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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.
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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. Central chemoreceptors do not respond directly to which parameter?
P02
Dressler's - autoimmune
No
Decreased
2. absecnce of tricuspid valve - hypoplastic RV
Tricuspid atresia - requires ASD and VSD
Sturge weber - vasculitis of caps
LAD > RCA > circumflex
Transposition of great vessels
3. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
RCA - II - III - aVF
Postinfarction fibrinous pericarditis
140/90
4. Which class of drugs decrease the murmur heard in aortic regurg?
Plateau - influx of calcium through voltage gated ca channels - ca release from SR and contraction
Hyperlipidemia
Vasodilators
Aortic dilation - bicuspid aortic valve - RF -
5. tearing chest pain radiation to the back - associated with marfan
Aortic disecction - intraluminal tear forming false lumen
1st degree AV blodck
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Right sided
6. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
Fick principle
TAPVR
Liver
Granuloma with giant cells
7. polypoid capillary hemangioma that can ulcerate and bleed
Inc central venous pressure - inc resistance to portal flow
Pyogenic granuloma - associated with trauma and pregnancy
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
8. which heart valves are afected most in rheumatic heart diseease
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Microscopic polyangiitis - like wegener's without granulomas
Transposition of great vessels
Mitral>aortic>>tricuspid - high pressure valves affected most
9. Which valve is commonly involved in bacterial endocarditis from IV drug use and Which bacteria are most common?
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10. Which artery supplies the SA and AV nodes?
Pos inotropy - exercise
RCA
The plateau period
Extracellular calcium - calcium induced calcium release
11. Which organ has ht highest blood flow per gram of tissue
Atrial contraction
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Cyclophosphamide and corticosteroids
Kidney
12. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
RV failure - in venous pressure
In HF
Extracellular calcium - calcium induced calcium release
13. decrease stretch in baroreceptors leads to what response?
Kawasaki
Decrease in activity of Na/Ca exhanger and increase in contractility
5-10 days - macs have degraded structural components
Increased efferent SANS and decreased efferent PANS
14. Which vessels account for the most total peripheral resistance
SA and AV nodes
S. epidermidis
Atrial fiutter - identical back to back atrial depol's - convert to sinus - cal IA - IC or III antiarrhythmics
Arteriorles
15. Unilateral headache - jaw claudication - impaired vision
Mitral stenosis
2-4 day - early coag necrosis on the first day
Tempral arteritis - may cause irreversible blindness
In parallel
16. What happens with a decrease of extracellular Na
P02
Decrease in activity of Na/Ca exhanger and increase in contractility
Polyarteritis nodosum
2-4 day - early coag necrosis on the first day
17. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect
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18. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Wolff - Parkinson white syndrome
RCA - II - III - aVF
Black > white > asian
Fast volatge gated Na channels
19. Which enzyme rises after 4 hours and is elevated for 7 to 10 days after an MI?
The plateau period
Decreased
Troponin I
Atrial contraction
20. skin rash on buttocks and legs - arthralgia - intestinal hemorrhage - abdominal pain - melena. Follows URI - IgA immune complex - most common childhood systemic vasculitis
