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 is the most common form of cardiomyopathy?
Dilated
Mitral regurgitation due to vegetations
Concentric LV hypertophy
Fibrosis and dystrophic calcification

2. What causes notching of the ribs in adult coarctation of the aorta?
Fetal alcohol syndrome
Asymptomatic
Intercostal arteries enlarged due to collateral circulation
2-4 hours - 24 hours - 7-10 days

3. What type of vegetations are associated with Libman - Sacks endocarditis?
PDA
Sterile vegetations on surface and undersurface on mitral valve
Stable and unstable prinzmetal
VSD

4. How do beta blockers tx MI?
S aureus
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Slow HR - decreasing O2 demand and risk for arrhythmia
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

5. What is the murmur of mitral valve prolapse?
Increased blood in right heart delays closure of P valve
4-24 hours
Stable angina
Mid - systolic click followed by regurgitation murmur

6. What is the most common congenital heart defect?
Paradoxical emboli
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
Red border granulation tissue
VSD

7. What cardiac enzyme is useful for detecting reinfarction?
PDA
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Contraction band necrosis - reperfusion injury
CK- MB

8. What gross and microscopic changes occur 4-7 days after an MI?
SLE
Yellow pallor macrophages
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
ACE inhibitor

9. How does O2 tx MI?
Minimizes ischemia
R-->L
Decreases LV dilation by decreasing volume
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets

10. What drugs can cause dilated cardiomyopathy?
Sterile vegetations on mitral valve along lines of closure
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
RCA
Doxorubicin - cocaine

11. What does rupture of the IV septum cause?
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Shunt
Valve replacement AFTER the onset of complications
4-24 hours

12. In which chamber of the heart are cardiac myxomas found?
LA
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Chest pain <20 min brought on by exertion or emotional stress
Rhadbomyoma - benign

13. What is the gold standard blood marker for MI?
Sterile vegetations on surface and undersurface on mitral valve
Left -->right
Fibrosis and dystrophic calcification
Troponin I

14. At what point in development do congenital heart defects arise?
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Aschoff bodies
3-8 wks
Janeway lesions

15. What are the causes of LHF?
Transesophageal echo
S epidermidis
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
LAD

16. With what developmental disorder is VSD associated?
Right -->left
LA
Fetal alcohol syndrome
Loeffler syndrome

17. What is the JOneS mneumonic?
Osler nodes (ouch - ouch Osler)
Infectious endocarditis
Open blocked vessels
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

18. Is scar tissue or myocardium stronger?
Myocardium
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Right to left
VSD

19. What is the only Jones criteria that doesn't resolve with time?
Myxoma - benign
Circumflex
Congestive heart failure
Pancarditis

20. What are the causes of restrictive cardiomyopathy in adults?
Troponin I
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
When a bacterial protein resembles a protein in human tissue
Autoimmune pericarditis 6-8 wks post MI

21. What causes microangiopathic hemolytic anemia in aortic stenosis?
Atherosclerosis of coronary arteries
RBC damaged while crossing the calcified valve causing schistocytes
Limits thrombosis
Hemosiderin laden macrophages

22. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
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
Myxoma - benign
Systemic venous congestion
Stable and unstable prinzmetal

23. What type of vegetations does Strep viridans cause?
Small - nondestructive vegetations (subacute endocarditis)
Mitral mitral+aortic
Membrane damage
Contraction band necrosis - reperfusion injury

24. What is the basic principle of CHF?
Pump failure
Systolic dysfx leading to biventricular CHF
Ischemic heart disease
Mitral stenosis

25. Which congenital heart defect is associated with congenital rubella?
Mitral and tricuspid regurg - arrhythmia
Months out fibrosis
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
PDA

26. With what disease is infantile coarctation of the aorta associated?
Papillary muscle - free wall - IV septum
Low voltage EKG w/diminished QRS amplitude
Systolic dysfx leading to biventricular CHF
Turner syndrome

27. Drug that vasodilates both arteries and veins but mostly veins. Used to decrease preload to heart.
Prinzmetal stable and unstable
Nitroglycerin
Coronary artery vasospasm
Louder - increased systemic resistence decreases LV emptying

28. What is chronic rheumatic heart disease?
Aortic stenosis
Prinzmetal angina
Valve scarring that arises as a consequence of rheumatic fever
Tuberous sclerosis

29. What generally causes ischemic heart disease?
Sterile vegetations on mitral valve along lines of closure
Tuberous sclerosis
Atherosclerosis of coronary arteries
Ostium primum

30. Large vegetations on tricuspid valve?
Mitral regurg
Stable angina
S aureus
ST- segment depression

31. Small - sterile fibrin deposits randomly arranged on closure of valve leaflets in a pt w/metastatic colon cancer?
Left -->right
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Regurg vs stenosis
Concentric hypertrophy - can't oxygenate full wall - ischemic damage

32. In which chamber of the heart are rhabdomyomas found?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Ventricle
Loeffler syndrome
ST- segment depression

33. What causes prinzmetal angina?
Dilated
Coronary artery vasospasm
Aschoff bodies
2-3%

34. What increases the risk for chronic rheumatic heart disease?
4-6 hours - 24 hours - 72 hours
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Ostium secundum (90%)
Atherosclerosis of coronary arteries

35. What are the complications of aortic stenosis?
Endocarditis of prosthetic valves
Myxoid degeneration
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Streptococcus viridans

36. What is the most common cause of RHF? What are others?
Myxoid degeneration
Chronic rheumatic heart disease
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
S aureus

37. Why are cardiac enzymes elevated after an MI?
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Membrane damage
Increased hydrostatic pressure
S epidermidis

38. What imaging test is useful for detecting lesions on valves?
Mitral regurgitation due to vegetations
Transesophageal echo
Pericardial effusion due to pericardial involvement
Anitschow cell

39. What effect does dilated cardiomyopathy have on the heart?
Systolic dysfx leading to biventricular CHF
LV dilation and eccentric hypertrophy
Large vegetations of S aureus
LAD

40. What does rupture of a papillary muscle cause?
Mitral regurg
Within the first day
Mitral insufficiency
Myxoid degeneration

41. What are the two effects of ATII?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
PDA
Endocarditis of prosthetic valves

42. What two things cause coronary artery vasospasm?
Holosystolic machine like murmur
Myocardium
Doxorubicin - cocaine
Prinzmetal angina - cocaine

43. What areas of the heart does the LAD supply?
Anterior wall of LV and anterior septum
Gelatinous - abundant ground substance
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
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar

44. Boot - shaped heart on x- ray?
Friction rub and chest pain
Louder - increased systemic resistence decreases LV emptying
Endocardial fibroelastosis
Tetralogy of fallot

45. How does dilated cardiomyopathy cause LHF?
Stretched muscle loses contractility
Granulation tissue
Loss of fx
PDA

46. What is a common complication of cardiac metastasis?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
ST- segment depression
Pericardial effusion due to pericardial involvement
Increased arterial resistence decreases shunting - allowing more blood to reach lungs

47. What is the most common cause of aortic stenosis?
Wear and tear
Valve scarring that arises as a consequence of rheumatic fever
Endocardial fibroelastosis
Group A beta - hemolytic streptococci

48. What are the cancers that most commonly metastasize to the heart?
Plump fibroblasts - collagen - blood vessels
S viridans
Migratory polyarthritis
Breast and lung carcinoma - melanoma - lymphoma

49. What is the rate of mitral valve prolapse in the US?
Hypertrophic cardiomyopathy
2-3%
Infantile coarctation of the aorta
Spontaneous

50. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Pericarditits
Pump failure
Stable and unstable prinzmetal