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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 common cause of myocarditis?
Coxsackie A or B
Months out fibrosis
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
LA dilation
2. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
Ostium secundum (90%)
Anterior wall of LV and anterior septum
Dilation of all four chambers of the heart
Reperfusion injury
3. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Loss of LV fx
PDA
Doxorubicin - cocaine
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
4. Why are cardiac enzymes elevated after an MI?
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Membrane damage
45%
Months out fibrosis
5. What type of vegetations does Strep viridans cause?
Small - nondestructive vegetations (subacute endocarditis)
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
6. Which congenital heart defect is associated with maternal diabetes?
Large vegetations of S aureus
Dilation of all four chambers of the heart
Transposition of the great vessels
Systolic ejection click followed by crescendo - decrescendo murmur
7. What is the tx for aortic stenosis?
Membrane damage
Regurg vs stenosis
Rupture of free wall - IV septum - or papillary muscle
Valve replacement AFTER the onset of complications
8. Reactive histiocyte with slender - wavy 'caterpillar' nucleus.
Backward LHF pulm htn and RHF - afib and associated mural thombis
Inability to fill ventricles
Indomethacin - decreases PGE
Anitschow cell
9. When would arrhythmia occur after MI?
Decreased forward perfusion pulmonary congestion
Within the first day
Congenital rubella
Friction rub and chest pain
10. What is an Aschoff body?
Spontaneous
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Infectious
Pts w/previously damaged valves
11. When do neutrophils infiltrate the myocardium post MI?
Within the first day
Sudden cardiac death
Ventricular arrhythmia
1-3 days
12. What does rupture of the LV free wall cause?
VSD
Ventricles cannot pump
Nitroglycerin
Cardiac tamponade
13. How does subendocardial MI/ischemia present on EKG?
Ostium secundum (90%)
Decreased forward perfusion pulmonary congestion
ST- segment depression
Valve replacement once LV dysfx develops
14. What causes heart failure cells?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Mitral regurg
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Decrease preload -->lowers myocardial stress
15. What disesase has Aschoff bodies?
Surgical closure small defects may close spontaneously
Plump fibroblasts - collagen - blood vessels
Coronary artery vasospasm - emboli - vasculitis
Myocarditis in acute rheumatic heart fever
16. What is the most common form of cardiomyopathy?
IV drug users
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Dilated
Large - destructive vegetations
17. What cardiac disease is associated with tuberous sclerosis?
Rhabdomyoma
2-3%
ST- segment depression
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
18. What is the most common cause of mitral stenosis?
Chronic rheumatic heart disease
R-->L
Papillary muscle - free wall - IV septum
Valve scarring that arises as a consequence of rheumatic fever
19. Dilated cardiomyopathy is a late complication of what illness?
Myocarditis
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Louder - increased systemic resistence decreases LV emptying
2-3 weeks
20. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Decrease preload -->lowers myocardial stress
ASD - R-->L
Ventricles cannot pump
Chronic ischemic heart disease
21. Drug that vasodilates both arteries and veins but mostly veins. Used to decrease preload to heart.
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
ST- segment depression
Mitral regurg
Nitroglycerin
22. What bug causes acute rheumatic fever?
Infantile coarctation of the aorta PDA
Group A beta - hemolytic streptococci
Hypertrophic cardiomyopathy
Minimizes ischemia
23. What two things happen when a blocked vessel is opened after an MI?
Contraction band necrosis - reperfusion injury
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Rhadbomyoma - benign
24. Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia.
