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Cardiology

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. with what heart sounds do ASD usually present?
Pulmonary flow murmur and diastolic rumble
Gap junctions
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
CO

2. S3 - dilated heart on US - balloon appearance on CXR - eccentric hypertrophy
Sudden tensing of chordae tendinae
Resting potential high K perm
Dilated cardiomyopathy
Ventricular repolarization

3. What does the starling curve show?
Vasodilators
Afterload (proportional to peripheral resistance)
In RA return (inspiration)
Changes in CO as a function of preload

4. What causes the CO curve to shift upwards?
Mitral valve prolapse
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy
Group a beta hemolytic strep
Pos inotropy - exercise

5. progressive lengthening of PR until beat is dropped - a p wave not followed by QRS
Rhabdomyomas
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 1
Gap junctions

6. Which enzymes are useful for diagnosing reinfarction
Greater ventricular EDV
Stable angina
Cystic hygroma
CK- MB

7. What is the formula for EF?
Afterload (proportional to peripheral resistance)
LV failure - pulm venous distention transudation of fluid
SV/ EDV
Atherosclerosis

8. What does T wave inversion indicated?
MI
Subendocardial - fewer collaterals and higher pressure
MAP
During diastole

9. Which class of drugs decreases afterload?
Vasodilators - (hydrAlAzine)
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Decreased
Cardiac tamponde

10. What is the effect on the slope of phase 4 in pacemaker cells by Ach or adenosine?
Coarcation of aorta
HypoK and bradycardia
Decreases
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea

11. rate of 02 consumption/ arterial 02 - venous 02 ccontent=CO
No
Tetrology of fallot - pulmonary stenosis - RVH - overiding aorta - VSD
Resting potential high K perm
Fick principle

12. necrotizing granulomas in lung and upper airways - nectrotizing GN - small vessel vasculitis

13. What happens with a decrease of extracellular Na
In series
Decrease in activity of Na/Ca exhanger and increase in contractility
Inc RA pressure - due to filling against closed tricupsid valve
Ventricles are depolarized

14. In an EKG - What is the T wave?
Ventricular repolarization
Mean arterial pressure
Unstable/crescendo angina
CHF

15. What cardiac change occurs in pregnancy?
Strawberry hemangioma
Pulmonic stenosis and RBBB
Increased SV
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

16. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Libman - sacks endocarditis
Turners
Medullary vasomotor center senses baroreceptors and JGA
Age related calcifications or bicuspid aortic valve

17. What is the difference between adult and infantile type aortic coarctation?
Stroke volume affected by contractility - afterload - and preload
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
In RA return (inspiration)
Lower right - MC - upper right - AO - upper right AC - lower left MO

18. moncekberg
HTN - bradycardia - and respiratory depression
Wegener's
Glomus tumor
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

19. what percentage of HTN is secondary to renal disease?
10%
Stroke volume affected by contractility - afterload - and preload
Inc TPR and LA return (expiration)
Rapid repol - massive K influx - opening of voltage gated slow K channels and closure of Ca channels

20. What 4 things drive myocardial 02 demand?
Truncus - tet of fallot
Subendocardial
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Calcification in media of arteries esp radial and ulnar - does not obstruct blood flow - intima not involved

21. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
MAP
Systolic dysfunction
Aneurysms - ischemia - infarcts - peripheral vasc dz - thromboemboli
Non

22. coronary artery spasm - ST elevation
Dec P02 - inc PC02 and dec pH
Systolic dysfunction
Inc venous return exaccerbates pulm vasc congestion
Prinzmetal angina

23. In an EKG - What is the QT interval?
Mechanican contraction of the ventricles
Diastolic
Black > white > asian
Septal defects - PDA - pulm art stenosis

24. prolonged PR interval
Kidney
1st degree AV blodck
Truncus - tet of fallot
PDA

25. delta wave on ECG - accesory conduction pathway from atria to ventricles - reentry leading to supraventricular tachycardia
Babies
Wolff - Parkinson white syndrome
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Black > white > asian

