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. How does hypertension cause LHF?

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

2. 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

3. When do CK- MB levels rise - peak - and return to normal?
Slow HR - decreasing O2 demand and risk for arrhythmia
Red border granulation tissue
4-6 hours - 24 hours - 72 hours
Dilation of all four chambers of the heart

4. Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material.
Boot shaped heart
Loss of LV fx
Aschoff bodies
Months out fibrosis

5. What are the complications that occur months after an MI?
45%
Right to left
Hypercoagulable state or underlying adenocarcinoma
Aneurysm - mural thrombus - Dressler syndrome

6. What is the characteristic murmurr of mitral stenosis?
Pts w/previously damaged valves
Prinzmetal angina
Hypertophy of RV atrophy of LV
Opening snap followed by diastolic rumble

7. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Adult coarctation of the aorta
PDA
Myocardium
S epidermidis

8. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Right to left
Squat in response to cyanotic spell
Aortic regurg
Ventricles cannot pump

9. What is Loeffler syndrome?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
S epidermidis
Dilated
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia

10. What are the sx of PDA at birth?
Blood vessels coming in from normal tissue
ASD - R-->L
Asymptomatic
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy

11. What causes microangiopathic hemolytic anemia in aortic stenosis?
Elevated ASO anti - DNase B titers
RBC damaged while crossing the calcified valve causing schistocytes
Yellow pallor neutrophils
Concentric hypertrophy - can't oxygenate full wall - ischemic damage

12. How does transmural MI/ischemia present on EKG?
ST- segment elevation
LHF
Fibrosis and dystrophic calcification
Spontaneous

13. What type of shunt does ASD cause?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
20 min
Left -->right

14. What type of collagen is involved in fibrosis?
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
Aortic regurg
Type I
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes

15. Which vasculitis can cause MI?
Posterior wall of LV - posterior septum - papillary muscles
Congested central veins
Kawasaki disease
Asymptomatic

16. What valves are involved in rhuematic endocarditis?
Rhadbomyoma - benign
Aschoff bodies
Squatting - increased systemic resistence decreases LV emptying
Mitral mitral+aortic

17. Which angina is relieved by Ca channel blockers?
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
Small vegetations along the line of closure
Prinzmetal
Reversible

18. What does rupture of a papillary muscle cause?
1-3 days
Mitral insufficiency
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Tuberous sclerosis

19. Why would cardiac enzymes continue to increase after the initial MI?
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Reperfusion injury
Rupture of free wall - IV septum - or papillary muscle
Turner syndrome

20. What are Janeway lesions?
Libman - Sacks endocarditis
Erythematous nontender lesions on palms and soles.
Mitral stenosis
Type I

21. What is dilated cardiomyopathy?
Systolic ejection click followed by crescendo - decrescendo murmur
Dilation of all four chambers of the heart
Infectious endocarditis - arrythmias - severe mitral regurg no
Ventricles cannot pump

22. What % of MIs involve the LAD?
45%
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Mitral stenosis
Sterile vegetations on mitral valve along lines of closure

23. What congenital heart defect presents later in life with lower extremity cyanosis?
PDA
Split S2 on auscultation
Squatting - increased systemic resistence decreases LV emptying
Ostium primum

24. Chest pain the arises with exertion or emotional stress and is relieved by NG or rest. The pain lasts <20 min and radiates to the left arm or jaw. There is also diaphoresis and SOB - EKG shows ST- segment depression.
Stable angina
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Increased blood in right heart delays closure of P valve
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery

25. Is scar tissue or myocardium stronger?
Myocardium
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Aschoff bodies
Squatting - increased systemic resistence decreases LV emptying

26. What is the most common primary cardiac tumor in children? Is it malignant or benign?
Stable angina
Minimizes ischemia
RBC damaged while crossing the calcified valve causing schistocytes
Rhadbomyoma - benign

27. What are the causes of restrictive cardiomyopathy in adults?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Paradoxical emboli
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Positive blood cultures anemia of chronic disease

28. Infects predamaged valves after transient bacteremia?
S viridans
Wear and tear
Opening snap followed by diastolic rumble
White scar fibrosis

29. What is the most common cause of dilated cardiomyopathy? What are other causes?
ST- segment depression
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Valve scarring that arises as a consequence of rheumatic fever
Osler nodes (ouch - ouch Osler)

30. What does nonbacterial thrombotic endocarditis cause?
RHF
Infectious
Mitral regurg
RCA

31. Where is the coarctation in infantile coarctation of the aorta?
Squatting - expiration
Day 1-7
Concentric LV hypertophy
Preductal - post aortic arch

32. How do you tx prinzmetal angina?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Infectious endocarditis
Adult coarctation of the aorta
NG or Ca channel blocker

33. What is the most common cause of aortic stenosis?
VSD
Wear and tear
45%
Aneurysm - mural thrombus - Dressler syndrome

34. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
Contraction band necrosis - reperfusion injury
LA dilation
Stable and unstable prinzmetal
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase

35. What type of shunt dose PDA cause?
Red border granulation tissue
Mitral regurg
Left -->right
Decreases LV dilation by decreasing volume

36. When would arrhythmia occur after MI?
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Aortic stenosis
Within the first day

37. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
First 4 hours
Yellow pallor macrophages
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Myxoma - benign

38. What two things happen when a blocked vessel is opened after an MI?
Eisenmenger syndrome
Migratory polyarthritis
Backward LHF pulm htn and RHF - afib and associated mural thombis
Contraction band necrosis - reperfusion injury

39. What drug relieves stable angina?
Aortic regurg
Nitroglycerin
Infectious endocarditis - arrythmias - severe mitral regurg no
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume

40. What is the most common cause of mitral stenosis?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
RCA
Posterior wall of LV - posterior septum - papillary muscles
Chronic rheumatic heart disease

41. What disesase has Aschoff bodies?
Contraction band necrosis - reperfusion injury
4-24 hours
Cardiac tamponade
Myocarditis in acute rheumatic heart fever

42. In which chamber of the heart are cardiac myxomas found?
LA
Aschoff bodies
Mitral regurg
2-3%

43. What type of ischemia does stable angina cause?
Slow HR - decreasing O2 demand and risk for arrhythmia
Subendocardial
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Cardiogenic shock - CHF - arrhythmia

44. What are the sx of hypertrophic cardiomyopathy?
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Cyanosis - RV hypertrophy - polycythemia - clubbing
Shunt
Prinzmetal

45. What are the sx of pericardiits?
Rhadbomyoma - benign
Friction rub and chest pain
Erythematous nontender lesions on palms and soles.
Dressler syndrome

46. What is the most common congenital heart defect?
VSD
PDA
Preductal - post aortic arch
Opening snap followed by diastolic rumble

47. What characterizes acute rheumatic fever endocarditiis?
Heart can't fill
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Small vegetations along the line of closure
Dilated

48. What are the major criteria of the Jones criteria?
Left -->right
Asymptomatic
Kawasaki disease
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea

49. What increases the risk for chronic rheumatic heart disease?
Migratory polyarthritis
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
ST- segment elevation

50. What is the main cause of MV regurg? What are other causes?
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Volume overload and LHF
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia