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Cardiology

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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. Which valve is most commonly involved in bacterial endocarditis?
Postinfarction fibrinous pericarditis
Pulsus parvus and tardus - weak - can lead to syncope
Mitral valve
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis

2. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Adult type aortic coarctation
Increased efferent SANS and decreased efferent PANS
Lymphangiosarcoma
During diastole

3. What happens in phase 4 of the cardiac ventricular action potential?
Hypertrophied cardiomyopathy
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Resting potential high K perm
Unstable/crescendo angina

4. What is the result of not have fast sodium channels in pacemaker cells?
Decreased
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Liver
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis

5. failure of truncus arteriosus to divide?
Liver
Non
Hyperlipidemia
Persistant truncus arteriosus

6. What does the LAD supply?
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Late systolic crescendo murmur with a midsystolic click
Apex and anterior interventricular septum
Unstable/crescendo angina

7. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
3rd degree block - pacemaker - Lyme disease
Pulmonic stenosis and RBBB
Holosystolic - harsh sounding murmur - loudest over tricuspid area

8. dyspnea - fatigue - edema and rales - multiple causes
RV failure - in venous pressure
CHF
Isovolumetric contraction
Tempral arteritis - may cause irreversible blindness

9. immune mediated transmural vasculitis with fibrinoid necrosis - small and medium vessels - renal and viscera - not pulm arteries - hep B seropos in 30% of pts
Polyarteritis nodosum
Fetal right to left - neonate left to right leading to RVH and failure
Inc RA pressure - due to filling against closed tricupsid valve
Acute thrombosis of coronary artery

10. clinical signs of cardiac tamponade
Pulsus parvus and tardus - weak - can lead to syncope
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Varicose veins - thromboembolism rare
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

11. The carotid sinus transmits along which nerve?
Glossopharyngeal to soliary nucleus of medulla
1st degree AV blodck
Arteriorles
Dilated cardiomyopathy

12. decrease stretch in baroreceptors leads to what response?
Kids
Increased efferent SANS and decreased efferent PANS
Torsades de pointes
Isovolumetric contraction

13. The aortic arch receptors transmit along which nerve?
Vagus to medulla
Stroke volume
MI
Ventricular repolarization

14. Right to left shunts are more common in babies or kids?
Activated histiocytes
Babies
Prinzmetal angina
Pyogenic granuloma - associated with trauma and pregnancy

15. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
...
Dilated cardiomyopathy
Purkingee>atria>ventricles>AV node
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

16. In a lateral wall infarct - which artery is effected - and which leads show Q waves?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
140/90
Left atrial pressure
LCX - I - aVL

17. Which class of drugs decrease the murmur heard in aortic regurg?
Chordae rupture - GN - suppurative pericarditis - emboli
Mitral valve prolapse
Inc central venous pressure - inc resistance to portal flow
Vasodilators

18. What is the cushing triad?
HTN - bradycardia - and respiratory depression
Fetal right to left - neonate left to right leading to RVH and failure
Pulse pressure
Stable angina

19. MAP is also known as
Afterload (proportional to peripheral resistance)
Volatage gated Ca channels
Aortic dilation - bicuspid aortic valve - RF -
In RA return (inspiration)

20. 2/3 diastolic + 1/3 systolic
Sudden tensing of chordae tendinae
MAP
2-4 day - early coag necrosis on the first day
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

21. sawtooth wave

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22. In an EKG - What is the p wave?
Black > white > asian
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Cherry hemangioma
Atrial contraction

23. Which area of the endocardium is especially vulnerable to infarction? Why?
Decreased
Wolff - Parkinson white syndrome
Subendocardial - fewer collaterals and higher pressure
Activated histiocytes

24. The 7 complications of MI

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25. Chronic mitral stenosis can lead to what changes in size of the LA
Non
Troponin I
Dilation
Vasocxn

26. What happens in phase 3 of the cardiac ventricular action potential?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
At least 55%
Ischemic heart dz - mitral valve prolapse - LV dilation

27. How are cadiac myocytes eltrically coupled?
HypoK and bradycardia
Crescendo - decrescendo systolic ejection murmur following ejection click
Gap junctions
Failure of LV to in CO during exercise

28. What is the time frame for arrhythmia risk in the evolution of MI
The first 4 days
Kawasaki
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Aortic stenosis or LBBB

29. PCWP > LV diastolic pressure
Fetal right to left - neonate left to right leading to RVH and failure
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Mitral stenosis
Wegener's

30. benign - painful - red - blue tumor under fingernails from smooth muscle cells
2nd degree AV block - mobitz type 1
Increase in Pc
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Glomus tumor

31. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Stable angina
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
SV/ EDV
Non

32. What do the carotid and aortic bodies respond to?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Dec P02 - inc PC02 and dec pH
Volatage gated Ca channels
TAPVR

33. When does EF decrease
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
SA and AV nodes
CHF
In HF

34. smaller vegetations - congenitally abnormal or diseased valves - sequela of dental procedures. Insidious onset
Viridans streptococci
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Cherry hemangioma
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

35. What is the danger of torsades to pointes?
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Can progess to V fib
Atrial contraction
Transfusion

36. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
During diastole
Coarcation of aorta
Squat. Compression of femoral arteries - inc TPR - dec
Sturge weber - vasculitis of caps

37. What murmur is heard with aortic regurg?
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Postinfarction fibrinous pericarditis
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

38. fibrinous pericarditis several weeks post MI

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39. congenital heart defect in an infant with a diabetic mother?
Holosystoiic
Transposition of great vessels
Sturge weber - vasculitis of caps
Liver

40. What are the complications of atherosclerosis?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Stable angina
MAP

41. Which murmur is characteristic of mitral/tricuspid regurg?
Holosystoiic
Age related calcifications or bicuspid aortic valve
Myxoma
Preload

42. benign cap hemangioma of infancy - spont regresses
Vasocxn - while other tissues it causes vasodilation
2nd degree AV block - mobitz type 1
Strawberry hemangioma
RCA

43. Why is contractility decreased in heart failure?
Systolic dysfunction
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Viridans streptococci
EKG

44. In an anterolateral infarct - which artery is effected and which leads show Q waves
Total anomalous pulmonary trunk venous return
Septal defects - PDA - pulm art stenosis
MAP
LCX - V4- V6

45. no relation between p waves and QRS intervals - treatment and predisposing factor
Myxoma
Increase in Pc
Vasodilators - (hydrAlAzine)
3rd degree block - pacemaker - Lyme disease

46. When do coronary arteries fill?
MI
Torsades de pointes
Liver
During diastole

47. absecnce of tricuspid valve - hypoplastic RV
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Greater ventricular EDV
Extracellular calcium - calcium induced calcium release
Tricuspid atresia - requires ASD and VSD

48. The cause of cardiac dilation?
QRS complex
Atherosclerosis
Greater ventricular EDV
Conduction delay through AV node - nl < 200 msec

49. What causes the CO curve to shift upwards?
Activated histiocytes
Pos inotropy - exercise
Group a beta hemolytic strep
The first 4 days

50. How do beta blockers decrease contractility?
Decrease in cAMP
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Systolic dysfunction
Torsades de pointes