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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 is the gross and microscopic appearance of cardiac myxomas?
Prinzmetal
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
Gelatinous - abundant ground substance
Pericardial effusion due to pericardial involvement
2. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Aortic regurg
Valve replacement AFTER the onset of complications
Indomethacin - decreases PGE
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
3. What type of shunt does ASD cause?
Left -->right
Maternal diabetes
Preductal - post aortic arch
Systemic venous congestion
4. What are the complications of mitral valve prolapse? Are they common?
Loss of fx
Within the first day
Infectious endocarditis - arrythmias - severe mitral regurg no
Congested central veins
5. What cardiac enzyme is useful for detecting reinfarction?
Sterile vegetations on mitral valve along lines of closure
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Autoimmune pericarditis 6-8 wks post MI
CK- MB
6. What murmur ccan be heard in PDA?
Regurg vs stenosis
Rhadbomyoma - benign
Holosystolic machine like murmur
First 4 hours
7. What is eythema marginatum? What parts of the body does it commonly involve?
Sterile vegetations on surface and undersurface on mitral valve
Annular - non pruritic rash w/erythematous borders trunks and limbs
CHF
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
8. In which chamber of the heart are cardiac myxomas found?
Blood vessels coming in from normal tissue
Subendocardial
LA
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
9. What is endocardial fibroelastosis? In what population is it found?
Dense layer of elastic and fibrotic tissue in the endocardium - children
Infectious endocarditis - arrythmias - severe mitral regurg no
Doxorubicin - cocaine
1%
10. What type of endocarditis is associated w/metastatic cancer and wasting conditions?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
1-3 days out
Loss of fx
11. What gross and microscopic changes occur 4-7 days after an MI?
ACE inhibitor
Yellow pallor macrophages
Anterior wall of LV and anterior septum
Mitral regurg
12. When does the heart have a yellow pallor post MI?
Indomethacin - decreases PGE
Nitroglycerin
Day 1-7
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
13. What is the rate of congenital heart defects?
Prinzmetal stable and unstable
Hypertrophic cardiomyopathy
1%
Sterile vegetations on surface and undersurface on mitral valve
14. What type of collagen is involved in fibrosis?
Mitral valve prolapse
Type I
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Paradoxical emboli
15. Dilated cardiomyopathy is a late complication of what illness?
Myocarditis
Hypercoagulable state or underlying adenocarcinoma
Backward LHF pulm htn and RHF - afib and associated mural thombis
4-7 days macrophage infiltration
16. What is the rate of mitral valve prolapse in the US?
2-3%
Pts w/previously damaged valves
Increased blood in right heart delays closure of P valve
Squat in response to cyanotic spell
17. When would arrhythmia occur after MI?
Within the first day
Bounding pulse
Wear and tear
Ostium primum
18. What is the characteristic murmurr of mitral stenosis?
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Intercostal arteries enlarged due to collateral circulation
Fibrinous pericarditis
Opening snap followed by diastolic rumble
19. What artery is the 2nd most often occluded in an MI?
Hypercoagulable state or underlying adenocarcinoma
Squat in response to cyanotic spell
Shunt
RCA
20. What is diastolic dysfx?
Osler nodes (ouch - ouch Osler)
