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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. When is an MI patent at highest risk for fibrionous pericarditis?
1-3 days out
Streptococcus bovis/
Hemosiderin laden macrophages
Restrictive cardiomyopathy
2. What is the most common cause of RHF? What are others?
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Louder - increased systemic resistence decreases LV emptying
L->R
Spontaneous
3. What are the complications of mitral stenosis?
Transposition of the great vessels
Backward LHF pulm htn and RHF - afib and associated mural thombis
Preductal - post aortic arch
Coronary artery vasospasm
4. What artery is the 2nd most often occluded in an MI?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Ostium secundum (90%)
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
RCA
5. What typically causes hypertrophic cardiomyopathy?
AD mutation in sarcomere proteins
Opening snap followed by diastolic rumble
Wear and tear
Prophylactic abx during dental procedures
6. What effect does aortic stenosis have on the chambers of the heart?
Months out fibrosis
Concentric LV hypertophy
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Stable and unstable prinzmetal
7. Which coronary artery supplies the anterior wall and anterior septum?
Low voltage EKG w/diminished QRS amplitude
Reperfusion injury
Infantile coarctation of the aorta PDA
LAD
8. What murmur ccan be heard in PDA?
Posterior wall of LV - posterior septum - papillary muscles
Holosystolic machine like murmur
Atria and RV
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
9. What distinguishes stenosis caused by chronic rheumatic heart disease from wear and tear aortic stenosis?
Posterior wall of LV - posterior septum - papillary muscles
Valve replacement once LV dysfx develops
Hypertrophic cardiomyopathy
Coexisting mitral stenosis and fusion of commisures exist
10. What does granulation tissue contain?
Plump fibroblasts - collagen - blood vessels
Prinzmetal
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Membrane damage
11. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Aortic regurg
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
ST- segment elevation
12. What causes prinzmetal angina?
Hypertrophic cardiomyopathy
Coronary artery vasospasm
LA dilation
First 4 hours
13. Why would cardiac enzymes continue to increase after the initial MI?
Volume overload and LHF
Reperfusion injury
Congestive heart failure
Ventricle
14. What are the sx of pericardiits?
Friction rub and chest pain
Pericardial effusion due to pericardial involvement
Rhadbomyoma - benign
Maternal diabetes
15. What is the JOneS mneumonic?
Decreases LV dilation by decreasing volume
Cardiogenic shock - CHF - arrhythmia
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
Months out fibrosis
16. What disesase has Aschoff bodies?
Nitroglycerin
Shunt
Myocarditis in acute rheumatic heart fever
4-7 days
17. With what congenital heart defect is ADULT coarctation of the aorta associated?
Ventricle
Bicuspid aortic valve
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Yellow pallor macrophages
18. What is the most common congenital heart defect?
Rhabdomyoma
VSD
Positive blood cultures anemia of chronic disease
Within the first day
19. How does asprin/heparin tx MI?
S aureus
Limits thrombosis
Gelatinous - abundant ground substance
Wear and tear
20. What is the basic principle of CHF?
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Pump failure
Asymptomatic
Maternal diabetes
21. What type of vegetations are associated with Libman - Sacks endocarditis?
Sterile vegetations on surface and undersurface on mitral valve
Right to left
Left to right shunt causes increased flow thru pulm circulation which results in hypertrophy of pulm vessels and pulm htn - increased pulm resistance results in reveral of shunt
Endocardial fibroelastosis (rare)
22. When would arrhythmia occur after MI?
Within the first day
Louder - increased systemic resistence decreases LV emptying
PDA
Trisomy 21
23. In which chamber of the heart are cardiac myxomas found?
Decrease in blood flow to an organ
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
S aureus
LA
24. What complications occur within 4 hrs post MI?
Osler nodes (ouch - ouch Osler)
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Cardiogenic shock - CHF - arrhythmia
