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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. What is the tx for LHF?
1-3 days out
Infectious endocarditis - arrythmias - severe mitral regurg no
ACE inhibitor
Myocarditis in acute rheumatic heart fever
2. At what point in development do congenital heart defects arise?
Regurg vs stenosis
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
3-8 wks
Large - destructive vegetations
3. What type of shunt results in cyanosis at birth?
Subendocardial
MI
Right to left
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
4. What are the sx/complications of myocarditis?
L->R
Mitral insufficiency
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Acute inflammation
5. What genetic conditions predispose a pt to mitral valve prolapse?
Ehlers - Danlow and Marfan syndrome
Tender lesions on fingers or toes.
Squatting - increased systemic resistence decreases LV emptying
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
6. What effect does squatting have on the murmur of mitral valve prolapse? Why?
Louder - increased systemic resistence decreases LV emptying
White scar fibrosis
Coronary artery vasospasm
4-6 hours - 24 hours - 72 hours
7. What is the most common primary cardiac tumor in children? Is it malignant or benign?
Myocarditis
Rhadbomyoma - benign
Papillary muscle - free wall - IV septum
Atria and RV
8. What effect does chronic rheumatic heart disease have the mitral valve?
Dilation of all four chambers of the heart
Ischemic heart disease
Thickening of chrodae tendinae and cusps - mitral stenosis
Yellow pallor neutrophils
9. Which coronary artery supplies the posterior wall of the LV and posterior septum?
RCA
Streptococcus viridans
Low voltage EKG w/diminished QRS amplitude
Limits thrombosis
10. What are the two effects of ATII?
Paradoxical emboli
Stretched muscle loses contractility
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Autoimmune pericarditis 6-8 wks post MI
11. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Subendocardial
Troponin I
Adult coarctation of the aorta
Stable and unstable prinzmetal
12. What is cardiogenic shock?
Inability to maintain systemic pressure w/lack of O2 to vital organs
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Decrease in blood flow to an organ
Prophylactic abx during dental procedures
13. When is an MI pt at greatest risk for cardiogenic shock?
Acute inflammation
Ischemic heart disease
LAD
First 4 hours
14. In which pts does S viridans cause endocarditits?
4-6 hours - 24 hours - 72 hours
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Mitral regurg
Pts w/previously damaged valves
15. How does aortic regurg affect the heart chambers?
Tetralogy of fallot
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
LV dilation and eccentric hypertrophy
Stretched muscle loses contractility
16. What is the most common form of cardiomyopathy?
Loeffler syndrome
Dilated
Tuberous sclerosis
Prinzmetal angina - cocaine
17. What is the rate of mitral valve prolapse in the US?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
2-3%
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Reperfusion injury
18. What congenital heart defect often is present with infantile coarctation of the aorta?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
45%
Decrease preload -->lowers myocardial stress
PDA
19. What causes acute endocarditis?
Annular - non pruritic rash w/erythematous borders trunks and limbs
Regurg vs stenosis
Large vegetations of S aureus
Reactive histiocyte with caterpillar nucleus
20. What complications occur within 4 hrs post MI?
Cardiogenic shock - CHF - arrhythmia
Transposition of the great vessels
Rhadbomyoma - benign
Large - destructive vegetations
21. What is Loeffler syndrome?
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Mitral regurg
RBC damaged while crossing the calcified valve causing schistocytes
22. What type of endocarditis is associated w/metastatic cancer and wasting conditions?
Trisomy 21
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Turner syndrome
Circumflex
23. What are the minor critera of the Jones criteria?
ACE inhibitor
Transposition of the great vessels
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Nonspecific - eg fever and elevated ESR
24. What coronary arterysupplies the lateral wall of the LV?
Circumflex
Holosystolic machine like murmur
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Nitroglycerin
25. What are the clinical features of RHF?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
SLE
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
RCA
26. What is the main cause of MV regurg? What are other causes?
Ischemic heart disease
2-3%
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Cyanosis - RV hypertrophy - polycythemia - clubbing
27. What is the most common cause of endocarditis in IV drug users?
Inability to fill ventricles
S aureus
Coronary artery vasospasm
Atria and RV
28. How long can cardiac myocytes be deprived of oxygen before they become irreversibly injured?
Hypertrophic cardiomyopathy
20 min
Yellow pallor macrophages
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
29. What type of shunt does a VSD cause?
Mid - systolic click followed by regurgitation murmur
L->R
Coxsackie A or B
VSD
30. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Ventricles cannot pump
Transesophageal echo
Metastasis
ASD - R-->L
31. What congenital heart defect does indomethacin tx?
Yellow pallor neutrophils
Degree of pulmonary artery stenosis
PDA
Mitral insufficiency
32. How does stable angina present?
Chest pain <20 min brought on by exertion or emotional stress
Granulation tissue
Hemosiderin laden macrophages
2-3 weeks
33. What does rupture of the LV free wall cause?
Cardiac tamponade
Friction rub and chest pain
Ostium secundum (90%)
VSD
34. What causes microangiopathic hemolytic anemia in aortic stenosis?
>70%
RBC damaged while crossing the calcified valve causing schistocytes
Rhabdomyoma
Congestive heart failure
35. Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - pitting edema.
RHF
Red border granulation tissue
Fibrinous pericarditis
Papillary muscle - free wall - IV septum
36. What structures are susceptible to rupture post MI?
Months out fibrosis
Papillary muscle - free wall - IV septum
Mitral mitral+aortic
Reactive histiocyte with caterpillar nucleus
37. What causes notching of the ribs in adult coarctation of the aorta?
Intercostal arteries enlarged due to collateral circulation
Mitral regurg
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Months out fibrosis
38. What effect does mitral stenosis have on the heart chambers?
Spontaneous
RCA
Prinzmetal angina - cocaine
LA dilation
39. How does subendocardial MI/ischemia present on EKG?
Dark discoloration coagulative necrosis
Squatting - expiration
ST- segment depression
Right -->left
40. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Loss of LV fx
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Sudden cardiac death
Pericardial effusion due to pericardial involvement
41. How do beta blockers tx MI?
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Mid - systolic click followed by regurgitation murmur
Coronary artery vasospasm
Slow HR - decreasing O2 demand and risk for arrhythmia
42. What is the most common cause of mitral stenosis?
Chronic rheumatic heart disease
Congestive heart failure
CHF
MI
43. Why would cardiac enzymes continue to increase after the initial MI?
Shunt
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Reperfusion injury
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
44. Dilated cardiomyopathy is a late complication of what illness?
RHF
Endocarditis of prosthetic valves
PGE
Myocarditis
45. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
LHF
Ventricle
Ventricular arrhythmia
46. What does a biopsy of hypertrophic cardiomyopathy look like?
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
Myofiber hypertrophy with disarray
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Decrease in blood flow to an organ
47. What does rupture of the IV septum cause?
Decreased forward perfusion pulmonary congestion
Shunt
Rhadbomyoma - benign
VSD
48. How do you tx prinzmetal angina?
NG or Ca channel blocker
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Endocarditis of prosthetic valves
Myocarditis in acute rheumatic heart fever
49. What are the sx of cardiac myxoma?
Prinzmetal angina - cocaine
Major criteria of Jones criteria for acute rheumatic fever J: joint (migratory polyarthritis) O: heart (pancarditis) N: nodules (subcutaneous nodules) E: erythema marginatum S: Sydenham chorea
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Pedunculated mass in the LA that causes syncope due to obstruction of MV
50. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
VSD
Positive blood cultures anemia of chronic disease
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis