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Test your basic knowledge |
Cardiac
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
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. Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils.
Contraction band necrosis
Stable angina
MI
Myocarditis
2. What does nonbacterial thrombotic endocarditis cause?
Ehlers - Danlow and Marfan syndrome
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Mitral regurg
Group A beta - hemolytic streptococci
3. What % stenosis causes stable angina?
PGE
Decreases LV dilation by decreasing volume
>70%
1-3 days out
4. What gross and microscopic changes occur 1-3 days after an MI?
Yellow pallor neutrophils
LHF
Mitral mitral+aortic
Mitral regurg
5. With what endocarditis is S epidermidis associated?
Endocarditis of prosthetic valves
Stretched muscle loses contractility
PDA
Papillary muscle - free wall - IV septum
6. Large vegetations on tricuspid valve?
S aureus
Right -->left
Transposition of the great vessels
Left -->right
7. What is the most common cause of endocarditis in IV drug users?
S aureus
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Elevated ASO anti - DNase B titers
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
8. What causes endocarditis of prosthetic valves?
Aortic regurg
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
S epidermidis
Decreased forward perfusion pulmonary congestion
9. What does a biopsy of hypertrophic cardiomyopathy look like?
Myofiber hypertrophy with disarray
Cyanosis - RV hypertrophy - polycythemia - clubbing
Endocarditis of prosthetic valves
Months out fibrosis
10. What is the most common cause of infectious endocarditis?
VSD
Streptococcus viridans
Within the first day
4-7 days
11. With what condition are rhabdomyomas associated?
Tuberous sclerosis
Group A beta - hemolytic streptococci
Valve scarring that arises as a consequence of rheumatic fever
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
12. In which chamber of the heart are cardiac myxomas found?
Endocardial fibroelastosis
Stable and unstable prinzmetal
LA
Ventricle
13. What vavular defect results from acute rheumatic fever?
ST- segment elevation
Mitral regurgitation due to vegetations
LAD
Atherosclerosis of coronary arteries
14. What is the definition of ischemia?
Mitral regurg
Squatting - increased systemic resistence decreases LV emptying
4-24 hours
Decrease in blood flow to an organ
15. What are the sx of hypertrophic cardiomyopathy?
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Gelatinous - abundant ground substance
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
16. What is the most common cause of aortic stenosis?
Mitral regurg
Plump fibroblasts - collagen - blood vessels
Infantile coarctation of the aorta
Wear and tear
17. In which pts does S viridans cause endocarditits?
Metastasis
Pts w/previously damaged valves
PGE
Tender lesions on fingers or toes.
18. How does Eisenmeger syndrome occur?
Myofiber hypertrophy with disarray
SLE
Left to right shunt causes increased flow thru pulm circulation which results in hypertrophy of pulm vessels and pulm htn - increased pulm resistance results in reveral of shunt
PDA
19. What does rupture of the LV free wall cause?
Cardiac tamponade
Ischemic heart disease
Reperfusion injury
Ostium secundum (90%)
20. What cardiac disease is associated with tuberous sclerosis?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Boot shaped heart
ACE inhibitor
Rhabdomyoma
21. What causes an early - blowing diastolic murmur?
Valve replacement
Aortic regurg
Loss of fx
Mitral stenosis
22. What effect does mitral stenosis have on the heart chambers?
Left to right shunt causes increased flow thru pulm circulation which results in hypertrophy of pulm vessels and pulm htn - increased pulm resistance results in reveral of shunt
LA dilation
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Squatting - increased systemic resistence decreases LV emptying
23. What cardiac enzyme is useful for detecting reinfarction?
CK- MB
PDA
Nonspecific - eg fever and elevated ESR
VSD
24. Which chambers of the heart are generally spared in an MI?
Erythematous nontender lesions on palms and soles.