26. Which bacteria causes endocarditis in the presence of colon cancer
S. bovis
QRS complex
Atherosclerosis
Non

27. Unilateral headache - jaw claudication - impaired vision
Holosystolic - harsh sounding murmur - loudest over tricuspid area
Kawasaki
Tempral arteritis - may cause irreversible blindness
Fetal right to left - neonate left to right leading to RVH and failure

28. Which bacteria causes rheumatic heart disease
Group a beta hemolytic strep
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Persistant truncus arteriosus

29. Central chemoreceptors do not respond directly to which parameter?
P02
Sarcoid - amyloid - postradiation fibrosis - endocardial fibroelastosis - Loffler - hemochromatosis
Cyclophosphamide and corticosteroids
Prinzmetal angina

30. Which murmur is characteristic of mitral/tricuspid regurg?
Atherosclerosis
Holosystoiic
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
5-10 days - macs have degraded structural components

31. When during cardiac nodal cells depolarize?
CO
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Glossopharyngeal to soliary nucleus of medulla
During diastole

32. What causes the ejection click in the Cres - decres murmur?
Metastasis from melanoma or lymphoma
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Aburpt halting of valve leaflets
Increase contractility

33. benign capillary skin papules in AIDS patients mistaken for kaposi sarcoma - caused by bartonella henselae
Wegener's
Apex and anterior interventricular septum
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
...

34. In terms of starling forces - why does nephrotic syndrome or liver failure cause edems
Atrial contraction
Dec plasma proteins
Indomethacin closes - and pge keeps it open
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

35. In an EKG - What is the QRS complex?
Ventricular depolarization - nl < 120 msec
Pulmonary flow murmur and diastolic rumble
Kidney
S. aureus

36. bening capillary hemangioma of elderly - does not regress
Henoch - Schlonlein purpura
Septal defects - PDA - pulm art stenosis
Wolff - Parkinson white syndrome
Cherry hemangioma

37. diaphoresis - N/V - severe retrosternal pain - pain in left arm/jaw - SOB - fatigue - adrenergic symptoms
Aburpt halting of valve leaflets
MI
Extracellular calcium - calcium induced calcium release
Buerger's disease

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

39. Which murmur is heard with mitral prolapse?
Fever - roth's spots - osler's nodes - murmur - janeway lesions - anemia - nail - bed hemorrhages - emboli
Greater ventricular EDV
Viridans streptococci
Late systolic crescendo murmur with a midsystolic click

40. Do you see elevaged ASO titers in rheumatic heart disease
Glossopharyngeal to soliary nucleus of medulla
Torsades de pointes
Pos inotropy - exercise
Yes

41. What are common causes of mitral regurg?
Total anomalous pulmonary trunk venous return
Aortic stenosis or LBBB
Rhabdomyomas
Ischemic heart dz - mitral valve prolapse - LV dilation

42. What other syndrom is associated with infantile aortic coarctation
Failure of LV to in CO during exercise
Turners
Decreases
Postinfarction fibrinous pericarditis

43. What are the diastolic heart sounds?
Left sided
RCA - II - III - aVF
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Subendocardial

44. What is the most common cause of right heart failure
During HF from microhemorrhages from inc pulm cap pressure
Buerger's disease
Left heart failure
In parallel

45. The cause of dyspnea on exertion?
Posterior descending (80% off the RCA - 20% off the circumflex)
Failure of LV to in CO during exercise
Aortic/pulmonic regurg and mitral/tricuspid stenosis
MI

46. 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

47. retrosternal chest main with exertion - ST depression on ECG - likely due atherosclerosis
Neg inotropy - HF - narcotic overdose
Stable angina
CHF
Indomethacin closes - and pge keeps it open

48. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Dressler's - autoimmune
Mitral valve prolapse
Lower right - MC - upper right - AO - upper right AC - lower left MO

49. If HR is too fast (V tach) what happens during diastole?
Fetal right to left - neonate left to right leading to RVH and failure
Vagus to medulla
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Filling is incomplete and CO falls

50. What other sign is often present with congenital long QT syndrome - why?
The plateau period
Sensironeural deafness - defects in sodium and potassium channels - jervell and lange - neilsen syndrome
Viridans streptococci
Inc central venous pressure - inc resistance to portal flow