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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 type of vegetations are associated with Libman - Sacks endocarditis?
Holosystolic blowing murmur
Sterile vegetations on surface and undersurface on mitral valve
3-8 wks
AD mutation in sarcomere proteins
2. What causes endocarditis of prosthetic valves?
Harmartoma
Loss of fx
S epidermidis
Prophylactic abx during dental procedures
3. What is the most common type of endocarditis?
Infectious endocarditis
Left -->right
RBC damaged while crossing the calcified valve causing schistocytes
Infectious
4. In which chamber of the heart are rhabdomyomas found?
Right side - serotonin and other secretory products detoxified in the lung
Ventricle
Mitral regurgitation due to vegetations
Asymptomatic
5. How does squating decrease hypoxemia in tetralogy of fallot?
Pump failure
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Annular - non pruritic rash w/erythematous borders trunks and limbs
Anterior wall of LV and anterior septum
6. What is the most common valve infected by S aureus?
Endocardial fibroelastosis (rare)
MI
Tricuspid
Annular - non pruritic rash w/erythematous borders trunks and limbs
7. How does fibrinolysis/angioplasty tx MI?
Granulation tissue
Open blocked vessels
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Infectious
8. What iis the tx for aortic regurg?
Metastasis
Positive blood cultures anemia of chronic disease
Fetal alcohol syndrome
Valve replacement once LV dysfx develops
9. What causes unstable angina?
ASD - R-->L
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Decreased forward perfusion pulmonary congestion
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
10. When do troponin levels rise - peak - and return to normal?
2-4 hours - 24 hours - 7-10 days
S viridans
Infantile coarctation of the aorta
Months out fibrosis
11. What is the definition of ischemia?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Stretched muscle loses contractility
Tetralogy of fallot
Decrease in blood flow to an organ
12. Which artery is most often occluded in an MI?
Coronary artery vasospasm
LAD
Hypertrophic cardiomyopathy
Nonbacterial thrombotic endocarditis (marantic endocarditis)
13. Systolic ejection click followed by crescendo - decrescendo murmur.
Aortic stenosis
Dressler syndrome
Decreased forward perfusion pulmonary congestion
Aortic regurg
14. Where is the coarctation in infantile coarctation of the aorta?
Hemosiderin laden macrophages
Intercostal arteries enlarged due to collateral circulation
Preductal - post aortic arch
Pedunculated mass in the LA that causes syncope due to obstruction of MV
15. What heart sound manifest with an ASD?
Streptococcus viridans
PGE
Split S2 on auscultation
Tender lesions on fingers or toes.
16. What is the most common cause of mitral stenosis?
Intercostal arteries enlarged due to collateral circulation
Surgical closure small defects may close spontaneously
Chronic rheumatic heart disease
RCA
17. What always follows necrosis?
Acute inflammation
Loeffler syndrome
RCA
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
18. What are the complications of mitral valve prolapse? Are they common?
Mitral regurg
Prophylactic abx during dental procedures
Breast and lung carcinoma - melanoma - lymphoma
Infectious endocarditis - arrythmias - severe mitral regurg no
19. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Migratory polyarthritis
White scar fibrosis
S viridans
Thickening of chrodae tendinae and cusps - mitral stenosis
20. What is the most common form of cardiomyopathy?
Dilated
RCA
Heart can't fill
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
21. What does a biopsy of hypertrophic cardiomyopathy look like?
Myofiber hypertrophy with disarray
Cyanosis - RV hypertrophy - polycythemia - clubbing
Eisenmenger syndrome
Acute inflammation
22. Is scar tissue or myocardium stronger?
Infectious endocarditis - arrythmias - severe mitral regurg no
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Myocardium
Ventricular arrhythmia
23. EKG for stable angina?
Backward: dyspnea - PND - orthopnea - crackles (pulmonary congestion and edema) - heart failure cells forward: fluid retention due to decreased flow to kidneys leading to activation of RAA
Shunt - PGE to maintain PDA until surgical repair can be performed
Aortic regurg
ST- segment depression
24. What increases the risk for chronic rheumatic heart disease?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Reactive histiocyte with caterpillar nucleus
