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 the murmur of mitral valve prolapse?
Hypertrophic cardiomyopathy
Mid - systolic click followed by regurgitation murmur
Day 1-7
Pts w/previously damaged valves

2. What complication occurs 1-3 days post MI?
Endocardial fibroelastosis
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Fibrinous pericarditis
MI

3. How does dilated cardiomyopathy cause LHF?
Autoimmune pericarditis 6-8 wks post MI
Stretched muscle loses contractility
Heart can't fill
1-3 days out

4. Infects predamaged valves after transient bacteremia?
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
Myocardium
S viridans
Ventricular arrhythmia

5. What increases the risk for chronic rheumatic heart disease?
Small - nondestructive vegetations (subacute endocarditis)
Pericarditits
Thickening of chrodae tendinae and cusps - mitral stenosis
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase

6. What are heart failure cells?
Hemosiderin laden macrophages
Sterile vegetations on mitral valve along lines of closure
Doxorubicin - cocaine
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

7. What is the cause of restrictive cardiomyopathy in children?
Adult coarctation of the aorta
Endocardial fibroelastosis
Endocardial fibroelastosis (rare)
Posterior wall of LV - posterior septum - papillary muscles

8. Crushing chest pain lasting >20 minutes that radiates to left arm or jaw - diaphoresis - and dyspnea. Sx not relieved by NG.
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Fibrinous pericarditis
Colon cancer
MI

9. What type of ischemia does stable angina cause?
Mitral insufficiency
Pericarditits
Subendocardial
Concentric LV hypertophy

10. What is the gold standard blood marker for MI?
1-3 days
Myocardium
Troponin I
Mitral mitral+aortic

11. What are the cancers that most commonly metastasize to the heart?
Decrease preload -->lowers myocardial stress
Infectious endocarditis - arrythmias - severe mitral regurg no
PDA
Breast and lung carcinoma - melanoma - lymphoma

12. What is the 1day-1wk -1mo mneumonic for MI?
Small - nondestructive vegetations (subacute endocarditis)
Tricuspid
Ventricle
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar

13. What shunt does tetralogy of fallot produce?
ST- segment depression
Prophylactic abx during dental procedures
Squat in response to cyanotic spell
Right -->left

14. What effect does chronic rheumatic heart disease have on the aortic valve?

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

15. What is the characteristic murmur of aortic stenosis?
Papillary muscle - free wall - IV septum
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
ASD - R-->L
Systolic ejection click followed by crescendo - decrescendo murmur

16. Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia.
Mitral regurgitation due to vegetations
Prinzmetal stable and unstable
Loeffler syndrome
2-4 hours - 24 hours - 7-10 days

17. What does rupture of the IV septum cause?
Shunt
LAD
Autoimmune pericarditis 6-8 wks post MI
Stretched muscle loses contractility

18. What is a Quincke pulse?
Ventricular arrhythmia
Pulsating nail bed
20 min
Rhabdomyoma

19. Tender lesions on fingers or toes.
Osler nodes (ouch - ouch Osler)
Aschoff bodies
Dark discoloration coagulative necrosis
Mitral regurg

20. What are the sx of hypertrophic cardiomyopathy?
AD mutation in sarcomere proteins
Shunt - PGE to maintain PDA until surgical repair can be performed
PDA
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib

21. Myofiber hypertrophy with disarray.
Fibrinous pericarditis
Hypertrophic cardiomyopathy
Intercostal arteries enlarged due to collateral circulation
Ostium secundum (90%)

22. What are the clinical features of endocarditis? What causes each feature?
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
Bounding pulse
Prophylactic abx during dental procedures

23. What is the most common type of endocarditis?
Infectious endocarditis - arrythmias - severe mitral regurg no
VSD
Infectious
Loss of fx

24. What murmur ccan be heard in PDA?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Myxoid degeneration
Holosystolic machine like murmur
Right to left

