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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 is the most comon cause of aortic regurg? What are the other causes?
Small - nondestructive vegetations (subacute endocarditis)
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Positive blood cultures anemia of chronic disease
ASD - R-->L
2. What type of shunt results in cyanosis at birth?
Squat in response to cyanotic spell
Ehlers - Danlow and Marfan syndrome
Right to left
Aortic stenosis
3. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
L->R
Months out fibrosis
Concentric LV hypertophy
4. When is a post - MI pt at highest risk for a mural thrombus? With what microscopic change is this complication associated?
Months out fibrosis
Elevated ASO anti - DNase B titers
Coronary artery vasospasm
Endocarditis of prosthetic valves
5. How does transmural MI/ischemia present on EKG?
Sterile vegetations on mitral valve along lines of closure
ST- segment elevation
Mitral mitral+aortic
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
6. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
4-7 days macrophage infiltration
Decrease preload -->lowers myocardial stress
Louder - increased systemic resistence decreases LV emptying
Prinzmetal
7. What does rupture of the IV septum cause?
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
20 min
Shunt
Janeway lesions
8. What is the tx for dilated cardiomyopathy?
AD mutation in sarcomere proteins
Membrane damage
Heart transplant
ACE inhibitor
9. What causes microangiopathic hemolytic anemia in aortic stenosis?
Anitschow cell
4-24 hours
Kawasaki disease
RBC damaged while crossing the calcified valve causing schistocytes
10. What are the Jones criteria?
Myxoid degeneration
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Months out fibrosis
Reperfusion injury
11. What causes a mid - systolic click followed by a regurgitation murmur?
Nonspecific - eg fever and elevated ESR
Mitral valve prolapse
Reactive histiocyte with caterpillar nucleus
Eisenmenger syndrome
12. How does ischemia cause LHF?
Loss of fx
Ventricles cannot pump
Infantile coarctation of the aorta
Cardiac tamponade
13. Chest pain the arises with exertion or emotional stress and is relieved by NG or rest. The pain lasts <20 min and radiates to the left arm or jaw. There is also diaphoresis and SOB - EKG shows ST- segment depression.
Stable angina
Infectious endocarditis - arrythmias - severe mitral regurg no
NG or Ca channel blocker
VSD
14. How does stable angina present?
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Chest pain <20 min brought on by exertion or emotional stress
ST- segment elevation
Squat in response to cyanotic spell
15. What structures are susceptible to rupture post MI?
LAD
Aortic regurg
Papillary muscle - free wall - IV septum
Rupture of free wall - IV septum - or papillary muscle
16. What maintains patency of the PDA?
Paradoxical emboli
AD mutation in sarcomere proteins
PGE
Posterior wall of LV - posterior septum - papillary muscles
17. What are the tx for MI?
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Contraction band necrosis - reperfusion injury
Prinzmetal
Chronic rheumatic heart disease
18. How does aortic regurg affect the heart chambers?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
LV dilation and eccentric hypertrophy
Holosystolic machine like murmur
ST- segment depression
19. What artery is the 2nd most often occluded in an MI?
Inability to maintain systemic pressure w/lack of O2 to vital organs
Boot shaped heart
RCA
Tricuspid
20. What is cardiogenic shock?
Inability to maintain systemic pressure w/lack of O2 to vital organs
Nonbacterial thrombotic endocarditis (marantic endocarditis)
