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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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1. In an EKG - What is the QT interval?
Infective endocarditis
Mechanican contraction of the ventricles
Stroke volume affected by contractility - afterload - and preload
SA and AV nodes

2. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Glomus tumor
TAPVR
Stroke volume
Inc central venous pressure - inc resistance to portal flow

3. Do you see elevaged ASO titers in rheumatic heart disease
In HF
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Pos inotropy - exercise
Yes

4. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
In parallel
Maintain blood flow to organ over wide range of perfussion pressures
Apex and anterior interventricular septum

5. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Left heart failure
LCX - I - aVL
Purkingee>atria>ventricles>AV node
Atherosclerosis

6. What is the most common cause of MI
CFX
Acute thrombosis of coronary artery
Non
Anterosuperior displacement of the infundibular septum

7. congenital heart defect with congenital rubella
Acute thrombosis of coronary artery
Inc Kf - capillary perm
Indomethacin closes - and pge keeps it open
Septal defects - PDA - pulm art stenosis

8. What can cause mitral prolapse?
Myxomatous degeneration - RF - chordae rupture
Granuloma with giant cells
Mean arterial pressure
Postinfarction fibrinous pericarditis

9. In an EKG - What is the p wave?
Aortic stenosis or LBBB
Atrial contraction
Polyarteritis nodosum
No - no pressure gradient

10. What are the 5 T's of cyanoitc babies
MI
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Anterosuperior displacement of the infundibular septum
RV failure - in venous pressure

11. Why is contractility decreased in heart failure?
Systolic dysfunction
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Myxoma
Buerger's disease

12. in the JVP - What is the a wave?
Atrial contraction
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Kawasaki
HTN - bradycardia - and respiratory depression

13. When does EF decrease
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Changes in CO as a function of preload
Ventricular depolarization - nl < 120 msec
In HF

14. 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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15. What does increasing intracellular Ca do?
Aortic insuffic - late
Microscopic polyangiitis - like wegener's without granulomas
Increase contractility
V fib arrhythima

16. What are common causes of mitral regurg?
Cyclophosphamide and corticosteroids
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Wegener's
Ischemic heart dz - mitral valve prolapse - LV dilation

17. When and why is the S3 sound heard?
Buerger's disease
Cherry hemangioma
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

18. Rank the pacemakers cells
SA>AV>bundle of His>ventricles
Extracellular calcium - calcium induced calcium release
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida

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

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20. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Ventricles are depolarized
Lymphangiosarcoma
LAD - V1- V2
Arteriorles

21. what happens to capillaries in lymphatic blockage
Inc interstitial osmotic pressure pulling fliud out of capillaries
Dilated cardiomyopathy
RF
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open

22. prolonged PR interval
1st degree AV blodck
CK- MB
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Early deaths from myocarditis

23. What stimulates release of calcium from the SR?
Pulmonary flow murmur and diastolic rumble
Extracellular calcium - calcium induced calcium release
Mitral valve prolapse
Decrease in cAMP

24. Which sympathetic receptors raise MAP
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Proportional to viscosity and inversely proportional to the radius to the 4th power
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

25. fibrous plaques and atheromas in intima of arteries
Truncus - tet of fallot
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Decrease in activity of Na/Ca exhanger and increase in contractility
Atherosclerosis

26. Which area of the endocardium is especially vulnerable to infarction? Why?
Extracellular calcium - calcium induced calcium release
Strawberry hemangioma
Subendocardial - fewer collaterals and higher pressure
Buerger's disease

27. In an EKG - What is the T wave?
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
LAD - V1- V2
Maintain blood flow to organ over wide range of perfussion pressures
Ventricular repolarization

28. What is sudden cardiac death most commonly due to...
Stable angina
P02
Mechanican contraction of the ventricles
V fib arrhythima

29. failure of truncus arteriosus to divide?
Vasocxn - while other tissues it causes vasodilation
Myxoma
Persistant truncus arteriosus
...

30. Which murmur is heard in aortic stenosis?
Persistant truncus arteriosus
Pulmonic stenosis and RBBB
Subendocardial
Crescendo - decrescendo systolic ejection murmur following ejection click

31. What are anitschkow's cells
Activated histiocytes
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Libman - sacks endocarditis
Mitral and tricuspid closure

32. What are the different etiologies of dialted cardiomyopathy
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Late systolic crescendo murmur with a midsystolic click
Increase intracellular Na - resulting in increased Ca
140/90

33. What causes ankle - sacral edema - jugular venous distention
Pulmonic stenosis and RBBB
RV failure - in venous pressure
Resting potential high K perm
QRS complex

34. What kind of dysfunction ensues in restrictive cardiomyopathy
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Diastolic
No
Decrease in activity of Na/Ca exhanger and increase in contractility

35. congenital heart defect in an infant with a diabetic mother?
Left atrial pressure
Transposition of great vessels
In parallel
2nd degree AV block - mobitz type 1

36. When is the scar completely formed in an MI?
Increase contractility
Increase intracellular Na - resulting in increased Ca
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
7 weeks

37. coronary artery spasm - ST elevation
Right sided
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Late diastolic murmur following an opening snap
Prinzmetal angina

38. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
SA>AV>bundle of His>ventricles
Increase in Pc
The first 4 days

39. What are the systolic heart sounds
CHF
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Polyarteritis nodosum
Volatage gated Ca channels

40. What is the result of not have fast sodium channels in pacemaker cells?
Kidney
Dilation
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
SV/ EDV

41. What causes tet of fallot?
The plateau period
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Anterosuperior displacement of the infundibular septum
Indomethacin closes - and pge keeps it open

42. dyspnea - fatigue - edema and rales - multiple causes
CHF
During diastole
Pulmonary flow murmur and diastolic rumble
Lower right - MC - upper right - AO - upper right AC - lower left MO

43. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Libman - sacks endocarditis
Vasodilators - (hydrAlAzine)
Arteriorles

44. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Polyarteritis nodosum
Right sided
P02
CO

45. what conditions are associated with pulsus paradoxus
Mitral valve
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Cyclophosphamide and corticosteroids
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

46. Most common vasculitis affecting medium and large arteries
Inc TPR and LA return (expiration)
Temporal arteritis
Anterosuperior displacement of the infundibular septum
HTN - bradycardia - and respiratory depression

47. Hyperplastic onion skinning
Polyarteritis nodosum
Arteriolosclerosis in malignant hypertension
Aburpt halting of valve leaflets
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

48. CO x Total peripheral resistance
Maintain blood flow to organ over wide range of perfussion pressures
Mean arterial pressure
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
S. bovis

49. How does aldosterone raise MAP
Mitral stenosis
Myxomatous degeneration - RF - chordae rupture
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Inc blood volume

50. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Proportional to viscosity and inversely proportional to the radius to the 4th power
Glomus tumor
Venodilators (nitrogylcerine)
Temporal arteritis