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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. Why would cardiac enzymes continue to increase after the initial MI?
Reperfusion injury
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Elevated ASO anti - DNase B titers
2. What are the clinical features of RHF?
Myofiber hypertrophy with disarray
LHF
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
S epidermidis
3. What is the characteristic murmur of aortic stenosis?
Coronary artery vasospasm - emboli - vasculitis
Systolic ejection click followed by crescendo - decrescendo murmur
Ventricle
Papillary muscle - free wall - IV septum
4. What genetic conditions predispose a pt to mitral valve prolapse?
Ehlers - Danlow and Marfan syndrome
Day 1-7
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
White scar fibrosis
5. What effect does squatting have on the murmur of mitral valve prolapse? Why?
S aureus
Louder - increased systemic resistence decreases LV emptying
Prophylactic abx during dental procedures
Valve scarring that arises as a consequence of rheumatic fever
6. In transposition of the great vessels - What is required for survival? How is this achieved?
Coronary artery vasospasm - emboli - vasculitis
Shunt - PGE to maintain PDA until surgical repair can be performed
Nitroglycerin
Months out fibrosis
7. With what condition are rhabdomyomas associated?
4-7 days
Tuberous sclerosis
Ostium secundum (90%)
Trisomy 21
8. What causes mitral valve prolapse?
Myxoid degeneration
Coronary artery vasospasm
Mitral insufficiency
Rupture of free wall - IV septum - or papillary muscle
9. What does a biopsy of hypertrophic cardiomyopathy look like?
Stable angina
Myocarditis in acute rheumatic heart fever
Ostium primum
Myofiber hypertrophy with disarray
10. Friction rub and chest pain.
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Pericarditits
11. What is the most common cause of mitral stenosis?
Mitral and tricuspid regurg - arrhythmia
Small vegetations along the line of closure
Chronic rheumatic heart disease
R-->L
12. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Intercostal arteries enlarged due to collateral circulation
Mitral and tricuspid regurg - arrhythmia
Migratory polyarthritis
Red border granulation tissue
13. What causes the split S2 in ASD?
Congenital rubella
Tender lesions on fingers or toes.
Increased blood in right heart delays closure of P valve
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
14. What determines the extent of shunting and cyanosis in tetralogy of fallot?
Degree of pulmonary artery stenosis
Ventricular arrhythmia
Positive blood cultures anemia of chronic disease
2-4 hours - 24 hours - 7-10 days
15. In what pt population does S aureus commonly cause valvular disease?
Ischemic heart disease
Slow HR - decreasing O2 demand and risk for arrhythmia
IV drug users
PGE
16. What is the most common tumor of the heart?
Fetal alcohol syndrome
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Metastasis
Stable and unstable prinzmetal
17. Tx for PDA?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Elevated ASO anti - DNase B titers
Indomethacin - decreases PGE
Nitroglycerin
18. What is a water - hammer pulse?
Prinzmetal stable and unstable
Bounding pulse
Large - destructive vegetations
Anterior wall of LV and anterior septum
19. What drugs can cause dilated cardiomyopathy?
Mitral regurgitation due to vegetations
Doxorubicin - cocaine
Myocarditis
Small - nondestructive vegetations (subacute endocarditis)
