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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 type of shunt does a VSD cause?
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
PGE
L->R
Wear and tear
2. When do neutrophils infiltrate the myocardium post MI?
1-3 days
Aneurysm - mural thrombus - Dressler syndrome
Indomethacin - decreases PGE
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
3. How does restrictive cardiomyopathy present?
AD mutation in sarcomere proteins
Myocarditis
Congestive heart failure
Streptococcus viridans
4. Dense layer of elastic and fibrotic tissue in the endocardium.
3-8 wks
Heart can't fill
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Endocardial fibroelastosis
5. What is the tx for mitral valve prolapse?
Paradoxical emboli
Membrane damage
Bicuspid aortic valve
Valve replacement
6. What is the tx for dilated cardiomyopathy?
Endocardial fibroelastosis
Regurg vs stenosis
Heart transplant
CHF
7. What effect does dilated cardiomyopathy have on the heart?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Systolic dysfx leading to biventricular CHF
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
Friction rub and chest pain
8. What causes the dependent pitting edema in RHF?
Increased hydrostatic pressure
Decrease in blood flow to an organ
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
CHF
9. What are the sx of aortic regurg?
Prinzmetal angina - cocaine
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
45%
Slow HR - decreasing O2 demand and risk for arrhythmia
10. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Posterior wall of LV - posterior septum - papillary muscles
Aortic regurg
ACE inhibitor
Right -->left
11. What is an important complication of ASD?
Paradoxical emboli
Tender lesions on fingers or toes.
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Systolic ejection click followed by crescendo - decrescendo murmur
12. What is the cause of the red border around granulation tissue?
Blood vessels coming in from normal tissue
RCA
Boot shaped heart
Nitroglycerin
13. What is cardiogenic shock?
Reperfusion injury
Volume overload and LHF
SLE
Inability to maintain systemic pressure w/lack of O2 to vital organs
14. What gross and microscopic changes occur 4-24 hours after an MI?
Dilated
Dressler syndrome
Dark discoloration coagulative necrosis
Breast and lung carcinoma - melanoma - lymphoma
15. What side of the heart do carcinoid tumors affect? Why?
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Concentric LV hypertophy
Right side - serotonin and other secretory products detoxified in the lung
Cardiogenic shock - CHF - arrhythmia
16. What is the most common cause of sudden cardiac death? What are less common causes of sudden cardiac death?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Transesophageal echo
Friction rub and chest pain
Pericarditits
17. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
Fibrinous pericarditis
Months out fibrosis
Open blocked vessels
Myxoma - benign
18. What distinguishes stenosis caused by chronic rheumatic heart disease from wear and tear aortic stenosis?
Months out fibrosis
Coexisting mitral stenosis and fusion of commisures exist
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Opening snap followed by diastolic rumble
19. With what disease is infantile coarctation of the aorta associated?
Kawasaki disease
Annular - non pruritic rash w/erythematous borders trunks and limbs
R-->L
Turner syndrome
20. In which pts does S viridans cause endocarditits?
Trisomy 21
Streptococcus bovis/
Pts w/previously damaged valves
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
21. What effect does chronic rheumatic heart disease have the mitral valve?
Friction rub and chest pain
Atria and RV
IV drug users
Thickening of chrodae tendinae and cusps - mitral stenosis
22. Which congenital heart defect is associated with congenital rubella?
Aneurysm - mural thrombus - Dressler syndrome
Reversible
PDA
Nonbacterial thrombotic endocarditis (marantic endocarditis)
23. What disesase has Aschoff bodies?
Myocarditis in acute rheumatic heart fever
Decrease preload -->lowers myocardial stress
Aortic regurg
Pulsating nail bed
24. When does the heart have a yellow pallor post MI?
Nitroglycerin
Day 1-7
Prinzmetal angina
Congested central veins
25. What is eythema marginatum? What parts of the body does it commonly involve?
Breast and lung carcinoma - melanoma - lymphoma
Pancarditis
Chest pain <20 min brought on by exertion or emotional stress
Annular - non pruritic rash w/erythematous borders trunks and limbs
26. With what disease is transposition of the great vessels associated?
Coronary artery vasospasm - emboli - vasculitis
Ventricular arrhythmia
45%
Maternal diabetes
27. When is a post - MI pt at highest risk for rupture of a LV structure? With what microscopic change is this complication associated?
20 min
4-7 days macrophage infiltration
Infantile coarctation of the aorta PDA
Endocarditis of prosthetic valves
28. How does hypertension cause LHF?
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29. What is the most common type of ASD? What %?
Circumflex
Ostium secundum (90%)
Turner syndrome
Systemic venous congestion
30. What is systolic dysfx?
Ventricles cannot pump
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Loss of LV fx
Holosystolic machine like murmur
31. What is an Aschoff body?
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Endocardial fibroelastosis
LV dilation and eccentric hypertrophy
Left -->right
32. What increases the volume of mitral regurg murmur?
Infectious
Anitschow cell
Squatting - expiration
Pedunculated mass in the LA that causes syncope due to obstruction of MV
33. Pericarditis 6-8 wks post MI.
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Ventricular arrhythmia
RBC damaged while crossing the calcified valve causing schistocytes
Dressler syndrome
34. What characterizes acute rheumatic fever endocarditiis?
Hemosiderin laden macrophages
Indomethacin - decreases PGE
Prinzmetal stable and unstable
Small vegetations along the line of closure
35. What iis the tx for aortic regurg?
>70%
Valve replacement once LV dysfx develops
Right to left
Group A beta - hemolytic streptococci
36. When does the heart have dark discoloration post MI?
ASD - R-->L
4-24 hours
Increased hydrostatic pressure
Transposition of the great vessels
37. What two things cause coronary artery vasospasm?
Sterile vegetations on mitral valve along lines of closure
Tender lesions on fingers or toes.
Prinzmetal angina - cocaine
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
38. What is the cause of restrictive cardiomyopathy in children?
Eisenmenger syndrome
Endocardial fibroelastosis (rare)
Prinzmetal angina - cocaine
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
39. Why would cardiac enzymes continue to increase after the initial MI?
Split S2 on auscultation
Reperfusion injury
Decreased forward perfusion pulmonary congestion
Mitral insufficiency
40. What are the complications of mitral valve prolapse? Are they common?
Infectious endocarditis - arrythmias - severe mitral regurg no
Large - destructive vegetations
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Infantile coarctation of the aorta PDA
41. What is the etiology of S viridans endocarditis?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Mitral mitral+aortic
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Congenital rubella
42. How do nitrates tx MI?
Decrease preload -->lowers myocardial stress
Myxoma - benign
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
NG or Ca channel blocker
43. What are the clinical features of endocarditis? What causes each feature?
Months out fibrosis
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Asymptomatic
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
44. What genetic conditions predispose a pt to mitral valve prolapse?
Ehlers - Danlow and Marfan syndrome
Yellow pallor macrophages
Mitral regurgitation due to vegetations
Squatting - expiration
45. What type of ASD is associated w/Down syndrome?
Ostium primum
>70%
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
1%
46. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Preductal - post aortic arch
Tricuspid
Minimizes ischemia
RCA
47. What conditions can cause nonbacterial thrombotic endocarditis?
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Hypercoagulable state or underlying adenocarcinoma
Nitroglycerin
Tetralogy of fallot
48. What is a water - hammer pulse?
Boot shaped heart
Bounding pulse
White scar fibrosis
Transesophageal echo
49. Which chambers of the heart are generally spared in an MI?
Dressler syndrome
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Atria and RV
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
50. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
Holosystolic machine like murmur
Colon cancer
Acute inflammation
MI