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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. Wegener's tx
Changes in CO as a function of preload
Cyclophosphamide and corticosteroids
Aortic disecction - intraluminal tear forming false lumen
Age related calcifications or bicuspid aortic valve

2. acute - self limiting necrotizing vasculitis in children associated with fever - conjunctivitis - strawberry tongue - desquamatous skin rash - lymphadenitis - coronary sinus aneurysms. Seen in asians
Mitral and tricuspid closure
Kawasaki
EKG
Right sided

3. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Dec plasma proteins
Atrial contraction
Buerger's disease
Boot shaped heart

4. What is the time frame for arrhythmia risk in the evolution of MI
Pyogenic granuloma - associated with trauma and pregnancy
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Mean arterial pressure
The first 4 days

5. What are aschoff bodies
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
R to L shunt caused by stenoic pulmonic valve
Granuloma with giant cells
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

6. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Cherry hemangioma
2nd degree AV block - mobitz type 1
HTN - bradycardia - and respiratory depression
Non

7. friction rub - 3-5 days post MI
In RA return (inspiration)
In HF
Postinfarction fibrinous pericarditis
Venodilators (nitrogylcerine)

8. What causes the midsystolic click
Sudden tensing of chordae tendinae
Pulsus parvus and tardus - weak - can lead to syncope
Neg inotropy - HF - narcotic overdose
Decrease in cAMP

9. p - anca

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10. what percentage of HTN is secondary to renal disease?
Mitral valve
10%
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Temporal arteritis

11. Hyperplastic onion skinning
ASD
Decrease in activity of Na/Ca exhanger and increase in contractility
Arteriolosclerosis in malignant hypertension
Henoch - Schlonlein purpura

12. MAP is also known as
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
Unstable/crescendo angina
Afterload (proportional to peripheral resistance)

13. What is the association with wide S2 splitting?
Mitral valve prolapse
Metastasis from melanoma or lymphoma
In HF
Pulmonic stenosis and RBBB

14. Which two mechanisms sense decrease MAP?
Medullary vasomotor center senses baroreceptors and JGA
RCA
S. bovis
Preload

15. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
Cardiac tamponde
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Kidney
Mitral valve

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

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17. EDV is also known as
Preload
HTN - bradycardia - and respiratory depression
Can progess to V fib
Fick principle

18. systolic - diastolic
Wegener's
Inc blood volume
Pulse pressure
S. bovis

19. prolonged PR interval
Volatage gated Ca channels
1st degree AV blodck
RCA - II - III - aVF
Kawasaki

20. Which class of drugs decrease preload
At least 55%
Venodilators (nitrogylcerine)
Cardiac tamponde
Eccentric - concentric hypertrophy causes diastolic disfunction

21. Restrictive cardiomyopathy causes
CO
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
If sodium channel
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis

22. tearing chest pain radiation to the back - associated with marfan
Aortic disecction - intraluminal tear forming false lumen
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
In series
7 weeks

23. What is the most common cause of MI
Pulsus parvus and tardus - weak - can lead to syncope
Atherosclerosis
Acute thrombosis of coronary artery
Vagus to medulla

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

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25. What is the progression of atherosclerosis?
CHF
V fib arrhythima
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
SV/ EDV

26. In terms of starling forces - why does heart failure cause edema?
TAPVR
During diastole
Increase - increase the chance the If are open
Increase in Pc

27. clinical signs of cardiac tamponade
Metastasis from melanoma or lymphoma
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Pyogenic granuloma - associated with trauma and pregnancy
Henoch - Schlonlein purpura

28. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Myxoma
Medullary vasomotor center senses baroreceptors and JGA
Increasing activity of Ca pump in SR
Rhabdomyomas

29. Do you see elevaged ASO titers in rheumatic heart disease
Atherosclerosis
Ventricular depolarization - nl < 120 msec
Yes
7 weeks

30. Where is the most posterior portion of the heart and What can it cause?
During diastole
Subendocardial
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
V fib

31. PCWP is an estimate of...
LCX - V4- V6
Left atrial pressure
Chordae rupture - GN - suppurative pericarditis - emboli
Purkingee>atria>ventricles>AV node

32. most common primary cardiac tumor in children - associated with tuberous sclerosis
The first 4 days
Rhabdomyomas
Volatage gated Ca channels
Changes in CO as a function of preload

33. Churg Strauss - presentation and test
ASD
CK- MB
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
MI

34. Which murmur is heard in aortic stenosis?
Crescendo - decrescendo systolic ejection murmur following ejection click
Pulsus parvus and tardus - weak - can lead to syncope
Increase contractility
LCX - V4- V6

35. which medications are used to maintain patency or close the ductus arteriosus?
Indomethacin closes - and pge keeps it open
Right sided
V fib
Inc Kf - capillary perm

36. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
The first 4 days
Crescendo - decrescendo systolic ejection murmur following ejection click
Decreases
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

37. failure of truncus arteriosus to divide?
At least 55%
Indomethacin closes - and pge keeps it open
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Persistant truncus arteriosus

38. How does acidosis affect contractility?
Squat. Compression of femoral arteries - inc TPR - dec
Cyclophosphamide and corticosteroids
Decreased
Vasocxn - while other tissues it causes vasodilation

39. What do the starling forces determine
Fluid movement through capillaries
CHF
Dressler's - autoimmune
Diastolic

40. What other sign is often present with congenital long QT syndrome - why?
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Wolff - Parkinson white syndrome
Ventricular depolarization - nl < 120 msec
P02

41. What causes the CO curve to shift downwards?
Glossopharyngeal to soliary nucleus of medulla
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Early deaths from myocarditis
Neg inotropy - HF - narcotic overdose

42. What is a normal EF
At least 55%
MAP
Arteriolosclerosis in malignant hypertension
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

43. bening capillary hemangioma of elderly - does not regress
Cherry hemangioma
Atherosclerosis
Kids
Turners

44. PROVe
Kids
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Torsades de pointes
Subendocardial - fewer collaterals and higher pressure

45. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
Mechanican contraction of the ventricles
LV failure - pulm venous distention transudation of fluid
LAD - V1 - V4
Inc Kf - capillary perm

46. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
Rhabdomyomas
Apex and anterior interventricular septum
Pulmonary flow murmur and diastolic rumble

47. What causes the CO curve to shift upwards?
During diastole
Henoch - Schlonlein purpura
Pos inotropy - exercise
...

48. What causes the ejection click in the Cres - decres murmur?
LCX - I - aVL
During diastole
Aburpt halting of valve leaflets
Changes in CO as a function of preload

49. What does FROM JANE stand for in bacterial endocarditis?

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50. What can cause mitral prolapse?
Myxomatous degeneration - RF - chordae rupture
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
S. bovis
Viridans streptococci