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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 does granulation tissue contain?
Plump fibroblasts - collagen - blood vessels
Decrease preload -->lowers myocardial stress
Ostium primum
Myxoma - benign
2. What complications occur 4-7 days post MI?
Regurg vs stenosis
Contraction band necrosis - reperfusion injury
Rupture of free wall - IV septum - or papillary muscle
Anitschow cell
3. What is a common complication of cardiac metastasis?
3-8 wks
Subendocardial
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Pericardial effusion due to pericardial involvement
4. What is the leading cause of death in the US?
Ischemic heart disease
PDA
Day 1-7
Mitral mitral+aortic
5. What is the JOneS mneumonic?
Heart can't fill
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
S aureus
Loss of LV fx
6. What are the laboratory findings of bacterial endocarditis?
Months out fibrosis
MI
Shunt - PGE to maintain PDA until surgical repair can be performed
Positive blood cultures anemia of chronic disease
7. What areas of the heart does the LAD supply?
Anterior wall of LV and anterior septum
Congestive heart failure
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
When a bacterial protein resembles a protein in human tissue
8. Sudden death in a young athlete.
LAD
Hypertrophic cardiomyopathy
Prinzmetal
Anterior wall of LV and anterior septum
9. Why would cardiac enzymes continue to increase after the initial MI?
PDA
Hemosiderin laden macrophages
Reperfusion injury
Holosystolic blowing murmur
10. Low voltage EKG w/diminished QRS amplitude.
Restrictive cardiomyopathy
Decreases LV dilation by decreasing volume
Loeffler syndrome
Aneurysm - mural thrombus - Dressler syndrome
11. Systolic ejection click followed by crescendo - decrescendo murmur.
Red border granulation tissue
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Aortic stenosis
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
12. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
RBC damaged while crossing the calcified valve causing schistocytes
Mitral mitral+aortic
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Small vegetations along the line of closure
13. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
Autoimmune pericarditis 6-8 wks post MI
Cardiac tamponade
4-7 days macrophage infiltration
Type I
14. With what disease is transposition of the great vessels associated?
Fever: due to bacteremia murmur: due to vegetations janeway lesions - osler nodes - and splinter hemorrhages: due to embolization of septic vegetations anemia of chronic disease: due to chronic inflammation
Myocardium
Maternal diabetes
Decrease preload -->lowers myocardial stress
15. What bug causes acute rheumatic fever?
Group A beta - hemolytic streptococci
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Kawasaki disease
Shunt - PGE to maintain PDA until surgical repair can be performed
16. What genetic conditions predispose a pt to mitral valve prolapse?
Ischemic heart disease
Mitral regurg
Ehlers - Danlow and Marfan syndrome
Indomethacin - decreases PGE
17. What is the most common type of ASD? What %?
Systolic dysfx leading to biventricular CHF
Backward LHF pulm htn and RHF - afib and associated mural thombis
Ostium secundum (90%)
