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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 artery is the 2nd most often occluded in an MI?
PDA
RCA
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
LA dilation
2. Tender lesions on fingers or toes.
Osler nodes (ouch - ouch Osler)
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Systemic venous congestion
Intercostal arteries enlarged due to collateral circulation
3. What congenital heart defect presents later in life with lower extremity cyanosis?
MI
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Limits thrombosis
PDA
4. What type of vegetations form in nonbacterial thrombotic endocarditis?
Sterile vegetations on mitral valve along lines of closure
Dressler syndrome
Tricuspid
Cyanosis - RV hypertrophy - polycythemia - clubbing
5. What are the sx of hypertrophic cardiomyopathy?
Mitral regurg
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Mitral valve prolapse
6. What are the tx for MI?
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Squatting - expiration
Hemosiderin laden macrophages
Trisomy 21
7. What is an important complication of ASD?
Valve replacement AFTER the onset of complications
Tricuspid
Paradoxical emboli
Infectious endocarditis
8. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
Valve scarring that arises as a consequence of rheumatic fever
Prophylactic abx during dental procedures
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Dense layer of elastic and fibrotic tissue in the endocardium - children
9. 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
Reversible
Prinzmetal angina - cocaine
Squatting - expiration
10. Is injury due angina reversible or irreversible?
Reversible
CHF
Endocardial fibroelastosis (rare)
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
11. What is the definition of ischemia?
Decrease in blood flow to an organ
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Cardiogenic shock - CHF - arrhythmia
Tetralogy of fallot
12. When does the heart have a yellow pallor post MI?
LAD
Day 1-7
RBC damaged while crossing the calcified valve causing schistocytes
Reperfusion injury
13. With what condition are rhabdomyomas associated?
Bacterial endocarditis
Tuberous sclerosis
Minimizes ischemia
1-3 days
14. Is scar tissue or myocardium stronger?
Regurg vs stenosis
Aortic stenosis
Myocardium
Acute inflammation
15. What is the murmur of mitral regurg?
Opening snap followed by diastolic rumble
Small - nondestructive vegetations (subacute endocarditis)
Shunt - PGE to maintain PDA until surgical repair can be performed
Holosystolic blowing murmur
16. What endocarditis is commonly found in patients with colon cancer?
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
Streptococcus bovis/
Holosystolic blowing murmur
Concentric LV hypertophy
17. Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material.
LAD
Contraction band necrosis
Aschoff bodies
Dense layer of elastic and fibrotic tissue in the endocardium - children
18. What are the two effects of ATII?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Dense layer of elastic and fibrotic tissue in the endocardium - children
VSD
19. What is the 1day-1wk -1mo mneumonic for MI?
PGE
Months out fibrosis
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
PDA
20. What is the tx for dilated cardiomyopathy?
Mitral regurgitation due to vegetations
Tetralogy of fallot
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
Heart transplant
21. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
ASD - R-->L
PDA
Friction rub and chest pain
Months out fibrosis
22. At what point in development do congenital heart defects arise?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Pancarditis
3-8 wks
Myofiber hypertrophy with disarray
23. What are the causes of restrictive cardiomyopathy in adults?
Red border granulation tissue
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Aneurysm - mural thrombus - Dressler syndrome
Pericardial effusion due to pericardial involvement
24. With what developmental disorder is VSD associated?
Right to left
Thickening of chrodae tendinae and cusps - mitral stenosis
MI
Fetal alcohol syndrome
25. When do troponin levels rise - peak - and return to normal?
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
2-4 hours - 24 hours - 7-10 days
Ventricles cannot pump
Janeway lesions
26. In transposition of the great vessels - What is required for survival? How is this achieved?
4-24 hours
Shunt - PGE to maintain PDA until surgical repair can be performed
Shunt
Myofiber hypertrophy with disarray
27. EKG for stable angina?
Reperfusion injury
Endocardial fibroelastosis
ST- segment depression
Decrease preload -->lowers myocardial stress
28. What drugs can cause dilated cardiomyopathy?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Doxorubicin - cocaine
Mitral and tricuspid regurg - arrhythmia
Turner syndrome
29. What is the most common cause of aortic stenosis?
Wear and tear
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Reactive histiocyte with caterpillar nucleus
30. What are the complications of mitral stenosis?
Red border granulation tissue
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Backward LHF pulm htn and RHF - afib and associated mural thombis
31. What is a water - hammer pulse?
Bounding pulse
RCA
Rhadbomyoma - benign
Colon cancer
32. L- to - R shunt switching to R- to - L shunt.
Trisomy 21
Aortic regurg
Eisenmenger syndrome
Surgical closure small defects may close spontaneously
33. What % stenosis causes stable angina?
>70%
Day 1-7
Infantile coarctation of the aorta
20 min
34. What is eythema marginatum? What parts of the body does it commonly involve?
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Fibrinous pericarditis
Annular - non pruritic rash w/erythematous borders trunks and limbs
Backward LHF pulm htn and RHF - afib and associated mural thombis
35. Turner syndrome is associated with which congenital heart defect?
Mitral mitral+aortic
Infantile coarctation of the aorta
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Adult coarctation of the aorta
36. What is the only Jones criteria that doesn't resolve with time?
Loss of LV fx
Decrease preload -->lowers myocardial stress
Hypertrophic cardiomyopathy
Pancarditis
37. What are the minor critera of the Jones criteria?
2-3 weeks
Degree of pulmonary artery stenosis
When a bacterial protein resembles a protein in human tissue
Nonspecific - eg fever and elevated ESR
38. How long after pharyngitis does acute rheumatic fever occur?
2-3 weeks
Harmartoma
Hemosiderin laden macrophages
Prinzmetal angina - cocaine
39. What are the clinical features of RHF?
Indomethacin - decreases PGE
Valve replacement
Dilation of all four chambers of the heart
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
40. Why would cardiac enzymes continue to increase after the initial MI?
Months out fibrosis
Aschoff bodies
Mitral regurg
Reperfusion injury
41. When is an MI pt at greatest risk for cardiogenic shock?
PDA
First 4 hours
RHF
Holosystolic blowing murmur
42. What does granulation tissue contain?
Plump fibroblasts - collagen - blood vessels
Minimizes ischemia
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
43. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
Stretched muscle loses contractility
Congestive heart failure
Transposition of the great vessels
Reperfusion injury
44. What effect does aortic stenosis have on the chambers of the heart?
Concentric LV hypertophy
Prinzmetal angina
Ventricle
Boot shaped heart
45. What areas of the heart does the RCA supply?
Nonspecific - eg fever and elevated ESR
SLE
Posterior wall of LV - posterior septum - papillary muscles
Thickening of chrodae tendinae and cusps - mitral stenosis
46. How does hypertension cause LHF?
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47. What is the characteristic murmurr of mitral stenosis?
Opening snap followed by diastolic rumble
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Contraction band necrosis
Nitroglycerin
48. When do macrophagess infiltrate the myocardium post MI?
Transesophageal echo
Nitroglycerin
Breast and lung carcinoma - melanoma - lymphoma
4-7 days
49. What is migratory polyarthritis?
Infectious endocarditis
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Contraction band necrosis
Prinzmetal
50. How do you prevent S viridans endocarditis?
IV drug users
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Prophylactic abx during dental procedures
Inability to maintain systemic pressure w/lack of O2 to vital organs