Test your basic knowledge |

Cardiac

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 type of ASD is associated w/Down syndrome?
Ostium primum
Sudden cardiac death
Intercostal arteries enlarged due to collateral circulation
Myofiber hypertrophy with disarray

2. How do you prevent S viridans endocarditis?
Prophylactic abx during dental procedures
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Mitral regurgitation due to vegetations
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

3. What are the complications of mitral stenosis?
Backward LHF pulm htn and RHF - afib and associated mural thombis
Louder - increased systemic resistence decreases LV emptying
PDA
RCA

4. What effect does aortic stenosis have on the chambers of the heart?
Squat in response to cyanotic spell
Autoimmune pericarditis 6-8 wks post MI
Left -->right
Concentric LV hypertophy

5. What causes endocarditis of prosthetic valves?
Heart can't fill
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Circumflex
S epidermidis

6. What effect does chronic rheumatic heart disease have on the aortic valve?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

7. What always follows necrosis?
Myocarditis
Tender lesions on fingers or toes.
Acute inflammation
Contraction band necrosis - reperfusion injury

8. With what disease is transposition of the great vessels associated?
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Holosystolic machine like murmur
Red border granulation tissue
Maternal diabetes

9. What is endocardial fibroelastosis? In what population is it found?
Adult coarctation of the aorta
Right -->left
Red border granulation tissue
Dense layer of elastic and fibrotic tissue in the endocardium - children

10. What is the rate of mitral valve prolapse in the US?
Plump fibroblasts - collagen - blood vessels
2-3%
Spontaneous
Reactive histiocyte with caterpillar nucleus

11. Which congenital heart defect is associated with congenital rubella?
PDA
Libman - Sacks endocarditis
Ostium secundum (90%)
Congested central veins

12. What are the major criteria of the Jones criteria?
Shunt - PGE to maintain PDA until surgical repair can be performed
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Atherosclerosis of coronary arteries
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea

13. What causes notching of the ribs in adult coarctation of the aorta?
Intercostal arteries enlarged due to collateral circulation
Ventricle
Mitral and tricuspid regurg - arrhythmia
Coexisting mitral stenosis and fusion of commisures exist

14. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
Elevated ASO anti - DNase B titers
Months out fibrosis
R-->L
Large - destructive vegetations

15. Poor myocardial fx due to chronic ischemic damage?
Myxoma - benign
Chronic ischemic heart disease
Thickening of chrodae tendinae and cusps - mitral stenosis
Erythematous nontender lesions on palms and soles.

16. What is eythema marginatum? What parts of the body does it commonly involve?
S viridans
Left -->right
Stable angina
Annular - non pruritic rash w/erythematous borders trunks and limbs

17. What gross and microscopic changes occur months after an MI?
Myxoma - benign
White scar fibrosis
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Reversible

18. What are the laboratory findings of bacterial endocarditis?
Positive blood cultures anemia of chronic disease
CHF
Chest pain <20 min brought on by exertion or emotional stress
Posterior wall of LV - posterior septum - papillary muscles

19. What effect does aortic regurg have on the pulse pressure? Why?
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Endocardial fibroelastosis (rare)
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Boot shaped heart

20. Why are cardiac enzymes elevated after an MI?
Spontaneous
Membrane damage
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Contraction band necrosis - reperfusion injury

21. What is the tx for LHF?
Opening snap followed by diastolic rumble
ACE inhibitor
Positive blood cultures anemia of chronic disease
Pts w/previously damaged valves

22. What is the most common cause of mitral stenosis?
Migratory polyarthritis
Ostium primum
Chronic rheumatic heart disease
Mitral valve prolapse

23. Dense layer of elastic and fibrotic tissue in the endocardium.
Endocardial fibroelastosis
White scar fibrosis
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
RCA

24. What causes wear and tear aortic stenosis?
Streptococcus viridans
Fibrosis and dystrophic calcification
Myxoid degeneration
Plump fibroblasts - collagen - blood vessels

25. What are the complications of aortic stenosis?
Harmartoma
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Systemic venous congestion
Congestive heart failure

26. What does a biopsy of hypertrophic cardiomyopathy look like?
Prinzmetal stable and unstable
Myofiber hypertrophy with disarray
Thickening of chrodae tendinae and cusps - mitral stenosis
4-24 hours

27. What is dilated cardiomyopathy?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
First 4 hours
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Dilation of all four chambers of the heart

28. How long after pharyngitis does acute rheumatic fever occur?
Mitral regurg
2-3 weeks
Dressler syndrome
Louder - increased systemic resistence decreases LV emptying

29. Is scar tissue or myocardium stronger?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
PDA
Acute inflammation
Myocardium

30. What causes unstable angina?
Myxoid degeneration
PDA
Transposition of the great vessels
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery

31. What type of vegetations are associated with Libman - Sacks endocarditis?
RCA
Mitral regurg
S epidermidis
Sterile vegetations on surface and undersurface on mitral valve

32. How does squating decrease hypoxemia in tetralogy of fallot?
Pericardial effusion due to pericardial involvement
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Type I

33. What shunt does tetralogy of fallot produce?
CK- MB
Right -->left
>60 years - bicuspid aortic valve
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar

34. How do nitrates tx MI?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Decrease preload -->lowers myocardial stress
Bacterial endocarditis
Mitral regurg

35. Reactive histiocyte with slender - wavy 'caterpillar' nucleus.
Restrictive cardiomyopathy
Surgical closure small defects may close spontaneously
Anitschow cell
Reactive histiocyte with caterpillar nucleus

36. How does restrictive cardiomyopathy present?
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Congestive heart failure
CK- MB
Dark discoloration coagulative necrosis

37. What type of collagen is involved in fibrosis?
Prophylactic abx during dental procedures
Stretched muscle loses contractility
Yellow pallor neutrophils
Type I

38. When does the heart have a yellow pallor post MI?
Asymptomatic
Ischemic heart disease
Day 1-7
Rhadbomyoma - benign

39. What does rupture of the LV free wall cause?
Valve scarring that arises as a consequence of rheumatic fever
Cardiac tamponade
L->R
2-3%

40. What are the Jones criteria?
Congenital rubella
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Concentric LV hypertophy
Mitral stenosis

41. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Months out fibrosis
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
PGE

42. What is the only Jones criteria that doesn't resolve with time?
Pancarditis
SLE
Nonspecific - eg fever and elevated ESR
Myxoid degeneration

43. With what endocarditis is S epidermidis associated?
Shunt
Endocarditis of prosthetic valves
4-7 days macrophage infiltration
Mitral regurg

44. What are Osler nodes?
Tender lesions on fingers or toes.
Dressler syndrome
Squatting - increased systemic resistence decreases LV emptying
Ventricles cannot pump

45. In which pts does S viridans cause endocarditits?
Hypertrophic cardiomyopathy
Volume overload and LHF
Pts w/previously damaged valves
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume

46. What are the sx of pericardiits?
Friction rub and chest pain
Rhabdomyoma
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Tender lesions on fingers or toes.

47. What is Loeffler syndrome?
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Streptococcus bovis/
Coxsackie A or B
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint

48. What is the effect of mitral regurg on the heart?
Infantile coarctation of the aorta
Volume overload and LHF
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Mitral stenosis

49. What vavular defect results from acute rheumatic fever?
Blood vessels coming in from normal tissue
Congestive heart failure
Mitral regurgitation due to vegetations
Mitral valve prolapse

50. Lower extremity cyanosis in infants? In adults?
Infantile coarctation of the aorta PDA
Myocarditis
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Transposition of the great vessels