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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 complications occur within 4 hrs post MI?
Mitral valve prolapse
Heart transplant
Cardiogenic shock - CHF - arrhythmia
ACE inhibitor
2. In what pt population does S aureus commonly cause valvular disease?
Right -->left
Annular - non pruritic rash w/erythematous borders trunks and limbs
IV drug users
Trisomy 21
3. What is the murmur of mitral regurg?
Congestive heart failure
MI
Holosystolic blowing murmur
Hypertrophic cardiomyopathy
4. What effect does transposition of the great vessels have on the ventricles?
Atria and RV
Hypertophy of RV atrophy of LV
LHF
Reperfusion injury
5. What are the sx of right - to - left shunt?
Cyanosis - RV hypertrophy - polycythemia - clubbing
Coexisting mitral stenosis and fusion of commisures exist
Aortic stenosis
Hemosiderin laden macrophages
6. What is the most common cause of aortic stenosis?
Wear and tear
Shunt
Ventricular arrhythmia
Posterior wall of LV - posterior septum - papillary muscles
7. What are the four defects in tetralogy of fallot?
Congested central veins
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Reactive histiocyte with caterpillar nucleus
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
8. Boot - shaped heart on x- ray?
Tetralogy of fallot
Boot shaped heart
Metastasis
First 4 hours
9. What is the most common type of ASD? What %?
Mitral insufficiency
Infectious endocarditis - arrythmias - severe mitral regurg no
Ostium secundum (90%)
ST- segment depression
10. What is the foundation of a scar?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
LA dilation
Mitral regurg
Granulation tissue
11. What is the most common cause of endocarditis in IV drug users?
Breast and lung carcinoma - melanoma - lymphoma
Transesophageal echo
Streptococcus viridans
S aureus
12. What is the only Jones criteria that doesn't resolve with time?
Ventricle
Pancarditis
Surgical closure small defects may close spontaneously
Pedunculated mass in the LA that causes syncope due to obstruction of MV
13. What does rupture of the IV septum cause?
S aureus
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Osler nodes (ouch - ouch Osler)
Shunt
14. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Adult coarctation of the aorta
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Myocarditis in acute rheumatic heart fever
Reactive histiocyte with caterpillar nucleus
15. With what disease is transposition of the great vessels associated?
Maternal diabetes
Contraction band necrosis - reperfusion injury
Trisomy 21
Backward LHF pulm htn and RHF - afib and associated mural thombis
16. Which chambers of the heart are generally spared in an MI?
Stable and unstable prinzmetal
PDA
Atria and RV
Turner syndrome
17. What tests show prior group A beta - hemolytic strep infection?
Ventricles cannot pump
S epidermidis
Elevated ASO anti - DNase B titers
Reperfusion injury
18. With what disease is infantile coarctation of the aorta associated?
Decreased forward perfusion pulmonary congestion
Turner syndrome
Transesophageal echo
Transposition of the great vessels
19. Lower extremity cyanosis later in life - holostystolic machine like murmur.
1%
PDA
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Mitral regurgitation due to vegetations
20. What causes a mid - systolic click followed by a regurgitation murmur?
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Mitral valve prolapse
Mid - systolic click followed by regurgitation murmur
Myocarditis
21. What gross and microscopic changes occur months after an MI?
Reversible
White scar fibrosis
Coexisting mitral stenosis and fusion of commisures exist
SLE
22. Is scar tissue or myocardium stronger?
Myocardium
Squatting - expiration
Stretched muscle loses contractility
Membrane damage
23. What are the complications of mitral stenosis?
Backward LHF pulm htn and RHF - afib and associated mural thombis
RCA
Infantile coarctation of the aorta PDA
Hypertrophic cardiomyopathy
24. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Sudden cardiac death
Right -->left
Transposition of the great vessels
Small vegetations along the line of closure
25. What are Janeway lesions?
Erythematous nontender lesions on palms and soles.
