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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. Are most congenital heart defects spontaneous or inherited?
Spontaneous
Aortic regurg
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
Ventricles cannot pump
2. What are the HACEK organisms? With what condition are they associated?
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Reversible
Migratory polyarthritis
S viridans
3. What are other (not atherosclerotic) causes of MI?
Coronary artery vasospasm - emboli - vasculitis
Prophylactic abx during dental procedures
Pulsating nail bed
Atherosclerosis of coronary arteries
4. What is the most common cause of mitral stenosis?
Systolic dysfx leading to biventricular CHF
Chronic rheumatic heart disease
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
ASD - R-->L
5. Infects predamaged valves after transient bacteremia?
S viridans
Systolic ejection click followed by crescendo - decrescendo murmur
ACE inhibitor
RCA
6. How do you tx prinzmetal angina?
Group A beta - hemolytic streptococci
Squat in response to cyanotic spell
NG or Ca channel blocker
Pulsating nail bed
7. What is typically the mechanims of sudden cardiac death?
Ventricular arrhythmia
Subendocardial
Prinzmetal angina - cocaine
Myofiber hypertrophy with disarray
8. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Migratory polyarthritis
PDA
SLE
Erythematous nontender lesions on palms and soles.
9. What is the characteristic murmur of aortic stenosis?
Trisomy 21
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Systolic ejection click followed by crescendo - decrescendo murmur
Dressler syndrome
10. What two things cause coronary artery vasospasm?
Prinzmetal angina - cocaine
Circumflex
L->R
S viridans
11. What is a water - hammer pulse?
Nitroglycerin
Bounding pulse
Chest pain <20 min brought on by exertion or emotional stress
Ischemic heart disease
12. What are the sx of right - to - left shunt?
Regurg vs stenosis
Cyanosis - RV hypertrophy - polycythemia - clubbing
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
13. What is the leading cause of death in the US?
Ischemic heart disease
Reperfusion injury
Thickening of chrodae tendinae and cusps - mitral stenosis
Maternal diabetes
14. Ostium primum ASD is associated with what congenital disorder?
Trisomy 21
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Metastasis
Heart transplant
15. What murmur ccan be heard in PDA?
Increased blood in right heart delays closure of P valve
Within the first day
Pump failure
Holosystolic machine like murmur
16. What are the sx of pericardiits?
S epidermidis
Decrease preload -->lowers myocardial stress
Friction rub and chest pain
AD mutation in sarcomere proteins
17. What are the laboratory findings of bacterial endocarditis?
Myofiber hypertrophy with disarray
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Positive blood cultures anemia of chronic disease
Papillary muscle - free wall - IV septum
18. What causes an early - blowing diastolic murmur?
S aureus
Aortic regurg
Volume overload and LHF
Open blocked vessels
19. How do ACE inhibitors tx MI?
Decreases LV dilation by decreasing volume
Valve scarring that arises as a consequence of rheumatic fever
Valve replacement
Hemosiderin laden macrophages
20. Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia.
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Loeffler syndrome
Chest pain <20 min brought on by exertion or emotional stress
When a bacterial protein resembles a protein in human tissue
21. L- to - R shunt switching to R- to - L shunt.
Eisenmenger syndrome
Months out fibrosis
PDA
Infantile coarctation of the aorta
22. What type of tumor is a rhabdomyoma?
Granulation tissue
Migratory polyarthritis
Mitral stenosis
Harmartoma
23. When is a post - MI pt at highest risk for an aneurysm? With what microscopic change is this complication associated?
Months out fibrosis
Prinzmetal angina
Shunt
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
24. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Myocarditis in acute rheumatic heart fever
Slow HR - decreasing O2 demand and risk for arrhythmia
Sudden cardiac death
Mitral mitral+aortic
25. Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - pitting edema.
Heart can't fill
Stable and unstable prinzmetal
When a bacterial protein resembles a protein in human tissue
RHF
26. What valves are most commonly involved in chronic rheumatic heart disease?
Mitral mitral+aortic
Congested central veins
Holosystolic machine like murmur
Dressler syndrome
27. What are the tx for MI?
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
White scar fibrosis
Reperfusion injury
LV dilation and eccentric hypertrophy
28. What cardiac enzyme is useful for detecting reinfarction?
1%
Right -->left
CK- MB
Coronary artery vasospasm - emboli - vasculitis
29. Which vasculitis can cause MI?
Bicuspid aortic valve
Kawasaki disease
Mitral valve prolapse
Dilation of all four chambers of the heart
30. What causes prinzmetal angina?
Loeffler syndrome
R-->L
Loss of fx
Coronary artery vasospasm
31. What is an important complication of ASD?
Hypertophy of RV atrophy of LV
Paradoxical emboli
Congested central veins
Hypertrophic cardiomyopathy
32. What coronary arterysupplies the lateral wall of the LV?
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Slow HR - decreasing O2 demand and risk for arrhythmia
Hemosiderin laden macrophages
Circumflex
33. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
ASD - R-->L
Dilated
Ostium primum
Chronic ischemic heart disease
34. What are the two effects of ATII?
Prinzmetal
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Blood vessels coming in from normal tissue
CHF
35. How does adult coarctation of the aorta present?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Ventricles cannot pump
Dilation of all four chambers of the heart
36. How does reperfusion injury occur?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Squat in response to cyanotic spell
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Mid - systolic click followed by regurgitation murmur
37. What are the sx of hypertrophic cardiomyopathy?
Libman - Sacks endocarditis
Decrease in blood flow to an organ
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Stable angina
38. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Inability to fill ventricles
Migratory polyarthritis
Posterior wall of LV - posterior septum - papillary muscles
Aortic stenosis
39. What are complications of dilated cardiomyopathy?
Troponin I
Heart can't fill
Mitral and tricuspid regurg - arrhythmia
Nitroglycerin
40. What vavular defect results from acute rheumatic fever?
Fibrinous pericarditis
Mitral regurgitation due to vegetations
Friction rub and chest pain
Boot shaped heart
41. What gross and microscopic changes occur 4-24 hours after an MI?
Myxoid degeneration
Loss of fx
Ostium primum
Dark discoloration coagulative necrosis
42. What causes notching of the ribs in adult coarctation of the aorta?
AD mutation in sarcomere proteins
Intercostal arteries enlarged due to collateral circulation
Gelatinous - abundant ground substance
1-3 days out
43. What is molecular mimicry?
When a bacterial protein resembles a protein in human tissue
Reperfusion injury
Indomethacin - decreases PGE
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
44. What effect does aortic regurg have on the pulse pressure? Why?
1-3 days
Dilated
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Inability to maintain systemic pressure w/lack of O2 to vital organs
45. What areas of the heart does the LAD supply?
RCA
Yellow pallor neutrophils
Anterior wall of LV and anterior septum
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
46. What are the sx of aortic regurg?
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Large vegetations of S aureus
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
AD mutation in sarcomere proteins
47. What effect does chronic rheumatic heart disease have the mitral valve?
Thickening of chrodae tendinae and cusps - mitral stenosis
45%
Myofiber hypertrophy with disarray
Ehlers - Danlow and Marfan syndrome
48. What gross and microscopic changes occur months after an MI?
Dense layer of elastic and fibrotic tissue in the endocardium - children
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
White scar fibrosis
PDA
49. Boot - shaped heart on x- ray?
LAD
20 min
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Tetralogy of fallot
50. What always follows necrosis?
Acute inflammation
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Subendocardial
Stretched muscle loses contractility