Systolic dysfunction
Inc central venous pressure - inc resistance to portal flow
Changes in CO as a function of preload
Henoch - Schlonlein purpura
21. dyspnea - fatigue - edema and rales - multiple causes
The plateau period
Inc venous return exaccerbates pulm vasc congestion
Strawberry hemangioma
CHF
22. Which valve is most commonly involved in bacterial endocarditis?
Decreases
Ventricular repolarization
Mitral valve
HypoK and bradycardia
23. Mitral stenosis is most often secondary to which condition?
Hematocrit
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
RF
Anterosuperior displacement of the infundibular septum
24. What is the S1 sound?
LAD
Yes
Mitral and tricuspid closure
Tempral arteritis - may cause irreversible blindness
25. What does autoregulation do?
Infective endocarditis
Maintain blood flow to organ over wide range of perfussion pressures
Anterosuperior displacement of the infundibular septum
Arteriolosclerosis in malignant hypertension
26. What does FAN MY SKIN On Wednesday stand for?
Increased SV
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Transfusion
Mechanican contraction of the ventricles
27. serum marker for wegener's
Glossopharyngeal to soliary nucleus of medulla
Myxomatous degeneration - RF - chordae rupture
C - ANCA
CO
28. How are cadiac myocytes eltrically coupled?
Gap junctions
HTN - bradycardia - and respiratory depression
Henoch - Schlonlein purpura
Sturge weber - vasculitis of caps
29. If HR is too fast (V tach) what happens during diastole?
LAD
Filling is incomplete and CO falls
Hyperlipidemia
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
30. Which lab value indicates blood viscosity?
Activated histiocytes
Buerger's disease
2-4 day - early coag necrosis on the first day
Hematocrit
31. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis
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32. When is the scar completely formed in an MI?
7 weeks
Activated histiocytes
Rapid upstroke - voltage gated Na channels open
P02
33. most common primary cardiac tumor in children - associated with tuberous sclerosis
Maintain blood flow to organ over wide range of perfussion pressures
Rhabdomyomas
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Granuloma with giant cells
34. What other congenital abnormality is necessary for life for a patient with transposition of the great vesses?
Varicose veins - thromboembolism rare
Mitral valve
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Infective endocarditis
35. Which sympathetic receptors raise MAP
Inc blood volume
Beta 1 inc HR and cont - alpha 1 venocxn - alpha 1 arteriolar vascxn
LAD > RCA > circumflex
Libman - sacks endocarditis
36. In an EKG - What is the T wave?
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Mitral valve prolapse
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Ventricular repolarization
37. clinical signs of cardiac tamponade
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Stroke volume affected by contractility - afterload - and preload
Transfusion
Inc central venous pressure - inc resistance to portal flow
38. congenital heart defect with marfan's
Aortic insuffic - late
Aortic/pulmonic regurg and mitral/tricuspid stenosis
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
RCA
39. Which murmur is heard in aortic stenosis?
Pos inotropy - exercise
CK- MB
Crescendo - decrescendo systolic ejection murmur following ejection click
PDA
40. What are the complications of atherosclerosis?
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
Activated histiocytes
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Liver
41. Rank the pacemakers cells
Kaposi's sarcoma
Tricuspid - don't tri drugs - S. aureus - pseudomonas - candida
SA>AV>bundle of His>ventricles
Dilated cardiomyopathy
42. What are aschoff bodies
Granuloma with giant cells
Fast volatge gated Na channels
Atherosclerosis
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
43. no relation between p waves and QRS intervals - treatment and predisposing factor
Cardiac tamponde
Aortic disecction - intraluminal tear forming false lumen
3rd degree block - pacemaker - Lyme disease
Aortic and pulmonary closing
44. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Fast volatge gated Na channels
Dec plasma proteins
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Lower right - MC - upper right - AO - upper right AC - lower left MO
45. PCWP is an estimate of...
Left atrial pressure
Late systolic crescendo murmur with a midsystolic click
Fetal right to left - neonate left to right leading to RVH and failure
ASD - VSD - AV septal defect (endocardial cushion defect)
46. What is the time frame for arrhythmia risk in the evolution of MI
The plateau period
Tempral arteritis - may cause irreversible blindness
Fick principle
The first 4 days
47. most common heart tumor
No - no pressure gradient
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Heart - 02 extraction is always around 100%
Metastasis from melanoma or lymphoma
48. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
Eccentric - concentric hypertrophy causes diastolic disfunction
RCA - II - III - aVF
Mitral valve prolapse
Adult type aortic coarctation
49. When and why is the S3 sound heard?
Increased SV
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
LCX - I - aVL
Glossopharyngeal to soliary nucleus of medulla
50. What kind of dysfunction ensues in restrictive cardiomyopathy
Diastolic
Atherosclerosis
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Kids
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