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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 is the most common cause of death during the acute phase of rheumatic fever?
LA
Large - destructive vegetations
Myocarditis
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
2. Dilated cardiomyopathy is a late complication of what illness?
Membrane damage
Myocarditis
Systolic ejection click followed by crescendo - decrescendo murmur
ASD - R-->L
3. Why would cardiac enzymes continue to increase after the initial MI?
4-7 days
Reperfusion injury
Loeffler syndrome
Restrictive cardiomyopathy
4. What are the sx of PDA at birth?
Asymptomatic
Nitroglycerin
Reperfusion injury
RBC damaged while crossing the calcified valve causing schistocytes
5. What always follows necrosis?
Contraction band necrosis
Acute inflammation
Dilated
4-7 days
6. What effect does squatting have on the murmur of mitral valve prolapse? Why?
PDA
Systemic venous congestion
Group A beta - hemolytic streptococci
Louder - increased systemic resistence decreases LV emptying
7. What type of endocarditis is associated with SLE?
Libman - Sacks endocarditis
Mitral and tricuspid regurg - arrhythmia
LAD
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
8. What two things cause coronary artery vasospasm?
Mitral regurg
Intercostal arteries enlarged due to collateral circulation
Prinzmetal angina - cocaine
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
9. What characterizes acute rheumatic fever endocarditiis?
Small vegetations along the line of closure
Decrease preload -->lowers myocardial stress
When a bacterial protein resembles a protein in human tissue
Fibrinous pericarditis
10. What is the foundation of a scar?
Granulation tissue
Tuberous sclerosis
Regurg vs stenosis
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
11. When would arrhythmia occur after MI?
Squatting - increased systemic resistence decreases LV emptying
45%
Within the first day
Heart can't fill
12. What complications occur 4-7 days post MI?
Spontaneous
Rupture of free wall - IV septum - or papillary muscle
Libman - Sacks endocarditis
Valve replacement AFTER the onset of complications
13. What is the tx for mitral valve prolapse?
Pancarditis
Hypertrophic cardiomyopathy
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Valve replacement
14. Pericarditis 6-8 wks post MI.
RBC damaged while crossing the calcified valve causing schistocytes
Day 1-7
Dressler syndrome
Friction rub and chest pain
15. What gross and microscopic changes occur 4-7 days after an MI?
Ventricular arrhythmia
Friction rub and chest pain
Yellow pallor macrophages
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
16. What increases the volume of mitral regurg murmur?
Sterile vegetations on mitral valve along lines of closure
Squatting - expiration
Decreases LV dilation by decreasing volume
Backward LHF pulm htn and RHF - afib and associated mural thombis
17. What does chronic ischemic heart disease progress to?
Prinzmetal angina
Troponin I
CHF
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
18. What is the most comon cause of aortic regurg? What are the other causes?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Ehlers - Danlow and Marfan syndrome
Anterior wall of LV and anterior septum
Small - nondestructive vegetations (subacute endocarditis)
19. L- to - R shunt switching to R- to - L shunt.
Eisenmenger syndrome
Contraction band necrosis - reperfusion injury
Reperfusion injury
Systolic dysfx leading to biventricular CHF
20. When do CK- MB levels rise - peak - and return to normal?
Dressler syndrome
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
4-6 hours - 24 hours - 72 hours
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
21. What artery is the 2nd most often occluded in an MI?
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
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
RCA
22. How does aortic regurg affect the heart chambers?
RBC damaged while crossing the calcified valve causing schistocytes
Coronary artery vasospasm - emboli - vasculitis
LV dilation and eccentric hypertrophy
Small - nondestructive vegetations (subacute endocarditis)
