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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 causes an early - blowing diastolic murmur?
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
First 4 hours
Aortic regurg
Shunt - PGE to maintain PDA until surgical repair can be performed
2. Which chambers of the heart are generally spared in an MI?
Infantile coarctation of the aorta
Atria and RV
Dilation of all four chambers of the heart
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
3. What causes the split S2 in ASD?
Reversible
Increased blood in right heart delays closure of P valve
Decreased forward perfusion pulmonary congestion
VSD
4. What is the only Jones criteria that doesn't resolve with time?
Valve replacement
PDA
Decreased forward perfusion pulmonary congestion
Pancarditis
5. What does nonbacterial thrombotic endocarditis cause?
Libman - Sacks endocarditis
Mitral regurg
CHF
Shunt
6. What is the tx for mitral valve prolapse?
Valve replacement
Slow HR - decreasing O2 demand and risk for arrhythmia
Maternal diabetes
Ischemic heart disease
7. What causes heart failure cells?
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Months out fibrosis
Decreases LV dilation by decreasing volume
Indomethacin - decreases PGE
8. What are the clinical features of RHF?
Rhabdomyoma
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
9. Fever - murmur - Janeway lesions - Osler nodes - splinter hemorrhages - anemia of chronic disease?
Bacterial endocarditis
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Aortic regurg
10. What cardiac disease is associated with tuberous sclerosis?
Endocardial fibroelastosis
Dressler syndrome
Rhabdomyoma
Endocardial fibroelastosis (rare)
11. What gross and microscopic changes occur 1-3 days after an MI?
Boot shaped heart
Yellow pallor neutrophils
Ehlers - Danlow and Marfan syndrome
R-->L
12. What endocarditis is commonly found in patients with colon cancer?
Myocarditis
Streptococcus bovis/
Myocarditis
Limits thrombosis
13. What is the characteristic murmur of aortic stenosis?
PDA
Systolic ejection click followed by crescendo - decrescendo murmur
Myxoma - benign
Infectious endocarditis - arrythmias - severe mitral regurg no
14. With what disease is infantile coarctation of the aorta associated?
VSD
Mitral insufficiency
Shunt
Turner syndrome
15. What coronary arterysupplies the lateral wall of the LV?
Circumflex
Atria and RV
Prinzmetal angina
Thickening of chrodae tendinae and cusps - mitral stenosis
16. With what disease is Libman - Sacks endocarditis associated?
Mitral stenosis
SLE
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Anterior wall of LV and anterior septum
17. What type of shunt results in cyanosis at birth?
Prophylactic abx during dental procedures
Blood vessels coming in from normal tissue
Right to left
4-7 days macrophage infiltration
18. What effect does squatting have on the murmur of mitral valve prolapse? Why?
Autoimmune pericarditis 6-8 wks post MI
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Louder - increased systemic resistence decreases LV emptying
19. When do macrophagess infiltrate the myocardium post MI?
Shunt
Libman - Sacks endocarditis
Yellow pallor macrophages
4-7 days
20. What gross and microscopic changes occur months after an MI?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
White scar fibrosis
Surgical closure small defects may close spontaneously
Open blocked vessels
21. What gross and microscopic changes occur 1-3 weeks after an MI?
Pts w/previously damaged valves
Red border granulation tissue
Rupture of free wall - IV septum - or papillary muscle
Heart transplant
22. What is the definition of ischemia?
2-3 weeks
Squatting - increased systemic resistence decreases LV emptying
Rhabdomyoma
Decrease in blood flow to an organ
23. What congenital heart defect presents later in life with lower extremity cyanosis?
Bounding pulse
PDA
Small vegetations along the line of closure
Pancarditis
24. Which vasculitis can cause MI?
Coronary artery vasospasm
Ventricle
Osler nodes (ouch - ouch Osler)
Kawasaki disease
25. How does hypertension cause LHF?
26. What does rupture of a papillary muscle cause?
Mitral insufficiency
Paradoxical emboli
Janeway lesions
Prinzmetal
27. Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils.
