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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. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Activated histiocytes
Group a beta hemolytic strep
Heart - 02 extraction is always around 100%
Adult type aortic coarctation

2. How does angiotensin II raise MAP
Temporal arteritis
Black > white > asian
Vasocxn
Dec plasma proteins

3. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Persistant truncus arteriosus
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
QRS complex
TAPVR

4. What causes tet of fallot?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Atrial contraction
Anterosuperior displacement of the infundibular septum

5. In an EKG - What is the QRS complex?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Ventricular depolarization - nl < 120 msec
HypoK and bradycardia
Mitral valve prolapse

6. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
LV failure - pulm venous distention transudation of fluid
Glomus tumor
In parallel

7. When do coronary arteries fill?
During diastole
QRS complex
Glossopharyngeal to soliary nucleus of medulla
S. aureus

8. machine murmer
PDA
Patent ductus arteriosus - congenital rubella or prematurity
Yes
Stable angina

9. congenital heart defect with marfan's
Fetal right to left - neonate left to right leading to RVH and failure
Dilated cardiomyopathy
3rd degree block - pacemaker - Lyme disease
Aortic insuffic - late

10. What causes the CO curve to shift downwards?
Neg inotropy - HF - narcotic overdose
Inc interstitial osmotic pressure pulling fliud out of capillaries
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

11. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Left atrial pressure
MI
Mitral valve prolapse
Changes in CO as a function of preload

12. EDV is also known as
Preload
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Vagus to medulla
Coarcation of aorta

13. which medications are used to maintain patency or close the ductus arteriosus?
Hypertrophied cardiomyopathy
RV failure - in venous pressure
Microscopic polyangiitis - like wegener's without granulomas
Indomethacin closes - and pge keeps it open

14. Which murmur is heard with VSD?
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Left atrial pressure
Troponin I
Systolic dysfunction

15. In an anterior wall infarct - which artery is effected and which leads show Q waves
LAD - V1 - V4
Afterload (proportional to peripheral resistance)
Increase - increase the chance the If are open
Mitral>aortic>>tricuspid - high pressure valves affected most

16. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
Total anomalous pulmonary trunk venous return
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Babies

17. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
S. aureus
Henoch - Schlonlein purpura
Rapid upstroke - voltage gated Na channels open
Extracellular calcium - calcium induced calcium release

18. What is the result of not have fast sodium channels in pacemaker cells?
Hemorrhage
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Strawberry hemangioma
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli

19. Hyperplastic onion skinning
Truncus - tet of fallot
ASD - VSD - AV septal defect (endocardial cushion defect)
Arteriolosclerosis in malignant hypertension
LAD - V1 - V4

20. Chronic mitral stenosis can lead to what changes in size of the LA
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Liver
Dilation
Varicose veins - thromboembolism rare

21. pulseless disease - granulomatous thickening of the aortic arch and/or proximal great vessels - elev ESR - asian females > 40

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22. What other syndrom is associated with infantile aortic coarctation
Dilated cardiomyopathy
Microscopic polyangiitis - like wegener's without granulomas
Pyogenic granuloma - associated with trauma and pregnancy
Turners

23. Which artery supplies the SA and AV nodes?
Ischemic heart dz - mitral valve prolapse - LV dilation
CK- MB
Wegener's
RCA

24. In an EKG - What is the QT interval?
In series
Increasing activity of Ca pump in SR
Viridans streptococci
Mechanican contraction of the ventricles

25. Given P = QR - what factors influence resistance?
Ventricular depolarization - nl < 120 msec
Posterior descending (80% off the RCA - 20% off the circumflex)
Aortic and pulmonary closing
Proportional to viscosity and inversely proportional to the radius to the 4th power

26. polypoid capillary hemangioma that can ulcerate and bleed
Septal defects - PDA - pulm art stenosis
Pyogenic granuloma - associated with trauma and pregnancy
Proportional to viscosity and inversely proportional to the radius to the 4th power
Vasodilators

27. no relation between p waves and QRS intervals - treatment and predisposing factor
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
The operating point of the heart
Age related calcifications or bicuspid aortic valve
3rd degree block - pacemaker - Lyme disease

28. systolic - diastolic
Fluid movement through capillaries
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Pulse pressure
Group a beta hemolytic strep

29. which ethnic groups have higher association with HTN?
Ventricular repolarization
Black > white > asian
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Inc venous return exaccerbates pulm vasc congestion

30. What are the four most common locations for atherosclerosis?
Pulsus parvus and tardus - weak - can lead to syncope
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
LAD - V1 - V4
Vasocxn - while other tissues it causes vasodilation

31. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Aortic stenosis or LBBB
Posterior descending (80% off the RCA - 20% off the circumflex)
Fick principle
Indomethacin closes - and pge keeps it open

32. Which bacteria can cause endocarditis from prosthetic valves?
Inc Kf - capillary perm
S. epidermidis
ANP
Kawasaki

33. Which area of the endocardium is especially vulnerable to infarction? Why?
Subendocardial - fewer collaterals and higher pressure
Takayasu's arteritis
Decrease in activity of Na/Ca exhanger and increase in contractility
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

34. What stimulates release of calcium from the SR?
Varicose veins - thromboembolism rare
Extracellular calcium - calcium induced calcium release
Increase - increase the chance the If are open
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

35. What is the most common cause of MI
Acute thrombosis of coronary artery
Boot shaped heart
Kaposi's sarcoma
MAP

36. Which organ has the largest arteriovenous difference
Heart - 02 extraction is always around 100%
10%
Non
Atherosclerosis

37. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Mean arterial pressure
Increasing activity of Ca pump in SR
Transfusion
LAD - V1 - V4

38. Which bacteria causes endocarditis in the presence of colon cancer
Polyarteritis nodosum
S. bovis
Vasodilators
3rd degree block - pacemaker - Lyme disease

39. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
2nd degree AV block - mobitz type 1
V fib arrhythima
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Crescendo - decrescendo systolic ejection murmur following ejection click

40. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Subendocardial
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Glomus tumor
Total anomalous pulmonary trunk venous return

41. clinical signs of cardiac tamponade
Inc interstitial osmotic pressure pulling fliud out of capillaries
S. aureus
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Aortic dilation - bicuspid aortic valve - RF -

42. 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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43. What causes the early cyanosis in Tet of Fallot?
Ventricular repolarization
Myxoma
Right sided
R to L shunt caused by stenoic pulmonic valve

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

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45. fibrous plaques and atheromas in intima of arteries
Resting potential high K perm
Neg inotropy - HF - narcotic overdose
LAD > RCA > circumflex
Atherosclerosis

46. friction rub - 3-5 days post MI
Postinfarction fibrinous pericarditis
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Group a beta hemolytic strep
Inc blood volume

47. When and why is the S3 sound heard?
Inc blood volume
Vagus to medulla
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
LAD

48. What is the time frame for arrhythmia risk in the evolution of MI
Atherosclerosis
The first 4 days
Babies
Dec plasma proteins

49. Most common vasculitis affecting medium and large arteries
The first 4 days
Medullary vasomotor center senses baroreceptors and JGA
Stroke volume
Temporal arteritis

50. What are anitschkow's cells
RF
Activated histiocytes
Preload
Tempral arteritis - may cause irreversible blindness