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 are the sx of PDA at birth?
Asymptomatic
Troponin I
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Decrease in blood flow to an organ

2. What two things happen when a blocked vessel is opened after an MI?
Group A beta - hemolytic streptococci
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Contraction band necrosis - reperfusion injury
Transposition of the great vessels

3. What is the most common primary cardiac tumor in children? Is it malignant or benign?
Infectious
Rhadbomyoma - benign
3-8 wks
Myxoma - benign

4. What causes microangiopathic hemolytic anemia in aortic stenosis?
Ostium primum
RBC damaged while crossing the calcified valve causing schistocytes
Anitschow cell
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD

5. Which angina is relieved by Ca channel blockers?
Prinzmetal
IV drug users
Dense layer of elastic and fibrotic tissue in the endocardium - children
First 4 hours

6. What causes the dependent pitting edema in RHF?
2-3 weeks
Prinzmetal
Increased hydrostatic pressure
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint

7. What is dilated cardiomyopathy?
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
Libman - Sacks endocarditis
Dilation of all four chambers of the heart
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve

8. What is the murmur of mitral valve prolapse?
Reversible
VSD
Reperfusion injury
Mid - systolic click followed by regurgitation murmur

9. What are the four defects in tetralogy of fallot?
Annular - non pruritic rash w/erythematous borders trunks and limbs
Myocarditis in acute rheumatic heart fever
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema

10. What type of vegetations does Strep viridans cause?
Libman - Sacks endocarditis
Hypercoagulable state or underlying adenocarcinoma
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Small - nondestructive vegetations (subacute endocarditis)

11. With what disease is Libman - Sacks endocarditis associated?
SLE
R-->L
Prinzmetal angina
Streptococcus bovis/

12. What are the sx of aortic regurg?
Adult coarctation of the aorta
Ventricles cannot pump
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Red border granulation tissue

13. How does adult coarctation of the aorta present?
4-6 hours - 24 hours - 72 hours
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Loss of fx
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase

14. What does rupture of a papillary muscle cause?
Shunt
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
PDA
Mitral insufficiency

15. What are the cancers that most commonly metastasize to the heart?
Doxorubicin - cocaine
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Breast and lung carcinoma - melanoma - lymphoma
Right -->left

16. How does hypertension cause LHF?

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

17. What is the main cause of MV regurg? What are other causes?
Granulation tissue
Kawasaki disease
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Pericarditits

18. How do you tx prinzmetal angina?
Streptococcus bovis/
NG or Ca channel blocker
Mitral mitral+aortic
Fibrinous pericarditis

19. What are the sx of hypertrophic cardiomyopathy?
Fibrinous pericarditis
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
LA dilation
R-->L

20. What valves are involved in rhuematic endocarditis?
Prinzmetal angina - cocaine
Rupture of free wall - IV septum - or papillary muscle
Mitral mitral+aortic
Yellow pallor neutrophils

21. What is the most common valve infected by S aureus?
Tricuspid
Fetal alcohol syndrome
PDA
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia

22. What effect does squatting have on the murmur of mitral valve prolapse? Why?
Tender lesions on fingers or toes.
Louder - increased systemic resistence decreases LV emptying
Hypertrophic cardiomyopathy
Mitral regurg

23. How do ACE inhibitors tx MI?
Sterile vegetations on mitral valve along lines of closure
AD mutation in sarcomere proteins
Mitral valve prolapse
Decreases LV dilation by decreasing volume

24. What congenital heart defect does indomethacin tx?
PDA
Mitral regurg
Congenital rubella
LAD

25. When is a post - MI pt at highest risk for an aneurysm? With what microscopic change is this complication associated?
Mitral mitral+aortic
Months out fibrosis
Preductal - post aortic arch
4-24 hours

26. Pericarditis 6-8 wks post MI.
Dressler syndrome
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Nitroglycerin
PDA

27. What gross and microscopic changes occur 4-7 days after an MI?
Loss of LV fx
Fibrinous pericarditis
Yellow pallor macrophages
Myxoma - benign

28. Boot - shaped heart on x- ray?
Kawasaki disease
Anitschow cell
Prinzmetal angina
Tetralogy of fallot

29. What always follows necrosis?
Pump failure
Endocarditis of prosthetic valves
Acute inflammation
Valve replacement once LV dysfx develops

30. What congenital heart defect presents later in life with lower extremity cyanosis?
Heart transplant
Subendocardial
Sterile vegetations on mitral valve along lines of closure
PDA

31. Tx for PDA?
Infantile coarctation of the aorta
Fibrinous pericarditis
Nitroglycerin
Indomethacin - decreases PGE

32. When does the heart have dark discoloration post MI?
Pancarditis
Systemic venous congestion
Stable and unstable prinzmetal
4-24 hours

33. What are complications of dilated cardiomyopathy?
Mitral and tricuspid regurg - arrhythmia
Ventricular arrhythmia
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
Rupture of free wall - IV septum - or papillary muscle

34. Why are cardiac enzymes elevated after an MI?
ST- segment elevation
Membrane damage
Small vegetations along the line of closure
Valve scarring that arises as a consequence of rheumatic fever

35. What effect does aortic regurg have on the pulse pressure? Why?
1-3 days out
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Slow HR - decreasing O2 demand and risk for arrhythmia

36. What is cardiogenic shock?
Inability to maintain systemic pressure w/lack of O2 to vital organs
Type I
Infectious endocarditis - arrythmias - severe mitral regurg no
Turner syndrome

37. What causes an early - blowing diastolic murmur?
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Endocarditis of prosthetic valves
Louder - increased systemic resistence decreases LV emptying
Aortic regurg

38. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
Stable and unstable prinzmetal
S aureus
Janeway lesions
Streptococcus bovis/

39. What is the cause of the red border around granulation tissue?
Tuberous sclerosis
ASD - R-->L
Blood vessels coming in from normal tissue
Systolic dysfx leading to biventricular CHF

40. What is the most common cause of death during the acute phase of rheumatic fever?
Myocarditis
Myxoid degeneration
Months out fibrosis
PDA

41. Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils.
Reactive histiocyte with caterpillar nucleus
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Contraction band necrosis
Decrease preload -->lowers myocardial stress

42. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Cyanosis - RV hypertrophy - polycythemia - clubbing
RCA
Open blocked vessels
Coronary artery vasospasm - emboli - vasculitis

43. What does Libman - Sacks endocarditis cause?
Pump failure
Mitral regurg
First 4 hours
Aortic regurg

44. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Eisenmenger syndrome
ST- segment depression
L->R
LHF

45. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
Louder - increased systemic resistence decreases LV emptying
Small - nondestructive vegetations (subacute endocarditis)
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Prinzmetal

46. What type of ASD is associated w/Down syndrome?
Ostium primum
Ventricles cannot pump
Nitroglycerin
Myocardium

47. How does reperfusion injury occur?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Membrane damage
Increased hydrostatic pressure

48. What is the most common type of endocarditis?
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Hypercoagulable state or underlying adenocarcinoma
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Infectious

49. What does nonbacterial thrombotic endocarditis cause?
Chronic rheumatic heart disease
Mitral regurg
Stable and unstable prinzmetal
Ventricles cannot pump

50. How does dilated cardiomyopathy cause LHF?
Janeway lesions
Stretched muscle loses contractility
Wear and tear
Prinzmetal stable and unstable