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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 murmur ccan be heard in PDA?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Systemic venous congestion
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Holosystolic machine like murmur
2. What always follows necrosis?
Acute inflammation
Surgical closure small defects may close spontaneously
Coexisting mitral stenosis and fusion of commisures exist
Ischemic heart disease
3. Systolic ejection click followed by crescendo - decrescendo murmur.
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Indomethacin - decreases PGE
Louder - increased systemic resistence decreases LV emptying
Aortic stenosis
4. What are the complications of aortic stenosis?
Chronic ischemic heart disease
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Mitral mitral+aortic
5. What conditions can cause nonbacterial thrombotic endocarditis?
Right -->left
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Hypercoagulable state or underlying adenocarcinoma
20 min
6. 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
Breast and lung carcinoma - melanoma - lymphoma
45%
PGE
7. What vavular defect results from acute rheumatic fever?
Large vegetations of S aureus
3-8 wks
Mitral regurgitation due to vegetations
Intercostal arteries enlarged due to collateral circulation
8. Why would cardiac enzymes continue to increase after the initial MI?
Wear and tear
Tricuspid
Loss of fx
Reperfusion injury
9. Which chambers of the heart are generally spared in an MI?
Myxoid degeneration
Fetal alcohol syndrome
Atria and RV
Hypercoagulable state or underlying adenocarcinoma
10. What is eythema marginatum? What parts of the body does it commonly involve?
Months out fibrosis
Mitral mitral+aortic
Annular - non pruritic rash w/erythematous borders trunks and limbs
PDA
11. How does hypertension cause LHF?
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12. How does stable angina present?
Chest pain <20 min brought on by exertion or emotional stress
Shunt
Bounding pulse
Reactive histiocyte with caterpillar nucleus
13. With what endocarditis is S epidermidis associated?
Decrease preload -->lowers myocardial stress
LAD
Endocarditis of prosthetic valves
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
14. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
Osler nodes (ouch - ouch Osler)
Reperfusion injury
Squatting - expiration
PDA
15. What is molecular mimicry?
Decreased forward perfusion pulmonary congestion
When a bacterial protein resembles a protein in human tissue
Ventricle
Tricuspid
16. What two things cause coronary artery vasospasm?
Prinzmetal angina - cocaine
Stable angina
Atria and RV
Nitroglycerin
17. What causes wear and tear aortic stenosis?
Left -->right
Anterior wall of LV and anterior septum
Prophylactic abx during dental procedures
Fibrosis and dystrophic calcification
18. Holosystolic blowing murmur that increases w/expiration?
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Mitral regurg
Prinzmetal angina
Squatting - increased systemic resistence decreases LV emptying
19. What is the most common cause of dilated cardiomyopathy? What are other causes?
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Cardiogenic shock - CHF - arrhythmia
Reperfusion injury
20. What is the characteristic finding on CXR in tetralogy of fallot?
ST- segment depression
Boot shaped heart
Mitral regurg
Valve replacement
21. What are the Jones criteria?
Stable and unstable prinzmetal
Myocarditis
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
LAD
22. What imaging test is useful for detecting lesions on valves?
Myofiber hypertrophy with disarray
Aschoff bodies
Transesophageal echo
Mitral valve prolapse
23. Sudden death in a young athlete.
RCA
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Tricuspid
Hypertrophic cardiomyopathy
24. What are the major criteria of the Jones criteria?
Hypercoagulable state or underlying adenocarcinoma
Minimizes ischemia
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Eisenmenger syndrome
25. What is the most common cause of infectious endocarditis?
Months out fibrosis
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
Streptococcus viridans
Holosystolic machine like murmur
26. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
Rhabdomyoma
Myocardium
Prinzmetal angina - cocaine
Myxoma - benign
27. If a pt has an endocarditis caused by Streptococcus bovis - what underlying condition should you test for?
Colon cancer
Dark discoloration coagulative necrosis
Pts w/previously damaged valves
Infantile coarctation of the aorta PDA
28. What is the tx for VSD?
Maternal diabetes
R-->L
Surgical closure small defects may close spontaneously
Aortic stenosis
29. Chest pain the arises with exertion or emotional stress and is relieved by NG or rest. The pain lasts <20 min and radiates to the left arm or jaw. There is also diaphoresis and SOB - EKG shows ST- segment depression.
Stable angina
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Minimizes ischemia
Volume overload and LHF
30. What complications occur 4-7 days post MI?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
S viridans
Rupture of free wall - IV septum - or papillary muscle
Papillary muscle - free wall - IV septum
31. How long after pharyngitis does acute rheumatic fever occur?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
2-3 weeks
4-7 days
Aortic regurg
32. What congenital heart defect does indomethacin tx?
>60 years - bicuspid aortic valve
AD mutation in sarcomere proteins
PDA
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
33. What are heart failure cells?
Hemosiderin laden macrophages
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Myxoma - benign
LA dilation
34. Where is the coarctation in infantile coarctation of the aorta?
Rupture of free wall - IV septum - or papillary muscle
Preductal - post aortic arch
White scar fibrosis
Boot shaped heart
35. Pericarditis 6-8 wks post MI.
Dressler syndrome
Gelatinous - abundant ground substance
Hypertrophic cardiomyopathy
S epidermidis
36. What characterizes acute rheumatic fever endocarditiis?
Prinzmetal angina
Small vegetations along the line of closure
Troponin I
S viridans
37. What causes prinzmetal angina?
Coronary artery vasospasm
Shunt
S viridans
Open blocked vessels
38. How do you tx prinzmetal angina?
NG or Ca channel blocker
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Nitroglycerin
Eisenmenger syndrome
39. What type of collagen is involved in fibrosis?
Louder - increased systemic resistence decreases LV emptying
Decrease in blood flow to an organ
Type I
Large - destructive vegetations
40. What complications occur within 4 hrs post MI?
3-8 wks
Decrease in blood flow to an organ
Cardiogenic shock - CHF - arrhythmia
ACE inhibitor
41. How does subendocardial MI/ischemia present on EKG?
Preductal - post aortic arch
Valve replacement once LV dysfx develops
ST- segment depression
VSD
42. What is dilated cardiomyopathy?
Mitral insufficiency
Minimizes ischemia
Anterior wall of LV and anterior septum
Dilation of all four chambers of the heart
43. What are the HACEK organisms? With what condition are they associated?
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
RHF
Mitral insufficiency
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
44. What effect does dilated cardiomyopathy have on the heart?
Anitschow cell
Tricuspid
Reperfusion injury
Systolic dysfx leading to biventricular CHF
45. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Atria and RV
Migratory polyarthritis
Libman - Sacks endocarditis
Group A beta - hemolytic streptococci
46. What are the complications of mitral valve prolapse? Are they common?
Sterile vegetations on mitral valve along lines of closure
Infectious endocarditis - arrythmias - severe mitral regurg no
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Myocarditis
47. What increases the volume of mitral regurg murmur?
Boot shaped heart
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Squatting - expiration
Minimizes ischemia
48. EKG for stable angina?
Backward LHF pulm htn and RHF - afib and associated mural thombis
20 min
ST- segment depression
Small - nondestructive vegetations (subacute endocarditis)
49. With what developmental disorder is VSD associated?
Fetal alcohol syndrome
Inability to maintain systemic pressure w/lack of O2 to vital organs
RHF
S aureus
50. What is the most common valve infected by S aureus?
Tricuspid
Trisomy 21
Dressler syndrome
Stable and unstable prinzmetal