Tuberous sclerosis
25. What type of tumor is a rhabdomyoma?
Harmartoma
>70%
Libman - Sacks endocarditis
Nonbacterial thrombotic endocarditis (marantic endocarditis)
26. What does rupture of the LV free wall cause?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Cardiac tamponade
Mitral valve prolapse
27. What are the two effects of ATII?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Pericardial effusion due to pericardial involvement
Stable angina
LHF
28. What causes the dependent pitting edema in RHF?
Increased hydrostatic pressure
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Nonspecific - eg fever and elevated ESR
29. What % of MIs involve the LAD?
Indomethacin - decreases PGE
Rhadbomyoma - benign
45%
Endocardial fibroelastosis
30. When is a post - MI pt at highest risk for an aneurysm? With what microscopic change is this complication associated?
Eisenmenger syndrome
Inability to fill ventricles
Ehlers - Danlow and Marfan syndrome
Months out fibrosis
31. What structures are susceptible to rupture post MI?
RCA
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Papillary muscle - free wall - IV septum
ST- segment elevation
32. What is an Anitschow cell?
Prinzmetal
Reactive histiocyte with caterpillar nucleus
4-6 hours - 24 hours - 72 hours
Chest pain <20 min brought on by exertion or emotional stress
33. Tender lesions on fingers or toes.
S epidermidis
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Osler nodes (ouch - ouch Osler)
Pedunculated mass in the LA that causes syncope due to obstruction of MV
34. With what endocarditis is S epidermidis associated?
CHF
Endocarditis of prosthetic valves
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Trisomy 21
35. Myofiber hypertrophy with disarray.
Fetal alcohol syndrome
4-7 days macrophage infiltration
Hypertrophic cardiomyopathy
Limits thrombosis
36. What are the complications that occur months after an MI?
Prinzmetal
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Shunt
Aneurysm - mural thrombus - Dressler syndrome
37. What effect does squatting have on the murmur of mitral valve prolapse? Why?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Dressler syndrome
Louder - increased systemic resistence decreases LV emptying
Heart can't fill
38. What does chronic ischemic heart disease progress to?
Loeffler syndrome
Acute inflammation
CHF
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
39. When does the heart have dark discoloration post MI?
4-24 hours
1-3 days
Ventricles cannot pump
Anterior wall of LV and anterior septum
40. Erythematous nontender lesions on palms and soles.
Janeway lesions
ASD - R-->L
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Autoimmune pericarditis 6-8 wks post MI
41. What congenital heart defect does indomethacin tx?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Hypertophy of RV atrophy of LV
PDA
Anitschow cell
42. What compensatory mechanism do tetralogy of fallot pts learn?
Squat in response to cyanotic spell
2-3 weeks
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
>60 years - bicuspid aortic valve
43. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
Fetal alcohol syndrome
4-7 days macrophage infiltration
Tuberous sclerosis
Ehlers - Danlow and Marfan syndrome
44. What does rupture of the IV septum cause?
R-->L
Right to left
Colon cancer
Shunt
45. What effect does aortic regurg have on the pulse pressure? Why?
Left to right shunt causes increased flow thru pulm circulation which results in hypertrophy of pulm vessels and pulm htn - increased pulm resistance results in reveral of shunt
Pericarditits
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Decrease in blood flow to an organ
46. What are the Jones criteria?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Heart can't fill
Wear and tear
Congestive heart failure
47. How do you prevent S viridans endocarditis?
RHF
Prophylactic abx during dental procedures
Cyanosis - RV hypertrophy - polycythemia - clubbing
Holosystolic blowing murmur
48. What type of collagen is involved in fibrosis?
Decreases LV dilation by decreasing volume
Pulsating nail bed
>70%
Type I
49. What are Janeway lesions?
Erythematous nontender lesions on palms and soles.
Myofiber hypertrophy with disarray
Acute inflammation
CK- MB
50. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Sterile vegetations on surface and undersurface on mitral valve
Left to right shunt causes increased flow thru pulm circulation which results in hypertrophy of pulm vessels and pulm htn - increased pulm resistance results in reveral of shunt
Annular - non pruritic rash w/erythematous borders trunks and limbs
LHF