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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. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Dec P02 - inc PC02 and dec pH
Greater ventricular EDV
Fetal right to left - neonate left to right leading to RVH and failure
Dilated cardiomyopathy

2. What are the complications from bacterial endocarditis?
Cherry hemangioma
Chordae rupture - GN - suppurative pericarditis - emboli
Volatage gated Ca channels
Kidney

3. What is the formula for EF?
SV/ EDV
R to L shunt caused by stenoic pulmonic valve
At least 55%
Inc TPR and LA return (expiration)

4. What is the progression of atherosclerosis?
P02
7 weeks
Conduction delay through AV node - nl < 200 msec
Endothelial cell dysfxn - mac and LDL accum - foam cell - fatty streaks - smooth muscle cell migration - fibrous plaque - comlex atheromas

5. What is the definition of HTN?
140/90
2nd degree AV block - mobitz type 1
Boot shaped heart
Inc interstitial osmotic pressure pulling fliud out of capillaries

6. What is indicated when CO and venous return are equal?
The operating point of the heart
LV failure - pulm venous distention transudation of fluid
Systolic dysfunction
Dilated cardiomyopathy

7. What constitues the upstroke in pacemaker cells?
Volatage gated Ca channels
Cherry hemangioma
R to L shunt caused by stenoic pulmonic valve
Increasing activity of Ca pump in SR

8. segmental thrombosing vasculitis of small and medium vessels in smokers with intermittent claudication - superficial nodular phlebitis - raynaud's - gangrene and severe pain - autoamputation of digits is possible

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9. prolonged PR interval
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
LAD > RCA > circumflex
Subendocardial - fewer collaterals and higher pressure
1st degree AV blodck

10. fibrous plaques and atheromas in intima of arteries
Atherosclerosis
No
Rhabdomyomas
LAD > RCA > circumflex

11. Equilibration of diastolic pressures in all 4 chambers - decreased CO from compression of heart by fluid in pericardium
During diastole
Decrease in cAMP
HypoK and bradycardia
Cardiac tamponde

12. What supplies the posterior left ventricle?
No - no pressure gradient
Polyarteritis nodosum
CFX
Transmural

13. What is the classic X ray finding for tet of fallot?
Aortic disecction - intraluminal tear forming false lumen
Ischemic heart dz - mitral valve prolapse - LV dilation
Boot shaped heart
Dec P02 - inc PC02 and dec pH

14. When do you find hemosiderin laden macrophages in the lungs?
MI
During HF from microhemorrhages from inc pulm cap pressure
7 weeks
Metastasis from melanoma or lymphoma

15. What does the atria release in response to inc blood volume and atrial pressure
ANP
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Persistant truncus arteriosus
LAD > RCA > circumflex

16. What does an isoelectric ST segment indicate?
Ventricles are depolarized
Volatage gated Ca channels
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Kidney

17. In an EKG - What is the QT interval?
Pyogenic granuloma - associated with trauma and pregnancy
Acute thrombosis of coronary artery
Mechanican contraction of the ventricles
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

18. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the right?
Inc interstitial osmotic pressure pulling fliud out of capillaries
Torsades de pointes
Transfusion
RF

19. list the coronary vessels most likely to be occluded
Early deaths from myocarditis
Temporal arteritis
LAD > RCA > circumflex
Yes

20. What are anitschkow's cells
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Activated histiocytes
R to L shunt caused by stenoic pulmonic valve
1st degree AV blodck

21. What is the effect on the slope of phase 4 in pacemaker cells by catecholamines and
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Increase - increase the chance the If are open
Stable angina
RV failure - in venous pressure

22. no change in PR interval followed by dropped beat
HypoK and bradycardia
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Buerger's disease
Greater ventricular EDV

23. What causes the cushing reflex and why
7 weeks
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
MI
Inc ICP - cerebral ischemia - inc SANS tone (HTN) and reflex bradycardia

24. Left to right shunts are more common in babies or kids?
Granuloma with giant cells
LCX - V4- V6
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Kids

25. Mitral stenosis is most often secondary to which condition?
HTN - bradycardia - and respiratory depression
Transposition of great vessels
RF
Dilated cardiomyopathy