Dilation of all four chambers of the heart
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Contraction band necrosis
28. What is the most common cause of death during the acute phase of rheumatic fever?
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Myocarditis
Aschoff bodies
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
29. Opening snap followed by diastolic rumble.
Fibrosis and dystrophic calcification
Inability to maintain systemic pressure w/lack of O2 to vital organs
Small vegetations along the line of closure
Mitral stenosis
30. What is the tx for VSD?
R-->L
Indomethacin - decreases PGE
Surgical closure small defects may close spontaneously
Erythematous nontender lesions on palms and soles.
31. When is a post - MI pt at highest risk for an aneurysm? With what microscopic change is this complication associated?
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
LAD
Chronic rheumatic heart disease
Months out fibrosis
32. What valves are involved in rhuematic endocarditis?
Mitral mitral+aortic
R-->L
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Systemic venous congestion
33. At What age does wear and tear aortic stenosis present? What congenital disease hastens the onset?
Restrictive cardiomyopathy
Atherosclerosis of coronary arteries
>60 years - bicuspid aortic valve
LV dilation and eccentric hypertrophy
34. What type of ASD is associated w/Down syndrome?
S viridans
Reactive histiocyte with caterpillar nucleus
Thickening of chrodae tendinae and cusps - mitral stenosis
Ostium primum
35. Which congenital heart defect is associated with maternal diabetes?
Mitral regurgitation due to vegetations
Limits thrombosis
Transposition of the great vessels
Inability to maintain systemic pressure w/lack of O2 to vital organs
36. What complications occur within 4 hrs post MI?
Reactive histiocyte with caterpillar nucleus
Cardiogenic shock - CHF - arrhythmia
ACE inhibitor
4-6 hours - 24 hours - 72 hours
37. What does rupture of the IV septum cause?
Harmartoma
Shunt
L->R
Valve replacement
38. Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material.
Ostium primum
Harmartoma
4-6 hours - 24 hours - 72 hours
Aschoff bodies
39. Friction rub and chest pain.
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Dressler syndrome
1-3 days out
Pericarditits
40. What is the cause of the red border around granulation tissue?
Plump fibroblasts - collagen - blood vessels
Blood vessels coming in from normal tissue
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Coxsackie A or B
41. Ostium primum ASD is associated with what congenital disorder?
Trisomy 21
Infantile coarctation of the aorta
45%
Backward LHF pulm htn and RHF - afib and associated mural thombis
42. Is scar tissue or myocardium stronger?
When a bacterial protein resembles a protein in human tissue
Tetralogy of fallot
Infantile coarctation of the aorta PDA
Myocardium
43. What is the most common cause of mitral stenosis?
Chronic rheumatic heart disease
CHF
Blood vessels coming in from normal tissue
S viridans
44. When is an MI pt at greatest risk for cardiogenic shock?
Group A beta - hemolytic streptococci
Aortic regurg
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
First 4 hours
45. What conditions can cause nonbacterial thrombotic endocarditis?
Hypertrophic cardiomyopathy
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
Rhabdomyoma
Hypercoagulable state or underlying adenocarcinoma
46. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
ST- segment depression
White scar fibrosis
Months out fibrosis
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
47. When does the heart have dark discoloration post MI?
4-6 hours - 24 hours - 72 hours
Pts w/previously damaged valves
Gelatinous - abundant ground substance
4-24 hours
48. What causes unstable angina?
>70%
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
CK- MB
ST- segment elevation
49. What does rupture of the LV free wall cause?
Nonspecific - eg fever and elevated ESR
Prinzmetal stable and unstable
Cardiac tamponade
First 4 hours
50. What increases the volume of mitral regurg murmur?
Holosystolic machine like murmur
Streptococcus bovis/
Squatting - expiration
LV dilation and eccentric hypertrophy