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Test your basic knowledge |
Cardiology
Start Test
Study First
Subject
:
health-sciences
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. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis
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2. Which organ has ht highest blood flow per gram of tissue
Kidney
Indomethacin closes - and pge keeps it open
RCA - II - III - aVF
Aortic/pulmonic regurg and mitral/tricuspid stenosis
3. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
Decreases
Chordae rupture - GN - suppurative pericarditis - emboli
Ischemic heart dz - mitral valve prolapse - LV dilation
4. When does EF decrease
Lower right - MC - upper right - AO - upper right AC - lower left MO
In HF
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Hematocrit
5. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Postinfarction fibrinous pericarditis
Kawasaki
R to L shunt caused by stenoic pulmonic valve
Transposition of great vessels
6. SV CAP means?
10%
Stroke volume affected by contractility - afterload - and preload
Conduction delay through AV node - nl < 200 msec
Dilated cardiomyopathy
7. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
In parallel
LAD - V1- V2
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Unstable/crescendo angina
8. The aortic arch receptors transmit along which nerve?
Vagus to medulla
MI
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Fluid movement through capillaries
9. Where is the most posterior portion of the heart and What can it cause?
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Patent ductus arteriosus - congenital rubella or prematurity
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Increase contractility
10. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Decreased
Age related calcifications or bicuspid aortic valve
Increase intracellular Na - resulting in increased Ca
11. in the JVP - What is the v wave?
Pulmonary flow murmur and diastolic rumble
Inc RA pressure - due to filling against closed tricupsid valve
Extracellular calcium - calcium induced calcium release
Systolic dysfunction
12. Which kind of infarct show ST elevation - and/or pathologic Q waves
Mitral>aortic>>tricuspid - high pressure valves affected most
Granuloma with giant cells
Transmural
Truncus - tet of fallot
13. coronary artery spasm - ST elevation
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
HypoK and bradycardia
During diastole
Prinzmetal angina
14. What does the U wave indicated?
HypoK and bradycardia
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
3rd degree block - pacemaker - Lyme disease
Glomus tumor
15. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
Subendocardial - fewer collaterals and higher pressure
V fib
In HF
16. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
Ischemic heart dz - mitral valve prolapse - LV dilation
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Cyclophosphamide and corticosteroids
17. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Tempral arteritis - may cause irreversible blindness
Polyarteritis nodosum
Volatage gated Ca channels
Fast volatge gated Na channels
18. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Venodilators (nitrogylcerine)
Sturge weber - vasculitis of caps
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
19. What does the starling curve show?
2-4 day - early coag necrosis on the first day
Decreased
Changes in CO as a function of preload
SV/ EDV
20. In an anterolateral infarct - which artery is effected and which leads show Q waves
Decreases
Hyperlipidemia
Diastolic
LCX - V4- V6
21. Which organ gets the largest share of systemic cardiac output
Late systolic crescendo murmur with a midsystolic click
Changes in CO as a function of preload
Liver
No
22. Right to left shunts are more common in babies or kids?
Unstable/crescendo angina
Eccentric - concentric hypertrophy causes diastolic disfunction
Hematocrit
Babies
23. What is the characteristic pulse in aortic stenosis?
Hematocrit
Pulsus parvus and tardus - weak - can lead to syncope
Squat. Compression of femoral arteries - inc TPR - dec
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
24. prolonged PR interval
1st degree AV blodck
10%
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Right sided
25. What causes the early cyanosis in Tet of Fallot?
R to L shunt caused by stenoic pulmonic valve
Takayasu's arteritis
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Angiosarcoma
26. What other sign is often present with congenital long QT syndrome - why?
Postinfarction fibrinous pericarditis
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Inc interstitial osmotic pressure pulling fliud out of capillaries
Yes
27. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Eccentric - concentric hypertrophy causes diastolic disfunction
Increasing activity of Ca pump in SR
PDA
Mean arterial pressure
28. What does the LAD supply?
Aburpt halting of valve leaflets
Apex and anterior interventricular septum
Ventricular depolarization - nl < 120 msec
SA and AV nodes
29. Mitral stenosis is most often secondary to which condition?
2nd degree AV block - mobitz type 1
Metastasis from melanoma or lymphoma
Proportional to viscosity and inversely proportional to the radius to the 4th power
RF
30. In what disease states is blood viscosity increased?
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Increasing activity of Ca pump in SR
Takayasu's arteritis
Vasodilators - (hydrAlAzine)
31. decrease stretch in baroreceptors leads to what response?
No
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Torsades de pointes
Increased efferent SANS and decreased efferent PANS
32. What does FAN MY SKIN On Wednesday stand for?
Vasocxn - while other tissues it causes vasodilation
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Kawasaki
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
33. Exercise - overtransfusiion and excitiment causes and increase in...?
Hematocrit
Glomus tumor
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Preload
34. What is indicated when CO and venous return are equal?
The operating point of the heart
Varicose veins - thromboembolism rare
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
No
35. What happens in phase 3 of the cardiac ventricular action potential?
Cyclophosphamide and corticosteroids
Pulmonic stenosis and RBBB
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Pulmonary flow murmur and diastolic rumble
36. What does the atria release in response to inc blood volume and atrial pressure
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Turners
The operating point of the heart
ANP
37. What causes the CO curve to shift upwards?
Pos inotropy - exercise
Decreased
Granuloma with giant cells
LCX - V4- V6
38. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Fetal right to left - neonate left to right leading to RVH and failure
S. epidermidis
Proportional to viscosity and inversely proportional to the radius to the 4th power
39. What is the difference between adult and infantile type aortic coarctation?
Atrial contraction
Medullary vasomotor center senses baroreceptors and JGA
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
During diastole
40. What causes the ejection click in the Cres - decres murmur?
Mean arterial pressure
Increasing activity of Ca pump in SR
Indomethacin closes - and pge keeps it open
Aburpt halting of valve leaflets
41. Which area of the endocardium is especially vulnerable to infarction? Why?
S. bovis
Raynaud's
Inc blood volume
Subendocardial - fewer collaterals and higher pressure
42. Which two mechanisms sense decrease MAP?
Medullary vasomotor center senses baroreceptors and JGA
Arteriolosclerosis in malignant hypertension
Resting potential high K perm
ASD - VSD - AV septal defect (endocardial cushion defect)
43. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
The first 4 days
Kawasaki
RCA
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
44. What does FROM JANE stand for in bacterial endocarditis?
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45. list the coronary vessels most likely to be occluded
LCX - V4- V6
LAD > RCA > circumflex
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
46. What does prolonged QT predispose to?
In RA return (inspiration)
S. epidermidis
Gap junctions
Torsades de pointes
47. What can cause mitral prolapse?
Persistant truncus arteriosus
LAD - V1 - V4
CHF
Myxomatous degeneration - RF - chordae rupture
48. What causes the midsystolic click
Sudden tensing of chordae tendinae
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Hypertrophied cardiomyopathy
49. When does extracellular calcium enter the cardiac muscle cells during contraction?
No - no pressure gradient
Tempral arteritis - may cause irreversible blindness
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
The plateau period
50. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
2nd degree AV block - mobitz type 1
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Subendocardial