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Test your basic knowledge |
Cardiology
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Subject
:
health-sciences
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 stimulates release of calcium from the SR?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Extracellular calcium - calcium induced calcium release
LAD > RCA > circumflex
LCX - I - aVL
2. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Sudden tensing of chordae tendinae
S. aureus
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Mitral>aortic>>tricuspid - high pressure valves affected most
3. decrease stretch in baroreceptors leads to what response?
Increased efferent SANS and decreased efferent PANS
Pulse pressure
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Mitral valve prolapse
4. In normal S2 splitting - which valve closes first? What increases it?
Ventricular repolarization
Kidney
The aortic before pulmonic - inspiration increases diff
Age related calcifications or bicuspid aortic valve
5. 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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6. The 7 complications of MI
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7. How do catecholamines increase contractility?
P02
Aortic disecction - intraluminal tear forming false lumen
Increasing activity of Ca pump in SR
Aortic insuffic - late
8. what conditions are associated with pulsus paradoxus
Atherosclerosis
RV failure - in venous pressure
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
9. Which class of drugs decrease the murmur heard in aortic regurg?
Vasodilators
Cherry hemangioma
Pos inotropy - exercise
Aortic/pulmonic regurg and mitral/tricuspid stenosis
10. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
TAPVR
Myxomatous degeneration - RF - chordae rupture
Myxoma
Pulmonic stenosis and RBBB
11. What causes tet of fallot?
In parallel
Pulmonic stenosis and RBBB
Rhabdomyomas
Anterosuperior displacement of the infundibular septum
12. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
Strawberry hemangioma
5-10 days - macs have degraded structural components
Rhabdomyomas
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
13. The cause of dyspnea on exertion?
Kidney
Eccentric - concentric hypertrophy causes diastolic disfunction
Failure of LV to in CO during exercise
V fib
14. Inspiration causes an increase in which sided heart sounds?
Systolic dysfunction
C - ANCA
Right sided
Transmural
15. What causes the midsystolic click
Sudden tensing of chordae tendinae
Fluid movement through capillaries
Strawberry hemangioma
Preload
16. What is the progression of atherosclerosis?
Hypertrophied cardiomyopathy
Systolic dysfunction
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
17. In an anterolateral infarct - which artery is effected and which leads show Q waves
Rhabdomyomas
Temporal arteritis
LCX - V4- V6
Late systolic crescendo murmur with a midsystolic click
18. congenital heart defect with marfan's
Isovolumetric contraction
Aortic insuffic - late
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Crescendo - decrescendo systolic ejection murmur following ejection click
19. Mitral stenosis is most often secondary to which condition?
2nd degree AV block - mobitz type 1
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
RF
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
20. What constitues the upstroke in pacemaker cells?
Viridans streptococci
Infective endocarditis
CK- MB
Volatage gated Ca channels
21. machine murmer
PDA
At least 55%
In series
SA>AV>bundle of His>ventricles
22. What causes aortic stenosis
Decrease in activity of Na/Ca exhanger and increase in contractility
Age related calcifications or bicuspid aortic valve
...
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
23. What are the 5 T's of cyanoitc babies
Stable angina
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Posterior descending (80% off the RCA - 20% off the circumflex)
Conduction delay through AV node - nl < 200 msec
24. cavernous lymphangioma of the neck - associated with turner's
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Cystic hygroma
MI
Wolff - Parkinson white syndrome
25. Which organ has ht highest blood flow per gram of tissue
Tempral arteritis - may cause irreversible blindness
ANP
Crescendo - decrescendo systolic ejection murmur following ejection click
Kidney
26. When and why do you hear the S4 sound
Decrease in cAMP
Squat. Compression of femoral arteries - inc TPR - dec
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
27. PCWP is an estimate of...
Fetal right to left - neonate left to right leading to RVH and failure
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Left atrial pressure
Left heart failure
28. How does acidosis affect contractility?
Ventricular depolarization - nl < 120 msec
Decreased
Pulmonic stenosis and RBBB
Black > white > asian
29. In an EKG - What is the QRS complex?
At least 55%
Ventricular depolarization - nl < 120 msec
P02
Subendocardial - fewer collaterals and higher pressure
30. Chronic mitral stenosis can lead to what changes in size of the LA
Lymphangiosarcoma
Dilation
Stable angina
Ischemic heart dz - mitral valve prolapse - LV dilation
31. systolic - diastolic
Pulse pressure
2-4 day - early coag necrosis on the first day
Atherosclerosis
SV/ EDV
32. fibrous plaques and atheromas in intima of arteries
Turners
LCX - V4- V6
In series
Atherosclerosis
33. What causes the CO curve to shift upwards?
CFX
At least 55%
Pos inotropy - exercise
Venodilators (nitrogylcerine)
34. How does angiotensin II raise MAP
Raynaud's
Anterosuperior displacement of the infundibular septum
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Vasocxn
35. what happens to capillaries in lymphatic blockage
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Inc interstitial osmotic pressure pulling fliud out of capillaries
36. What do the carotid and aortic bodies respond to?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Dec P02 - inc PC02 and dec pH
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
37. exaggerated decrease in pulse during inspiration.
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38. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
Truncus - tet of fallot
Troponin I
C - ANCA
Dec plasma proteins
39. polypoid capillary hemangioma that can ulcerate and bleed
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Pyogenic granuloma - associated with trauma and pregnancy
Mitral stenosis
Atherosclerosis
40. What can cause mitral prolapse?
Mitral>aortic>>tricuspid - high pressure valves affected most
Apex and anterior interventricular septum
Vagus to medulla
Myxomatous degeneration - RF - chordae rupture
41. Fatal arrhythmia
PDA
Sturge weber - vasculitis of caps
Holosystoiic
V fib
42. The aortic arch receptors transmit along which nerve?
Vagus to medulla
Increase contractility
Vasodilators - (hydrAlAzine)
Hypertrophied cardiomyopathy
43. thrombosis w/o necrosis - ST elevation - worsening chest pain at rest or with minimal exertion
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
RCA - II - III - aVF
Unstable/crescendo angina
Persistant truncus arteriosus
44. In what disease states is blood viscosity increased?
Holosystoiic
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Sturge weber - vasculitis of caps
3rd degree block - pacemaker - Lyme disease
45. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST
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46. highly lethal malignancy of the liver - associated with vinyl chloride - arsenic - and thorosrast exposure
Changes in CO as a function of preload
Granuloma with giant cells
Tricuspid atresia - requires ASD and VSD
Angiosarcoma
47. What is the formula for EF?
Afterload (proportional to peripheral resistance)
SV/ EDV
Anterosuperior displacement of the infundibular septum
Vasocxn
48. Why is there edema after burns or during infection
Activated histiocytes
Cherry hemangioma
Inc Kf - capillary perm
5-10 days - macs have degraded structural components
49. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Arteriorles
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Dilation
No - no pressure gradient
50. What causes the cushing reflex and why
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Hematocrit
Truncus - tet of fallot
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