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Cardiology
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Subject
:
health-sciences
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. What happens in phase 3 of the cardiac ventricular action potential?
Postinfarction fibrinous pericarditis
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Late systolic crescendo murmur with a midsystolic click
Mitral and tricuspid closure
2. What are the complications from bacterial endocarditis?
Vasodilators - (hydrAlAzine)
Chordae rupture - GN - suppurative pericarditis - emboli
Ventricles are depolarized
Aortic/pulmonic regurg and mitral/tricuspid stenosis
3. CO x Total peripheral resistance
Mean arterial pressure
Lower right - MC - upper right - AO - upper right AC - lower left MO
V fib arrhythima
Left atrial pressure
4. failure of truncus arteriosus to divide?
Activated histiocytes
Right sided
PDA
Persistant truncus arteriosus
5. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Total anomalous pulmonary trunk venous return
...
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
6. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
Aortic and pulmonary closing
ASD - VSD - AV septal defect (endocardial cushion defect)
TAPVR
7. What does increasing intracellular Ca do?
Increase contractility
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Volatage gated Ca channels
8. When during cardiac nodal cells depolarize?
Vasodilators
During diastole
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Indomethacin closes - and pge keeps it open
9. Which bacteria can cause endocarditis from prosthetic valves?
Isovolumetric contraction
SV/ EDV
S. epidermidis
Resting potential high K perm
10. What is a normal EF
HTN - bradycardia - and respiratory depression
Conduction delay through AV node - nl < 200 msec
At least 55%
Babies
11. What constitues the upstroke in pacemaker cells?
Stable angina
Dec plasma proteins
Volatage gated Ca channels
LCX - I - aVL
12. What is the gold standard for dx of MI in the first 6 hours
Transfusion
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Holosystoiic
EKG
13. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
Extracellular calcium - calcium induced calcium release
Mitral and tricuspid closure
Polyarteritis nodosum
14. What stimulates release of calcium from the SR?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Kidney
Extracellular calcium - calcium induced calcium release
QRS complex
15. machine murmer
V fib arrhythima
Afterload (proportional to peripheral resistance)
Fast volatge gated Na channels
PDA
16. What does the starling curve show?
Patent ductus arteriosus - congenital rubella or prematurity
Left atrial pressure
S. bovis
Changes in CO as a function of preload
17. Which two mechanisms sense decrease MAP?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Medullary vasomotor center senses baroreceptors and JGA
Inc interstitial osmotic pressure pulling fliud out of capillaries
If sodium channel
18. Do you see elevaged ASO titers in rheumatic heart disease
Yes
SA and AV nodes
Tempral arteritis - may cause irreversible blindness
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
19. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Neg inotropy - HF - narcotic overdose
LAD - V1- V2
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
SA and AV nodes
20. What causes the cushing reflex and why
Increase intracellular Na - resulting in increased Ca
Cardiac tamponde
Inc RA pressure - due to filling against closed tricupsid valve
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
21. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Heart - 02 extraction is always around 100%
MAP
Kawasaki
...
22. Mitral stenosis is most often secondary to which condition?
RF
Atrial contraction
R to L shunt caused by stenoic pulmonic valve
Kawasaki
23. What kind of infarct show ST depression
Increase contractility
Temporal arteritis
Cyclophosphamide and corticosteroids
Subendocardial
24. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Non
Troponin I
25. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
In RA return (inspiration)
Viridans streptococci
Varicose veins - thromboembolism rare
Strawberry hemangioma
26. Wegener's presentation
Acute thrombosis of coronary artery
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Rapid upstroke - voltage gated Na channels open
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
27. What happens in phase 4 of the cardiac ventricular action potential?
Resting potential high K perm
Can progess to V fib
Mean arterial pressure
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
28. What is the progression of atherosclerosis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
SA and AV nodes
Aortic and pulmonary closing
Late systolic crescendo murmur with a midsystolic click
29. How are sarcomeres added in concentric hypertrophy?
Atrial contraction
Hyperlipidemia
Anterosuperior displacement of the infundibular septum
In parallel
30. What causes the midsystolic click
Mean arterial pressure
Dressler's - autoimmune
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Sudden tensing of chordae tendinae
31. When is the scar completely formed in an MI?
Decreases
7 weeks
Subendocardial - fewer collaterals and higher pressure
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
32. In an anterolateral infarct - which artery is effected and which leads show Q waves
Fast volatge gated Na channels
Non
LCX - V4- V6
The aortic before pulmonic - inspiration increases diff
33. What causes aortic stenosis
Greater ventricular EDV
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Age related calcifications or bicuspid aortic valve
Increased efferent SANS and decreased efferent PANS
34. What causes orthopnea?
Hypertrophied cardiomyopathy
Inc venous return exaccerbates pulm vasc congestion
Mechanican contraction of the ventricles
Pulmonary flow murmur and diastolic rumble
35. The cause of dyspnea on exertion?
Atherosclerosis
Aortic and pulmonary closing
Failure of LV to in CO during exercise
Resting potential high K perm
36. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Myxomatous degeneration - RF - chordae rupture
Increase intracellular Na - resulting in increased Ca
Fick principle
Venodilators (nitrogylcerine)
37. What do the starling forces determine
RCA - II - III - aVF
Fluid movement through capillaries
Eisenmenger's syndrome
Purkingee>atria>ventricles>AV node
38. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Henoch - Schlonlein purpura
Boot shaped heart
Decreased
Changes in CO as a function of preload
39. In an EKG - What is the QRS complex?
Total anomalous pulmonary trunk venous return
10%
Ventricular depolarization - nl < 120 msec
Adult type aortic coarctation
40. Exercise - overtransfusiion and excitiment causes and increase in...?
Hemorrhage
Stroke volume
Late diastolic murmur following an opening snap
Preload
41. What causes the ejection click in the Cres - decres murmur?
MI
Inc venous return exaccerbates pulm vasc congestion
Mitral valve prolapse
Aburpt halting of valve leaflets
42. coronary artery spasm - ST elevation
Prinzmetal angina
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Unstable/crescendo angina
Increasing activity of Ca pump in SR
43. Which vessels account for the most total peripheral resistance
Infective endocarditis
Arteriorles
Aortic and pulmonary closing
Squat. Compression of femoral arteries - inc TPR - dec
44. What are the complications of atherosclerosis?
Turners
Hemorrhage
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
RF
45. fibrous plaques and atheromas in intima of arteries
Kids
In series
Atherosclerosis
Sturge weber - vasculitis of caps
46. Which sympathetic receptors raise MAP
Aortic and pulmonary closing
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
47. Which enzymes are useful for diagnosing reinfarction
Persistant truncus arteriosus
CK- MB
Granuloma with giant cells
Inc TPR and LA return (expiration)
48. Right to left shunts are more common in babies or kids?
Babies
Dressler's - autoimmune
Stroke volume affected by contractility - afterload - and preload
Patent ductus arteriosus - congenital rubella or prematurity
49. What causes ankle - sacral edema - jugular venous distention
Mitral valve prolapse
RV failure - in venous pressure
HypoK and bradycardia
Myxoma
50. What is the machine like murmur? What is the heart pathology and the predisposing causes
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Cherry hemangioma
Indomethacin closes - and pge keeps it open
Patent ductus arteriosus - congenital rubella or prematurity
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