Test your basic knowledge |

Cardiac

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 the split S2 in ASD?
Pericarditits
Harmartoma
Months out fibrosis
Increased blood in right heart delays closure of P valve

2. How do you tx prinzmetal angina?
NG or Ca channel blocker
Nitroglycerin
Endocarditis of prosthetic valves
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'

3. Reactive histiocyte with slender - wavy 'caterpillar' nucleus.
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Anitschow cell
Metastasis
Kawasaki disease

4. What areas of the heart does the LAD supply?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Anterior wall of LV and anterior septum
Preductal - post aortic arch
ST- segment depression

5. What are the Jones criteria?
Myocarditis
Decrease in blood flow to an organ
2-3 weeks
Evidence of prior group A beta - hemolytic strep plus major and minor criteria

6. What type of shunt results in cyanosis at birth?
ST- segment depression
Right to left
Inability to maintain systemic pressure w/lack of O2 to vital organs
Small vegetations along the line of closure

7. What effect does transposition of the great vessels have on the ventricles?
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Hypertophy of RV atrophy of LV
Mitral stenosis

8. How does aortic regurg affect the heart chambers?
Myxoma - benign
Aschoff bodies
LV dilation and eccentric hypertrophy
Dilated

9. What conditions can cause nonbacterial thrombotic endocarditis?
Membrane damage
Cyanosis - RV hypertrophy - polycythemia - clubbing
Mitral and tricuspid regurg - arrhythmia
Hypercoagulable state or underlying adenocarcinoma

10. What are the causes of restrictive cardiomyopathy in adults?
RCA
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Rupture of free wall - IV septum - or papillary muscle
4-6 hours - 24 hours - 72 hours

11. With what disease is Libman - Sacks endocarditis associated?
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Contraction band necrosis - reperfusion injury
SLE
PDA

12. What tests show prior group A beta - hemolytic strep infection?
Chronic rheumatic heart disease
Wear and tear
Atria and RV
Elevated ASO anti - DNase B titers

13. L- to - R shunt switching to R- to - L shunt.
Eisenmenger syndrome
SLE
Endocardial fibroelastosis (rare)
Libman - Sacks endocarditis

14. What is Loeffler syndrome?
Valve scarring that arises as a consequence of rheumatic fever
Endocardial fibroelastosis
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Infantile coarctation of the aorta PDA

15. What is the most common type of endocarditis?
Stable angina
Infectious
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Positive blood cultures anemia of chronic disease

16. What are heart failure cells?
2-3 weeks
Bicuspid aortic valve
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Hemosiderin laden macrophages

17. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
Myxoma - benign
Membrane damage
Asymptomatic
Streptococcus bovis/

18. When does the heart have a yellow pallor post MI?
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Plump fibroblasts - collagen - blood vessels
Day 1-7
LA

19. When do troponin levels rise - peak - and return to normal?
Pericarditits
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
2-4 hours - 24 hours - 7-10 days
Decreased forward perfusion pulmonary congestion

20. Drug that vasodilates both arteries and veins but mostly veins. Used to decrease preload to heart.
Harmartoma
Group A beta - hemolytic streptococci
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Nitroglycerin

21. What are the sx/complications of myocarditis?
Valve scarring that arises as a consequence of rheumatic fever
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Cardiogenic shock - CHF - arrhythmia
Cyanosis - RV hypertrophy - polycythemia - clubbing

22. What is the most common form of cardiomyopathy?
Reperfusion injury
Dilated
Intercostal arteries enlarged due to collateral circulation
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material

23. What is the most common cause of endocarditis in IV drug users?
Stable angina
>70%
Right -->left
S aureus

24. Friction rub and chest pain.
Systolic dysfx leading to biventricular CHF
Group A beta - hemolytic streptococci
Pericarditits
Valve replacement