23. How does transmural MI/ischemia present on EKG?
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
ST- segment elevation
Day 1-7
Decreased forward perfusion pulmonary congestion
24. What does granulation tissue contain?
Harmartoma
Plump fibroblasts - collagen - blood vessels
2-4 hours - 24 hours - 7-10 days
IV drug users
25. What creates the immune reaction in acute rhuematic fever?
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26. What is the tx for LHF?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
ACE inhibitor
Myocarditis
ST- segment depression
27. What type of ASD is associated w/Down syndrome?
RCA
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Ostium primum
Eisenmenger syndrome
28. What are the complications of aortic stenosis?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Congestive heart failure
LV dilation and eccentric hypertrophy
S aureus
29. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Louder - increased systemic resistence decreases LV emptying
Sudden cardiac death
Infantile coarctation of the aorta
30. What are the complications of mitral stenosis?
Endocardial fibroelastosis (rare)
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Backward LHF pulm htn and RHF - afib and associated mural thombis
4-7 days macrophage infiltration
31. What causes mitral valve prolapse?
Myxoid degeneration
Large vegetations of S aureus
Osler nodes (ouch - ouch Osler)
When a bacterial protein resembles a protein in human tissue
32. What is the characteristic finding on CXR in tetralogy of fallot?
Boot shaped heart
Tender lesions on fingers or toes.
Hypertrophic cardiomyopathy
Mitral stenosis
33. What is the definition of ischemia?
AD mutation in sarcomere proteins
Reperfusion injury
Decrease in blood flow to an organ
Coronary artery vasospasm
34. What complication occurs 1-3 days post MI?
Left -->right
Fibrinous pericarditis
PDA
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
35. What is the most common cause of RHF? What are others?
Posterior wall of LV - posterior septum - papillary muscles
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Inability to fill ventricles
Pulsating nail bed
36. What is the cause of the red border around granulation tissue?
Positive blood cultures anemia of chronic disease
4-7 days
Blood vessels coming in from normal tissue
Ehlers - Danlow and Marfan syndrome
37. 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
Gelatinous - abundant ground substance
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
Regurg vs stenosis
38. 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
Tricuspid
Transposition of the great vessels
Granulation tissue
39. What conditions can cause nonbacterial thrombotic endocarditis?
Cardiogenic shock - CHF - arrhythmia
Hypercoagulable state or underlying adenocarcinoma
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Tuberous sclerosis
40. What % of MIs involve the LAD?
45%
Bacterial endocarditis
Aortic regurg
Within the first day
41. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Inability to maintain systemic pressure w/lack of O2 to vital organs
Ostium primum
Adult coarctation of the aorta
Nitroglycerin
42. Low voltage EKG w/diminished QRS amplitude.
IV drug users
Infantile coarctation of the aorta
L->R
Restrictive cardiomyopathy
43. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Endocardial fibroelastosis (rare)
S viridans
LHF
Mitral stenosis
44. What typically causes hypertrophic cardiomyopathy?
Myocarditis
Nitroglycerin
AD mutation in sarcomere proteins
Boot shaped heart
45. Which angina(s) show ST elevation on EKG? ST depression?
ACE inhibitor
Prinzmetal stable and unstable
Hemosiderin laden macrophages
Pedunculated mass in the LA that causes syncope due to obstruction of MV
46. What does rupture of a papillary muscle cause?
Mitral insufficiency
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
S aureus
Systolic ejection click followed by crescendo - decrescendo murmur
47. What effect does aortic stenosis have on the chambers of the heart?
Concentric LV hypertophy
Mitral mitral+aortic
Aortic stenosis
Cardiac tamponade
48. In what pt population does S aureus commonly cause valvular disease?
IV drug users
Coexisting mitral stenosis and fusion of commisures exist
VSD
Endocarditis of prosthetic valves
49. What is the JOneS mneumonic?
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
VSD
Mitral mitral+aortic
Slow HR - decreasing O2 demand and risk for arrhythmia
50. With what disease is Libman - Sacks endocarditis associated?
Valve replacement AFTER the onset of complications
Ischemic heart disease
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
SLE