Test your basic knowledge |

Cardiac

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 Loeffler syndrome?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
>70%
2-3 weeks

2. With what condition are rhabdomyomas associated?
Prinzmetal angina - cocaine
L->R
Prinzmetal
Tuberous sclerosis

3. What is the most common tumor of the heart?
Metastasis
PDA
Annular - non pruritic rash w/erythematous borders trunks and limbs
Yellow pallor macrophages

4. What are the Jones criteria?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Pump failure
Congestive heart failure
Nitroglycerin

5. What does granulation tissue contain?
Migratory polyarthritis
Plump fibroblasts - collagen - blood vessels
Myocarditis in acute rheumatic heart fever
ASD - R-->L

6. What gross and microscopic changes occur 1-3 days after an MI?
Yellow pallor neutrophils
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Myocardium
Rhabdomyoma

7. What is the major cause of MI?
S aureus
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Pulsating nail bed
Coronary artery vasospasm - emboli - vasculitis

8. 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
Decreases LV dilation by decreasing volume
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
NG or Ca channel blocker

9. What type of ASD is associated w/Down syndrome?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Holosystolic machine like murmur
Ostium primum
When a bacterial protein resembles a protein in human tissue

10. What are the cancers that most commonly metastasize to the heart?
Day 1-7
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Breast and lung carcinoma - melanoma - lymphoma
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing

11. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Thickening of chrodae tendinae and cusps - mitral stenosis
Surgical closure small defects may close spontaneously
Pump failure
PDA

12. What structures are susceptible to rupture post MI?
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
ST- segment depression
Papillary muscle - free wall - IV septum
CK- MB

13. When does the heart have a yellow pallor post MI?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Day 1-7
Large - destructive vegetations
RCA

14. Tender lesions on fingers or toes.
3-8 wks
Infantile coarctation of the aorta
Holosystolic blowing murmur
Osler nodes (ouch - ouch Osler)

15. What tests show prior group A beta - hemolytic strep infection?
Elevated ASO anti - DNase B titers
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Wear and tear
1-3 days out

16. How does hypertension cause LHF?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

17. What drug relieves stable angina?
Chest pain <20 min brought on by exertion or emotional stress
Nitroglycerin
R-->L
Valve replacement once LV dysfx develops

18. Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia.
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
Loeffler syndrome
Large vegetations of S aureus
Tender lesions on fingers or toes.

19. With what endocarditis is S epidermidis associated?
Surgical closure small defects may close spontaneously
SLE
Endocarditis of prosthetic valves
Holosystolic machine like murmur

20. Which artery is most often occluded in an MI?
Fetal alcohol syndrome
LAD
Autoimmune pericarditis 6-8 wks post MI
ST- segment depression

21. Which vasculitis can cause MI?
Kawasaki disease
Fibrosis and dystrophic calcification
Mitral regurg
Minimizes ischemia

22. What is the definition of ischemia?
Harmartoma
Atherosclerosis of coronary arteries
Decrease in blood flow to an organ
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy

23. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Mitral regurgitation due to vegetations
ASD - R-->L
Valve replacement AFTER the onset of complications
Plump fibroblasts - collagen - blood vessels

24. What makes the MV prolapse murmur louder? Why?
Squatting - increased systemic resistence decreases LV emptying
Erythematous nontender lesions on palms and soles.
Left -->right
Osler nodes (ouch - ouch Osler)

25. What is chronic rheumatic heart disease?
Valve scarring that arises as a consequence of rheumatic fever
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Increased blood in right heart delays closure of P valve
Boot shaped heart

26. What causes the split S2 in ASD?
Subendocardial
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Increased blood in right heart delays closure of P valve
Sterile vegetations on mitral valve along lines of closure

27. What is the characteristic murmurr of mitral stenosis?
Hypercoagulable state or underlying adenocarcinoma
Opening snap followed by diastolic rumble
LA dilation
4-7 days

28. What does rupture of a papillary muscle cause?
Mid - systolic click followed by regurgitation murmur
Ventricle
Mitral insufficiency
Decrease in blood flow to an organ

29. Friction rub and chest pain.
Holosystolic machine like murmur
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Pericarditits
Louder - increased systemic resistence decreases LV emptying

30. Tx for PDA?
Low voltage EKG w/diminished QRS amplitude
Yellow pallor neutrophils
Indomethacin - decreases PGE
Shunt

31. What type of endocarditis is associated with SLE?
Libman - Sacks endocarditis
Squat in response to cyanotic spell
Maternal diabetes
Hypertophy of RV atrophy of LV

32. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Dense layer of elastic and fibrotic tissue in the endocardium - children
Harmartoma
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
LHF

33. What is the most common cause of myocarditis?
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Coxsackie A or B
Anterior wall of LV and anterior septum
Pedunculated mass in the LA that causes syncope due to obstruction of MV

34. What are the sx of hypertrophic cardiomyopathy?
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Heart transplant
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Anterior wall of LV and anterior septum

35. Which congenital heart defect is associated with congenital rubella?
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Mitral regurg
Group A beta - hemolytic streptococci
PDA

36. What are the sx of pericardiits?
Dense layer of elastic and fibrotic tissue in the endocardium - children
Friction rub and chest pain
PDA
Nitroglycerin

37. Where is the coarctation in infantile coarctation of the aorta?
Reactive histiocyte with caterpillar nucleus
Months out fibrosis
Preductal - post aortic arch
Aortic stenosis

38. What are the clinical features of endocarditis? What causes each feature?
Shunt
Osler nodes (ouch - ouch Osler)
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
Eisenmenger syndrome

39. How does ischemia cause LHF?
Loss of fx
Degree of pulmonary artery stenosis
MI
Louder - increased systemic resistence decreases LV emptying

40. What is a common complication of cardiac metastasis?
Hemosiderin laden macrophages
Coronary artery vasospasm
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
Pericardial effusion due to pericardial involvement

41. What is the characteristic murmur of aortic stenosis?
Nitroglycerin
Tender lesions on fingers or toes.
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Systolic ejection click followed by crescendo - decrescendo murmur

42. What cardiac enzyme is useful for detecting reinfarction?
First 4 hours
CK- MB
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD

43. What two things happen when a blocked vessel is opened after an MI?
LV dilation and eccentric hypertrophy
Rhabdomyoma
Transesophageal echo
Contraction band necrosis - reperfusion injury

44. What gross and microscopic changes occur 4-24 hours after an MI?
Pericardial effusion due to pericardial involvement
Infectious endocarditis
Dark discoloration coagulative necrosis
4-6 hours - 24 hours - 72 hours

45. Dense layer of elastic and fibrotic tissue in the endocardium.
RCA
Chronic rheumatic heart disease
Endocardial fibroelastosis
CHF

46. How long after pharyngitis does acute rheumatic fever occur?
Myocarditis
ST- segment depression
Coxsackie A or B
2-3 weeks

47. What does rupture of the LV free wall cause?
S aureus
Cardiac tamponade
Decreases LV dilation by decreasing volume
Myxoid degeneration

48. What is the most common cause of infectious endocarditis?
2-3%
Surgical closure small defects may close spontaneously
Streptococcus viridans
Myofiber hypertrophy with disarray

49. What causes notching of the ribs in adult coarctation of the aorta?
Rupture of free wall - IV septum - or papillary muscle
ASD - R-->L
Left -->right
Intercostal arteries enlarged due to collateral circulation

50. What are the complications of mitral stenosis?
Chronic rheumatic heart disease
Backward LHF pulm htn and RHF - afib and associated mural thombis
Contraction band necrosis
LAD