25. How does dilated cardiomyopathy cause LHF?
Nonspecific - eg fever and elevated ESR
Holosystolic blowing murmur
Inability to maintain systemic pressure w/lack of O2 to vital organs
Stretched muscle loses contractility

26. What disesase has Aschoff bodies?
4-24 hours
Myocarditis in acute rheumatic heart fever
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Reperfusion injury

27. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
VSD
4-7 days macrophage infiltration
Prinzmetal angina
Preductal - post aortic arch

28. What shunt does tetralogy of fallot produce?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Ostium secundum (90%)
Right -->left
RCA

29. What does rupture of the IV septum cause?
Shunt
Stable angina
White scar fibrosis
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume

30. What % of MIs involve the LAD?
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
PDA
45%
1%

31. What is the classic EKG finding of restrictive cardiomyopathy?
Low voltage EKG w/diminished QRS amplitude
Endocardial fibroelastosis (rare)
Nonspecific - eg fever and elevated ESR
Metastasis

32. What are the sx of pericardiits?
Friction rub and chest pain
VSD
Aneurysm - mural thrombus - Dressler syndrome
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume

33. What is the most comon cause of aortic regurg? What are the other causes?
4-24 hours
Increased blood in right heart delays closure of P valve
Eisenmenger syndrome
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)

34. What effect does chronic rheumatic heart disease have on the aortic valve?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

35. How do beta blockers tx MI?
Congested central veins
Troponin I
Slow HR - decreasing O2 demand and risk for arrhythmia
Prinzmetal angina - cocaine

36. What congenital heart defect does indomethacin tx?
Dressler syndrome
Coronary artery vasospasm - emboli - vasculitis
PDA
Atria and RV

37. What are the clinical features of RHF?
Nonspecific - eg fever and elevated ESR
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Right to left
Nonbacterial thrombotic endocarditis (marantic endocarditis)

38. What are the clinical features of LHF due to?
Decreased forward perfusion pulmonary congestion
Dark discoloration coagulative necrosis
ST- segment depression
Coexisting mitral stenosis and fusion of commisures exist

39. What valves are most commonly involved in chronic rheumatic heart disease?
Heart transplant
Mitral mitral+aortic
Rhadbomyoma - benign
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia

40. What complication occurs 1-3 days post MI?
Aneurysm - mural thrombus - Dressler syndrome
Preductal - post aortic arch
Fibrinous pericarditis
Coexisting mitral stenosis and fusion of commisures exist

41. Vegetations on surface and undersurface of mitral valve.
Heart transplant
Backward LHF pulm htn and RHF - afib and associated mural thombis
Breast and lung carcinoma - melanoma - lymphoma
Libman - Sacks endocarditis

42. What type of vegetations does Strep viridans cause?
Small - nondestructive vegetations (subacute endocarditis)
Sterile vegetations on mitral valve along lines of closure
Breast and lung carcinoma - melanoma - lymphoma
Open blocked vessels

43. What is the major cause of MI?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Infectious endocarditis
RBC damaged while crossing the calcified valve causing schistocytes

44. What two things cause coronary artery vasospasm?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Papillary muscle - free wall - IV septum
Prinzmetal angina - cocaine
Congenital rubella

45. How does fibrinolysis/angioplasty tx MI?
Preductal - post aortic arch
Open blocked vessels
Loeffler syndrome
>70%

46. What coronary arterysupplies the lateral wall of the LV?
Circumflex
Increased hydrostatic pressure
Valve replacement
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD

47. How does MI cause LHF?
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Streptococcus viridans
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Loss of LV fx

48. How does restrictive cardiomyopathy present?
Kawasaki disease
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Myocarditis
Congestive heart failure

49. What type of ASD is associated w/Down syndrome?
Circumflex
Decreases LV dilation by decreasing volume
Loss of LV fx
Ostium primum

50. Myofiber hypertrophy with disarray.
Hypertrophic cardiomyopathy
Pericarditits
Dilated
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty