus and tardus - weak - can lead to syncope
Unstable/crescendo angina
Liver

29. What is the most common cause of MI
Anterosuperior displacement of the infundibular septum
Acute thrombosis of coronary artery
Yes
Maintain blood flow to organ over wide range of perfussion pressures

30. What is the characteristic pulse in aortic stenosis?
The plateau period
Pulsus parvus and tardus - weak - can lead to syncope
Kids
Mitral stenosis

31. What are the different etiologies of dialted cardiomyopathy
Chordae rupture - GN - suppurative pericarditis - emboli
Crescendo - decrescendo systolic ejection murmur following ejection click
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
2nd degree AV block - mobitz type 1

32. p - anca

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33. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
LAD > RCA > circumflex
Fick principle
Tempral arteritis - may cause irreversible blindness

34. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Pyogenic granuloma - associated with trauma and pregnancy
V fib arrhythima
Kawasaki
Decrease in cAMP

35. Which channel accounts for automaticity of the SA and AV nodes?
During HF from microhemorrhages from inc pulm cap pressure
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
If sodium channel

36. what percentage of HTN is secondary to renal disease?
10%
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Left heart failure
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

37. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Conduction delay through AV node - nl < 200 msec
Vasocxn - while other tissues it causes vasodilation

38. What is association with fixed S2 splitting - does not increase with inspiration
Glomus tumor
ASD
The operating point of the heart
Dressler's - autoimmune

39. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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40. What is the classic X ray finding for tet of fallot?
Inc blood volume
Sudden tensing of chordae tendinae
Boot shaped heart
Can progess to V fib

41. What is the association with wide S2 splitting?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Myxomatous degeneration - RF - chordae rupture
Pulmonic stenosis and RBBB
Mitral>aortic>>tricuspid - high pressure valves affected most

42. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Takayasu's arteritis
In RA return (inspiration)
LV failure - pulm venous distention transudation of fluid
Proportional to viscosity and inversely proportional to the radius to the 4th power

43. SV CAP means?
S. aureus
Turners
Stroke volume affected by contractility - afterload - and preload
Neg inotropy - HF - narcotic overdose

44. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
MI
Apex and anterior interventricular septum
Adult type aortic coarctation

45. What does the U wave indicated?
5-10 days - macs have degraded structural components
R to L shunt caused by stenoic pulmonic valve
HypoK and bradycardia
Mitral stenosis

46. PCWP is an estimate of...
Babies
S. bovis
V fib
Left atrial pressure

47. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Eisenmenger's syndrome
Henoch - Schlonlein purpura
Dilated cardiomyopathy
Wolff - Parkinson white syndrome

48. What causes the ejection click in the Cres - decres murmur?
Black > white > asian
Aburpt halting of valve leaflets
Wolff - Parkinson white syndrome
Inc TPR and LA return (expiration)

49. What is the result of not have fast sodium channels in pacemaker cells?
Increase contractility
LAD - V1- V2
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
No - no pressure gradient

50. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Sturge weber - vasculitis of caps
Age related calcifications or bicuspid aortic valve
QRS complex
Inc interstitial osmotic pressure pulling fliud out of capillaries