25. What is the most common cause of sudden cardiac death? What are less common causes of sudden cardiac death?
S epidermidis
Acute inflammation
Red border granulation tissue
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse

26. What are the causes of LHF?
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Pulsating nail bed
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Within the first day

27. EKG for stable angina?
ST- segment depression
Aortic stenosis
Trisomy 21
Annular - non pruritic rash w/erythematous borders trunks and limbs

28. When is a post - MI pt at highest risk for a mural thrombus? With what microscopic change is this complication associated?
Months out fibrosis
Valve scarring that arises as a consequence of rheumatic fever
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
MI

29. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Stable angina
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Stable and unstable prinzmetal

30. What congenital heart defect is associated with fetal alcohol syndrome?
Restrictive cardiomyopathy
VSD
Tetralogy of fallot
Aschoff bodies

31. What is the most common cause of aortic stenosis?
Wear and tear
LV dilation and eccentric hypertrophy
>60 years - bicuspid aortic valve
Prinzmetal angina - cocaine

32. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Wear and tear
Streptococcus bovis/
PDA
Nonspecific - eg fever and elevated ESR

33. What are the minor critera of the Jones criteria?
Nonspecific - eg fever and elevated ESR
Mitral regurg
Maternal diabetes
Infectious endocarditis - arrythmias - severe mitral regurg no

34. What % of MIs involve the LAD?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Chronic ischemic heart disease
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
45%

35. What is the characteristic murmurr of mitral stenosis?
Posterior wall of LV - posterior septum - papillary muscles
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Opening snap followed by diastolic rumble
VSD

36. Small - sterile fibrin deposits randomly arranged on closure of valve leaflets in a pt w/metastatic colon cancer?
Pericarditits
Endocardial fibroelastosis
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Prinzmetal angina

37. What is the most common type of ASD? What %?
Pts w/previously damaged valves
Months out fibrosis
Ostium secundum (90%)
Infectious endocarditis

38. In which pts does S viridans cause endocarditits?
Dark discoloration coagulative necrosis
Pts w/previously damaged valves
Hemosiderin laden macrophages
ST- segment depression

39. How does squating decrease hypoxemia in tetralogy of fallot?
Chronic ischemic heart disease
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Systolic ejection click followed by crescendo - decrescendo murmur
Chronic rheumatic heart disease

40. What does rupture of the LV free wall cause?
PDA
R-->L
Large - destructive vegetations
Cardiac tamponade

41. What is the murmur of mitral regurg?
1-3 days out
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Holosystolic blowing murmur
Large - destructive vegetations

42. What valves are most commonly involved in chronic rheumatic heart disease?
Group A beta - hemolytic streptococci
Myxoid degeneration
Mitral mitral+aortic
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea

43. What iis the tx for aortic regurg?
Valve replacement once LV dysfx develops
ACE inhibitor
R-->L
Dilated

44. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Sterile vegetations on mitral valve along lines of closure
Maternal diabetes
Congested central veins
Sudden cardiac death

45. What causes notching of the ribs in adult coarctation of the aorta?
Posterior wall of LV - posterior septum - papillary muscles
LHF
Congestive heart failure
Intercostal arteries enlarged due to collateral circulation

46. What type of ASD is associated w/Down syndrome?
Endocardial fibroelastosis (rare)
LAD
Ostium primum
Volume overload and LHF

47. What valves are involved in rhuematic endocarditis?
Aschoff bodies
Streptococcus bovis/
Tuberous sclerosis
Mitral mitral+aortic

48. What causes mitral valve prolapse?
Mitral mitral+aortic
Tetralogy of fallot
Myxoid degeneration
4-24 hours

49. What creates the immune reaction in acute rhuematic fever?

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

50. What makes the MV prolapse murmur louder? Why?
Squatting - increased systemic resistence decreases LV emptying
NG or Ca channel blocker
Ischemic heart disease
PDA