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USMLE Cardiovascular Physiology

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. Continuous machine - like murmur that is loudest at S2
Common causes of edema
Phase 3 of nodal AP
Patent ductus arteriosus
Mean arterial pressure (MAP) =

2. Caused by hypokalemia or bradycardia
Fick principle
Wide S2 splitting
Phase 4 of ventricular AP
U wave on EKG

3. Indicates recent MI
U wave on EKG
Effect of inspiration on S2 splitting
T wave inversion on EKG
Phase 3 of ventricular AP

4. Mitral & tripcuspid valve closure
S1
Phase 4 of ventricular AP
Interstitial fluid colloid osmotic pressure
Ventricular septal defect

5. Rapid upstroke due to voltage - gated Na channel opening
Phase 0 of ventricular AP
Mean arterial pressure (MAP) =
Phase 4 of nodal AP
Auscultation location of tricuspid area

6. Dropped QRS complexes not preceded by change in PR interval (can be 2:1 - 3:1 - etc)
Ventricular septal defect
Interstital hydrostatic pressure (Pi)
Mobitz type II 2nd degree AV block
Phase 4 of nodal AP

7. Associated with pulmonic stenosis or RBBB (delayed RV emptying)
Lyme disease can cause why type of AV block?
S4
Mobitz type II 2nd degree AV block
Wide S2 splitting

8. Holosystolic 'blowing murmur' loudest at left sternal border near 4th rib - & is enhanced by inspiration (increased RA return)
Tricuspid Regurgitation
1st degree AV block on EKG
Phase 3 of ventricular AP
Interstitial fluid colloid osmotic pressure

9. Associated with atrial septal defect (ASD) - allowing a left to right shunt that increases flow through pulmonic valve and delays closure
Fixed S2 splitting
T wave inversion on EKG
Plasma colloid osmotic pressure
Phase 2 of ventricular AP

10. Late systolic crescendo murmur (loudest at S2) following a midsystolic click - enhanced by squatting (increased TPR)
Mitral prolapse
3rd degree complete AV block
Resistance is directly proportional to...
Paradoxical S2 splitting

11. High pitched 'blowing' diastolic murmur - can decrease intensity of murmur with vasodilation
Mitral stenosis
Ventricular septal defect
Aortic regurgitation
Effect of inspiration on S2 splitting

12. Holosystolic 'harsh' murmur that is loudest at left sternal border near 4th rib
Supplies blood to the base of the left ventricle
Ventricular septal defect
Paradoxical S2 splitting
Resistance is directly proportional to...

13. Atria & ventricles beat independent of each other - no relation between P waves & QRS complexes
Auscultation location of tricuspid area
3rd degree complete AV block
Capillary hydrostatic pressure (Pc)
1st degree AV block on EKG

14. 2nd intercostal space along left sternal border
Patent ductus arteriosus
Phase 3 of ventricular AP
Auscultation location of pulmonic area
Interstitial fluid colloid osmotic pressure

15. Plateau due to Ca influx balancing K efflux Myocyte contraction
Phase 2 of ventricular AP
Patent ductus arteriosus
Phase 4 of ventricular AP
Phase 3 of ventricular AP

16. Aortic & pulmonic valve closure
Aortic Stenosis
Fixed S2 splitting
S2
S1

17. 3rd degree
1st degree AV block on EKG
Lyme disease can cause why type of AV block?
S3
Common causes of edema

18. Blood viscosity (increased in polycythemia - hyperproteinemia - & hereditary spherocytosis)
Resistance is directly proportional to...
Auscultation location of pulmonic area
Phase 3 of ventricular AP
Phase 2 of nodal AP

19. 5th intercostal space at left midclavicular line
Fick principle
Auscultation location of mitral area
Auscultation location of tricuspid area
Plasma colloid osmotic pressure

20. Aortic valve closure slightly before pulmonic valve closure at end of systolic ejection
Normal S2 splitting
Wolff - Parkinson - White Syndrome
Phase 4 of nodal AP
Auscultation location of mitral area

21. Pulmonic valve closure before aortic valve closure associated with aortic stenosis or LBBB (delayed left ventrical emptying)
Paradoxical S2 splitting
Phase 2 of nodal AP
Auscultation location of pulmonic area
Interstitial fluid colloid osmotic pressure

22. Pulls fluid into capillary
Mobitz type I (Wenckebach) 2nd degree AV block
Plasma colloid osmotic pressure
Auscultation location of mitral area
Mitral stenosis

23. Repolarization due to inactivation of Ca channels & activation of K channels
Capillary hydrostatic pressure (Pc)
1st degree AV block on EKG
Auscultation location of pulmonic area
Phase 3 of nodal AP

24. Posterior descending artery (80% from RCA - 20% from CFX via LCA)
Effect of inspiration on S2 splitting
T wave inversion on EKG
Phase 0 of ventricular AP
Supplies blood to the base of the left ventricle

25. = (capillary pressure - interstital fluid pressure) - (plasma oncotic pressure - interstital fluid oncotic pressure)
Fixed S2 splitting
Net filtration pressure
Interstital hydrostatic pressure (Pi)
Mitral prolapse

26. CO = rate of O2 consumption / (arterial O2 content - venous arterial O2 content)
Phase 4 of ventricular AP
Phase 4 of nodal AP
Effect of inspiration on S2 splitting
Fick principle

27. Upstroke due to opening of Ca channels (Nodal tissues lack fast Na channels which allows for a prolonged AV node transmission from atria to ventricles)
Resistance is inversely proportional to...
Interstitial fluid colloid osmotic pressure
3rd degree complete AV block
Phase 0 of nodal AP

28. Rapid back - to - back atrial depolarization -> 'sawtooth' appearance
A flutter on EKG
Phase 4 of ventricular AP
Phase 3 of nodal AP
Auscultation location of aortic area

29. Pull fluid out of capillary
Fixed S2 splitting
Phase 0 of ventricular AP
Interstitial fluid colloid osmotic pressure
Common causes of edema

30. 2nd intercostal space along right sternal border
U wave on EKG
Resistance is directly proportional to...
Auscultation location of aortic area
Patent ductus arteriosus

31. Absent (no plateau in nodal tissue)
T wave inversion on EKG
Aortic Stenosis
Phase 2 of nodal AP
1st degree AV block on EKG

32. Pushes fluid into capillary
Interstital hydrostatic pressure (Pi)
Auscultation location of mitral area
Phase 4 of nodal AP
Phase 2 of ventricular AP

33. Holosystolic 'blowing murmur' loudest at left 5th intercostal space midclavicular line - & is enhanced by expiration (increased LA return) & squatting (increased TPR)
Mitral Regurgitation
Auscultation location of pulmonic area
Fixed S2 splitting
U wave on EKG

34. Ventricular pre - excitation caused by an accessory conduction pathway that bypasses the AV node. Delta wave on EKG. Can lead to SVT.
Paradoxical S2 splitting
Ventricular septal defect
Phase 0 of ventricular AP
Wolff - Parkinson - White Syndrome

35. Initial repolarization due to inactivation of Na channels & opening of voltaged - gated K channels
Auscultation location of pulmonic area
Mobitz type I (Wenckebach) 2nd degree AV block
Auscultation location of tricuspid area
Phase 1 of ventricular AP

36. Slow diastolic depolarization with Na conductance that accounts for automaticity of SA/AV nodes (slope determines HR)
A flutter on EKG
Auscultation location of pulmonic area
Phase 4 of nodal AP
S2

37. 'Irregularly irregular' - No discrete P waves and irregularly spaced QRS complexes
Fick principle
Auscultation location of aortic area
A fib on EKG
Common causes of edema

38. Late diastole 'atrial kick' sound against increased pressure from ventricular hypertrophy
Auscultation location of mitral area
Phase 2 of ventricular AP
A flutter on EKG
S4

39. Crescendo - decrescendo systolic ejection murmur following an ejection click. Associated with weak pulses & syncope.
Aortic Stenosis
Phase 2 of ventricular AP
Paradoxical S2 splitting
S4

40. Delayed 'rumbling' late diastolic murmur following an opening snap
S4
Normal S2 splitting
Mitral stenosis
Phase 0 of nodal AP

41. Progressive lengthening of PR interval until dropped QRS complex
Supplies blood to the base of the left ventricle
Mobitz type I (Wenckebach) 2nd degree AV block
S1
Capillary hydrostatic pressure (Pc)

42. Early diastole rapid filling sound heard with dilated ventricle (normal in children & pregnant women)
Phase 4 of nodal AP
S3
Phase 2 of nodal AP
Phase 4 of ventricular AP

43. Rapid repolarization due to massive K efflux & closure of Ca channels
Phase 3 of ventricular AP
T wave inversion on EKG
Phase 4 of ventricular AP
Auscultation location of aortic area

44. Resting potential due to high K permeability
Tricuspid Regurgitation
Phase 4 of ventricular AP
S4
Auscultation location of aortic area

45. Cardiac output (CO) x total peripheral resistance (TPR) - or 2/3 diastolic pressure + 1/3 systolic pressure
Phase 3 of ventricular AP
Phase 1 of ventricular AP
Net filtration pressure
Mean arterial pressure (MAP) =

46. Radius to the 4th power
Paradoxical S2 splitting
A fib on EKG
S2
Resistance is inversely proportional to...

47. Inspiration delays pulmonic valve closure - which increases S2 splitting
Supplies blood to the base of the left ventricle
Effect of inspiration on S2 splitting
Mitral stenosis
Aortic Stenosis

48. 4th rib at left sternal border
Mean arterial pressure (MAP) =
Auscultation location of tricuspid area
Phase 0 of ventricular AP
S3

49. Prolonged PR interval
Torsades de Pointes
Interstitial fluid colloid osmotic pressure
1st degree AV block on EKG
Plasma colloid osmotic pressure

50. V Tach with shifting sinusoidal waveforms on EKG - can progess to V fib - Predisposed by QT prolongation
Torsades de Pointes
Interstitial fluid colloid osmotic pressure
Common causes of edema
Net filtration pressure