Reperfusion injury
Prinzmetal
LV dilation and eccentric hypertrophy
26. What is the most comon cause of aortic regurg? What are the other causes?
Contraction band necrosis - reperfusion injury
Ostium secundum (90%)
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
27. Is injury due angina reversible or irreversible?
NG or Ca channel blocker
Ostium primum
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Reversible
28. What type of tumor is a rhabdomyoma?
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
Harmartoma
1%
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
29. What type of vegetations does Strep viridans cause?
Small - nondestructive vegetations (subacute endocarditis)
Hypertophy of RV atrophy of LV
4-7 days macrophage infiltration
Libman - Sacks endocarditis
30. What increases the risk for chronic rheumatic heart disease?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Colon cancer
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Nonbacterial thrombotic endocarditis (marantic endocarditis)
31. What bug causes acute rheumatic fever?
Spontaneous
R-->L
Right side - serotonin and other secretory products detoxified in the lung
Group A beta - hemolytic streptococci
32. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
LHF
Migratory polyarthritis
Colon cancer
S aureus
33. What type of shunt dose PDA cause?
Increased hydrostatic pressure
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Pericarditits
Left -->right
34. What causes the dependent pitting edema in RHF?
Dilated
Increased hydrostatic pressure
Yellow pallor neutrophils
Prophylactic abx during dental procedures
35. How does squating decrease hypoxemia in tetralogy of fallot?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Slow HR - decreasing O2 demand and risk for arrhythmia
Coexisting mitral stenosis and fusion of commisures exist
36. How does reperfusion injury occur?
Acute inflammation
PDA
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Cardiogenic shock - CHF - arrhythmia
37. Drug that vasodilates both arteries and veins but mostly veins. Used to decrease preload to heart.
Nitroglycerin
Large - destructive vegetations
Valve replacement once LV dysfx develops
Sudden cardiac death
38. What structures are susceptible to rupture post MI?
Papillary muscle - free wall - IV septum
When a bacterial protein resembles a protein in human tissue
Aortic stenosis
3-8 wks
39. Fever - murmur - Janeway lesions - Osler nodes - splinter hemorrhages - anemia of chronic disease?
Left -->right
Large vegetations of S aureus
Mitral insufficiency
Bacterial endocarditis
40. What is Loeffler syndrome?
Volume overload and LHF
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Tuberous sclerosis
Trisomy 21
41. Which artery is most often occluded in an MI?
Nonspecific - eg fever and elevated ESR
Limits thrombosis
LAD
RBC damaged while crossing the calcified valve causing schistocytes
42. What is the JOneS mneumonic?
Posterior wall of LV - posterior septum - papillary muscles
Squat in response to cyanotic spell
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
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
43. When is an MI patent at highest risk for fibrionous pericarditis?
1-3 days out
Bounding pulse
3-8 wks
Prophylactic abx during dental procedures
44. What does a biopsy of hypertrophic cardiomyopathy look like?
Surgical closure small defects may close spontaneously
Myofiber hypertrophy with disarray
LHF
Dilated
45. In which chamber of the heart are cardiac myxomas found?
Left -->right
LA
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Degree of pulmonary artery stenosis
46. How does O2 tx MI?
Coexisting mitral stenosis and fusion of commisures exist
Ostium secundum (90%)
Minimizes ischemia
Months out fibrosis
47. What type of shunt does ASD cause?
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
Colon cancer
Left -->right
Aneurysm - mural thrombus - Dressler syndrome
48. What are the clinical features of LHF due to?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Infectious
Decreased forward perfusion pulmonary congestion
Infectious endocarditis - arrythmias - severe mitral regurg no
49. What congenital heart defect often is present with infantile coarctation of the aorta?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
PDA
Prinzmetal stable and unstable
ASD - R-->L
50. What is the 1day-1wk -1mo mneumonic for MI?
2-3%
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Transesophageal echo