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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. If HR is too fast (V tach) what happens during diastole?
Cystic hygroma
Subendocardial
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Filling is incomplete and CO falls

2. What kind of infarct show ST depression
Subendocardial
CO
Vasocxn
Aortic/pulmonic stenosis and mitral/tricuspid regurg

3. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Pyogenic granuloma - associated with trauma and pregnancy
Hyperlipidemia
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

4. When does extracellular calcium enter the cardiac muscle cells during contraction?
The first 4 days
Increased SV
The plateau period
Increasing activity of Ca pump in SR

5. in the JVP - What is the v wave?
Arteriorles
During diastole
Inc RA pressure - due to filling against closed tricupsid valve
Anterosuperior displacement of the infundibular septum

6. How do beta blockers decrease contractility?
Decrease in cAMP
Atherosclerosis
Hyperlipidemia
Holosystoiic

7. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
R to L shunt caused by stenoic pulmonic valve
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Tricuspid atresia - requires ASD and VSD

8. benign - painful - red - blue tumor under fingernails from smooth muscle cells
The aortic before pulmonic - inspiration increases diff
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Subendocardial
Glomus tumor

9. disease of elastic arteries and large and medium sized muscular arteries
Decreased
Diastolic
Atherosclerosis
QRS complex

10. How are sarcomeres added in concentric hypertrophy?
In parallel
Rhabdomyomas
Glossopharyngeal to soliary nucleus of medulla
Decreases

11. What is the progression of atherosclerosis?
Transmural
Neg inotropy - HF - narcotic overdose
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

12. most common primary cardiac tumor in children - associated with tuberous sclerosis
Persistant truncus arteriosus
10%
Rhabdomyomas
Tricuspid atresia - requires ASD and VSD

13. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Glomus tumor
Liver
MAP

14. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Libman - sacks endocarditis
Kids
During HF from microhemorrhages from inc pulm cap pressure
R to L shunt caused by stenoic pulmonic valve

15. Which sympathetic receptors raise MAP
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
ASD - VSD - AV septal defect (endocardial cushion defect)
Failure of LV to in CO during exercise
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

16. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Stroke volume
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

17. Which artery supplies the SA and AV nodes?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Dilated cardiomyopathy
RCA

18. What causes aortic regurg
Increase in Pc
LAD - V1- V2
Angiosarcoma
Aortic dilation - bicuspid aortic valve - RF -

19. What happens in phase 3 of the cardiac ventricular action potential?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Greater ventricular EDV
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Eisenmenger's syndrome

20. absecnce of tricuspid valve - hypoplastic RV
Inc Kf - capillary perm
Tricuspid atresia - requires ASD and VSD
Septal defects - PDA - pulm art stenosis
Babies

21. What are the complications of atherosclerosis?
S. aureus
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
During HF from microhemorrhages from inc pulm cap pressure
Volatage gated Ca channels

22. Which kind of infarct show ST elevation - and/or pathologic Q waves
No - no pressure gradient
Myxoma
Transmural
Total anomalous pulmonary trunk venous return

23. Which vessels account for the most total peripheral resistance
Arteriorles
Prinzmetal angina
MAP
Increase - increase the chance the If are open

24. with what heart sounds do ASD usually present?
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Kidney
Pulmonary flow murmur and diastolic rumble
Right sided

25. What causes tet of fallot?
The plateau period
Anterosuperior displacement of the infundibular septum
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Aortic and pulmonary closing

26. What is indicated when CO and venous return are equal?
CHF
PDA
The operating point of the heart
Age related calcifications or bicuspid aortic valve

27. which ethnic groups have higher association with HTN?
Dec plasma proteins
Black > white > asian
Henoch - Schlonlein purpura
Cardiac tamponde

28. In terms of starling forces - why does heart failure cause edema?
LAD - V1 - V4
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Persistant truncus arteriosus
Increase in Pc

29. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Angiosarcoma
Myxoma
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Eccentric - concentric hypertrophy causes diastolic disfunction

30. What is the characteristic pulse in aortic stenosis?
Pulsus parvus and tardus - weak - can lead to syncope
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Activated histiocytes
Truncus - tet of fallot

31. which heart valves are afected most in rheumatic heart diseease
Mitral>aortic>>tricuspid - high pressure valves affected most
Aortic insuffic - late
Varicose veins - thromboembolism rare
Holosystoiic

32. In an EKG - What is the p wave?
S. bovis
Atrial contraction
Decreases
The operating point of the heart

33. congenital heart defect with marfan's
Aortic insuffic - late
The plateau period
P02
The aortic before pulmonic - inspiration increases diff

34. Central chemoreceptors do not respond directly to which parameter?
No
Left sided
P02
Angiosarcoma

35. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Vasocxn
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Ischemic heart dz - mitral valve prolapse - LV dilation

36. systolic - diastolic
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Left heart failure
Buerger's disease
Pulse pressure

37. What supplies the posterior left ventricle?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
LAD > RCA > circumflex
Failure of LV to in CO during exercise
CFX

38. What do the starling forces determine
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
P02
Eccentric - concentric hypertrophy causes diastolic disfunction
Fluid movement through capillaries

39. What stimulates release of calcium from the SR?
The plateau period
Angiosarcoma
Extracellular calcium - calcium induced calcium release
Dec plasma proteins

40. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
5-10 days - macs have degraded structural components
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
During HF from microhemorrhages from inc pulm cap pressure
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

41. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Adult type aortic coarctation
Fluid movement through capillaries
Decreases
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities

42. Hyperplastic onion skinning
Arteriolosclerosis in malignant hypertension
In RA return (inspiration)
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Libman - sacks endocarditis

43. Exercise - overtransfusiion and excitiment causes and increase in...?
Preload
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
LV failure - pulm venous distention transudation of fluid
Stroke volume

44. Rank the pacemakers cells
SA>AV>bundle of His>ventricles
The plateau period
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Mechanican contraction of the ventricles

45. What does increasing intracellular Ca do?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Turners
2nd degree AV block - mobitz type 1
Increase contractility

46. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Tempral arteritis - may cause irreversible blindness
Transmural
Troponin I
No - no pressure gradient

47. What does the LAD supply?
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Increased SV
Apex and anterior interventricular septum

48. What happends in phase 1 of the ventricular cardiac action potential?
Arteriolosclerosis in malignant hypertension
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Kidney
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

49. What causes ankle - sacral edema - jugular venous distention
Eccentric - concentric hypertrophy causes diastolic disfunction
RV failure - in venous pressure
C - ANCA
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

50. MAP is also known as
Preload
Aburpt halting of valve leaflets
Gap junctions
Afterload (proportional to peripheral resistance)