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. What does autoregulation do?
Pulsus parvus and tardus - weak - can lead to syncope
Maintain blood flow to organ over wide range of perfussion pressures
Decreased
Indomethacin closes - and pge keeps it open


2. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Diastolic
RCA - II - III - aVF
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Non


3. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
LCX - I - aVL
Transfusion
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Eccentric - concentric hypertrophy causes diastolic disfunction


4. In an EKG - What is the QT interval?
ANP
Mechanican contraction of the ventricles
Inc venous return exaccerbates pulm vasc congestion
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics


5. Which organ gets the largest share of systemic cardiac output
ASD
Hyperlipidemia
RCA
Liver


6. Where does coronary artery occlusion occur most commonly?
ASD - VSD - AV septal defect (endocardial cushion defect)
Gap junctions
LAD
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup


7. bening capillary hemangioma of elderly - does not regress
Increase - increase the chance the If are open
Cherry hemangioma
Vagus to medulla
Polyarteritis nodosum


8. What is the characteristic pulse in aortic stenosis?
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Pulsus parvus and tardus - weak - can lead to syncope
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Viridans streptococci


9. What causes aortic regurg
At least 55%
Aortic dilation - bicuspid aortic valve - RF -
LV failure - pulm venous distention transudation of fluid
Early deaths from myocarditis


10. What is the most common cause of MI
Hematocrit
Acute thrombosis of coronary artery
Aortic dilation - bicuspid aortic valve - RF -
Libman - sacks endocarditis


11. In normal S2 splitting - which valve closes first? What increases it?
Truncus - tet of fallot
5-10 days - macs have degraded structural components
The aortic before pulmonic - inspiration increases diff
Pulmonary flow murmur and diastolic rumble


12. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
ASD - VSD - AV septal defect (endocardial cushion defect)
CO
Increase contractility
LAD - V1- V2


13. What kind of dysfunction ensues in restrictive cardiomyopathy
Diastolic
Right sided
Ventricular repolarization
Venodilators (nitrogylcerine)


14. If HR is too fast (V tach) what happens during diastole?
Filling is incomplete and CO falls
Apex and anterior interventricular septum
Polyarteritis nodosum
Mitral and tricuspid closure


15. sawtooth wave

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16. What is associated with paradoxical spliting of S2
Metastasis from melanoma or lymphoma
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Aortic stenosis or LBBB
Rhabdomyomas


17. what conditions are associated with pulsus paradoxus
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Atherosclerosis


18. Which organ has the largest arteriovenous difference
Decreased
Heart - 02 extraction is always around 100%
3rd degree block - pacemaker - Lyme disease
Vasodilators - (hydrAlAzine)


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

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21. How does angiotensin II raise MAP
In HF
Can progess to V fib
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Vasocxn


22. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Crescendo - decrescendo systolic ejection murmur following ejection click
LV failure - pulm venous distention transudation of fluid
S. bovis
Purkingee>atria>ventricles>AV node


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

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24. What causes the early cyanosis in Tet of Fallot?
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
R to L shunt caused by stenoic pulmonic valve
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)


25. In an acute MI - are there any visible changes via LM in the first 2-4 hours
No
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Conduction delay through AV node - nl < 200 msec
Glomus tumor


26. Which murmur is heard in aortic stenosis?
LAD - V1 - V4
Crescendo - decrescendo systolic ejection murmur following ejection click
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Yes


27. What is the early and late lesion in rheumatic heart disease
Increase intracellular Na - resulting in increased Ca
Mitral valve prolapse
Mean arterial pressure
MI


28. When and why is the S3 sound heard?
P02
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
LCX - V4- V6
Ischemic heart dz - mitral valve prolapse - LV dilation


29. What is the difference between adult and infantile type aortic coarctation?
Preload
Transmural
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Takayasu's arteritis


30. What masks atrial repolarization?
The plateau period
QRS complex
Henoch - Schlonlein purpura
LAD


31. What is indicated when CO and venous return are equal?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
The operating point of the heart
Libman - sacks endocarditis
Stroke volume


32. What does mitral prolapse predeispose to?
Inc venous return exaccerbates pulm vasc congestion
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Infective endocarditis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy


33. Right to left shunts are more common in babies or kids?
Hypertrophied cardiomyopathy
Turners
Filling is incomplete and CO falls
Babies


34. What is the definition of HTN?
Vagus to medulla
140/90
Cardiac tamponde
Pos inotropy - exercise


35. list the coronary vessels most likely to be occluded
Medullary vasomotor center senses baroreceptors and JGA
Pos inotropy - exercise
Pyogenic granuloma - associated with trauma and pregnancy
LAD > RCA > circumflex


36. congenital heart defect with congenital rubella
Myxoma
Septal defects - PDA - pulm art stenosis
...
MAP


37. What causes the midsystolic click
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Increased efferent SANS and decreased efferent PANS
Medullary vasomotor center senses baroreceptors and JGA
Sudden tensing of chordae tendinae


38. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Decrease in cAMP
2nd degree AV block - mobitz type 1
MI
Ventricular depolarization - nl < 120 msec


39. exaggerated decrease in pulse during inspiration.

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40. In an EKG - What is the QRS complex?
Rhabdomyomas
Volatage gated Ca channels
Mechanican contraction of the ventricles
Ventricular depolarization - nl < 120 msec


41. Which artery supplies the inferior portion of the left ventricle and posterior septum?
LCX - I - aVL
Posterior descending (80% off the RCA - 20% off the circumflex)
Granuloma with giant cells
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection


42. most common primary cardiac tumor in children - associated with tuberous sclerosis
Subendocardial - fewer collaterals and higher pressure
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
LAD
Rhabdomyomas


43. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
Gap junctions
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Fick principle
Pyogenic granuloma - associated with trauma and pregnancy


44. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Aortic insuffic - late
CHF
RF
S. aureus


45. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
5-10 days - macs have degraded structural components
Myxoma
3rd degree block - pacemaker - Lyme disease
Heart - 02 extraction is always around 100%


46. What causes aortic stenosis
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Age related calcifications or bicuspid aortic valve
Eccentric - concentric hypertrophy causes diastolic disfunction
In HF


47. Which enzymes are useful for diagnosing reinfarction
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Greater ventricular EDV
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
CK- MB


48. serum marker for wegener's
C - ANCA
Purkingee>atria>ventricles>AV node
Mechanican contraction of the ventricles
RV contraction (closed tricuspid valve bulding into atrium


49. What does an isoelectric ST segment indicate?
Ventricles are depolarized
Cystic hygroma
Can progess to V fib
Boot shaped heart


50. Which class of drugs decrease preload
Venodilators (nitrogylcerine)
Aortic and pulmonary closing
Age related calcifications or bicuspid aortic valve
Inc central venous pressure - inc resistance to portal flow