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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 FROM JANE stand for in bacterial endocarditis?

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2. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Libman - sacks endocarditis
Glossopharyngeal to soliary nucleus of medulla
Granuloma with giant cells
Group a beta hemolytic strep

3. most common primary cardiac tumor in adults - ball - valve obstruction in left atrium
Holosystoiic
Myxoma
Libman - sacks endocarditis
Mitral valve prolapse

4. what conditions are associated with pulsus paradoxus
LAD > RCA > circumflex
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Inc venous return exaccerbates pulm vasc congestion
Stable angina

5. congenital heart defect with marfan's
HTN - bradycardia - and respiratory depression
Aortic insuffic - late
Extracellular calcium - calcium induced calcium release
Boot shaped heart

6. port wine stains on face - intracerebral AVM - siezures - early onset glaucoma - congenital
The operating point of the heart
LCX - V4- V6
Sturge weber - vasculitis of caps
CHF

7. What is a normal EF
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
At least 55%
No - no pressure gradient
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

8. In the evolution of an MI - when the risk for free wall rupture - tamponade - papillary muscle rupture - or interventricular septal rupture the hightest? Why?
Transfusion
RCA - II - III - aVF
No - no pressure gradient
5-10 days - macs have degraded structural components

9. When and why is the S3 sound heard?
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Eccentric - concentric hypertrophy causes diastolic disfunction
Viridans streptococci
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys

10. What are the complications of atherosclerosis?
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Activated histiocytes
Increased SV
Lymphangiosarcoma

11. Which vessels account for the most total peripheral resistance
Sudden tensing of chordae tendinae
Arteriorles
Hypertrophied cardiomyopathy
Granuloma with giant cells

12. friction rub - 3-5 days post MI
Decreases
Stroke volume affected by contractility - afterload - and preload
Wolff - Parkinson white syndrome
Postinfarction fibrinous pericarditis

13. EDV is also known as
In series
Preload
In HF
Aburpt halting of valve leaflets

14. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
No
Lower right - MC - upper right - AO - upper right AC - lower left MO
In RA return (inspiration)
Atherosclerosis

15. What is indicated when CO and venous return are equal?
In parallel
The operating point of the heart
Tricuspid atresia - requires ASD and VSD
Coarcation of aorta

16. Inspiration causes an increase in which sided heart sounds?
Dressler's - autoimmune
Apex and anterior interventricular septum
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Right sided

17. congenital heart defect with congenital rubella
Fast volatge gated Na channels
Mitral>aortic>>tricuspid - high pressure valves affected most
Septal defects - PDA - pulm art stenosis
LAD - V1- V2

18. What causes the midsystolic click
Sudden tensing of chordae tendinae
Diastolic
LAD > RCA > circumflex
Holosystoiic

19. What cardiac change occurs in pregnancy?
Increased SV
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels
Left sided
Lymphangiosarcoma

20. When during cardiac nodal cells depolarize?
During diastole
Early deaths from myocarditis
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Apex and anterior interventricular septum

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

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22. In an EKG - What is the T wave?
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Ventricular repolarization
Acute thrombosis of coronary artery

23. What 4 things drive myocardial 02 demand?
Hypertrophied cardiomyopathy
Postinfarction fibrinous pericarditis
Kidney
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)

24. disease of elastic arteries and large and medium sized muscular arteries
Atherosclerosis
Conduction delay through AV node - nl < 200 msec
LCX - I - aVL
Tempral arteritis - may cause irreversible blindness

25. fibrinous pericarditis several weeks post MI

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26. most common heart tumor
MI
Varicose veins - thromboembolism rare
Atherosclerosis
Metastasis from melanoma or lymphoma

27. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Activated histiocytes
Cardiac tamponde
2nd degree AV block - mobitz type 1
MI

28. prolonged PR interval
10%
1st degree AV blodck
Increasing activity of Ca pump in SR
Sturge weber - vasculitis of caps

29. How are cadiac myocytes eltrically coupled?
Temporal arteritis
Inc central venous pressure - inc resistance to portal flow
Gap junctions
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

30. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Coarcation of aorta
Non
Vasodilators
Squat. Compression of femoral arteries - inc TPR - dec

31. What causes the murmur heard in MR to enhance?
Babies
Systolic dysfunction
Vasocxn
Inc TPR and LA return (expiration)

32. Which two mechanisms sense decrease MAP?
Atherosclerosis
Maintain blood flow to organ over wide range of perfussion pressures
Liver
Medullary vasomotor center senses baroreceptors and JGA

33. What is association with fixed S2 splitting - does not increase with inspiration
ASD
Metastasis from melanoma or lymphoma
Vasocxn - while other tissues it causes vasodilation
Neg inotropy - HF - narcotic overdose

34. When do you find hemosiderin laden macrophages in the lungs?
Persistant truncus arteriosus
Mitral>aortic>>tricuspid - high pressure valves affected most
During HF from microhemorrhages from inc pulm cap pressure
Indomethacin closes - and pge keeps it open

35. Which murmur is heard with VSD?
MI
Stroke volume affected by contractility - afterload - and preload
Wolff - Parkinson white syndrome
Holosystolic - harsh sounding murmur - loudest over tricuspid area

36. congenital heart defect with 22q11
Aortic stenosis or LBBB
Truncus - tet of fallot
3rd degree block - pacemaker - Lyme disease
Purkingee>atria>ventricles>AV node

37. What can cause mitral prolapse?
S. bovis
Myxomatous degeneration - RF - chordae rupture
MI
140/90

38. What are common causes of mitral regurg?
Kids
RCA - II - III - aVF
Isovolumetric contraction
Ischemic heart dz - mitral valve prolapse - LV dilation

39. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
...
Transposition of great vessels
Granuloma with giant cells
Pyogenic granuloma - associated with trauma and pregnancy

40. What causes orthopnea?
Inc venous return exaccerbates pulm vasc congestion
Cherry hemangioma
Inc TPR and LA return (expiration)
Patent ductus arteriosus - congenital rubella or prematurity

41. Hyperplastic onion skinning
140/90
Arteriolosclerosis in malignant hypertension
CK- MB
TAPVR

42. What is the most common cause of MI
Acute thrombosis of coronary artery
Aortic disecction - intraluminal tear forming false lumen
Raynaud's
Vagus to medulla

43. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Cystic hygroma
Transfusion
Subendocardial - fewer collaterals and higher pressure
Stroke volume affected by contractility - afterload - and preload

44. In an EKG - What is the PR interval?
Tricuspid atresia - requires ASD and VSD
Conduction delay through AV node - nl < 200 msec
HypoK and bradycardia
Hyperlipidemia

45. sawtooth wave

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46. In an acute MI - are there any visible changes via LM in the first 2-4 hours
Inc venous return exaccerbates pulm vasc congestion
2-4 day - early coag necrosis on the first day
No
Postinfarction fibrinous pericarditis

47. Why is contractility decreased in heart failure?
Subendocardial - fewer collaterals and higher pressure
Systolic dysfunction
Varicose veins - thromboembolism rare
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

48. What is the S2 sound?
Resting potential high K perm
Eccentric - concentric hypertrophy causes diastolic disfunction
In RA return (inspiration)
Aortic and pulmonary closing

49. benign - painful - red - blue tumor under fingernails from smooth muscle cells
Apex and anterior interventricular septum
Glomus tumor
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's
1st degree AV blodck

50. Given P = QR - what factors influence resistance?
Inc central venous pressure - inc resistance to portal flow
Proportional to viscosity and inversely proportional to the radius to the 4th power
140/90
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical

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