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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 gross and microscopic changes occur 1-3 days after an MI?
Ostium secundum (90%)
Harmartoma
Pump failure
Yellow pallor neutrophils
2. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Mitral regurg
Sudden cardiac death
Adult coarctation of the aorta
Dark discoloration coagulative necrosis
3. What type of vegetations does Strep viridans cause?
Preductal - post aortic arch
Small - nondestructive vegetations (subacute endocarditis)
Infectious endocarditis - arrythmias - severe mitral regurg no
Valve replacement AFTER the onset of complications
4. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Blood vessels coming in from normal tissue
Tricuspid
Aortic regurg
Adult coarctation of the aorta
5. 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
Spontaneous
Streptococcus viridans
Mitral mitral+aortic
6. What areas of the heart does the RCA supply?
Endocarditis of prosthetic valves
Posterior wall of LV - posterior septum - papillary muscles
Preductal - post aortic arch
Breast and lung carcinoma - melanoma - lymphoma
7. How does ischemia cause LHF?
Loss of fx
Shunt
Mid - systolic click followed by regurgitation murmur
Doxorubicin - cocaine
8. What disesase has Aschoff bodies?
S aureus
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Myocarditis in acute rheumatic heart fever
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
9. Is injury due angina reversible or irreversible?
Dense layer of elastic and fibrotic tissue in the endocardium - children
Reversible
Turner syndrome
L->R
10. What is the most common cause of myocarditis?
Coxsackie A or B
Transposition of the great vessels
Colon cancer
Aschoff bodies
11. What congenital heart defect often is present with infantile coarctation of the aorta?
Ehlers - Danlow and Marfan syndrome
Chronic rheumatic heart disease
Mitral regurg
PDA
12. What is the cause of restrictive cardiomyopathy in children?
Left -->right
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
RBC damaged while crossing the calcified valve causing schistocytes
Endocardial fibroelastosis (rare)
13. What is the gold standard blood marker for MI?
Mitral mitral+aortic
Tricuspid
Troponin I
Stretched muscle loses contractility
14. What complications occur within 4 hrs post MI?
Cardiogenic shock - CHF - arrhythmia
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Fetal alcohol syndrome
Transposition of the great vessels
15. What are the major criteria of the Jones criteria?
Slow HR - decreasing O2 demand and risk for arrhythmia
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Metastasis
Louder - increased systemic resistence decreases LV emptying
16. What is cardiogenic shock?
ST- segment depression
Inability to maintain systemic pressure w/lack of O2 to vital organs
Left -->right
Infectious
17. What complications occur 4-7 days post MI?
Circumflex
Intercostal arteries enlarged due to collateral circulation
MI
Rupture of free wall - IV septum - or papillary muscle
18. What is the basic principle of CHF?
LAD
Pump failure
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Cyanosis - RV hypertrophy - polycythemia - clubbing
19. Lower extremity cyanosis in infants? In adults?
Infantile coarctation of the aorta PDA
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Myocarditis in acute rheumatic heart fever
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
20. Which artery is most often occluded in an MI?
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
LAD
Pts w/previously damaged valves
Nonbacterial thrombotic endocarditis (marantic endocarditis)
21. Sudden death in a young athlete.
Systolic ejection click followed by crescendo - decrescendo murmur
Hypertrophic cardiomyopathy
Migratory polyarthritis
Decrease in blood flow to an organ
22. What are other (not atherosclerotic) causes of MI?
Coronary artery vasospasm - emboli - vasculitis
Pts w/previously damaged valves
Turner syndrome
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
23. What creates the immune reaction in acute rhuematic fever?
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24. What causes angina and syncope in aortic stenosis?
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25. What causes mitral valve prolapse?
Mitral and tricuspid regurg - arrhythmia
Myxoid degeneration
R-->L
Degree of pulmonary artery stenosis
26. What type of shunt does transposition of the great vessels cause?
Adult coarctation of the aorta
Transposition of the great vessels
Large vegetations of S aureus
R-->L
27. What is the tx for mitral valve prolapse?
Valve replacement
Annular - non pruritic rash w/erythematous borders trunks and limbs
Myocarditis in acute rheumatic heart fever
Stretched muscle loses contractility
28. What type of endocarditis is associated w/metastatic cancer and wasting conditions?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Chronic rheumatic heart disease
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
4-6 hours - 24 hours - 72 hours
29. What does chronic ischemic heart disease progress to?
CHF
Valve replacement
Regurg vs stenosis
Squatting - increased systemic resistence decreases LV emptying
30. What is the most common congenital heart defect?
White scar fibrosis
Systolic ejection click followed by crescendo - decrescendo murmur
Posterior wall of LV - posterior septum - papillary muscles
VSD
31. What is endocardial fibroelastosis? In what population is it found?
Congested central veins
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Mitral regurgitation due to vegetations
Dense layer of elastic and fibrotic tissue in the endocardium - children
32. In which pts does S viridans cause endocarditits?
Ventricular arrhythmia
Endocardial fibroelastosis
Pts w/previously damaged valves
Stretched muscle loses contractility
33. What is the tx for LHF?
Contraction band necrosis - reperfusion injury
Type I
Stretched muscle loses contractility
ACE inhibitor
34. What effect does chronic rheumatic heart disease have on the aortic valve?
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35. With what congenital heart defect is ADULT coarctation of the aorta associated?
Cyanosis - RV hypertrophy - polycythemia - clubbing
Boot shaped heart
Bicuspid aortic valve
Bounding pulse
36. How does contraction band necrosis occur?
Mitral stenosis
Contraction band necrosis - reperfusion injury
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Posterior wall of LV - posterior septum - papillary muscles
37. What type of valvular vegetations does S aureus cause?
Large - destructive vegetations
Prinzmetal angina
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
LA dilation
38. What are the complications of mitral stenosis?
Coronary artery vasospasm - emboli - vasculitis
Libman - Sacks endocarditis
Backward LHF pulm htn and RHF - afib and associated mural thombis
RHF
39. What is systolic dysfx?
Ventricles cannot pump
Pericarditits
Troponin I
Holosystolic machine like murmur
40. Which angina is relieved by Ca channel blockers?
Months out fibrosis
Prinzmetal
Migratory polyarthritis
Pump failure
41. What is Loeffler syndrome?
1-3 days out
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Kawasaki disease
1-3 days
42. What type of ASD is associated w/Down syndrome?
Mitral mitral+aortic
Pancarditis
RCA
Ostium primum
43. What is migratory polyarthritis?
45%
S aureus
Ostium secundum (90%)
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
44. What type of shunt does ASD cause?
L->R
Left -->right
Endocardial fibroelastosis
Reversible
45. Turner syndrome is associated with which congenital heart defect?
Infantile coarctation of the aorta
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
Bounding pulse
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
46. What is the tx for aortic stenosis?
Colon cancer
Valve replacement AFTER the onset of complications
Cardiogenic shock - CHF - arrhythmia
Degree of pulmonary artery stenosis
47. Opening snap followed by diastolic rumble.
Type I
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Mitral stenosis
Coronary artery vasospasm
48. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
Volume overload and LHF
Breast and lung carcinoma - melanoma - lymphoma
4-7 days macrophage infiltration
Coronary artery vasospasm
49. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Acute inflammation
Stable and unstable prinzmetal
Group A beta - hemolytic streptococci
50. What cardiac enzyme is useful for detecting reinfarction?
Rupture of free wall - IV septum - or papillary muscle
Decrease in blood flow to an organ
Janeway lesions
CK- MB