SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
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 structures are susceptible to rupture post MI?
Type I
Papillary muscle - free wall - IV septum
45%
Ventricle
2. What type of shunt does a VSD cause?
L->R
Stable angina
Wear and tear
Reperfusion injury
3. Is injury due angina reversible or irreversible?
Mitral regurg
Plump fibroblasts - collagen - blood vessels
Reversible
Preductal - post aortic arch
4. What % of MIs involve the LAD?
Nonspecific - eg fever and elevated ESR
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
45%
PDA
5. Poor myocardial fx due to chronic ischemic damage?
Chronic ischemic heart disease
Troponin I
Loss of fx
CHF
6. What is the characteristic murmur of aortic stenosis?
Systolic ejection click followed by crescendo - decrescendo murmur
Chronic rheumatic heart disease
Degree of pulmonary artery stenosis
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
7. When do macrophagess infiltrate the myocardium post MI?
S aureus
LA dilation
4-7 days
20 min
8. How does hypertension cause LHF?
9. What areas of the heart does the RCA supply?
Reversible
Posterior wall of LV - posterior septum - papillary muscles
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Sudden cardiac death
10. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
Systolic dysfx leading to biventricular CHF
Systemic venous congestion
Nitroglycerin
Myxoma - benign
11. Boot - shaped heart on x- ray?
Infectious
2-4 hours - 24 hours - 7-10 days
Membrane damage
Tetralogy of fallot
12. Drug that vasodilates both arteries and veins but mostly veins. Used to decrease preload to heart.
Volume overload and LHF
Dilated
Nitroglycerin
Valve scarring that arises as a consequence of rheumatic fever
13. Opening snap followed by diastolic rumble.
45%
Posterior wall of LV - posterior septum - papillary muscles
Membrane damage
Mitral stenosis
14. What does granulation tissue contain?
Tuberous sclerosis
1%
White scar fibrosis
Plump fibroblasts - collagen - blood vessels
15. What causes an early - blowing diastolic murmur?
>70%
Prophylactic abx during dental procedures
Holosystolic blowing murmur
Aortic regurg
16. What % stenosis causes stable angina?
Slow HR - decreasing O2 demand and risk for arrhythmia
Stable and unstable prinzmetal
Aortic regurg
>70%
17. Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia.
Membrane damage
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Loeffler syndrome
MI
18. What side of the heart do carcinoid tumors affect? Why?
Elevated ASO anti - DNase B titers
Right side - serotonin and other secretory products detoxified in the lung
Loss of fx
Within the first day
19. What is the effect of acute vs chronic rheumatic disease off the mitral valve?
Pericardial effusion due to pericardial involvement
Infectious endocarditis
Regurg vs stenosis
Metastasis
20. What are the sx of right - to - left shunt?
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Hemosiderin laden macrophages
Cyanosis - RV hypertrophy - polycythemia - clubbing
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
21. What congenital heart defect often is present with infantile coarctation of the aorta?
PDA
Bicuspid aortic valve
Myocarditis
Coexisting mitral stenosis and fusion of commisures exist
22. What is the most common cause of myocarditis?
Cardiac tamponade
Decrease in blood flow to an organ
Coxsackie A or B
Right side - serotonin and other secretory products detoxified in the lung
23. Why would cardiac enzymes continue to increase after the initial MI?
Reperfusion injury
Holosystolic blowing murmur
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Mitral regurg
24. In what pt population does S aureus commonly cause valvular disease?
IV drug users
Mitral regurgitation due to vegetations
4-7 days macrophage infiltration
Rhadbomyoma - benign
25. Large vegetations on tricuspid valve?
Surgical closure small defects may close spontaneously
S aureus
Day 1-7
ST- segment depression
26. What does rupture of the IV septum cause?
Increased blood in right heart delays closure of P valve
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
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Shunt
27. What type of shunt does ASD cause?
Shunt
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Left -->right
Type I
28. Dilated cardiomyopathy is a late complication of what illness?
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Squatting - expiration
Myocarditis
Decrease in blood flow to an organ
29. What type of vegetations are associated with Libman - Sacks endocarditis?
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
Restrictive cardiomyopathy
Sterile vegetations on surface and undersurface on mitral valve
Months out fibrosis
30. What type of ASD is associated w/Down syndrome?
Ostium primum
LHF
1%
Increased hydrostatic pressure
31. What is the most common cause of endocarditis in IV drug users?
Dense layer of elastic and fibrotic tissue in the endocardium - children
Decrease preload -->lowers myocardial stress
Split S2 on auscultation
S aureus
32. What type of tumor is a rhabdomyoma?
Adult coarctation of the aorta
Harmartoma
S aureus
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
33. What is migratory polyarthritis?
Heart transplant
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Gelatinous - abundant ground substance
Coronary artery vasospasm - emboli - vasculitis
34. How does contraction band necrosis occur?
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
RCA
Hypercoagulable state or underlying adenocarcinoma
Restrictive cardiomyopathy
35. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Sterile vegetations on surface and undersurface on mitral valve
RBC damaged while crossing the calcified valve causing schistocytes
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
ASD - R-->L
36. What type of collagen is involved in fibrosis?
Posterior wall of LV - posterior septum - papillary muscles
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Type I
Aortic regurg
37. What heart sound manifest with an ASD?
Prinzmetal stable and unstable
Aortic regurg
Split S2 on auscultation
PDA
38. What are the complications that occur months after an MI?
Loeffler syndrome
Months out fibrosis
Circumflex
Aneurysm - mural thrombus - Dressler syndrome
39. When is a post - MI pt at highest risk for a mural thrombus? With what microscopic change is this complication associated?
Rhadbomyoma - benign
Months out fibrosis
Concentric LV hypertophy
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
40. What are the sx of hypertrophic cardiomyopathy?
Myocarditis
Transesophageal echo
Increased blood in right heart delays closure of P valve
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
41. What is a complication of chronic rheumatic heart disease?
Pericardial effusion due to pericardial involvement
Stable angina
Infectious endocarditis
Boot shaped heart
42. How do ACE inhibitors tx MI?
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
NG or Ca channel blocker
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Decreases LV dilation by decreasing volume
43. What does Libman - Sacks endocarditis cause?
Mitral regurg
SLE
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
LA
44. What valves are involved in rhuematic endocarditis?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Prophylactic abx during dental procedures
Heart can't fill
Mitral mitral+aortic
45. How long can cardiac myocytes be deprived of oxygen before they become irreversibly injured?
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
Coexisting mitral stenosis and fusion of commisures exist
20 min
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
46. Which chambers of the heart are generally spared in an MI?
Minimizes ischemia
Prinzmetal angina - cocaine
Atria and RV
Tender lesions on fingers or toes.
47. What is the most common cause of RHF? What are others?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Squatting - increased systemic resistence decreases LV emptying
Contraction band necrosis - reperfusion injury
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
48. What congenital heart defect presents later in life with lower extremity cyanosis?
Coronary artery vasospasm
Bacterial endocarditis
PDA
Squatting - increased systemic resistence decreases LV emptying
49. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
MI
Mitral valve prolapse
Blood vessels coming in from normal tissue
50. What drug relieves stable angina?
Nitroglycerin
Squatting - increased systemic resistence decreases LV emptying
Coexisting mitral stenosis and fusion of commisures exist
>60 years - bicuspid aortic valve