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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. What does an isoelectric ST segment indicate?
Medullary vasomotor center senses baroreceptors and JGA
Ventricles are depolarized
Cystic hygroma
CO

2. What channels do the the pacemaker cells lack?
Atrial contraction
10%
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Fast volatge gated Na channels

3. Irregularly irregular ECG - no p waves: dx and treatment
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Venodilators (nitrogylcerine)
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Vasocxn - while other tissues it causes vasodilation

4. What are common causes of mitral regurg?
Transposition of great vessels
HTN - bradycardia - and respiratory depression
Ischemic heart dz - mitral valve prolapse - LV dilation
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR

5. most common primary cardiac tumor in children - associated with tuberous sclerosis
During diastole
Mechanican contraction of the ventricles
Eisenmenger's syndrome
Rhabdomyomas

6. What causes the CO curve to shift upwards?
Pos inotropy - exercise
Stroke volume
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Chordae rupture - GN - suppurative pericarditis - emboli

7. moncekberg
Hemorrhage
Failure of LV to in CO during exercise
HTN - bradycardia - and respiratory depression
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

8. The 7 complications of MI

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9. What causes the murmur heard in MR to enhance?
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
Stroke volume
SV/ EDV
Inc TPR and LA return (expiration)

10. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

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11. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Neg inotropy - HF - narcotic overdose
Dilated cardiomyopathy
Vasocxn - while other tissues it causes vasodilation

12. What does increasing intracellular Ca do?
Increase contractility
Wegener's
Chordae rupture - GN - suppurative pericarditis - emboli
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

13. How does angiotensin II raise MAP
Vagus to medulla
Mitral stenosis
Vasocxn
Greater ventricular EDV

14. In an EKG - What is the T wave?
Conduction delay through AV node - nl < 200 msec
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Ventricular repolarization
Venodilators (nitrogylcerine)

15. What does the U wave indicated?
HypoK and bradycardia
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
MI

16. What is the difference between adult and infantile type aortic coarctation?
The aortic before pulmonic - inspiration increases diff
Buerger's disease
Varicose veins - thromboembolism rare
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

17. What cardiac change occurs in pregnancy?
Kaposi's sarcoma
Increased SV
Subendocardial
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

18. What does TAPVR stand for
Non
Indomethacin closes - and pge keeps it open
Total anomalous pulmonary trunk venous return
ASD - VSD - AV septal defect (endocardial cushion defect)

19. What are the 5 T's of cyanoitc babies
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Eisenmenger's syndrome
Crescendo - decrescendo systolic ejection murmur following ejection click
Atrial contraction

20. When is the scar completely formed in an MI?
Left sided
Vagus to medulla
7 weeks
Mitral>aortic>>tricuspid - high pressure valves affected most

21. In the cardiac cycle - which period has the highest 02 consumption?
Fetal right to left - neonate left to right leading to RVH and failure
Isovolumetric contraction
Granuloma with giant cells
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus

22. What is the danger of torsades to pointes?
Decreased
Cyclophosphamide and corticosteroids
Can progess to V fib
During HF from microhemorrhages from inc pulm cap pressure

23. What is the result of not have fast sodium channels in pacemaker cells?
Stroke volume affected by contractility - afterload - and preload
Medullary vasomotor center senses baroreceptors and JGA
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Aortic insuffic - late

24. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Coarcation of aorta
Polyarteritis nodosum
Patent ductus arteriosus - congenital rubella or prematurity
Wolff - Parkinson white syndrome

25. serum marker for wegener's
C - ANCA
Aortic disecction - intraluminal tear forming false lumen
Stroke volume
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

26. Exercise - overtransfusiion and excitiment causes and increase in...?
Cardiac tamponde
Preload
Purkingee>atria>ventricles>AV node
Metastasis from melanoma or lymphoma

27. in the JVP - What is the c wave?
Patent ductus arteriosus - congenital rubella or prematurity
RV contraction (closed tricuspid valve bulding into atrium
Kidney
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

28. what happens to capillaries in lymphatic blockage
In HF
Decrease in cAMP
Aortic and pulmonary closing
Inc interstitial osmotic pressure pulling fliud out of capillaries

29. Rank the following by speed of conduction - av node - atria - purkinjee - ventricles
Purkingee>atria>ventricles>AV node
Infective endocarditis
Mitral and tricuspid closure
Transmural

30. Right to left shunts are more common in babies or kids?
Mitral stenosis
Babies
Inc blood volume
2-4 day - early coag necrosis on the first day

31. Restrictive cardiomyopathy causes
Kaposi's sarcoma
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Inc RA pressure - due to filling against closed tricupsid valve
Rhabdomyomas

32. decrease blood flow to the skin due to arteriolar vasospasm in cold temp - emotional stress - also in SLE and CREST

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33. What causes the murmur heard in tricuspid regurg to enhance
In RA return (inspiration)
Maintain blood flow to organ over wide range of perfussion pressures
Rapid upstroke - voltage gated Na channels open
Tempral arteritis - may cause irreversible blindness

34. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
MI
LAD - V1- V2
Left atrial pressure
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli

35. When and why is the S3 sound heard?
Total anomalous pulmonary trunk venous return
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Purkingee>atria>ventricles>AV node
Kussmaul's sign - cardiac tamponade - pulsus paradoxus

36. In an EKG - What is the PR interval?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
The plateau period
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
Conduction delay through AV node - nl < 200 msec

37. What kind of dysfunction ensues in restrictive cardiomyopathy
Lymphangiosarcoma
Greater ventricular EDV
Stable angina
Diastolic

38. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Glossopharyngeal to soliary nucleus of medulla
Ischemic heart dz - mitral valve prolapse - LV dilation
Lower right - MC - upper right - AO - upper right AC - lower left MO
Raynaud's

39. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Kawasaki
Vasodilators - (hydrAlAzine)
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

40. Which organ has ht highest blood flow per gram of tissue
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Kidney
RV failure - in venous pressure
Stroke volume

41. What causes aortic regurg
S. aureus
Aortic dilation - bicuspid aortic valve - RF -
Boot shaped heart
Cystic hygroma

42. exaggerated decrease in pulse during inspiration.

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43. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Atrial contraction
Heart - 02 extraction is always around 100%
Early deaths from myocarditis
Henoch - Schlonlein purpura

44. Which kind of infarct show ST elevation - and/or pathologic Q waves
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Transmural
Microscopic polyangiitis - like wegener's without granulomas
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

45. In an EKG - What is the QT interval?
Myxomatous degeneration - RF - chordae rupture
Mechanican contraction of the ventricles
CO
MAP

46. What causes ankle - sacral edema - jugular venous distention
Prinzmetal angina
Volatage gated Ca channels
Hyperlipidemia
RV failure - in venous pressure

47. which medications are used to maintain patency or close the ductus arteriosus?
LAD - V1- V2
Indomethacin closes - and pge keeps it open
Resting potential high K perm
Crescendo - decrescendo systolic ejection murmur following ejection click

48. congenital heart defect with congenital rubella
Age related calcifications or bicuspid aortic valve
Septal defects - PDA - pulm art stenosis
Sudden tensing of chordae tendinae
Increase intracellular Na - resulting in increased Ca

49. congenital heart defect with 22q11
Truncus - tet of fallot
Increase - increase the chance the If are open
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

50. Which artery supplies the SA and AV nodes?
MI
RCA
Stable angina
Aortic/pulmonic stenosis and mitral/tricuspid regurg