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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. SV CAP means?
Unstable/crescendo angina
Stroke volume affected by contractility - afterload - and preload
Dressler's - autoimmune
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

2. Which class of drugs decrease preload
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Venodilators (nitrogylcerine)
Subendocardial - fewer collaterals and higher pressure

3. What are the diastolic heart sounds?
RV failure - in venous pressure
Aortic/pulmonic regurg and mitral/tricuspid stenosis
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Cardiac tamponade - asthma - obstructive sleep apnea - pericarditis and croup

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

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5. What does FAN MY SKIN On Wednesday stand for?
Kawasaki
Fever - Arthritis - Night sweats - Myalgia - SKIN nodules - Ocular disturbances - Weak pulses in upper extremities
Atrial contraction
In RA return (inspiration)

6. What causes the CO curve to shift downwards?
Preload
Increased efferent SANS and decreased efferent PANS
Neg inotropy - HF - narcotic overdose
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling

7. What is the time frame for arrhythmia risk in the evolution of MI
Increase contractility
The first 4 days
10%
Unstable/crescendo angina

8. What does the atria release in response to inc blood volume and atrial pressure
Slow conduction velocity - used by AV node prolongs transmission from atria to ventrical
Decrease in activity of Na/Ca exhanger and increase in contractility
Initial repol - inactivation of of voltage gated Na channels - voltage gated K channels begin to open
ANP

9. What is the S2 sound?
Increasing activity of Ca pump in SR
Aortic and pulmonary closing
Myxomatous degeneration - RF - chordae rupture
CO

10. Which artery supplies the inferior portion of the left ventricle and posterior septum?
Posterior descending (80% off the RCA - 20% off the circumflex)
Transposition of great vessels
Polycythemia - hyperproteinemic states (multiple myeloma) - hereditary spherocytosis
Pulmonary flow murmur and diastolic rumble

11. What 4 things drive myocardial 02 demand?
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa
Tetralogy of fallot - transposition of great vessels - truncus arteriosus - tricuspid atresia - TAPVR
Inc afterload - inc contractility - inc heart rate - inc heart size (inc wall tension)
Ventricles are depolarized

12. What causes orthopnea?
Inc venous return exaccerbates pulm vasc congestion
In series
Anterosuperior displacement of the infundibular septum
V fib

13. systolic - diastolic
Non
Unstable/crescendo angina
Pulse pressure
EtOh - wet Beriberi - Coxsackie B - cocaine - chagas - doxorubicin - hemochromatosis - peripartum cardiomyopathy

14. congenital heart defect with turner's
Dilated cardiomyopathy
Unstable/crescendo angina
Coarcation of aorta
2-4 day - early coag necrosis on the first day

15. In an anteroseptal infarct - which artery is effected - and which leads show Q waves?
Myxomatous degeneration - RF - chordae rupture
Left sided
LAD - V1- V2
Hypotension - inc venous pressure - distant heart sounds - inc HR - pulsus paradoxus

16. benign cap hemangioma of infancy - spont regresses
Hemoptysis - hematuria - perforation of nasal septum - chronic sinusitis - otitis media - mastoiditis - cough dyspnea
Subendocardial - fewer collaterals and higher pressure
Kawasaki
Strawberry hemangioma

17. What does FEVERSS stand for in rheumatic heart disease
Fever - erythema marginatum - valvular damage - ESR - red hot joints - subQ nodules - St. vitus dance (chorea)
Vasodilators - (hydrAlAzine)
Holosystolic - harsh sounding murmur - loudest over tricuspid area
MI

18. What is the machine like murmur? What is the heart pathology and the predisposing causes
Postinfarction fibrinous pericarditis
Black > white > asian
LCX - I - aVL
Patent ductus arteriosus - congenital rubella or prematurity

19. What does prolonged QT predispose to?
Tricuspid atresia - requires ASD and VSD
Torsades de pointes
LCX - V4- V6
Hyperlipidemia

20. no change in PR interval followed by dropped beat
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Kussmaul's sign - cardiac tamponade - pulsus paradoxus
In parallel
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

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

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22. 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
2-4 day - early coag necrosis on the first day
Tricuspid atresia - requires ASD and VSD
During diastole

23. When and why do you hear the S4 sound
Atrial contraction
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy
Temporal arteritis
S. aureus

24. CO x Total peripheral resistance
Mean arterial pressure
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Prinzmetal angina
Aortic stenosis or LBBB

25. Which class of drugs decrease the murmur heard in aortic regurg?
Preload
Fick principle
Vasodilators
Vasodilators - (hydrAlAzine)

26. Do dihydropyridine or non - dihyrdropyridine Ca channel blockers decrease contractility
Apex and anterior interventricular septum
Non
Decrease in cAMP
Abdominal aorta>coronary artery>popliteal artery>carotid artery ACoPCa

