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. With what condition are rhabdomyomas associated?
Tuberous sclerosis
Rhadbomyoma - benign
Streptococcus viridans
3-8 wks

2. What type of endocarditis is associated w/metastatic cancer and wasting conditions?
Rhadbomyoma - benign
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing

3. How do ACE inhibitors tx MI?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Decreases LV dilation by decreasing volume
S epidermidis
VSD

4. What causes endocarditis of prosthetic valves?
Mitral mitral+aortic
Yellow pallor macrophages
S epidermidis
Atria and RV

5. What does granulation tissue contain?
RBC damaged while crossing the calcified valve causing schistocytes
Plump fibroblasts - collagen - blood vessels
Mitral mitral+aortic
Pulsating nail bed

6. What are the clinical features of LHF due to?
Ventricle
Decreased forward perfusion pulmonary congestion
Loss of LV fx
Systolic dysfx leading to biventricular CHF

7. What is the characteristic murmurr of mitral stenosis?
Inability to fill ventricles
Within the first day
Ventricles cannot pump
Opening snap followed by diastolic rumble

8. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
Cardiac tamponade
Mitral regurg
Inability to fill ventricles
4-7 days macrophage infiltration

9. What congenital heart defect is associated with fetal alcohol syndrome?
Split S2 on auscultation
Tricuspid
VSD
Months out fibrosis

10. What is the gold standard blood marker for MI?
Troponin I
Streptococcus bovis/
Preductal - post aortic arch
LHF

11. How does hypertension cause LHF?

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

12. What is the etiology of S viridans endocarditis?
Right side - serotonin and other secretory products detoxified in the lung
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
When a bacterial protein resembles a protein in human tissue
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy

13. What side of the heart do carcinoid tumors affect? Why?
ST- segment depression
Dilation of all four chambers of the heart
LHF
Right side - serotonin and other secretory products detoxified in the lung

14. What imaging test is useful for detecting lesions on valves?
Friction rub and chest pain
Transesophageal echo
SLE
VSD

15. What makes the MV prolapse murmur louder? Why?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Pericardial effusion due to pericardial involvement
Squatting - increased systemic resistence decreases LV emptying
Pulsating nail bed

16. What are the complications of aortic stenosis?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Months out fibrosis
Contraction band necrosis
MI

17. What is a complication of chronic rheumatic heart disease?
Ischemic heart disease
Infectious endocarditis
Aneurysm - mural thrombus - Dressler syndrome
Mitral insufficiency

18. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Pump failure
Streptococcus bovis/
LHF

19. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Migratory polyarthritis
Colon cancer
Decrease preload -->lowers myocardial stress
Troponin I

20. What is eythema marginatum? What parts of the body does it commonly involve?
Annular - non pruritic rash w/erythematous borders trunks and limbs
IV drug users
Endocarditis of prosthetic valves
Mitral and tricuspid regurg - arrhythmia

21. In which chamber of the heart are rhabdomyomas found?
Months out fibrosis
Ventricle
ST- segment elevation
Maternal diabetes

22. Which coronary artery supplies the posterior wall of the LV and posterior septum?
RCA
Right side - serotonin and other secretory products detoxified in the lung
Troponin I
Janeway lesions

23. What is the most common cause of myocarditis?
ST- segment depression
Squat in response to cyanotic spell
Coxsackie A or B
Paradoxical emboli

24. How does squating decrease hypoxemia in tetralogy of fallot?
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
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
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
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia

25. What is a common complication of cardiac metastasis?
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Pericardial effusion due to pericardial involvement
Nitroglycerin
RHF

26. Which angina is relieved by Ca channel blockers?
Regurg vs stenosis
Nitroglycerin
Prinzmetal
Paradoxical emboli

27. What causes the dependent pitting edema in RHF?
Increased hydrostatic pressure
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Boot shaped heart
Mitral and tricuspid regurg - arrhythmia

28. What is the most common cause of mitral stenosis?
Chronic rheumatic heart disease
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
IV drug users
Tuberous sclerosis

29. What % stenosis causes stable angina?
Prinzmetal angina - cocaine
>70%
4-6 hours - 24 hours - 72 hours
Pedunculated mass in the LA that causes syncope due to obstruction of MV

30. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Chest pain <20 min brought on by exertion or emotional stress
Sudden cardiac death
CK- MB
Boot shaped heart

31. How does contraction band necrosis occur?
S aureus
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Reversible
Boot shaped heart

32. Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - pitting edema.
LAD
>60 years - bicuspid aortic valve
Prophylactic abx during dental procedures
RHF

33. What cardiac enzyme is useful for detecting reinfarction?
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Myofiber hypertrophy with disarray
CK- MB

34. What is the leading cause of death in the US?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Ischemic heart disease
Metastasis
Congested central veins

35. What are the cancers that most commonly metastasize to the heart?
CK- MB
Breast and lung carcinoma - melanoma - lymphoma
Type I
ST- segment depression

36. How do nitrates tx MI?
Aortic stenosis
LHF
CHF
Decrease preload -->lowers myocardial stress

37. What type of shunt does a VSD cause?
L->R
Thickening of chrodae tendinae and cusps - mitral stenosis
Mitral regurg
Transesophageal echo

38. What areas of the heart does the RCA supply?
Kawasaki disease
Paradoxical emboli
Papillary muscle - free wall - IV septum
Posterior wall of LV - posterior septum - papillary muscles

39. How does fibrinolysis/angioplasty tx MI?
Open blocked vessels
Migratory polyarthritis
Myofiber hypertrophy with disarray
Fetal alcohol syndrome

40. What conditions can cause nonbacterial thrombotic endocarditis?
Tuberous sclerosis
Reactive histiocyte with caterpillar nucleus
R-->L
Hypercoagulable state or underlying adenocarcinoma

41. Which congenital heart defect is associated with congenital rubella?
Granulation tissue
LHF
Valve replacement once LV dysfx develops
PDA

42. What causes the split S2 in ASD?
Increased blood in right heart delays closure of P valve
Surgical closure small defects may close spontaneously
Nitroglycerin
ACE inhibitor

43. How does dilated cardiomyopathy cause LHF?
Stretched muscle loses contractility
2-4 hours - 24 hours - 7-10 days
Bicuspid aortic valve
Group A beta - hemolytic streptococci

44. How does asprin/heparin tx MI?
Sterile vegetations on mitral valve along lines of closure
Circumflex
Limits thrombosis
Mitral and tricuspid regurg - arrhythmia

45. What does nonbacterial thrombotic endocarditis cause?
Opening snap followed by diastolic rumble
Reactive histiocyte with caterpillar nucleus
Dense layer of elastic and fibrotic tissue in the endocardium - children
Mitral regurg

46. In which pts does S viridans cause endocarditits?
Mitral regurg
Papillary muscle - free wall - IV septum
SLE
Pts w/previously damaged valves

47. What is the most common form of cardiomyopathy?
Boot shaped heart
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Dilated
Metastasis

48. What are the four defects in tetralogy of fallot?
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Coxsackie A or B
Myocarditis in acute rheumatic heart fever
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery

49. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Months out fibrosis
Coronary artery vasospasm
S epidermidis

50. Is injury due angina reversible or irreversible?
Months out fibrosis
Subendocardial
Reversible
45%