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Cardiology

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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. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
ASD
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Aortic insuffic - late
Sturge weber - vasculitis of caps

2. Which valve is most commonly involved in bacterial endocarditis?
Group a beta hemolytic strep
Unstable/crescendo angina
Mitral valve
Transfusion

3. p - anca

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4. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
S. aureus
HTN - bradycardia - and respiratory depression
Left sided

5. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
2-4 day - early coag necrosis on the first day
Angiosarcoma
Dec plasma proteins
Medullary vasomotor center senses baroreceptors and JGA

6. serum marker for wegener's
Preload
C - ANCA
Dilated cardiomyopathy
10%

7. When do you find hemosiderin laden macrophages in the lungs?
TAPVR
Resting potential high K perm
MI
During HF from microhemorrhages from inc pulm cap pressure

8. disease of elastic arteries and large and medium sized muscular arteries
Left heart failure
Persistant truncus arteriosus
Atherosclerosis
Rhabdomyomas

9. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Increased efferent SANS and decreased efferent PANS
CK- MB

10. Where does coronary artery occlusion occur most commonly?
Preload
LAD
Boot shaped heart
Henoch - Schlonlein purpura

11. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
Total anomalous pulmonary trunk venous return
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
At least 55%

12. clinical signs of cardiac tamponade
Mitral valve prolapse
Afterload (proportional to peripheral resistance)
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Holosystolic - harsh sounding murmur - loudest over tricuspid area

13. What does T wave inversion indicated?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Arteriorles
Dilation
MI

14. Which organ has ht highest blood flow per gram of tissue
Hemorrhage
Late diastolic murmur following an opening snap
Kidney
Temporal arteritis

15. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
During diastole
Prinzmetal angina
Resting potential high K perm

16. What are the diastolic heart sounds?
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Increased SV
The first 4 days

17. EDV - ESV
TAPVR
Postinfarction fibrinous pericarditis
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Stroke volume

18. Hyperplastic onion skinning
The plateau period
Arteriolosclerosis in malignant hypertension
Total anomalous pulmonary trunk venous return
Increase - increase the chance the If are open

19. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
LAD - V1- V2
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
TAPVR
Pos inotropy - exercise

20. How does acidosis affect contractility?
In series
HypoK and bradycardia
Posterior descending (80% off the RCA - 20% off the circumflex)
Decreased

21. most common heart tumor
Lower right - MC - upper right - AO - upper right AC - lower left MO
Metastasis from melanoma or lymphoma
Wegener's
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics

22. What is the characteristic pulse in aortic stenosis?
Viridans streptococci
Pulmonary flow murmur and diastolic rumble
Increased efferent SANS and decreased efferent PANS
Pulsus parvus and tardus - weak - can lead to syncope

23. What is the association with wide S2 splitting?
Isovolumetric contraction
Left sided
Dec plasma proteins
Pulmonic stenosis and RBBB

24. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Yes
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Eccentric - concentric hypertrophy causes diastolic disfunction
7 weeks

25. What does the U wave indicated?
During diastole
Changes in CO as a function of preload
RCA
HypoK and bradycardia

26. 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
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
2nd degree AV block - mobitz type 1

27. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
If sodium channel
Libman - sacks endocarditis
Transposition of great vessels
Left atrial pressure

28. What can cause mitral prolapse?
Raynaud's
Isovolumetric contraction
Microscopic polyangiitis - like wegener's without granulomas
Myxomatous degeneration - RF - chordae rupture

29. If HR is too fast (V tach) what happens during diastole?
Filling is incomplete and CO falls
Buerger's disease
Lymphangiosarcoma
CK- MB

30. The cause of dyspnea on exertion?
10%
EKG
Failure of LV to in CO during exercise
Varicose veins - thromboembolism rare

31. absecnce of tricuspid valve - hypoplastic RV
LV failure - pulm venous distention transudation of fluid
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Tricuspid atresia - requires ASD and VSD
Unstable/crescendo angina

32. What happens in phase 3 of the cardiac ventricular action potential?
Buerger's disease
Decrease in cAMP
Hypertrophied cardiomyopathy
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

33. list the coronary vessels most likely to be occluded
Pulse pressure
LAD > RCA > circumflex
EKG
Crescendo - decrescendo systolic ejection murmur following ejection click

34. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Systolic dysfunction
Varicose veins - thromboembolism rare
Atrial contraction
Acute thrombosis of coronary artery

35. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Transfusion
LCX - I - aVL
Preload
PDA

36. Given P = QR - what factors influence resistance?
SA>AV>bundle of His>ventricles
Afterload (proportional to peripheral resistance)
Proportional to viscosity and inversely proportional to the radius to the 4th power
Transfusion

37. Exercise - overtransfusiion and excitiment causes and increase in...?
Ischemic heart dz - mitral valve prolapse - LV dilation
Preload
Apex and anterior interventricular septum
Coarcation of aorta

38. tearing chest pain radiation to the back - associated with marfan
Aortic disecction - intraluminal tear forming false lumen
Sturge weber - vasculitis of caps
Medullary vasomotor center senses baroreceptors and JGA
Changes in CO as a function of preload

39. Which bacteria causes endocarditis in the presence of colon cancer
2-4 day - early coag necrosis on the first day
S. bovis
Preload
Left sided

40. CO x Total peripheral resistance
Hyperlipidemia
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Henoch - Schlonlein purpura
Mean arterial pressure

41. Which bacteria can cause endocarditis from prosthetic valves?
At least 55%
Preload
S. epidermidis
Torsades de pointes

42. Which area of the endocardium is especially vulnerable to infarction? Why?
Subendocardial - fewer collaterals and higher pressure
Gap junctions
Stable angina
Myxoma

43. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Boot shaped heart
No
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Liver

44. What is the cushing triad?
Aburpt halting of valve leaflets
Eccentric - concentric hypertrophy causes diastolic disfunction
HTN - bradycardia - and respiratory depression
Black > white > asian

45. How does digitatlis increase contractility?
Crescendo - decrescendo systolic ejection murmur following ejection click
Isovolumetric contraction
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Increase intracellular Na - resulting in increased Ca

46. How does a patient with Tet of fallot learn to improve symptoms?
Mitral and tricuspid closure
Squat. Compression of femoral arteries - inc TPR - dec
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Aortic/pulmonic regurg and mitral/tricuspid stenosis

47. Mitral stenosis is most often secondary to which condition?
Crescendo - decrescendo systolic ejection murmur following ejection click
Mechanican contraction of the ventricles
Patent ductus arteriosus - congenital rubella or prematurity
RF

48. Which class of drugs decrease the murmur heard in aortic regurg?
ANP
Activated histiocytes
Vasodilators
Crescendo - decrescendo systolic ejection murmur following ejection click

49. What causes the CO curve to shift downwards?
Afterload (proportional to peripheral resistance)
Neg inotropy - HF - narcotic overdose
Aortic stenosis or LBBB
Aortic dilation - bicuspid aortic valve - RF -

50. In normal S2 splitting - which valve closes first? What increases it?
Greater ventricular EDV
Tempral arteritis - may cause irreversible blindness
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
The aortic before pulmonic - inspiration increases diff

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