2-3%
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
21. What cardiac enzyme is useful for detecting reinfarction?
CK- MB
Streptococcus viridans
Type I
Pts w/previously damaged valves
22. How does MI cause LHF?
Holosystolic blowing murmur
Loss of LV fx
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
PDA
23. What type of tumor is a rhabdomyoma?
Loss of fx
Prinzmetal stable and unstable
Chest pain <20 min brought on by exertion or emotional stress
Harmartoma
24. What does nonbacterial thrombotic endocarditis cause?
Ventricle
Yellow pallor neutrophils
Valve replacement
Mitral regurg
25. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Sudden cardiac death
Streptococcus bovis/
LHF
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
26. Turner syndrome is associated with which congenital heart defect?
Mitral and tricuspid regurg - arrhythmia
Infantile coarctation of the aorta
2-3 weeks
Shunt
27. How do you prevent S viridans endocarditis?
Mitral regurgitation due to vegetations
Prophylactic abx during dental procedures
LA dilation
Stable and unstable prinzmetal
28. Is scar tissue or myocardium stronger?
Myocardium
Reperfusion injury
Stretched muscle loses contractility
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
29. What coronary arterysupplies the lateral wall of the LV?
Pancarditis
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Mitral regurg
Circumflex
30. What causes unstable angina?
Regurg vs stenosis
Prinzmetal
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Holosystolic machine like murmur
31. Opening snap followed by diastolic rumble.
Infantile coarctation of the aorta PDA
LV dilation and eccentric hypertrophy
Myocarditis
Mitral stenosis
32. What are the major criteria of the Jones criteria?
Sterile vegetations on surface and undersurface on mitral valve
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Minimizes ischemia
Mitral regurgitation due to vegetations
33. What effect does aortic regurg have on the pulse pressure? Why?
ST- segment elevation
4-7 days macrophage infiltration
Infectious
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
34. Tx for PDA?
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
Indomethacin - decreases PGE
Sudden cardiac death
35. With what disease is transposition of the great vessels associated?
Maternal diabetes
RCA
3-8 wks
Minimizes ischemia
36. What are the complications of aortic stenosis?
Intercostal arteries enlarged due to collateral circulation
Systolic dysfx leading to biventricular CHF
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
37. What is an important complication of ASD?
RCA
Paradoxical emboli
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Right side - serotonin and other secretory products detoxified in the lung
38. Vegetations on surface and undersurface of mitral valve.
Pulsating nail bed
LA dilation
Myocarditis
Libman - Sacks endocarditis
39. What is chronic rheumatic heart disease?
Concentric LV hypertophy
Valve scarring that arises as a consequence of rheumatic fever
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Prophylactic abx during dental procedures
40. What disesase has Aschoff bodies?
Streptococcus bovis/
Holosystolic blowing murmur
4-7 days macrophage infiltration
Myocarditis in acute rheumatic heart fever
41. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Within the first day
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
PDA
RCA
42. What bug causes acute rheumatic fever?
Group A beta - hemolytic streptococci
20 min
Papillary muscle - free wall - IV septum
L->R
43. Which chambers of the heart are generally spared in an MI?
Atria and RV
Pts w/previously damaged valves
Systemic venous congestion
Valve replacement once LV dysfx develops
44. What effect does chronic rheumatic heart disease have the mitral valve?
Within the first day
Louder - increased systemic resistence decreases LV emptying
Thickening of chrodae tendinae and cusps - mitral stenosis
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
45. At What age does wear and tear aortic stenosis present? What congenital disease hastens the onset?
Chronic ischemic heart disease
20 min
Nitroglycerin
>60 years - bicuspid aortic valve
46. What are the clinical features of RHF due to?
Systemic venous congestion
Annular - non pruritic rash w/erythematous borders trunks and limbs
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Erythematous nontender lesions on palms and soles.
47. What effect does transposition of the great vessels have on the ventricles?
Mitral regurg
S aureus
Hypertophy of RV atrophy of LV
Circumflex
48. What is the gold standard blood marker for MI?
Intercostal arteries enlarged due to collateral circulation
20 min
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Troponin I
49. What two things cause coronary artery vasospasm?
Gelatinous - abundant ground substance
Prinzmetal angina - cocaine
Restrictive cardiomyopathy
Aschoff bodies
50. What is the characteristic murmur of aortic stenosis?
Pulsating nail bed
Systolic ejection click followed by crescendo - decrescendo murmur
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Mitral regurg