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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 complication occurs 1-3 days post MI?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
2-3%
Fibrinous pericarditis
Intercostal arteries enlarged due to collateral circulation
2. In which chamber of the heart are cardiac myxomas found?
Myocardium
LA
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Myocarditis in acute rheumatic heart fever
3. What disesase has Aschoff bodies?
Coronary artery vasospasm - emboli - vasculitis
Nitroglycerin
Congestive heart failure
Myocarditis in acute rheumatic heart fever
4. Is scar tissue or myocardium stronger?
RCA
Myocardium
Atria and RV
Stable angina
5. What type of shunt results in cyanosis at birth?
Right to left
Infectious endocarditis
Increased hydrostatic pressure
Kawasaki disease
6. What is the cause of the red border around granulation tissue?
PDA
Blood vessels coming in from normal tissue
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
Anterior wall of LV and anterior septum
7. What is the most common cause of endocarditis in IV drug users?
S aureus
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Opening snap followed by diastolic rumble
3-8 wks
8. At What age does wear and tear aortic stenosis present? What congenital disease hastens the onset?
RHF
Coxsackie A or B
>60 years - bicuspid aortic valve
ST- segment depression
9. Pericarditis 6-8 wks post MI.
Dressler syndrome
Prinzmetal stable and unstable
Endocardial fibroelastosis (rare)
Dark discoloration coagulative necrosis
10. What areas of the heart does the LAD supply?
Hemosiderin laden macrophages
Congestive heart failure
Anterior wall of LV and anterior septum
Prinzmetal angina - cocaine
11. What gross and microscopic changes occur 4-24 hours after an MI?
Group A beta - hemolytic streptococci
Dark discoloration coagulative necrosis
Breast and lung carcinoma - melanoma - lymphoma
Type I
12. What is the etiology of S viridans endocarditis?
ACE inhibitor
Loss of fx
ASD - R-->L
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
13. What is the classic EKG finding of restrictive cardiomyopathy?
Rhadbomyoma - benign
Ischemic heart disease
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Low voltage EKG w/diminished QRS amplitude
14. What is the murmur of mitral regurg?
Colon cancer
Holosystolic blowing murmur
PDA
Myxoma - benign
15. Dilated cardiomyopathy is a late complication of what illness?
Myocarditis
Mitral mitral+aortic
Rhabdomyoma
RCA
16. What bug causes acute rheumatic fever?
Small - nondestructive vegetations (subacute endocarditis)
Group A beta - hemolytic streptococci
PDA
Slow HR - decreasing O2 demand and risk for arrhythmia
17. What effect does aortic stenosis have on the chambers of the heart?
Yellow pallor macrophages
MI
Concentric LV hypertophy
Myxoid degeneration
18. With what condition are rhabdomyomas associated?
CK- MB
Loss of LV fx
Tuberous sclerosis
VSD
19. What are the causes of restrictive cardiomyopathy in adults?
Coronary artery vasospasm - emboli - vasculitis
Ostium primum
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
LV dilation and eccentric hypertrophy
20. Tender lesions on fingers or toes.
Osler nodes (ouch - ouch Osler)
SLE
Tuberous sclerosis
Reversible
21. What is the most common type of ASD? What %?
Opening snap followed by diastolic rumble
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Ostium secundum (90%)
Elevated ASO anti - DNase B titers
22. Are most congenital heart defects spontaneous or inherited?
Aschoff bodies
Friction rub and chest pain
Spontaneous
Loss of fx
23. What characterizes acute rheumatic fever endocarditiis?
Small vegetations along the line of closure
Trisomy 21
Decrease preload -->lowers myocardial stress
Coexisting mitral stenosis and fusion of commisures exist
24. Systolic ejection click followed by crescendo - decrescendo murmur.
LHF
Aortic stenosis
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Surgical closure small defects may close spontaneously
25. What is the most common cause of death during the acute phase of rheumatic fever?
Loss of LV fx
2-4 hours - 24 hours - 7-10 days
Myocarditis
Dense layer of elastic and fibrotic tissue in the endocardium - children
26. When does the heart have dark discoloration post MI?
Type I
Reversible
4-24 hours
Left -->right
27. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Rupture of free wall - IV septum - or papillary muscle
Erythematous nontender lesions on palms and soles.
Pancarditis
28. Poor myocardial fx due to chronic ischemic damage?
Large vegetations of S aureus
Janeway lesions
Chronic ischemic heart disease
Valve replacement once LV dysfx develops
29. What determines the extent of shunting and cyanosis in tetralogy of fallot?
Left -->right
Ventricle
Degree of pulmonary artery stenosis
Squatting - increased systemic resistence decreases LV emptying
30. Holosystolic blowing murmur that increases w/expiration?
4-7 days
Mitral regurg
ACE inhibitor
Increased hydrostatic pressure
31. Which angina is relieved by Ca channel blockers?
Prinzmetal
RBC damaged while crossing the calcified valve causing schistocytes
Aortic regurg
Red border granulation tissue
32. Opening snap followed by diastolic rumble.
Mitral stenosis
1%
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Nonbacterial thrombotic endocarditis (marantic endocarditis)
33. What coronary arterysupplies the lateral wall of the LV?
4-24 hours
Circumflex
Thickening of chrodae tendinae and cusps - mitral stenosis
Mitral mitral+aortic
34. What are the complications of mitral valve prolapse? Are they common?
LA dilation
Infectious endocarditis - arrythmias - severe mitral regurg no
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Hypertrophic cardiomyopathy
35. What areas of the heart does the RCA supply?
Posterior wall of LV - posterior septum - papillary muscles
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Months out fibrosis
Coxsackie A or B
36. What is the characteristic murmur of aortic stenosis?
Systolic ejection click followed by crescendo - decrescendo murmur
Backward LHF pulm htn and RHF - afib and associated mural thombis
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Breast and lung carcinoma - melanoma - lymphoma
37. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Congested central veins
RCA
38. What type of shunt does ASD cause?
Squatting - expiration
Louder - increased systemic resistence decreases LV emptying
Left -->right
Dilation of all four chambers of the heart
39. Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils.
VSD
Contraction band necrosis
Wear and tear
Reversible
40. What is the characteristic finding on CXR in tetralogy of fallot?
Boot shaped heart
Yellow pallor macrophages
Yellow pallor neutrophils
Nonbacterial thrombotic endocarditis (marantic endocarditis)
41. With what endocarditis is S epidermidis associated?
Doxorubicin - cocaine
Endocarditis of prosthetic valves
Streptococcus bovis/
Aneurysm - mural thrombus - Dressler syndrome
42. What typically causes hypertrophic cardiomyopathy?
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Infectious
AD mutation in sarcomere proteins
Surgical closure small defects may close spontaneously
43. What is an Aschoff body?
Myocarditis in acute rheumatic heart fever
Transposition of the great vessels
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
44. What is endocardial fibroelastosis? In what population is it found?
Aortic regurg
Restrictive cardiomyopathy
Dense layer of elastic and fibrotic tissue in the endocardium - children
Atherosclerosis of coronary arteries
45. Fever - murmur - Janeway lesions - Osler nodes - splinter hemorrhages - anemia of chronic disease?
Reversible
White scar fibrosis
Bacterial endocarditis
Right to left
46. Why are cardiac enzymes elevated after an MI?
Membrane damage
Reperfusion injury
NG or Ca channel blocker
Ostium secundum (90%)
47. What type of vegetations are associated with Libman - Sacks endocarditis?
Sterile vegetations on surface and undersurface on mitral valve
Heart can't fill
Type I
Mitral mitral+aortic
48. With what disease is Libman - Sacks endocarditis associated?
Systolic dysfx leading to biventricular CHF
Paradoxical emboli
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
SLE
49. What % of MIs involve the LAD?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
ST- segment depression
45%
Shunt - PGE to maintain PDA until surgical repair can be performed
50. What type of collagen is involved in fibrosis?
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Type I
Mitral stenosis
Paradoxical emboli