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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. How does reperfusion injury occur?
Chronic rheumatic heart disease
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Shunt - PGE to maintain PDA until surgical repair can be performed
Congested central veins
2. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
Fibrinous pericarditis
1%
Autoimmune pericarditis 6-8 wks post MI
Months out fibrosis
3. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Endocardial fibroelastosis
Loss of LV fx
Anitschow cell
Sudden cardiac death
4. Opening snap followed by diastolic rumble.
Systemic venous congestion
Mitral stenosis
VSD
PDA
5. What are the cancers that most commonly metastasize to the heart?
LA dilation
Pulsating nail bed
RCA
Breast and lung carcinoma - melanoma - lymphoma
6. What effect does squatting have on the murmur of mitral valve prolapse? Why?
Louder - increased systemic resistence decreases LV emptying
Infantile coarctation of the aorta
Congested central veins
20 min
7. Ostium primum ASD is associated with what congenital disorder?
Trisomy 21
Loss of LV fx
Annular - non pruritic rash w/erythematous borders trunks and limbs
Wear and tear
8. What always follows necrosis?
Acute inflammation
Months out fibrosis
Maternal diabetes
Squatting - increased systemic resistence decreases LV emptying
9. What are the four defects in tetralogy of fallot?
Left -->right
S aureus
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
10. When do CK- MB levels rise - peak - and return to normal?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
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
4-6 hours - 24 hours - 72 hours
11. What type of shunt does truncus arteriosus cause?
Asymptomatic
R-->L
3-8 wks
Ventricle
12. When do troponin levels rise - peak - and return to normal?
Hemosiderin laden macrophages
Pericarditits
2-4 hours - 24 hours - 7-10 days
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
13. What increases the risk for chronic rheumatic heart disease?
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Erythematous nontender lesions on palms and soles.
Doxorubicin - cocaine
14. Dense layer of elastic and fibrotic tissue in the endocardium.
Endocardial fibroelastosis
Large - destructive vegetations
Aneurysm - mural thrombus - Dressler syndrome
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
15. What is the major cause of MI?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Rhabdomyoma
Membrane damage
Minimizes ischemia
16. Is scar tissue or myocardium stronger?
Elevated ASO anti - DNase B titers
Hypercoagulable state or underlying adenocarcinoma
Libman - Sacks endocarditis
Myocardium
17. What are the sx of right - to - left shunt?
Osler nodes (ouch - ouch Osler)
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Mitral insufficiency
Cyanosis - RV hypertrophy - polycythemia - clubbing
18. What is the gross and microscopic appearance of cardiac myxomas?
When a bacterial protein resembles a protein in human tissue
Right to left
Restrictive cardiomyopathy
Gelatinous - abundant ground substance
19. Which congenital heart defect is associated with congenital rubella?
PDA
Myofiber hypertrophy with disarray
Mitral regurg
Low voltage EKG w/diminished QRS amplitude
20. Lower extremity cyanosis later in life - holostystolic machine like murmur.
PDA
>60 years - bicuspid aortic valve
S epidermidis
Blood vessels coming in from normal tissue
21. Large vegetations on tricuspid valve?
S aureus
Pts w/previously damaged valves
Harmartoma
Nonbacterial thrombotic endocarditis (marantic endocarditis)
22. What is the most common type of endocarditis?
Ehlers - Danlow and Marfan syndrome
Systolic ejection click followed by crescendo - decrescendo murmur
Infectious
4-6 hours - 24 hours - 72 hours
23. What is the most common cause of endocarditis in IV drug users?
S aureus
Aschoff bodies
Ventricles cannot pump
Yellow pallor macrophages
24. What is the most common cause of myocarditis?
4-6 hours - 24 hours - 72 hours
Transposition of the great vessels
Boot shaped heart
Coxsackie A or B
25. How does aortic regurg affect the heart chambers?
LV dilation and eccentric hypertrophy
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Rhabdomyoma
4-7 days macrophage infiltration
26. What are the sx of cardiac myxoma?
Nitroglycerin
Mitral regurgitation due to vegetations
Aortic regurg
Pedunculated mass in the LA that causes syncope due to obstruction of MV
27. How does restrictive cardiomyopathy cause LHF?
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28. What type of vegetations form in nonbacterial thrombotic endocarditis?
First 4 hours
Mitral mitral+aortic
Sterile vegetations on mitral valve along lines of closure
Reperfusion injury
29. What are the major criteria of the Jones criteria?
Ostium primum
45%
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
30. What does rupture of a papillary muscle cause?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Mitral insufficiency
4-7 days macrophage infiltration
31. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Minimizes ischemia
Infectious endocarditis
Streptococcus bovis/
Adult coarctation of the aorta
32. What heart sound manifest with an ASD?
45%
Sterile vegetations on surface and undersurface on mitral valve
Split S2 on auscultation
Posterior wall of LV - posterior septum - papillary muscles
33. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Chest pain <20 min brought on by exertion or emotional stress
Aortic regurg
When a bacterial protein resembles a protein in human tissue
AD mutation in sarcomere proteins
34. What is systolic dysfx?
Dilated
Ventricles cannot pump
Boot shaped heart
1-3 days out
35. What causes wear and tear aortic stenosis?
Fibrosis and dystrophic calcification
Nitroglycerin
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
Asymptomatic
36. What is the classic EKG finding of restrictive cardiomyopathy?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Low voltage EKG w/diminished QRS amplitude
Colon cancer
Annular - non pruritic rash w/erythematous borders trunks and limbs
37. What congenital heart defect often is present with infantile coarctation of the aorta?
Mitral mitral+aortic
PDA
CK- MB
Tricuspid
38. What is the characteristic finding on CXR in tetralogy of fallot?
RBC damaged while crossing the calcified valve causing schistocytes
R-->L
Decreased forward perfusion pulmonary congestion
Boot shaped heart
39. What % of MIs involve the LAD?
RHF
Bacterial endocarditis
45%
Ehlers - Danlow and Marfan syndrome
40. What does granulation tissue contain?
Valve replacement
Mitral mitral+aortic
Plump fibroblasts - collagen - blood vessels
Yellow pallor macrophages
41. What is the rate of congenital heart defects?
4-7 days macrophage infiltration
1%
RHF
Pts w/previously damaged valves
42. What is the most common cause of RHF? What are others?
Friction rub and chest pain
Erythematous nontender lesions on palms and soles.
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Posterior wall of LV - posterior septum - papillary muscles
43. What are the sx of aortic regurg?
Wear and tear
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Myxoid degeneration
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
44. What complications occur 4-7 days post MI?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Rupture of free wall - IV septum - or papillary muscle
4-6 hours - 24 hours - 72 hours
Inability to maintain systemic pressure w/lack of O2 to vital organs
45. Sudden death in a young athlete.
Hypertrophic cardiomyopathy
Aortic regurg
PDA
Left -->right
46. What complications occur within 4 hrs post MI?
Increased hydrostatic pressure
Cardiogenic shock - CHF - arrhythmia
Loeffler syndrome
Ostium secundum (90%)
47. What causes an early - blowing diastolic murmur?
Ischemic heart disease
RCA
Aortic regurg
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
48. What type of ASD is associated w/Down syndrome?
Aortic stenosis
Ostium primum
Coronary artery vasospasm - emboli - vasculitis
1-3 days
49. Which congenital heart defect is associated with maternal diabetes?
4-7 days
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Mitral stenosis
Transposition of the great vessels
50. What shunt does tetralogy of fallot produce?
Tender lesions on fingers or toes.
Infectious endocarditis
Paradoxical emboli
Right -->left