Increased blood in right heart delays closure of P valve
18. Myofiber hypertrophy with disarray.
4-7 days
When a bacterial protein resembles a protein in human tissue
Valve replacement
Hypertrophic cardiomyopathy
19. What is the most common tumor of the heart?
Group A beta - hemolytic streptococci
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Metastasis
Left -->right
20. Turner syndrome is associated with which congenital heart defect?
Infantile coarctation of the aorta
Decreased forward perfusion pulmonary congestion
Thickening of chrodae tendinae and cusps - mitral stenosis
Dilated
21. What structures are susceptible to rupture post MI?
Aschoff bodies
Restrictive cardiomyopathy
Papillary muscle - free wall - IV septum
Cardiogenic shock - CHF - arrhythmia
22. What is eythema marginatum? What parts of the body does it commonly involve?
Wear and tear
Pedunculated mass in the LA that causes syncope due to obstruction of MV
R-->L
Annular - non pruritic rash w/erythematous borders trunks and limbs
23. When is an MI patent at highest risk for fibrionous pericarditis?
1-3 days out
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Small vegetations along the line of closure
Eisenmenger syndrome
24. How do nitrates tx MI?
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
Decrease preload -->lowers myocardial stress
Kawasaki disease
Mitral regurg
25. What causes prinzmetal angina?
Mid - systolic click followed by regurgitation murmur
Coronary artery vasospasm
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
26. Opening snap followed by diastolic rumble.
Nonspecific - eg fever and elevated ESR
Harmartoma
Mitral stenosis
Reactive histiocyte with caterpillar nucleus
27. What is Dressler syndrome? When does it occur?
LAD
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Autoimmune pericarditis 6-8 wks post MI
>60 years - bicuspid aortic valve
28. What is the most common primary cardiac tumor in children? Is it malignant or benign?
Rhadbomyoma - benign
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Hypertrophic cardiomyopathy
29. Holosystolic blowing murmur that increases w/expiration?
ASD - R-->L
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Maternal diabetes
Mitral regurg
30. What effect does squatting have on the murmur of mitral valve prolapse? Why?
Ventricle
Louder - increased systemic resistence decreases LV emptying
Dressler syndrome
Volume overload and LHF
31. What type of shunt does truncus arteriosus cause?
Spontaneous
Osler nodes (ouch - ouch Osler)
R-->L
Asymptomatic
32. What is the most common cause of mitral stenosis?
Atherosclerosis of coronary arteries
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Systemic venous congestion
Chronic rheumatic heart disease
33. What causes mitral valve prolapse?
Harmartoma
Posterior wall of LV - posterior septum - papillary muscles
Myxoid degeneration
Months out fibrosis
34. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
Coronary artery vasospasm
Reperfusion injury
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Troponin I
35. What is the gross and microscopic appearance of cardiac myxomas?
Gelatinous - abundant ground substance
Positive blood cultures anemia of chronic disease
Mitral stenosis
4-6 hours - 24 hours - 72 hours
36. What are the HACEK organisms? With what condition are they associated?
Dilated
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Holosystolic blowing murmur
37. What areas of the heart does the RCA supply?
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
Mitral regurg
Posterior wall of LV - posterior septum - papillary muscles
MI
38. What type of ischemia does stable angina cause?
Subendocardial
Pts w/previously damaged valves
Loeffler syndrome
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
39. When does the heart have a yellow pallor post MI?
Loss of fx
Tricuspid
Systolic dysfx leading to biventricular CHF
Day 1-7
40. What creates the immune reaction in acute rhuematic fever?
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41. When do neutrophils infiltrate the myocardium post MI?
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Valve replacement
1-3 days
Hypertrophic cardiomyopathy
42. When do troponin levels rise - peak - and return to normal?
Thickening of chrodae tendinae and cusps - mitral stenosis
Reperfusion injury
2-4 hours - 24 hours - 7-10 days
Myxoma - benign
43. What is the tx for LHF?
Hypertrophic cardiomyopathy
ACE inhibitor
RCA
Doxorubicin - cocaine
44. How does fibrinolysis/angioplasty tx MI?
Asymptomatic
Decrease in blood flow to an organ
Friction rub and chest pain
Open blocked vessels
45. What are the forward and backward sx of LHF?
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Restrictive cardiomyopathy
>60 years - bicuspid aortic valve
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
46. What causes acute endocarditis?
AD mutation in sarcomere proteins
Intercostal arteries enlarged due to collateral circulation
Large vegetations of S aureus
S aureus
47. What type of tumor is a rhabdomyoma?
Chest pain <20 min brought on by exertion or emotional stress
Harmartoma
Asymptomatic
Congenital rubella
48. Ostium primum ASD is associated with what congenital disorder?
Trisomy 21
Preductal - post aortic arch
ASD - R-->L
Harmartoma
49. What effect does dilated cardiomyopathy have on the heart?
1%
Systolic dysfx leading to biventricular CHF
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
50. Where is the coarctation in infantile coarctation of the aorta?
Preductal - post aortic arch
Regurg vs stenosis
Decreases LV dilation by decreasing volume
Mitral regurg