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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. Tender lesions on fingers or toes.
Nitroglycerin
Contraction band necrosis
Yellow pallor macrophages
Osler nodes (ouch - ouch Osler)
2. What effect does mitral stenosis have on the heart chambers?
Hypertrophic cardiomyopathy
Pericardial effusion due to pericardial involvement
LA dilation
RBC damaged while crossing the calcified valve causing schistocytes
3. What are the forward and backward sx of LHF?
Subendocardial
Acute inflammation
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
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
4. Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils.
Coronary artery vasospasm
Heart transplant
Coxsackie A or B
Contraction band necrosis
5. Lower extremity cyanosis in infants? In adults?
Hypertophy of RV atrophy of LV
Infantile coarctation of the aorta PDA
Prinzmetal
LV dilation and eccentric hypertrophy
6. How do you prevent S viridans endocarditis?
2-3 weeks
Pulsating nail bed
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Prophylactic abx during dental procedures
7. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
MI
Aneurysm - mural thrombus - Dressler syndrome
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Blood vessels coming in from normal tissue
8. What is a common complication of cardiac metastasis?
Mitral regurg
L->R
Minimizes ischemia
Pericardial effusion due to pericardial involvement
9. What is eythema marginatum? What parts of the body does it commonly involve?
Annular - non pruritic rash w/erythematous borders trunks and limbs
Infectious endocarditis
Rupture of free wall - IV septum - or papillary muscle
Acute inflammation
10. What imaging test is useful for detecting lesions on valves?
Hypercoagulable state or underlying adenocarcinoma
Libman - Sacks endocarditis
Concentric LV hypertophy
Transesophageal echo
11. Myofiber hypertrophy with disarray.
Day 1-7
Hypertrophic cardiomyopathy
Systolic ejection click followed by crescendo - decrescendo murmur
Coronary artery vasospasm
12. How does aortic regurg affect the heart chambers?
Within the first day
Cardiac tamponade
Autoimmune pericarditis 6-8 wks post MI
LV dilation and eccentric hypertrophy
13. In what pt population does S aureus commonly cause valvular disease?
Positive blood cultures anemia of chronic disease
Metastasis
2-3 weeks
IV drug users
14. What is the leading cause of death in the US?
Paradoxical emboli
Ischemic heart disease
Systolic dysfx leading to biventricular CHF
LHF
15. With what congenital heart defect is ADULT coarctation of the aorta associated?
Left -->right
LA dilation
Breast and lung carcinoma - melanoma - lymphoma
Bicuspid aortic valve
16. What structures are susceptible to rupture post MI?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Papillary muscle - free wall - IV septum
PDA
Mitral mitral+aortic
17. What type of vegetations does Strep viridans cause?
Mitral regurgitation due to vegetations
Small - nondestructive vegetations (subacute endocarditis)
Sterile vegetations on mitral valve along lines of closure
RCA
18. How does hypertension cause LHF?
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19. What two things happen when a blocked vessel is opened after an MI?
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Contraction band necrosis - reperfusion injury
Coronary artery vasospasm
Preductal - post aortic arch
20. What is the most common cause of sudden cardiac death? What are less common causes of sudden cardiac death?
Dark discoloration coagulative necrosis
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Fibrosis and dystrophic calcification
LA dilation
21. What is the most common type of endocarditis?
Infectious
Rupture of free wall - IV septum - or papillary muscle
Systemic venous congestion
Fibrosis and dystrophic calcification
22. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
20 min
Dilated
Myxoma - benign
1-3 days out
23. What is the etiology of S viridans endocarditis?
Cardiogenic shock - CHF - arrhythmia
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Mitral stenosis
Libman - Sacks endocarditis
24. What are the sx of hypertrophic cardiomyopathy?
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Positive blood cultures anemia of chronic disease
Anterior wall of LV and anterior septum
Endocardial fibroelastosis
25. What are the sx/complications of myocarditis?
LAD
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
4-24 hours
S epidermidis
26. What is the most common form of cardiomyopathy?
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
Red border granulation tissue
Dilated
27. What vavular defect results from acute rheumatic fever?
Asymptomatic
Bicuspid aortic valve
Mitral regurgitation due to vegetations
Endocardial fibroelastosis
28. What cardiac enzyme is useful for detecting reinfarction?
Bacterial endocarditis
Heart can't fill
Ostium secundum (90%)
CK- MB
29. Which chambers of the heart are generally spared in an MI?
RCA
Months out fibrosis
Rupture of free wall - IV septum - or papillary muscle
Atria and RV
30. What is the rate of mitral valve prolapse in the US?
2-3%
Systolic dysfx leading to biventricular CHF
ACE inhibitor
Systolic ejection click followed by crescendo - decrescendo murmur
31. What is the gross and microscopic appearance of cardiac myxomas?
Rhabdomyoma
Gelatinous - abundant ground substance
Opening snap followed by diastolic rumble
White scar fibrosis
32. What is the most common cause of death during the acute phase of rheumatic fever?
Atria and RV
Subendocardial
Inability to fill ventricles
Myocarditis
33. What is Loeffler syndrome?
Louder - increased systemic resistence decreases LV emptying
R-->L
PGE
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
34. What is molecular mimicry?
Myxoid degeneration
When a bacterial protein resembles a protein in human tissue
Months out fibrosis
Dilated
35. What areas of the heart does the RCA supply?
Rhabdomyoma
Adult coarctation of the aorta
Mitral stenosis
Posterior wall of LV - posterior septum - papillary muscles
36. What increases the risk for chronic rheumatic heart disease?
1%
Holosystolic blowing murmur
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Inability to fill ventricles
37. What causes acute endocarditis?
S viridans
Large vegetations of S aureus
Autoimmune pericarditis 6-8 wks post MI
Streptococcus viridans
38. What does nonbacterial thrombotic endocarditis cause?
LAD
Stretched muscle loses contractility
Low voltage EKG w/diminished QRS amplitude
Mitral regurg
39. In which chamber of the heart are rhabdomyomas found?
Nitroglycerin
Osler nodes (ouch - ouch Osler)
Ventricle
Prinzmetal
40. What type of vegetations form in nonbacterial thrombotic endocarditis?
Congenital rubella
Sterile vegetations on mitral valve along lines of closure
Reperfusion injury
LAD
41. What drugs can cause dilated cardiomyopathy?
Autoimmune pericarditis 6-8 wks post MI
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
S aureus
Doxorubicin - cocaine
42. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Within the first day
Pts w/previously damaged valves
Tetralogy of fallot
ASD - R-->L
43. What is the most common valve infected by S aureus?
Rhabdomyoma
Mitral stenosis
First 4 hours
Tricuspid
44. What are the clinical features of LHF due to?
Tetralogy of fallot
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Decreased forward perfusion pulmonary congestion
Paradoxical emboli
45. What are heart failure cells?
Hemosiderin laden macrophages
S aureus
Infectious endocarditis
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
46. What congenital heart defect does indomethacin tx?
Streptococcus bovis/
PDA
S aureus
Contraction band necrosis
47. What type of endocarditis is associated with SLE?
Paradoxical emboli
Libman - Sacks endocarditis
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
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
48. What maintains patency of the PDA?
PGE
Decrease in blood flow to an organ
RBC damaged while crossing the calcified valve causing schistocytes
Increased hydrostatic pressure
49. What is migratory polyarthritis?
Decrease preload -->lowers myocardial stress
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Asymptomatic
Right -->left
50. What effect does aortic stenosis have on the chambers of the heart?
Concentric LV hypertophy
Decrease in blood flow to an organ
Streptococcus bovis/
Hypertrophic cardiomyopathy