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Cardiac
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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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 characteristic murmurr of mitral stenosis?
Opening snap followed by diastolic rumble
Turner syndrome
LAD
When a bacterial protein resembles a protein in human tissue
2. Myofiber hypertrophy with disarray.
Nonspecific - eg fever and elevated ESR
Hypertrophic cardiomyopathy
Heart transplant
Regurg vs stenosis
3. How long after pharyngitis does acute rheumatic fever occur?
Cyanosis - RV hypertrophy - polycythemia - clubbing
PGE
Doxorubicin - cocaine
2-3 weeks
4. Low voltage EKG w/diminished QRS amplitude.
Turner syndrome
Restrictive cardiomyopathy
S aureus
Erythematous nontender lesions on palms and soles.
5. What is eythema marginatum? What parts of the body does it commonly involve?
Troponin I
Annular - non pruritic rash w/erythematous borders trunks and limbs
Infectious endocarditis - arrythmias - severe mitral regurg no
1-3 days
6. How does Eisenmeger syndrome occur?
Circumflex
2-4 hours - 24 hours - 7-10 days
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
Louder - increased systemic resistence decreases LV emptying
7. What causes wear and tear aortic stenosis?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Fibrosis and dystrophic calcification
Nonbacterial thrombotic endocarditis (marantic endocarditis)
ST- segment elevation
8. What are the sx of hypertrophic cardiomyopathy?
4-7 days
Tetralogy of fallot
Granulation tissue
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
9. What are the Jones criteria?
Ventricle
Fibrinous pericarditis
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Transposition of the great vessels
10. Which congenital heart defect is associated with maternal diabetes?
Ventricular arrhythmia
Minimizes ischemia
Hypercoagulable state or underlying adenocarcinoma
Transposition of the great vessels
11. What valves are most commonly involved in chronic rheumatic heart disease?
Valve replacement AFTER the onset of complications
Libman - Sacks endocarditis
Cardiogenic shock - CHF - arrhythmia
Mitral mitral+aortic
12. What causes angina and syncope in aortic stenosis?
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13. What areas of the heart does the LAD supply?
2-4 hours - 24 hours - 7-10 days
Mitral mitral+aortic
Squat in response to cyanotic spell
Anterior wall of LV and anterior septum
14. What is the most common cause of myocarditis?
Myocarditis in acute rheumatic heart fever
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Concentric LV hypertophy
Coxsackie A or B
15. What is systolic dysfx?
Ventricles cannot pump
S viridans
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Dark discoloration coagulative necrosis
16. What does Libman - Sacks endocarditis cause?
Ehlers - Danlow and Marfan syndrome
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
PDA
Mitral regurg
17. What are the sx of PDA at birth?
Asymptomatic
Trisomy 21
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Streptococcus bovis/
18. Tender lesions on fingers or toes.
1-3 days
Osler nodes (ouch - ouch Osler)
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
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
19. What complication occurs 1-3 days post MI?
Chest pain <20 min brought on by exertion or emotional stress
Regurg vs stenosis
Fibrinous pericarditis
Pedunculated mass in the LA that causes syncope due to obstruction of MV
20. What type of vegetations are associated with Libman - Sacks endocarditis?
LHF
LA dilation
Sterile vegetations on surface and undersurface on mitral valve
Decreases LV dilation by decreasing volume
21. What is cardiogenic shock?
Inability to maintain systemic pressure w/lack of O2 to vital organs
Heart can't fill
Cardiogenic shock - CHF - arrhythmia
Pts w/previously damaged valves
22. What is the most common cause of death during the acute phase of rheumatic fever?
Myocarditis
Infantile coarctation of the aorta
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Contraction band necrosis - reperfusion injury
