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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. How does angiotensin II raise MAP
Vasocxn
Vagus to medulla
Glossopharyngeal to soliary nucleus of medulla
Hyperlipidemia

2. If HR is too fast (V tach) what happens during diastole?
Wolff - Parkinson white syndrome
Buerger's disease
Stroke volume affected by contractility - afterload - and preload
Filling is incomplete and CO falls

3. What are the 5 T's of cyanoitc babies
Subendocardial - fewer collaterals and higher pressure
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Troponin I

4. How do beta blockers decrease contractility?
Decrease in cAMP
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Mitral valve prolapse
Aortic insuffic - late

5. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
140/90
Aortic stenosis or LBBB
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
MI

6. SV CAP means?
Holosystoiic
CK- MB
S. epidermidis
Stroke volume affected by contractility - afterload - and preload

7. How are cadiac myocytes eltrically coupled?
P02
Medullary vasomotor center senses baroreceptors and JGA
Gap junctions
Eccentric - concentric hypertrophy causes diastolic disfunction

8. What cardiac change occurs in pregnancy?
Dressler's - autoimmune
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Increased SV
Pos inotropy - exercise

9. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Granuloma with giant cells
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
...
HTN - bradycardia - and respiratory depression

10. What happens in phase 0 of the cardiac ventricular action potential?
Viridans streptococci
Cardiac tamponde
Rapid upstroke - voltage gated Na channels open
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

11. What is the difference between adult and infantile type aortic coarctation?
Vasocxn - while other tissues it causes vasodilation
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Dec P02 - inc PC02 and dec pH
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

12. What does an isoelectric ST segment indicate?
Stroke volume
Ventricles are depolarized
Atrial contraction
Temporal arteritis

13. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
CFX
Libman - sacks endocarditis
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

14. What is indicated when CO and venous return are equal?
Aortic disecction - intraluminal tear forming false lumen
Systolic dysfunction
Inc venous return exaccerbates pulm vasc congestion
The operating point of the heart

15. Where is the most posterior portion of the heart and What can it cause?
Boot shaped heart
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
No - no pressure gradient
SA>AV>bundle of His>ventricles

16. in the JVP - What is the v wave?
Transfusion
CFX
Cherry hemangioma
Inc RA pressure - due to filling against closed tricupsid valve

17. What does the LAD supply?
Decreases
In HF
10%
Apex and anterior interventricular septum

18. serum marker for wegener's
Vasodilators - (hydrAlAzine)
Strawberry hemangioma
C - ANCA
LAD > RCA > circumflex

19. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Apex and anterior interventricular septum
TAPVR
LAD - V1- V2
1st degree AV blodck

20. When do you find hemosiderin laden macrophages in the lungs?
During HF from microhemorrhages from inc pulm cap pressure
Inc RA pressure - due to filling against closed tricupsid valve
Postinfarction fibrinous pericarditis
Sturge weber - vasculitis of caps

21. 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
Glomus tumor
At least 55%
Left sided

22. bening capillary hemangioma of elderly - does not regress
Strawberry hemangioma
Viridans streptococci
Cardiac tamponde
Cherry hemangioma

23. congenital heart defect with marfan's
Cardiac tamponde
Atherosclerosis
Aortic insuffic - late
Adult type aortic coarctation

24. What is the characteristic pulse in aortic stenosis?
Pulsus parvus and tardus - weak - can lead to syncope
Lower right - MC - upper right - AO - upper right AC - lower left MO
At least 55%
Inc TPR and LA return (expiration)

25. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Inc TPR and LA return (expiration)
Polyarteritis nodosum
Chordae rupture - GN - suppurative pericarditis - emboli
Total anomalous pulmonary trunk venous return

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

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27. Which bacteria causes endocarditis in the presence of colon cancer
Holosystolic - harsh sounding murmur - loudest over tricuspid area
S. bovis
...
SV/ EDV

28. Unilateral headache - jaw claudication - impaired vision
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Truncus - tet of fallot
Tempral arteritis - may cause irreversible blindness
Postinfarction fibrinous pericarditis

29. EDV - ESV
In parallel
Stroke volume
Mean arterial pressure
...

30. congenital heart defect in an infant with a diabetic mother?
Transposition of great vessels
Late systolic crescendo murmur with a midsystolic click
Pulmonary flow murmur and diastolic rumble
Yes

31. What does the U wave indicated?
Cardiac tamponde
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Aortic/pulmonic stenosis and mitral/tricuspid regurg
HypoK and bradycardia

32. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Pulmonic stenosis and RBBB
Glomus tumor
Greater ventricular EDV
Angiosarcoma

33. Hyperplastic onion skinning
Transfusion
No - no pressure gradient
LCX - V4- V6
Arteriolosclerosis in malignant hypertension

34. congenital heart defect with turner's
Torsades de pointes
Kawasaki
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Coarcation of aorta

35. What causes tet of fallot?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Inc central venous pressure - inc resistance to portal flow
Anterosuperior displacement of the infundibular septum
Inc interstitial osmotic pressure pulling fliud out of capillaries

36. How does digitatlis increase contractility?
S. epidermidis
Raynaud's
Isovolumetric contraction
Increase intracellular Na - resulting in increased Ca

37. sawtooth wave

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38. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Chordae rupture - GN - suppurative pericarditis - emboli
Fetal right to left - neonate left to right leading to RVH and failure
Wolff - Parkinson white syndrome
2-4 day - early coag necrosis on the first day

39. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
The plateau period
Mitral stenosis
Viridans streptococci
Buerger's disease

40. Which bacteria can cause endocarditis from prosthetic valves?
Sudden tensing of chordae tendinae
S. epidermidis
Unstable/crescendo angina
C - ANCA

41. congenital heart defect with 22q11
Truncus - tet of fallot
Venodilators (nitrogylcerine)
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Holosystoiic

42. dilated tortous veins due to chronically inc venous pressure - poor wound healing - varicose ulcers
Varicose veins - thromboembolism rare
S. bovis
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Eisenmenger's syndrome

43. What are aschoff bodies
Increase intracellular Na - resulting in increased Ca
RF
Kaposi's sarcoma
Granuloma with giant cells

44. What other syndrom is associated with infantile aortic coarctation
Turners
Adult type aortic coarctation
Aortic dilation - bicuspid aortic valve - RF -
Viridans streptococci

45. What does the atria release in response to inc blood volume and atrial pressure
ANP
MI
R to L shunt caused by stenoic pulmonic valve
RF

46. fibrinous pericarditis several weeks post MI

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47. fibrous plaques and atheromas in intima of arteries
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Early deaths from myocarditis
Failure of LV to in CO during exercise
Atherosclerosis

48. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Changes in CO as a function of preload
Preload
Kawasaki
Increase - increase the chance the If are open

49. PCWP is an estimate of...
Prinzmetal angina
Left atrial pressure
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Late systolic crescendo murmur with a midsystolic click

50. What happends in phase 1 of the ventricular cardiac action potential?
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Raynaud's
Coarcation of aorta