Restrictive cardiomyopathy
Atria and RV
Endocarditis of prosthetic valves
25. What characterizes acute rheumatic fever endocarditiis?
LV dilation and eccentric hypertrophy
NG or Ca channel blocker
Small vegetations along the line of closure
Blood vessels coming in from normal tissue
26. Which artery is most often occluded in an MI?
PGE
Louder - increased systemic resistence decreases LV emptying
Limits thrombosis
LAD
27. What type of collagen is involved in fibrosis?
Mitral mitral+aortic
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Colon cancer
Type I
28. What bug causes acute rheumatic fever?
Group A beta - hemolytic streptococci
Infectious endocarditis
Prinzmetal angina
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
29. What is the most common cause of RHF? What are others?
Slow HR - decreasing O2 demand and risk for arrhythmia
Small - nondestructive vegetations (subacute endocarditis)
Libman - Sacks endocarditis
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
30. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
Myxoma - benign
4-7 days
Months out fibrosis
Eisenmenger syndrome
31. What does rupture of a papillary muscle cause?
1%
Right -->left
Decreases LV dilation by decreasing volume
Mitral insufficiency
32. How does O2 tx MI?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Rhadbomyoma - benign
Minimizes ischemia
R-->L
33. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
Sterile vegetations on mitral valve along lines of closure
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
MI
Valve scarring that arises as a consequence of rheumatic fever
34. How does restrictive cardiomyopathy present?
Congestive heart failure
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
LAD
Degree of pulmonary artery stenosis
35. What is chronic rheumatic heart disease?
Osler nodes (ouch - ouch Osler)
1-3 days
Day 1-7
Valve scarring that arises as a consequence of rheumatic fever
36. Reactive histiocyte with slender - wavy 'caterpillar' nucleus.
Stable angina
Anitschow cell
Contraction band necrosis - reperfusion injury
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
37. What causes acute endocarditis?
Large vegetations of S aureus
Pump failure
Loss of LV fx
Coronary artery vasospasm - emboli - vasculitis
38. What causes unstable angina?
Prinzmetal stable and unstable
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Mitral valve prolapse
Colon cancer
39. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
Annular - non pruritic rash w/erythematous borders trunks and limbs
4-7 days macrophage infiltration
Aortic regurg
Stretched muscle loses contractility
40. Systolic ejection click followed by crescendo - decrescendo murmur.
Inability to fill ventricles
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Aortic stenosis
Tetralogy of fallot
41. What distinguishes stenosis caused by chronic rheumatic heart disease from wear and tear aortic stenosis?
Coexisting mitral stenosis and fusion of commisures exist
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Shunt
Plump fibroblasts - collagen - blood vessels
42. What are the minor critera of the Jones criteria?
Stable angina
Nonspecific - eg fever and elevated ESR
PGE
Membrane damage
43. What causes wear and tear aortic stenosis?
Fibrosis and dystrophic calcification
Annular - non pruritic rash w/erythematous borders trunks and limbs
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Dressler syndrome
44. What type of ischemia does stable angina cause?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Pericardial effusion due to pericardial involvement
Harmartoma
Subendocardial
45. When do macrophagess infiltrate the myocardium post MI?
Posterior wall of LV - posterior septum - papillary muscles
4-7 days
Open blocked vessels
Myxoid degeneration
46. What is the gold standard blood marker for MI?
Mitral regurg
>60 years - bicuspid aortic valve
Troponin I
S aureus
47. Why are cardiac enzymes elevated after an MI?
Sudden cardiac death
Anitschow cell
RCA
Membrane damage
48. What is the most common valve infected by S aureus?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Stable angina
Loss of fx
Tricuspid
49. How long after pharyngitis does acute rheumatic fever occur?
Metastasis
Small - nondestructive vegetations (subacute endocarditis)
2-3 weeks
Stretched muscle loses contractility
50. What are the sx of aortic regurg?
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Bicuspid aortic valve
Backward: dyspnea - PND - orthopnea - crackles (pulmonary congestion and edema) - heart failure cells forward: fluid retention due to decreased flow to kidneys leading to activation of RAA