23. What increases the risk for chronic rheumatic heart disease?
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Heart transplant
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
24. With what disease is Libman - Sacks endocarditis associated?
Cyanosis - RV hypertrophy - polycythemia - clubbing
SLE
LA dilation
Anterior wall of LV and anterior septum
25. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
Transesophageal echo
Within the first day
Months out fibrosis
Elevated ASO anti - DNase B titers
26. Where is the coarctation in infantile coarctation of the aorta?
Months out fibrosis
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Preductal - post aortic arch
27. What cardiac disease is associated with tuberous sclerosis?
Rhabdomyoma
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Aortic stenosis
Aschoff bodies
28. What side of the heart do carcinoid tumors affect? Why?
Prinzmetal stable and unstable
Right side - serotonin and other secretory products detoxified in the lung
45%
Inability to maintain systemic pressure w/lack of O2 to vital organs
29. What is the tx for aortic stenosis?
Valve replacement AFTER the onset of complications
Elevated ASO anti - DNase B titers
Ehlers - Danlow and Marfan syndrome
Congenital rubella
30. What type of endocarditis is associated with SLE?
1-3 days out
Ostium secundum (90%)
Day 1-7
Libman - Sacks endocarditis
31. What congenital heart defect is associated with fetal alcohol syndrome?
VSD
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Prinzmetal
32. How does restrictive cardiomyopathy present?
Congestive heart failure
Ostium primum
Stable and unstable prinzmetal
Reperfusion injury
33. Systolic ejection click followed by crescendo - decrescendo murmur.
Aortic stenosis
Months out fibrosis
SLE
1-3 days out
34. In what pt population does S aureus commonly cause valvular disease?
IV drug users
LAD
Granulation tissue
Systolic ejection click followed by crescendo - decrescendo murmur
35. What bug causes acute rheumatic fever?
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Group A beta - hemolytic streptococci
4-6 hours - 24 hours - 72 hours
PDA
36. What effect does transposition of the great vessels have on the ventricles?
Hypertophy of RV atrophy of LV
Subendocardial
Low voltage EKG w/diminished QRS amplitude
Cardiogenic shock - CHF - arrhythmia
37. How does stable angina present?
Volume overload and LHF
Months out fibrosis
Chest pain <20 min brought on by exertion or emotional stress
2-3%
38. Which artery is most often occluded in an MI?
4-24 hours
20 min
LAD
4-6 hours - 24 hours - 72 hours
39. How does subendocardial MI/ischemia present on EKG?
ST- segment depression
Mitral regurgitation due to vegetations
Cardiac tamponade
>70%
40. What disesase has Aschoff bodies?
S viridans
Fibrinous pericarditis
VSD
Myocarditis in acute rheumatic heart fever
41. What is the leading cause of death in the US?
Ischemic heart disease
S viridans
Reperfusion injury
Endocarditis of prosthetic valves
42. Vegetations on surface and undersurface of mitral valve.
Libman - Sacks endocarditis
Large - destructive vegetations
Tuberous sclerosis
IV drug users
43. Which coronary artery supplies the posterior wall of the LV and posterior septum?
RCA
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Inability to maintain systemic pressure w/lack of O2 to vital organs
Contraction band necrosis - reperfusion injury
44. What is the most common cause of RHF? What are others?
Turner syndrome
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Gelatinous - abundant ground substance
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
45. What is the foundation of a scar?
Mitral mitral+aortic
Granulation tissue
Atria and RV
Infantile coarctation of the aorta
46. When is a post - MI pt at highest risk for an aneurysm? With what microscopic change is this complication associated?
Myocarditis
Sudden cardiac death
Left -->right
Months out fibrosis
47. What is molecular mimicry?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Bicuspid aortic valve
RCA
When a bacterial protein resembles a protein in human tissue
48. What are the sx/complications of myocarditis?
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
LA dilation
Infectious endocarditis - arrythmias - severe mitral regurg no
49. What is Loeffler syndrome?
Red border granulation tissue
Bicuspid aortic valve
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Loss of fx
50. How do nitrates tx MI?
Decrease preload -->lowers myocardial stress
Rhadbomyoma - benign
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
When a bacterial protein resembles a protein in human tissue
Sorry!:) No result found.
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