>70%
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
25. Dense layer of elastic and fibrotic tissue in the endocardium.
Endocardial fibroelastosis
Increased blood in right heart delays closure of P valve
Systolic dysfx leading to biventricular CHF
Shunt
26. What is systolic dysfx?
Infectious endocarditis
Yellow pallor neutrophils
Rhadbomyoma - benign
Ventricles cannot pump
27. What is eythema marginatum? What parts of the body does it commonly involve?
Gelatinous - abundant ground substance
Annular - non pruritic rash w/erythematous borders trunks and limbs
Mid - systolic click followed by regurgitation murmur
Blood vessels coming in from normal tissue
28. What are the laboratory findings of bacterial endocarditis?
First 4 hours
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Spontaneous
Positive blood cultures anemia of chronic disease
29. What does rupture of a papillary muscle cause?
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Nitroglycerin
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Mitral insufficiency
30. Myofiber hypertrophy with disarray.
Infantile coarctation of the aorta
>60 years - bicuspid aortic valve
Backward LHF pulm htn and RHF - afib and associated mural thombis
Hypertrophic cardiomyopathy
31. What does rupture of the IV septum cause?
Large vegetations of S aureus
Shunt
Congested central veins
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
32. What is the most common congenital heart defect?
Migratory polyarthritis
Pedunculated mass in the LA that causes syncope due to obstruction of MV
VSD
Tender lesions on fingers or toes.
33. What is the foundation of a scar?
Friction rub and chest pain
Granulation tissue
Limits thrombosis
Turner syndrome
34. What type of shunt does a VSD cause?
Acute inflammation
Ehlers - Danlow and Marfan syndrome
L->R
Adult coarctation of the aorta
35. L- to - R shunt switching to R- to - L shunt.
Eisenmenger syndrome
Yellow pallor macrophages
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
PDA
36. What compensatory mechanism do tetralogy of fallot pts learn?
ST- segment depression
Hypertophy of RV atrophy of LV
Decreased forward perfusion pulmonary congestion
Squat in response to cyanotic spell
37. What does rupture of the LV free wall cause?
Pericarditits
Tuberous sclerosis
Cardiac tamponade
LA
38. What congenital heart defect is associated with fetal alcohol syndrome?
4-7 days
Increased blood in right heart delays closure of P valve
VSD
Janeway lesions
39. What effect does transposition of the great vessels have on the ventricles?
Sterile vegetations on mitral valve along lines of closure
IV drug users
Hypertophy of RV atrophy of LV
Fibrosis and dystrophic calcification
40. What is dilated cardiomyopathy?
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
Dilation of all four chambers of the heart
Coexisting mitral stenosis and fusion of commisures exist
Pts w/previously damaged valves
41. What gross and microscopic changes occur months after an MI?
4-6 hours - 24 hours - 72 hours
Large vegetations of S aureus
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
White scar fibrosis
42. When is an MI pt at greatest risk for cardiogenic shock?
Pulsating nail bed
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Streptococcus viridans
First 4 hours
43. With what virus is PDA associated?
2-3%
Congenital rubella
Turner syndrome
Hypertrophic cardiomyopathy
44. With what disease is infantile coarctation of the aorta associated?
Turner syndrome
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Nitroglycerin
45. What are the sx of right - to - left shunt?
Coronary artery vasospasm
Limits thrombosis
Cyanosis - RV hypertrophy - polycythemia - clubbing
Mitral regurgitation due to vegetations
46. What are heart failure cells?
Pump failure
Hemosiderin laden macrophages
Restrictive cardiomyopathy
Myocarditis
47. What are the clinical features of endocarditis? What causes each feature?
Squatting - expiration
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
Backward: dyspnea - PND - orthopnea - crackles (pulmonary congestion and edema) - heart failure cells forward: fluid retention due to decreased flow to kidneys leading to activation of RAA
Coxsackie A or B
48. What generally causes ischemic heart disease?
Transposition of the great vessels
Anitschow cell
Loss of fx
Atherosclerosis of coronary arteries
49. Which chambers of the heart are generally spared in an MI?
Atria and RV
Erythematous nontender lesions on palms and soles.
RCA
Ostium secundum (90%)
50. What type of endocarditis is associated with SLE?
Tetralogy of fallot
Myofiber hypertrophy with disarray
AD mutation in sarcomere proteins
Libman - Sacks endocarditis