Usmle Cardiology Questions

Front 1

Heart defects that are left to right shunts:

Back 1

* VSD, ASD, PDA

Front 2

Heart defects that are right to left (blue babies):

Back 2

* Truncus arteriosis, transposition of great vessels, Tetrology of Fallot, Tricuspid atresia, TAPVR (total anomalous pulmonary venous return)

Front 3

Early cyanosis in Tetrology of Fallot is due to what:

Back 3

* the VSD

Front 4

Tetrology of Fallot is caused by displacement of:

Back 4

* The infundibular septum

Front 5

What are the 4 clinical features of Tetrology of Fallot:

Back 5

* Pulmonary stenosis (important pronostic factor), Overriding aorta, VSD, right vent hypertrophy (boot shaped heart)

Front 6

In transposition of the great vessels, where does the aorta leave the heart from?

Back 6

* The right ventricle

Front 7

Transposition is not compatible with life unless:

Back 7

* it has a shunt that allows adequate mixing of blood

Front 8

What is the congenital cause of transposition?

Back 8

* Failure of the aorticopulmonary septum to spiral

Front 9

Aortic stenosis proximal to the ductus arteriosis is called:

Back 9

* infantile type aortic stenosis (adult type is post-ductal)

Front 10

Presents as a "machine-like" murmur:

Back 10

* PDA (patent ductus arteriosis)

Front 11

Drug used to close a patent ductus arteriosis:

Back 11

* Indomethacin

Front 12

Prostaglandin used to maintain a patent ductus arteriosis:

Back 12

* Prostaglandin E (this would be needed in transposition of the great vessels)

Front 13

Genetic disorder associated with tructus arteriosis and tetrology of fallot:

Back 13

* 22q11

Front 14

Viral disease associated with PDA and septal defects:

Back 14

* Congenital rubella

Front 15

Turners syndrome is associated with what heart defect:

Back 15

* Coarcation of the aorta

Front 16

Offspring to diabetic moms are at risk of what cardiac anomaly:

Back 16

* Transposition of the great vessels

Front 17

Secondary HTN is associated with problems with what organ:

Back 17

* the kidney

Front 18

Atherosclerosis is deposits in the ____ of the artery.

Back 18

* Intima

Front 19

Associated with hyaline thickening of the small arteries:

Back 19

* Arteriosclerosis

Front 20

Onion skinning of arteries is associated with what type of HTN:

Back 20

* Malignant

Front 21

Pt with "tearing" chest pain radiating to the back has:

Back 21

* Aortic dissection

Front 22

Atherosclerosis is disease of what sized arteries?

Back 22

* medium and large sized arteries

Front 23

What is the progression of disease in atherosclerosis?

Back 23

* Fatty streaks to proliferative plaque to complex atheroma

Front 24

Most common location for atherosclerosis to develop:

Back 24

* the abdominal aorta

Front 25

Percentage of coronary block needed for angina:

Back 25

* 75%

Front 26

Angina upon exertion is:

Back 26

* Stable angina (result of atherosclerosis of medium/large arteries)

Front 27

What causes prinzmetals angina?

Back 27

* Coronary artery spasm

Front 28

Thrombosis without necrosis is characteristic of what angina?

Back 28

* Unstable angina

Front 29

Sudden cardiac death is most commonly caused by:

Back 29

* Lethal cardiac arrythmia

Front 30

What type of infarct do you get if it has a collateral circulation?

Back 30

* Red infarct

Front 31

Most common coronary artery to be included in a MI:

Back 31

* Left anterior descending (LAD)

Front 32

How long after a MI will the heart have neutrophils, macrophages, and have granulation tissue?

Back 32

* 5 to 10 days

Front 33

How long after a MI does the tissue show coagulative necrosis and inflammation?

Back 33

* 2 - 4 days

Front 34

How long after a MI will the myocardium turn pale on tetrazolium staining?

Back 34

* 1 day

Front 35

How long after an MI does the myocardium show contraction bands?