20 min
Loss of fx
Valve replacement once LV dysfx develops
Loeffler syndrome
25. Poor myocardial fx due to chronic ischemic damage?
Left -->right
Transposition of the great vessels
Chronic ischemic heart disease
Pts w/previously damaged valves
26. What valves are involved in rhuematic endocarditis?
Mitral mitral+aortic
ST- segment depression
Transposition of the great vessels
Degree of pulmonary artery stenosis
27. What endocarditis is commonly found in patients with colon cancer?
Stretched muscle loses contractility
Open blocked vessels
Streptococcus bovis/
Dilation of all four chambers of the heart
28. What creates the immune reaction in acute rhuematic fever?
29. What are the clinical features of RHF due to?
Bicuspid aortic valve
Systemic venous congestion
Posterior wall of LV - posterior septum - papillary muscles
Mitral and tricuspid regurg - arrhythmia
30. What side of the heart do carcinoid tumors affect? Why?
Valve scarring that arises as a consequence of rheumatic fever
Left -->right
Sterile vegetations on surface and undersurface on mitral valve
Right side - serotonin and other secretory products detoxified in the lung
31. Episodic chest pain unrelated to exertion due to coronary vasospasm. ST- segment elevation. Relieved by NG or Ca channel blockers.
Prinzmetal angina
Months out fibrosis
Valve replacement AFTER the onset of complications
Mitral stenosis
32. What maintains patency of the PDA?
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Inability to fill ventricles
PGE
33. What drugs can cause dilated cardiomyopathy?
4-24 hours
Squatting - expiration
Systolic ejection click followed by crescendo - decrescendo murmur
Doxorubicin - cocaine
34. How does hypertension cause LHF?
35. At What age does wear and tear aortic stenosis present? What congenital disease hastens the onset?
>60 years - bicuspid aortic valve
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Prinzmetal angina - cocaine
Anterior wall of LV and anterior septum
36. What always follows necrosis?
Concentric LV hypertophy
Acute inflammation
Friction rub and chest pain
Type I
37. When is a post - MI pt at highest risk for an aneurysm? With what microscopic change is this complication associated?
Months out fibrosis
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
Posterior wall of LV - posterior septum - papillary muscles
Valve replacement AFTER the onset of complications
38. What causes microangiopathic hemolytic anemia in aortic stenosis?
RBC damaged while crossing the calcified valve causing schistocytes
>70%
Split S2 on auscultation
Group A beta - hemolytic streptococci
39. When is an MI patent at highest risk for fibrionous pericarditis?
Low voltage EKG w/diminished QRS amplitude
1-3 days out
Thickening of chrodae tendinae and cusps - mitral stenosis
Coronary artery vasospasm
40. What type of valvular vegetations does S aureus cause?
Dark discoloration coagulative necrosis
Spontaneous
Large - destructive vegetations
Infantile coarctation of the aorta PDA
41. How do you tx prinzmetal angina?
ASD - R-->L
NG or Ca channel blocker
Prophylactic abx during dental procedures
Janeway lesions
42. What does nonbacterial thrombotic endocarditis cause?
Myocarditis in acute rheumatic heart fever
Heart transplant
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
Mitral regurg
43. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
Stable and unstable prinzmetal
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
ACE inhibitor
Inability to fill ventricles
44. What are the causes of restrictive cardiomyopathy in adults?
Myocarditis
Coexisting mitral stenosis and fusion of commisures exist
Chronic ischemic heart disease
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
45. What is endocardial fibroelastosis? In what population is it found?
Tuberous sclerosis
Wear and tear
Congested central veins
Dense layer of elastic and fibrotic tissue in the endocardium - children
46. What is the 1day-1wk -1mo mneumonic for MI?
Mitral mitral+aortic
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Slow HR - decreasing O2 demand and risk for arrhythmia
Months out fibrosis
47. How does stable angina present?
Breast and lung carcinoma - melanoma - lymphoma
S aureus
Chest pain <20 min brought on by exertion or emotional stress
Months out fibrosis
48. How does Eisenmeger syndrome occur?
Paradoxical emboli
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
Sterile vegetations on mitral valve along lines of closure
Fibrosis and dystrophic calcification
49. What is typically the mechanims of sudden cardiac death?
Subendocardial
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Ventricular arrhythmia
RCA
50. In what pt population does S aureus commonly cause valvular disease?
IV drug users
Circumflex
Ventricular arrhythmia
Months out fibrosis