20. With what developmental disorder is VSD associated?
1-3 days out
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Fetal alcohol syndrome
Loss of LV fx
21. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
PDA
Reperfusion injury
R-->L
LAD
22. Infects predamaged valves after transient bacteremia?
Prinzmetal
Minimizes ischemia
Stable angina
S viridans
23. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
Squatting - expiration
MI
Mitral insufficiency
Coexisting mitral stenosis and fusion of commisures exist
24. What is the most common cause of sudden cardiac death? What are less common causes of sudden cardiac death?
Ischemic heart disease
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Metastasis
Endocarditis of prosthetic valves
25. At what point in development do congenital heart defects arise?
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Kawasaki disease
3-8 wks
26. What causes the nutmeg color in nutmeg liver?
Holosystolic machine like murmur
Congested central veins
Reversible
Coronary artery vasospasm
27. What is the tx for LHF?
ACE inhibitor
Streptococcus viridans
Asymptomatic
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
28. Is scar tissue or myocardium stronger?
Slow HR - decreasing O2 demand and risk for arrhythmia
Myocardium
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Shunt
29. What type of ASD is associated w/Down syndrome?
Breast and lung carcinoma - melanoma - lymphoma
VSD
Myocarditis in acute rheumatic heart fever
Ostium primum
30. How does subendocardial MI/ischemia present on EKG?
Degree of pulmonary artery stenosis
Membrane damage
Decrease preload -->lowers myocardial stress
ST- segment depression
31. What artery is the 2nd most often occluded in an MI?
Ischemic heart disease
RCA
Friction rub and chest pain
Mitral and tricuspid regurg - arrhythmia
32. How does Eisenmeger syndrome occur?
Myxoid degeneration
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
CHF
Backward LHF pulm htn and RHF - afib and associated mural thombis
33. What type of shunt dose PDA cause?
4-7 days macrophage infiltration
Coronary artery vasospasm
LHF
Left -->right
34. Fever - murmur - Janeway lesions - Osler nodes - splinter hemorrhages - anemia of chronic disease?
Squatting - increased systemic resistence decreases LV emptying
Myocardium
Bacterial endocarditis
Within the first day
35. What heart sound manifest with an ASD?
Infantile coarctation of the aorta PDA
Asymptomatic
Circumflex
Split S2 on auscultation
36. What creates the immune reaction in acute rhuematic fever?
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37. What causes an early - blowing diastolic murmur?
Contraction band necrosis - reperfusion injury
Acute inflammation
Osler nodes (ouch - ouch Osler)
Aortic regurg
38. What causes unstable angina?
>60 years - bicuspid aortic valve
Myocardium
Loeffler syndrome
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
39. What are the complications that occur months after an MI?
Maternal diabetes
Aneurysm - mural thrombus - Dressler syndrome
Endocardial fibroelastosis (rare)
2-3 weeks
40. What effect does chronic rheumatic heart disease have the mitral valve?
Thickening of chrodae tendinae and cusps - mitral stenosis
AD mutation in sarcomere proteins
1-3 days
Large vegetations of S aureus
41. What is systolic dysfx?
Ventricles cannot pump
Ischemic heart disease
Loss of fx
Decreased forward perfusion pulmonary congestion
42. Drug that vasodilates both arteries and veins but mostly veins. Used to decrease preload to heart.
Nitroglycerin
LA dilation
Left -->right
Migratory polyarthritis
43. What are Janeway lesions?
Coexisting mitral stenosis and fusion of commisures exist
Harmartoma
Erythematous nontender lesions on palms and soles.
Nitroglycerin
44. What congenital heart defect often is present with infantile coarctation of the aorta?
R-->L
PDA
Squatting - expiration
Thickening of chrodae tendinae and cusps - mitral stenosis
45. What is diastolic dysfx?
Stable and unstable prinzmetal
Inability to fill ventricles
Prinzmetal angina - cocaine
Split S2 on auscultation
46. What are the complications of mitral stenosis?
Backward LHF pulm htn and RHF - afib and associated mural thombis
Hypertophy of RV atrophy of LV
Congenital rubella
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
47. What is the tx for aortic stenosis?
Sterile vegetations on mitral valve along lines of closure
Valve replacement AFTER the onset of complications
Myocarditis
S epidermidis
48. What type of vegetations does Strep viridans cause?
2-4 hours - 24 hours - 7-10 days
Myocarditis
Pericarditits
Small - nondestructive vegetations (subacute endocarditis)
49. What increases the volume of mitral regurg murmur?
Squatting - expiration
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Minimizes ischemia
Ischemic heart disease
50. How does stable angina present?
Chest pain <20 min brought on by exertion or emotional stress
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
RCA
Subendocardial