26. In the cardiac and vascular function curves - In what instance is the vascular curve shifted to the left?
Hemorrhage
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
Arteriolosclerosis in malignant hypertension
PDA

27. Wegener's tx
Cyclophosphamide and corticosteroids
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Dressler's - autoimmune
S. bovis

28. When and why do you hear the S4 sound
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
MI
Maintain blood flow to organ over wide range of perfussion pressures

29. what percentage of HTN is secondary to renal disease?
Granulomatous vasculitis with eosinophilia. Asthma - sinusitis - skin lesions and periphereal neuropathy (wrist/foot drop) heart - GI - kidneys
No
10%
Decrease in activity of Na/Ca exhanger and increase in contractility

30. Exercise - overtransfusiion and excitiment causes and increase in...?
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Angiosarcoma
In series
Preload

31. 2/3 diastolic + 1/3 systolic
MAP
In parallel
RF
Left atrial pressure

32. Where does coronary artery occlusion occur most commonly?
Fast volatge gated Na channels
LAD
Kawasaki
Inc TPR and LA return (expiration)

33. What causes aortic stenosis
C - ANCA
Group a beta hemolytic strep
Age related calcifications or bicuspid aortic valve
In parallel

34. What happends in phase 1 of the ventricular cardiac action potential?
Neg inotropy - HF - narcotic overdose
Eisenmenger's syndrome
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
Subendocardial

35. L to R shunt becomes R to L due to increase pulm pressures from original congenital heart defect

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36. Where are pacemaker cells?
SA and AV nodes
The plateau period
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup
Arrhythmia - LV failure and pulm edema - cardiogenic shock - free wall rupture - aneurysm - postinfarcation fibrinous pericarditis - dressler's

37. pulmonary veins drain into right heart circulation (SVC - coronary sinus)
TAPVR
2-4 day - early coag necrosis on the first day
Left atrial pressure
CK- MB

38. with what heart sounds do ASD usually present?
V fib
Dilation
Myxoma
Pulmonary flow murmur and diastolic rumble

39. Which murmur do you hear in mitral stenosis?
Varicose veins - thromboembolism rare
Late diastolic murmur following an opening snap
Pos inotropy - exercise
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

40. The aortic arch receptors transmit along which nerve?
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Medullary vasomotor center senses baroreceptors and JGA
Vagus to medulla
Immediate high pitched blowing diasystolic murmur with a wide pulse pressure

41. In what disease states is blood viscosity increased?
Failure of LV to in CO during exercise
Sturge weber - vasculitis of caps
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Total anomalous pulmonary trunk venous return

42. In an anterolateral infarct - which artery is effected and which leads show Q waves
Fluid movement through capillaries
LCX - I - aVL
LCX - V4- V6
Eccentric - concentric hypertrophy causes diastolic disfunction

43. Fatal arrhythmia
V fib
Pulmonary flow murmur and diastolic rumble
Unstable/crescendo angina
Conduction delay through AV node - nl < 200 msec

44. How does aldosterone raise MAP
Inc blood volume
Ventricular depolarization - nl < 120 msec
MI
Arteriorles

45. Does blood flow across the actual ASD account for abnormal heart sounds? What is the reason?
Strawberry hemangioma
Wolff - Parkinson white syndrome
Viridans streptococci
No - no pressure gradient

46. Weak pulses - notching of the ribs on xray - HTN in upper extremeties and weak peripheral pulses
LV failure - pulm venous distention transudation of fluid
Stable angina
Venodilators (nitrogylcerine)
Adult type aortic coarctation

47. congenital heart defect with 22q11
Truncus - tet of fallot
Pulse pressure
RV failure - in venous pressure
The aortic before pulmonic - inspiration increases diff

48. tearing chest pain radiation to the back - associated with marfan
Dilated cardiomyopathy
Aortic disecction - intraluminal tear forming false lumen
Can progess to V fib
Coarcation of aorta

49. What is associated with paradoxical spliting of S2
Vasodilators
Henoch - Schlonlein purpura
Aortic stenosis or LBBB
In HF

50. congenital heart defect in an infant with a diabetic mother?
Decrease in activity of Na/Ca exhanger and increase in contractility
Eisenmenger's syndrome
Transposition of great vessels
Lymphangiosarcoma