27. Which murmur do you hear in mitral stenosis?
Gap junctions
Isovolumetric contraction
Late diastolic murmur following an opening snap
V fib

28. Where is the most posterior portion of the heart and What can it cause?
Mitral>aortic>>tricuspid - high pressure valves affected most
5-10 days - macs have degraded structural components
The LA - can cause dysphagia because of compression of the esophageal nerve or hoarseness by compressing the the recurrent laryngeal nerve
Decreased

29. What is the difference between adult and infantile type aortic coarctation?
LCX - I - aVL
If sodium channel
Infantile is proximal to ductus arteriosus and adult is distal. Infantile In and aDult is Distal to Ductus
Vasodilators - (hydrAlAzine)

30. What are the systolic heart sounds
Infective endocarditis
Vasodilators
A fib - beta block or ca channel block - warfarin - thromboembolism prophylaxis
Aortic/pulmonic stenosis and mitral/tricuspid regurg

31. How do catecholamines increase contractility?
Increasing activity of Ca pump in SR
Kidney
2nd degree AV block - mobitz type 2 - may progess to 3rd degree block
Late in diastole - high atrial pressure - pushing against a stiff LV wall - associated with ventricular hypertrophy

32. What happens in phase 4 of the cardiac ventricular action potential?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Purkingee>atria>ventricles>AV node
Pulmonary flow murmur and diastolic rumble
Resting potential high K perm

33. What causes aortic regurg
Aortic dilation - bicuspid aortic valve - RF -
Arteriorles
Ischemic heart dz - mitral valve prolapse - LV dilation
Atherosclerosis - LVH - stroke - CHF - renal failure - retinopathy - aortic dissection

34. in the JVP - What is the a wave?
Dec plasma proteins
LAD > RCA > circumflex
Indomethacin closes - and pge keeps it open
Atrial contraction

35. What are tendinous xanthoma - atheromas - and corneal arcus signs of?
Hyperlipidemia
Cyclophosphamide and corticosteroids
Hemorrhage
TAPVR

36. Fatal arrhythmia
V fib
SA and AV nodes
ASD
Aortic and pulmonary closing

37. congenital heart defect with 22q11
Truncus - tet of fallot
Left atrial pressure
SA>AV>bundle of His>ventricles
Libman - sacks endocarditis

38. congenital heart defect with marfan's
C - ANCA
Normal in children and pregs - assoc with inc filling pressures - early in diastole during rapid ventricular filling
Aortic insuffic - late
LCX - I - aVL

39. What is the early and late lesion in rheumatic heart disease
Mitral valve prolapse
Babies
Hyperlipidemia
3rd degree syphillus - syphillit heart disease can lead to aortic valve incompetence

40. Most common vasculitis affecting medium and large arteries
Shunt - VSD - PDA or patent foramen ovale - due to failure of the aorticopulmonary septum to spiral
Inc blood volume
In series
Temporal arteritis

41. What is the association with wide S2 splitting?
Eccentric - concentric hypertrophy causes diastolic disfunction
Pulmonic stenosis and RBBB
Late systolic crescendo murmur with a midsystolic click
Proportional to viscosity and inversely proportional to the radius to the 4th power

42. What are the complications from bacterial endocarditis?
Black > white > asian
Chordae rupture - GN - suppurative pericarditis - emboli
Vasocxn
Septal defects - PDA - pulm art stenosis

43. lymphatic malignancy associated with persistant lymphadema - post radical mastectomy
Stroke volume affected by contractility - afterload - and preload
Vagus to medulla
Lymphangiosarcoma
Left sided

44. 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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45. bacterial endocarditis - previously normal valves - rapid onset - Which bacteria?
Aortic stenosis or LBBB
Transfusion
S. aureus
Gap junctions

46. When does extracellular calcium enter the cardiac muscle cells during contraction?
Stroke volume affected by contractility - afterload - and preload
Turners
The plateau period
Atherosclerosis

47. The cause of pulmonary edema - paroxysmal nocturnal dyspnea?
LV failure - pulm venous distention transudation of fluid
Transposition of great vessels
Increase in Pc
Glomus tumor

48. In an anterolateral infarct - which artery is effected and which leads show Q waves
Preload
Rapid upstroke - voltage gated Na channels open
LCX - V4- V6
Inc RA pressure - due to filling against closed tricupsid valve

49. wartiike - sterile vegetations occur on both sides of the valve - commonly causes mitral regurg. SLE causes it
Libman - sacks endocarditis
Left atrial pressure
Dec plasma proteins
Late diastolic murmur following an opening snap

50. On the cardiac cycle graph - on which corners do the opening and closing of the aortic and mitral valves occur?
Lower right - MC - upper right - AO - upper right AC - lower left MO
Aortic/pulmonic stenosis and mitral/tricuspid regurg
Kawasaki
Increased SV