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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. What causes the CO curve to shift downwards?
Left atrial pressure
P02
Neg inotropy - HF - narcotic overdose
2nd degree AV block - mobitz type 1

2. What are the complications of atherosclerosis?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Pulse pressure
Atherosclerosis
In RA return (inspiration)

3. In the cardiac cycle - which period has the highest 02 consumption?
Venodilators (nitrogylcerine)
In HF
Isovolumetric contraction
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

4. congenital heart defect with 22q11
EKG
LAD > RCA > circumflex
Wolff - Parkinson white syndrome
Truncus - tet of fallot

5. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
Henoch - Schlonlein purpura
Fast volatge gated Na channels
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn

6. Which bacteria causes rheumatic heart disease
SV/ EDV
Granuloma with giant cells
Group a beta hemolytic strep
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

7. What does hypoxia cause in the lung versus other tissues?
SV/ EDV
Left sided
Vasocxn - while other tissues it causes vasodilation
Crescendo - decrescendo systolic ejection murmur following ejection click

8. What do patients die early from in rheumatic heart disease?
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Hypertrophied cardiomyopathy
Early deaths from myocarditis
Inc venous return exaccerbates pulm vasc congestion

9. Exercise - overtransfusiion and excitiment causes and increase in...?
V fib arrhythima
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Non
Preload

10. What does mitral prolapse predeispose to?
Arteriolosclerosis in malignant hypertension
Temporal arteritis
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Infective endocarditis

11. What can cause mitral prolapse?
Inc interstitial osmotic pressure pulling fliud out of capillaries
S. aureus
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Myxomatous degeneration - RF - chordae rupture

12. In an acute MI - are there any visible changes via LM in the first 2-4 hours
MI
No
Mitral valve
Kawasaki

13. Which organ gets the largest share of systemic cardiac output
Dec plasma proteins
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Babies
Liver

14. What channels do the the pacemaker cells lack?
Prinzmetal angina
Mitral and tricuspid closure
Kaposi's sarcoma
Fast volatge gated Na channels

15. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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16. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Raynaud's
LCX - I - aVL
Increased efferent SANS and decreased efferent PANS

17. What causes hepatomegaly?
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Inc central venous pressure - inc resistance to portal flow
10%
Lymphangiosarcoma

18. list the coronary vessels most likely to be occluded
Cherry hemangioma
LAD > RCA > circumflex
Greater ventricular EDV
The plateau period

19. Which vessels account for the most total peripheral resistance
No
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Vasocxn - while other tissues it causes vasodilation
Arteriorles

20. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Fetal right to left - neonate left to right leading to RVH and failure
Dressler's - autoimmune

21. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Activated histiocytes
Hyperlipidemia
Glomus tumor
Mitral valve prolapse

22. What do the starling forces determine
S. epidermidis
Increased efferent SANS and decreased efferent PANS
Fluid movement through capillaries
10%

23. What are the four most common locations for atherosclerosis?
Atherosclerosis
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Crescendo - decrescendo systolic ejection murmur following ejection click
Inc central venous pressure - inc resistance to portal flow

24. Wegener's tx
Cyclophosphamide and corticosteroids
Metastasis from melanoma or lymphoma
Preload
Hypertrophied cardiomyopathy

25. in the JVP - What is the v wave?
RV failure - in venous pressure
Inc RA pressure - due to filling against closed tricupsid valve
Hemorrhage
Wolff - Parkinson white syndrome

26. what conditions are associated with pulsus paradoxus
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Dilation

27. What murmur is heard with aortic regurg?
Subendocardial - fewer collaterals and higher pressure
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
In series

28. When and why do you hear the S4 sound
Inc RA pressure - due to filling against closed tricupsid valve
Fick principle
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
HTN - bradycardia - and respiratory depression

29. Which kind of infarct show ST elevation - and/or pathologic Q waves
Increase - increase the chance the If are open
Hematocrit
Transmural
The aortic before pulmonic - inspiration increases diff

30. 2/3 diastolic + 1/3 systolic
V fib arrhythima
Inc venous return exaccerbates pulm vasc congestion
Aortic insuffic - late
MAP

31. which heart valves are afected most in rheumatic heart diseease
Mitral stenosis
Increase contractility
Mitral>aortic>>tricuspid - high pressure valves affected most
Stable angina

32. The 7 complications of MI

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33. Fatal arrhythmia
V fib
Increase intracellular Na - resulting in increased Ca
Sudden tensing of chordae tendinae
Lower right - MC - upper right - AO - upper right AC - lower left MO

34. What other syndrom is associated with infantile aortic coarctation
Turners
Polyarteritis nodosum
Preload
Increased efferent SANS and decreased efferent PANS

35. Inspiration causes an increase in which sided heart sounds?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Unstable/crescendo angina
Atrial contraction
Right sided

36. What does TAPVR stand for
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Total anomalous pulmonary trunk venous return
LV failure - pulm venous distention transudation of fluid
RCA

37. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Increase intracellular Na - resulting in increased Ca
Atherosclerosis
Purkingee>atria>ventricles>AV node
2nd degree AV block - mobitz type 1

38. What does FAN MY SKIN On Wednesday stand for?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Eisenmenger's syndrome
LCX - V4- V6

39. Unilateral headache - jaw claudication - impaired vision
Tempral arteritis - may cause irreversible blindness
Hyperlipidemia
Subendocardial
Vasocxn - while other tissues it causes vasodilation

40. What is indicated when CO and venous return are equal?
2nd degree AV block - mobitz type 1
R to L shunt caused by stenoic pulmonic valve
Glomus tumor
The operating point of the heart

41. What causes tet of fallot?
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Anterosuperior displacement of the infundibular septum

42. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
SV/ EDV
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
LV failure - pulm venous distention transudation of fluid
Pos inotropy - exercise

43. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
MI
Vasodilators - (hydrAlAzine)
Stable angina
LAD > RCA > circumflex

44. What does the starling curve show?
In parallel
Hematocrit
Changes in CO as a function of preload
Heart - 02 extraction is always around 100%

45. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
LCX - I - aVL
Ventricles are depolarized
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
The operating point of the heart

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

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47. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?

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48. What causes the murmur heard in tricuspid regurg to enhance
Vasodilators - (hydrAlAzine)
In RA return (inspiration)
Inc TPR and LA return (expiration)
Filling is incomplete and CO falls

49. In an EKG - What is the QRS complex?
ANP
Lymphangiosarcoma
Ventricular depolarization - nl < 120 msec
C - ANCA

50. Where are pacemaker cells?
SA>AV>bundle of His>ventricles
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Activated histiocytes
SA and AV nodes