Back 35

* 1 day

Front 36

During the 1st 6hrs of a MI what is the gold standard for diagnosis:

Back 36

* ECG

Front 37

Blood marker that is most specific early on for a MI:

Back 37

* Troponin I

Front 38

CK-MB isn't the best cardiac marker because it is found in these 2 places:

Back 38

* Cardiac AND skeletal muscle

Front 39

ST elevation or pathologic Q-waves signifies what type of infarct?

Back 39

* Transmural infarct

Front 40

ST depression signifies what type of infarct?

Back 40

* Subendothelial infarct

Front 41

What type of dysfunction ensues with dilated cardiomyopathy:

Back 41

* Systolic dysfunction

Front 42

Type of cardiomyopathy that causes young athletes to die suddenly?

Back 42

* Hypertrophic cardiomyopathy

Front 43

Hypertrophic cardiomyopathy is associated with what dysfunction:

Back 43

* Diastolic dysfunction

Front 44

What are 'heart failure cells"?

Back 44

* Hemosiderin laden macrophages

Front 45

What causes fat embolisms?

Back 45

* Long bone fractures (femur) or liposuction

Front 46

How can preggos get DIC?

Back 46

* Amniotic fluid gaining access to the vasculature

Front 47

The triad of stasis, endothelial damage, and hypercoagulability is:

Back 47

* Virchows triad

Front 48

Roth spots, splinter hemorrhages, janaway lesions, and osler's nodules are seen with:

Back 48

* Bacterial endocarditis

Front 49

Staph aureus produces what in bacterial endocarditis:

Back 49

* large vegetations (strep viridans produces small vegetations)

Front 50

The valve most affected by bacterial endocarditis is:

Back 50

* The mitral valve

Front 51

Classic renal complication seen with bacterial endocarditis:

Back 51

* Glomerulonephritis

Front 52

Endocarditis type seen with SLE:

Back 52

* Liebman-Sachs endocarditis (LSE from SLE)

Front 53

Rheumatic heart disease is associated with organism:

Back 53

* Group A beta-hemolytic strep

Front 54

What valve is most affected by rheumatic heart disease:

Back 54

* Mitral valve

Front 55

Aschoff bodies are associated with:

Back 55

* Rheumatic heart disease

Front 56

Elevated ASO titer, migratory polyarthritis, and erythema marginatum is associated with:

Back 56

* Rheumatic heart disease

Front 57

When systolic blood pressure is affected by inspiration this is:

Back 57

* Pulsus paradoxus

Front 58

What type of pericarditis does lupus cause?

Back 58

* Serous

Front 59

A large neoplasm affecting the R vent with areas of hemorrhage and necrosis would be a:

Back 59

* Angiosarcoma

Front 60

Neoplasm usually found in the atria that can obstruct the AV valve causing a "ball and valve" effect:

Back 60

* Myxoma

Front 61

4 days after a MI you'll see ____. 1 wk after an MI you'll see ____ in the heart.

Back 61

* 4 days= neutrophils and macs
1 wk = granulation tissue

Front 62

A girl with a midsystolic click might have a deficiency of what protein:

Back 62

* Fibrillin (seen in marfan syndrome) she has Mitral Valve Prolalpse (MVP)

Front 63

Organism that can cause a sudden death in young people due to a myocarditis is:

Back 63

* Coxsackie B

Front 64

Infective endocarditis due to drug use is most commonly caused by what 2 organisms:

Back 64

* Staph aureus and Pseudomonas aeuroginosa

Front 65

A kid with a VSD (L to R shunt) will eventually have what complication in adult life:

Back 65

* Eisenmeigers complex-- pulmonary HTN will cause the shunt to reverse to a R to L shunt

Front 66

The 2 valves most commonly affected by rheumatic heart disease are:

Back 66

* Mitral and Aortic valves

Front 67

A young person with mild acute cardiomegaly with no vegetations that spontaneously resolves probably has:

Back 67

* Myocarditis-- d/t Coxsackie B virus

Front 68

Common problem with a bicuspid aortic valve?

Back 68

* Later in life in can calcify and fail

Front 69

Fibrinous pericarditis is caused by:

Back 69

* MI's