Cardiology

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• 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. Where are pacemaker cells?
SA and AV nodes
Increase - increase the chance the If are open
Subendocardial
Inc central venous pressure - inc resistance to portal flow


2. What is the early and late lesion in rheumatic heart disease
Preload
Subendocardial
During diastole
Mitral valve prolapse


3. In terms of starling forces - why does heart failure cause edema?
RF
Non
Increase in Pc
Polyarteritis nodosum


4. prolonged PR interval
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
During diastole
Preload
1st degree AV blodck


5. In normal S2 splitting - which valve closes first? What increases it?
Torsades de pointes
In series
2nd degree AV block - mobitz type 1
The aortic before pulmonic - inspiration increases diff


6. moncekberg
Aortic and pulmonary closing
During HF from microhemorrhages from inc pulm cap pressure
Non
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved


7. Left to right shunts are more common in babies or kids?
Vasocxn
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Kids


8. The 7 complications of MI

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

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

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11. What causes the murmur heard in MR to enhance?
Inc blood volume
Inc TPR and LA return (expiration)
S. bovis
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved


12. Irregularly irregular ECG - no p waves: dx and treatment
During HF from microhemorrhages from inc pulm cap pressure
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
No - no pressure gradient
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis


13. What is the time frame for arrhythmia risk in the evolution of MI
Vasocxn - while other tissues it causes vasodilation
The first 4 days
Systolic dysfunction
LAD - V1 - V4


14. 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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15. Which murmur is heard in aortic stenosis?
Decrease in cAMP
In HF
Crescendo - decrescendo systolic ejection murmur following ejection click
Fick principle


16. What does FROM JANE stand for in bacterial endocarditis?

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17. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Indomethacin closes - and pge keeps it open
Inc interstitial osmotic pressure pulling fliud out of capillaries
No
Greater ventricular EDV


18. congenital heart defect with marfan's
Increased SV
Aortic insuffic - late
Late systolic crescendo murmur with a midsystolic click
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection


19. Which area of the endocardium is especially vulnerable to infarction? Why?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Mitral valve prolapse
Ventricular depolarization - nl < 120 msec
Subendocardial - fewer collaterals and higher pressure


20. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Lymphangiosarcoma
Glomus tumor
Fluid movement through capillaries


21. When and why is the S3 sound heard?
Dressler's - autoimmune
Cardiac tamponde
Mean arterial pressure
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling


22. What does prolonged QT predispose to?
At least 55%
Late systolic crescendo murmur with a midsystolic click
Inc central venous pressure - inc resistance to portal flow
Torsades de pointes


23. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Infective endocarditis
Strawberry hemangioma


24. What is the most common cause of MI
Acute thrombosis of coronary artery
MI
Stroke volume affected by contractility - afterload - and preload
RCA - II - III - aVF


25. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Viridans streptococci
In RA return (inspiration)
Pyogenic granuloma - associated with trauma and pregnancy
LV failure - pulm venous distention transudation of fluid


26. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Purkingee>atria>ventricles>AV node
Stable angina
Libman - sacks endocarditis
Neg inotropy - HF - narcotic overdose


27. Which channel accounts for automaticity of the SA and AV nodes?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
In parallel
If sodium channel
Polyarteritis nodosum


28. clinical signs of cardiac tamponade
No
Inc RA pressure - due to filling against closed tricupsid valve
Persistant truncus arteriosus
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus


29. no relation between p waves and QRS intervals - treatment and predisposing factor
Posterior descending (80% off the RCA - 20% off the circumflex)
In RA return (inspiration)
Ventricles are depolarized
3rd degree block - pacemaker - Lyme disease


30. Which kind of infarct show ST elevation - and/or pathologic Q waves
Transmural
Inc Kf - capillary perm
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Pulse pressure


31. What is the gold standard for dx of MI in the first 6 hours
Aortic dilation - bicuspid aortic valve - RF -
EKG
HTN - bradycardia - and respiratory depression
Ventricles are depolarized


32. In the cardiac cycle - which period has the highest 02 consumption?
Isovolumetric contraction
Infective endocarditis
During HF from microhemorrhages from inc pulm cap pressure
Decrease in cAMP


33. What constitues the upstroke in pacemaker cells?
Volatage gated Ca channels
Left heart failure
Posterior descending (80% off the RCA - 20% off the circumflex)
Postinfarction fibrinous pericarditis


34. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Rapid upstroke - voltage gated Na channels open
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Decreases
Angiosarcoma


35. Rank the pacemakers cells
Preload
SA>AV>bundle of His>ventricles
Can progess to V fib
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics


36. What does an isoelectric ST segment indicate?
Ventricles are depolarized
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Kawasaki
Hyperlipidemia


37. which medications are used to maintain patency or close the ductus arteriosus?
Increase - increase the chance the If are open
Indomethacin closes - and pge keeps it open
Vasocxn
Patent ductus arteriosus - congenital rubella or prematurity


38. Which organ has ht highest blood flow per gram of tissue
Group a beta hemolytic strep
Transposition of great vessels
Late diastolic murmur following an opening snap
Kidney


39. What does FAN MY SKIN On Wednesday stand for?
Liver
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Vasodilators - (hydrAlAzine)


40. What does T wave inversion indicated?
Right sided
Postinfarction fibrinous pericarditis
MI
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block


41. p - anca

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42. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Transfusion
QRS complex
LAD - V1 - V4
Kussmaul's sign - cardiac tamponade - pulsus paradoxus


43. Which bacteria causes endocarditis in the presence of colon cancer
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
S. bovis
ASD - VSD - AV septal defect (endocardial cushion defect)
Volatage gated Ca channels


44. Given P = QR - what factors influence resistance?
During HF from microhemorrhages from inc pulm cap pressure
MI
Decreases
Proportional to viscosity and inversely proportional to the radius to the 4th power


45. What can cause mitral prolapse?
Myxomatous degeneration - RF - chordae rupture
ASD
Ischemic heart dz - mitral valve prolapse - LV dilation
Increase in Pc


46. What is association with fixed S2 splitting - does not increase with inspiration
ASD
Atherosclerosis
Indomethacin closes - and pge keeps it open
Tempral arteritis - may cause irreversible blindness


47. Wegener's presentation
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Wolff - Parkinson white syndrome
Aortic and pulmonary closing
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea


48. most common primary cardiac tumor in children - associated with tuberous sclerosis
HypoK and bradycardia
Early deaths from myocarditis
Vasocxn
Rhabdomyomas


49. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Dec plasma proteins
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Liver


50. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Decrease in cAMP
Lymphangiosarcoma
LV failure - pulm venous distention transudation of fluid
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