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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 4-7 days after an MI?
Atherosclerosis of coronary arteries
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Stretched muscle loses contractility
Yellow pallor macrophages
2. What does rupture of the IV septum cause?
Shunt
Streptococcus bovis/
Large vegetations of S aureus
Kawasaki disease
3. What are other (not atherosclerotic) causes of MI?
Coronary artery vasospasm - emboli - vasculitis
Contraction band necrosis
Circumflex
Squatting - expiration
4. What maintains patency of the PDA?
PGE
Membrane damage
Subendocardial
LA dilation
5. What is the 1day-1wk -1mo mneumonic for MI?
Transposition of the great vessels
NG or Ca channel blocker
Libman - Sacks endocarditis
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
6. What bug causes acute rheumatic fever?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Group A beta - hemolytic streptococci
Backward LHF pulm htn and RHF - afib and associated mural thombis
Inability to fill ventricles
7. How do you prevent S viridans endocarditis?
PGE
Shunt
Prophylactic abx during dental procedures
Myocardium
8. Small - sterile fibrin deposits randomly arranged on closure of valve leaflets in a pt w/metastatic colon cancer?
Left -->right
Prinzmetal angina - cocaine
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Mitral regurgitation due to vegetations
9. When does the heart have a yellow pallor post MI?
Bounding pulse
Day 1-7
Myocardium
Prinzmetal stable and unstable
10. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
MI
Months out fibrosis
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
11. How does restrictive cardiomyopathy present?
Congestive heart failure
Within the first day
Infantile coarctation of the aorta PDA
Chronic rheumatic heart disease
12. What is the basic principle of CHF?
Loss of fx
Nitroglycerin
Pump failure
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
13. What compensatory mechanism do tetralogy of fallot pts learn?
Squat in response to cyanotic spell
Rupture of free wall - IV septum - or papillary muscle
Stable angina
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
14. What is the foundation of a scar?
Prophylactic abx during dental procedures
Bacterial endocarditis
Endocarditis of prosthetic valves
Granulation tissue
15. With what developmental disorder is VSD associated?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Fetal alcohol syndrome
2-3%
Granulation tissue
16. Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material.
Aschoff bodies
Months out fibrosis
Asymptomatic
Shunt
17. What are the four defects in tetralogy of fallot?
Ventricular arrhythmia
Dilated
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
18. What is the most common cause of myocarditis?
AD mutation in sarcomere proteins
Eisenmenger syndrome
Coxsackie A or B
Aortic stenosis
19. Sudden death in a young athlete.
Hypertrophic cardiomyopathy
1-3 days out
4-7 days
Fetal alcohol syndrome
20. What creates the immune reaction in acute rhuematic fever?
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21. When would arrhythmia occur after MI?
Libman - Sacks endocarditis
Within the first day
Coronary artery vasospasm
Hemosiderin laden macrophages
22. What does rupture of the LV free wall cause?
Cardiac tamponade
Infantile coarctation of the aorta PDA
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
2-3%
23. What effect does aortic regurg have on the pulse pressure? Why?
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Large vegetations of S aureus
Mitral regurg
24. Which vasculitis can cause MI?
Anterior wall of LV and anterior septum
Blood vessels coming in from normal tissue
Kawasaki disease
Mitral regurg
25. What are the sx of hypertrophic cardiomyopathy?
Posterior wall of LV - posterior septum - papillary muscles
Migratory polyarthritis
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
26. Holosystolic blowing murmur that increases w/expiration?
Hypertrophic cardiomyopathy
Bicuspid aortic valve
Endocardial fibroelastosis
Mitral regurg
27. What effect does mitral stenosis have on the heart chambers?
LA dilation
Sterile vegetations on mitral valve along lines of closure
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
45%
28. What is Dressler syndrome? When does it occur?
Autoimmune pericarditis 6-8 wks post MI
ST- segment depression
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Maternal diabetes
29. What makes the MV prolapse murmur louder? Why?
Large - destructive vegetations
Increased hydrostatic pressure
Squatting - increased systemic resistence decreases LV emptying
Endocardial fibroelastosis
30. What type of ASD is associated w/Down syndrome?
Ostium primum
Hypertrophic cardiomyopathy
S viridans
Doxorubicin - cocaine
31. What is the most common cause of endocarditis in IV drug users?
Yellow pallor macrophages
S aureus
Annular - non pruritic rash w/erythematous borders trunks and limbs
Infectious
32. What heart sound manifest with an ASD?
Cardiac tamponade
Ehlers - Danlow and Marfan syndrome
Split S2 on auscultation
RCA
33. What causes wear and tear aortic stenosis?
Systolic ejection click followed by crescendo - decrescendo murmur
Bacterial endocarditis
Fibrosis and dystrophic calcification
Chest pain <20 min brought on by exertion or emotional stress
34. What characterizes acute rheumatic fever endocarditiis?
Small vegetations along the line of closure
Trisomy 21
Infantile coarctation of the aorta PDA
Positive blood cultures anemia of chronic disease
35. What causes unstable angina?
Anitschow cell
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Dressler syndrome
36. What % stenosis causes stable angina?
Aortic regurg
Valve replacement
>70%
Nitroglycerin
37. At what point in development do congenital heart defects arise?
3-8 wks
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Pump failure
LA dilation
38. Ostium primum ASD is associated with what congenital disorder?
Mitral regurg
Erythematous nontender lesions on palms and soles.
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Trisomy 21
39. What is a water - hammer pulse?
Bounding pulse
LHF
Chronic ischemic heart disease
SLE
40. What causes the nutmeg color in nutmeg liver?
Myocardium
Congested central veins
Stable and unstable prinzmetal
Slow HR - decreasing O2 demand and risk for arrhythmia
41. What are the sx/complications of myocarditis?
Yellow pallor macrophages
ST- segment depression
Limits thrombosis
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
42. What genetic conditions predispose a pt to mitral valve prolapse?
Atria and RV
Anterior wall of LV and anterior septum
Ehlers - Danlow and Marfan syndrome
R-->L
43. Where is the coarctation in infantile coarctation of the aorta?
Reversible
White scar fibrosis
Preductal - post aortic arch
Doxorubicin - cocaine
44. How does Eisenmeger syndrome occur?
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Pts w/previously damaged valves
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
Slow HR - decreasing O2 demand and risk for arrhythmia
45. How does asprin/heparin tx MI?
Limits thrombosis
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Increased blood in right heart delays closure of P valve
Mitral regurgitation due to vegetations
46. What congenital heart defect does indomethacin tx?
PDA
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Within the first day
Harmartoma
47. What are the complications of aortic stenosis?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Libman - Sacks endocarditis
When a bacterial protein resembles a protein in human tissue
Slow HR - decreasing O2 demand and risk for arrhythmia
48. In which chamber of the heart are rhabdomyomas found?
Ventricle
Backward LHF pulm htn and RHF - afib and associated mural thombis
Cyanosis - RV hypertrophy - polycythemia - clubbing
Aschoff bodies
49. What effect does transposition of the great vessels have on the ventricles?
Hypertophy of RV atrophy of LV
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
Ostium secundum (90%)
Cyanosis - RV hypertrophy - polycythemia - clubbing
50. With what endocarditis is S epidermidis associated?
Endocarditis of prosthetic valves
Bounding pulse
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Limits thrombosis