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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 is the foundation of a scar?
Granulation tissue
Metastasis
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
R-->L
2. How does fibrinolysis/angioplasty tx MI?
Coronary artery vasospasm
Nitroglycerin
S aureus
Open blocked vessels
3. What is the most common cause of mitral stenosis?
Reactive histiocyte with caterpillar nucleus
Concentric LV hypertophy
Coronary artery vasospasm
Chronic rheumatic heart disease
4. What is the leading cause of death in the US?
Chronic rheumatic heart disease
Coronary artery vasospasm - emboli - vasculitis
Ischemic heart disease
Bicuspid aortic valve
5. What imaging test is useful for detecting lesions on valves?
Sudden cardiac death
Tuberous sclerosis
Transesophageal echo
Small - nondestructive vegetations (subacute endocarditis)
6. What typically causes hypertrophic cardiomyopathy?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
AD mutation in sarcomere proteins
Libman - Sacks endocarditis
Heart can't fill
7. When do troponin levels rise - peak - and return to normal?
Migratory polyarthritis
Infectious
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
2-4 hours - 24 hours - 7-10 days
8. Which congenital heart defect is associated with maternal diabetes?
L->R
Squat in response to cyanotic spell
Transposition of the great vessels
SLE
9. What heart sound manifest with an ASD?
Dense layer of elastic and fibrotic tissue in the endocardium - children
CK- MB
Aschoff bodies
Split S2 on auscultation
10. What congenital heart defect often is present with infantile coarctation of the aorta?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Right -->left
PDA
Infantile coarctation of the aorta
11. Turner syndrome is associated with which congenital heart defect?
Cardiac tamponade
Mitral mitral+aortic
Stretched muscle loses contractility
Infantile coarctation of the aorta
12. What are the Jones criteria?
Loss of fx
Cardiac tamponade
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Prinzmetal stable and unstable
13. What gross and microscopic changes occur 1-3 weeks after an MI?
Red border granulation tissue
R-->L
2-4 hours - 24 hours - 7-10 days
Stable angina
14. What artery is the 2nd most often occluded in an MI?
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Months out fibrosis
RCA
Endocardial fibroelastosis
15. What are the causes of restrictive cardiomyopathy in adults?
Right side - serotonin and other secretory products detoxified in the lung
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Right -->left
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
16. What is the most common cause of dilated cardiomyopathy? What are other causes?
AD mutation in sarcomere proteins
Myocardium
Months out fibrosis
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
17. What are the sx/complications of myocarditis?
Chronic rheumatic heart disease
Bicuspid aortic valve
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Large - destructive vegetations
18. How does MI cause LHF?
Chronic rheumatic heart disease
Loss of LV fx
PDA
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
19. What are the sx of right - to - left shunt?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Cyanosis - RV hypertrophy - polycythemia - clubbing
Maternal diabetes
Myocardium
20. What causes prinzmetal angina?
Inability to maintain systemic pressure w/lack of O2 to vital organs
Regurg vs stenosis
Thickening of chrodae tendinae and cusps - mitral stenosis
Coronary artery vasospasm
21. What is the only Jones criteria that doesn't resolve with time?
Loss of fx
Pancarditis
Spontaneous
Fibrosis and dystrophic calcification
22. What gross and microscopic changes occur 4-7 days after an MI?
Yellow pallor macrophages
Ventricles cannot pump
Tuberous sclerosis
Papillary muscle - free wall - IV septum
23. Where is the coarctation in infantile coarctation of the aorta?
Preductal - post aortic arch
Coronary artery vasospasm - emboli - vasculitis
IV drug users
Dense layer of elastic and fibrotic tissue in the endocardium - children
24. What are complications of dilated cardiomyopathy?
Low voltage EKG w/diminished QRS amplitude
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Mitral and tricuspid regurg - arrhythmia
Opening snap followed by diastolic rumble
25. What coronary arterysupplies the lateral wall of the LV?
Atria and RV
Circumflex
Hypercoagulable state or underlying adenocarcinoma
Stable angina
26. Myofiber hypertrophy with disarray.
Slow HR - decreasing O2 demand and risk for arrhythmia
Limits thrombosis
Maternal diabetes
Hypertrophic cardiomyopathy
27. What is the most common form of cardiomyopathy?
Breast and lung carcinoma - melanoma - lymphoma
Dilated
Ventricular arrhythmia
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
28. With what disease is transposition of the great vessels associated?
Maternal diabetes
Contraction band necrosis - reperfusion injury
2-3 weeks
Tetralogy of fallot
29. Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia.
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Loeffler syndrome
Heart transplant
Pulsating nail bed
30. What drugs can cause dilated cardiomyopathy?
Bicuspid aortic valve
Doxorubicin - cocaine
Pump failure
Infectious
31. What is the most common cause of sudden cardiac death? What are less common causes of sudden cardiac death?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Nitroglycerin
Congestive heart failure
PDA
32. Dense layer of elastic and fibrotic tissue in the endocardium.
LHF
Elevated ASO anti - DNase B titers
Endocardial fibroelastosis
Surgical closure small defects may close spontaneously
33. Which vasculitis can cause MI?
Mitral regurgitation due to vegetations
Kawasaki disease
IV drug users
Systolic ejection click followed by crescendo - decrescendo murmur
34. What is the characteristic murmurr of mitral stenosis?
SLE
Streptococcus viridans
S epidermidis
Opening snap followed by diastolic rumble
35. When does the heart have a yellow pallor post MI?
Ostium primum
Day 1-7
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Fetal alcohol syndrome
36. What type of vegetations does Strep viridans cause?
Sudden cardiac death
Small - nondestructive vegetations (subacute endocarditis)
Day 1-7
Decreased forward perfusion pulmonary congestion
37. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
MI
Valve scarring that arises as a consequence of rheumatic fever
S aureus
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
38. What is the most common primary cardiac tumor in children? Is it malignant or benign?
Bacterial endocarditis
Prinzmetal stable and unstable
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Rhadbomyoma - benign
39. What type of collagen is involved in fibrosis?
Type I
Positive blood cultures anemia of chronic disease
Dressler syndrome
Bounding pulse
40. What effect does chronic rheumatic heart disease have on the aortic valve?
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41. What is the rate of mitral valve prolapse in the US?
Metastasis
Myocarditis
Decrease preload -->lowers myocardial stress
2-3%
42. Which coronary artery supplies the posterior wall of the LV and posterior septum?
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
RCA
Bounding pulse
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
43. Infects predamaged valves after transient bacteremia?
Right -->left
>70%
S viridans
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
44. What does granulation tissue contain?
Harmartoma
Anterior wall of LV and anterior septum
Backward LHF pulm htn and RHF - afib and associated mural thombis
Plump fibroblasts - collagen - blood vessels
45. How does squating decrease hypoxemia in tetralogy of fallot?
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Prinzmetal angina
R-->L
46. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Systemic venous congestion
Months out fibrosis
Shunt - PGE to maintain PDA until surgical repair can be performed
PDA
47. What gross and microscopic changes occur months after an MI?
Sterile vegetations on mitral valve along lines of closure
Yellow pallor neutrophils
White scar fibrosis
4-6 hours - 24 hours - 72 hours
48. What drug relieves stable angina?
Indomethacin - decreases PGE
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Nitroglycerin
Group A beta - hemolytic streptococci
49. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Split S2 on auscultation
Adult coarctation of the aorta
Membrane damage
SLE
50. What does nonbacterial thrombotic endocarditis cause?
Mitral regurg
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Congested central veins
VSD