Atherosclerosis of coronary arteries
Maternal diabetes
Inability to fill ventricles
21. What are the clinical features of RHF?
Shunt - PGE to maintain PDA until surgical repair can be performed
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Mitral stenosis
22. L- to - R shunt switching to R- to - L shunt.
Mitral and tricuspid regurg - arrhythmia
Tetralogy of fallot
Eisenmenger syndrome
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
23. Holosystolic blowing murmur that increases w/expiration?
Day 1-7
Group A beta - hemolytic streptococci
Aortic regurg
Mitral regurg
24. What are heart failure cells?
Mitral stenosis
R-->L
Hemosiderin laden macrophages
When a bacterial protein resembles a protein in human tissue
25. How does adult coarctation of the aorta present?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
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
Myofiber hypertrophy with disarray
Gelatinous - abundant ground substance
26. What shunt does tetralogy of fallot produce?
Systolic dysfx leading to biventricular CHF
Right -->left
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Tuberous sclerosis
27. What iis the tx for aortic regurg?
Systolic ejection click followed by crescendo - decrescendo murmur
Valve replacement once LV dysfx develops
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Aortic regurg
28. What gross and microscopic changes occur 4-24 hours after an MI?
Myofiber hypertrophy with disarray
Heart transplant
Right -->left
Dark discoloration coagulative necrosis
29. What congenital heart defect presents later in life with lower extremity cyanosis?
Mid - systolic click followed by regurgitation murmur
PDA
Increased hydrostatic pressure
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
30. What causes prinzmetal angina?
Pancarditis
Coronary artery vasospasm
Gelatinous - abundant ground substance
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
31. Opening snap followed by diastolic rumble.
IV drug users
Mitral mitral+aortic
Chest pain <20 min brought on by exertion or emotional stress
Mitral stenosis
32. What is Dressler syndrome? When does it occur?
>70%
Autoimmune pericarditis 6-8 wks post MI
Mitral regurg
Prinzmetal angina - cocaine
33. How does MI cause LHF?
Loss of LV fx
45%
Rhadbomyoma - benign
RBC damaged while crossing the calcified valve causing schistocytes
34. What type of valvular vegetations does S aureus cause?
Maternal diabetes
Large - destructive vegetations
Inability to fill ventricles
Coxsackie A or B
35. What makes the MV prolapse murmur louder? Why?
LA dilation
Squatting - increased systemic resistence decreases LV emptying
Prinzmetal
Annular - non pruritic rash w/erythematous borders trunks and limbs
36. What coronary artery supplies the mitral valve papillary muscles?
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Anitschow cell
RCA
PDA
37. In which pts does S viridans cause endocarditits?
Pts w/previously damaged valves
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Loeffler syndrome
Sterile vegetations on mitral valve along lines of closure
38. Why would cardiac enzymes continue to increase after the initial MI?
Reperfusion injury
Positive blood cultures anemia of chronic disease
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Prophylactic abx during dental procedures
39. EKG for stable angina?
PGE
Paradoxical emboli
ST- segment depression
RCA
40. What % of MIs involve the LAD?
SLE
45%
Pts w/previously damaged valves
Cardiogenic shock - CHF - arrhythmia
41. What endocarditis is commonly found in patients with colon cancer?
Myocarditis in acute rheumatic heart fever
Prinzmetal stable and unstable
LAD
Streptococcus bovis/
42. Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils.
Infectious endocarditis - arrythmias - severe mitral regurg no
Contraction band necrosis
1-3 days
Nitroglycerin
43. Fever - murmur - Janeway lesions - Osler nodes - splinter hemorrhages - anemia of chronic disease?
First 4 hours
Bacterial endocarditis
Dense layer of elastic and fibrotic tissue in the endocardium - children
4-7 days macrophage infiltration
44. With what virus is PDA associated?
PDA
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Squatting - increased systemic resistence decreases LV emptying
Congenital rubella
45. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Stable and unstable prinzmetal
Myocarditis in acute rheumatic heart fever
Tender lesions on fingers or toes.
Migratory polyarthritis
46. What does rupture of a papillary muscle cause?
Mitral insufficiency
Wear and tear
Contraction band necrosis
Metastasis
47. Ostium primum ASD is associated with what congenital disorder?
Endocardial fibroelastosis (rare)
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Trisomy 21
Pulsating nail bed
48. What is an Anitschow cell?
Valve scarring that arises as a consequence of rheumatic fever
Reactive histiocyte with caterpillar nucleus
Myofiber hypertrophy with disarray
Limits thrombosis
49. What causes an early - blowing diastolic murmur?
R-->L
S aureus
Adult coarctation of the aorta
Aortic regurg
50. What causes mitral valve prolapse?
Mitral and tricuspid regurg - arrhythmia
Myxoid degeneration
Red border granulation tissue
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