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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 is the characteristic pulse in aortic stenosis?
Pulsus parvus and tardus - weak - can lead to syncope
Viridans streptococci
SA and AV nodes
Failure of LV to in CO during exercise
2. What is the machine like murmur? What is the heart pathology and the predisposing causes
RV contraction (closed tricuspid valve bulding into atrium
Increase contractility
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Patent ductus arteriosus - congenital rubella or prematurity
3. Which murmur is heard with mitral prolapse?
RF
Takayasu's arteritis
Late systolic crescendo murmur with a midsystolic click
Cystic hygroma
4. what conditions are associated with pulsus paradoxus
LAD > RCA > circumflex
SV/ EDV
R to L shunt caused by stenoic pulmonic valve
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
5. What 4 things drive myocardial 02 demand?
Transposition of great vessels
Greater ventricular EDV
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Tempral arteritis - may cause irreversible blindness
6. What causes the cushing reflex and why
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Ventricular depolarization - nl < 120 msec
Aortic insuffic - late
Late systolic crescendo murmur with a midsystolic click
7. The 7 complications of MI
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8. What happens in phase 0 of the cardiac ventricular action potential?
Diastolic
Rapid upstroke - voltage gated Na channels open
Ventricles are depolarized
In RA return (inspiration)
9. What do the carotid and aortic bodies respond to?
Tricuspid atresia - requires ASD and VSD
Transmural
Dec P02 - inc PC02 and dec pH
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
10. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Transfusion
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
11. What can cause mitral prolapse?
Dec plasma proteins
Cystic hygroma
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Myxomatous degeneration - RF - chordae rupture
12. What is the progression of atherosclerosis?
LAD - V1 - V4
Decreases
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Dec P02 - inc PC02 and dec pH
13. no change in PR interval followed by dropped beat
Inc venous return exaccerbates pulm vasc congestion
RCA
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
14. absecnce of tricuspid valve - hypoplastic RV
Mechanican contraction of the ventricles
If sodium channel
Inc Kf - capillary perm
Tricuspid atresia - requires ASD and VSD
15. sudden death in young atheletes - S4 - apical impulses - outflow obstruction
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Hypertrophied cardiomyopathy
Mitral stenosis
16. Restrictive cardiomyopathy causes
Activated histiocytes
Inc Kf - capillary perm
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Takayasu's arteritis
17. congenital heart defect with turner's
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Cherry hemangioma
Coarcation of aorta
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
18. Churg Strauss - presentation and test
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Hemorrhage
TAPVR
Lower right - MC - upper right - AO - upper right AC - lower left MO
19. bening capillary hemangioma of elderly - does not regress
Kaposi's sarcoma
Hypertrophied cardiomyopathy
Eccentric - concentric hypertrophy causes diastolic disfunction
Cherry hemangioma
20. CO x Total peripheral resistance
Mean arterial pressure
Eisenmenger's syndrome
Lower right - MC - upper right - AO - upper right AC - lower left MO
Apex and anterior interventricular septum
21. in the JVP - What is the c wave?
RV contraction (closed tricuspid valve bulding into atrium
Fast volatge gated Na channels
Purkingee>atria>ventricles>AV node
HTN - bradycardia - and respiratory depression
22. What masks atrial repolarization?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Inc TPR and LA return (expiration)
10%
QRS complex
23. How are cadiac myocytes eltrically coupled?
Increased SV
Gap junctions
MI
At least 55%
24. What are aschoff bodies
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Heart - 02 extraction is always around 100%
RV failure - in venous pressure
Granuloma with giant cells
25. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Preload
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Adult type aortic coarctation
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved
26. Expiration causes an increase in which sided heart sounds
Ventricular depolarization - nl < 120 msec
Increase - increase the chance the If are open
Left sided
Posterior descending (80% off the RCA - 20% off the circumflex)
27. Which class of drugs decreases afterload?
Pulmonary flow murmur and diastolic rumble
Vasodilators - (hydrAlAzine)
V fib arrhythima
The first 4 days
28. What are the complications from bacterial endocarditis?
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas
Chordae rupture - GN - suppurative pericarditis - emboli
Cyclophosphamide and corticosteroids
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
29. What are the four most common locations for atherosclerosis?
Yes
Left sided
Proportional to viscosity and inversely proportional to the radius to the 4th power
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
30. list the coronary vessels most likely to be occluded
Subendocardial
LAD > RCA > circumflex
Cyclophosphamide and corticosteroids
Strawberry hemangioma
31. fibrous plaques and atheromas in intima of arteries
Glossopharyngeal to soliary nucleus of medulla
Atherosclerosis
Dilation
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
32. stroke volume x HR =?
CO
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Anterosuperior displacement of the infundibular septum
Kidney
33. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Non
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Neg inotropy - HF - narcotic overdose
Increasing activity of Ca pump in SR
34. Inspiration causes an increase in which sided heart sounds?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Right sided
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Arteriorles
35. Why is contractility decreased in heart failure?
Mitral>aortic>>tricuspid - high pressure valves affected most
LAD > RCA > circumflex
Systolic dysfunction
Hemorrhage
36. When during cardiac nodal cells depolarize?
Volatage gated Ca channels
During diastole
HypoK and bradycardia
Tricuspid atresia - requires ASD and VSD
37. In normal S2 splitting - which valve closes first? What increases it?
Angiosarcoma
Viridans streptococci
Subendocardial - fewer collaterals and higher pressure
The aortic before pulmonic - inspiration increases diff
38. Does eccentric hypertrophy or concentric hypertrophy cause systolic disfunction
Increased efferent SANS and decreased efferent PANS
Increasing activity of Ca pump in SR
Eccentric - concentric hypertrophy causes diastolic disfunction
Resting potential high K perm
39. In terms of starling forces - why does heart failure cause edema?
ANP
Increase in Pc
Eisenmenger's syndrome
During diastole
40. What is the S1 sound?
Unstable/crescendo angina
Mitral and tricuspid closure
Cyclophosphamide and corticosteroids
RCA - II - III - aVF
41. no relation between p waves and QRS intervals - treatment and predisposing factor
Diastolic
If sodium channel
In HF
3rd degree block - pacemaker - Lyme disease
42. What is the difference between the fetal and neonatal direction of blood flow in a patent ductus arteriosus
Fetal right to left - neonate left to right leading to RVH and failure
Postinfarction fibrinous pericarditis
Early deaths from myocarditis
Pulsus parvus and tardus - weak - can lead to syncope
43. What are the systolic heart sounds
Vasocxn
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Posterior descending (80% off the RCA - 20% off the circumflex)
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
44. What does the LAD supply?
CFX
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Apex and anterior interventricular septum
45. When and why do you hear the S4 sound
Subendocardial - fewer collaterals and higher pressure
Increase in Pc
Aortic stenosis or LBBB
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
46. disruption of the vasa vasorum of aorta - dilation of aorta and valve ring - tree bark appearance (calcifications on aortic root)
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence
Non
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Glomus tumor
47. What causes orthopnea?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Inc venous return exaccerbates pulm vasc congestion
MAP
R to L shunt caused by stenoic pulmonic valve
48. PCWP is an estimate of...
Left atrial pressure
140/90
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Mitral and tricuspid closure
49. What is indicated when CO and venous return are equal?
The operating point of the heart
CO
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Total anomalous pulmonary trunk venous return
50. What does HTN predispose to?
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia
Mitral valve
C - ANCA
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