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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 transposition of the great vessels cause?
R-->L
Sudden cardiac death
Circumflex
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
2. What is the most common cause of infectious endocarditis?
Streptococcus viridans
Kawasaki disease
R-->L
RCA
3. What is the tx for aortic stenosis?
Anterior wall of LV and anterior septum
Within the first day
Valve replacement AFTER the onset of complications
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
4. What is the effect of acute vs chronic rheumatic disease off the mitral valve?
Stable and unstable prinzmetal
Tricuspid
Regurg vs stenosis
Ventricle
5. What gross and microscopic changes occur 4-24 hours after an MI?
Aortic stenosis
Inability to maintain systemic pressure w/lack of O2 to vital organs
Left -->right
Dark discoloration coagulative necrosis
6. What is the 1day-1wk -1mo mneumonic for MI?
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Coexisting mitral stenosis and fusion of commisures exist
Split S2 on auscultation
Myocarditis
7. What shunt does tetralogy of fallot produce?
Right -->left
Mitral valve prolapse
Circumflex
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
8. 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.
Prinzmetal angina - cocaine
Large vegetations of S aureus
Stable angina
Kawasaki disease
9. What causes acute endocarditis?
Large vegetations of S aureus
Bounding pulse
Months out fibrosis
Chest pain <20 min brought on by exertion or emotional stress
10. Tender lesions on fingers or toes.
Osler nodes (ouch - ouch Osler)
Hypercoagulable state or underlying adenocarcinoma
Mitral regurg
Dressler syndrome
11. How does reperfusion injury occur?
RHF
Atria and RV
Endocardial fibroelastosis (rare)
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
12. What type of shunt dose PDA cause?
Nitroglycerin
Endocarditis of prosthetic valves
Stretched muscle loses contractility
Left -->right
13. What drugs can cause dilated cardiomyopathy?
RCA
Doxorubicin - cocaine
Coronary artery vasospasm
Months out fibrosis
14. What are the HACEK organisms? With what condition are they associated?
Chronic ischemic heart disease
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Dilation of all four chambers of the heart
15. What is the tx for LHF?
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
ACE inhibitor
Bicuspid aortic valve
Valve replacement once LV dysfx develops
16. In which chamber of the heart are rhabdomyomas found?
Membrane damage
Surgical closure small defects may close spontaneously
IV drug users
Ventricle
17. What heart sound manifest with an ASD?
Split S2 on auscultation
Sterile vegetations on mitral valve along lines of closure
Stable and unstable prinzmetal
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
18. What is the basic principle of CHF?
Pump failure
Limits thrombosis
Metastasis
Stable and unstable prinzmetal
19. What is typically the mechanims of sudden cardiac death?
Right to left
Contraction band necrosis
Mid - systolic click followed by regurgitation murmur
Ventricular arrhythmia
20. Small - sterile fibrin deposits randomly arranged on closure of valve leaflets in a pt w/metastatic colon cancer?
Tricuspid
Hypercoagulable state or underlying adenocarcinoma
Osler nodes (ouch - ouch Osler)
Nonbacterial thrombotic endocarditis (marantic endocarditis)
21. Dense layer of elastic and fibrotic tissue in the endocardium.
Endocardial fibroelastosis
LAD
Reperfusion injury
PDA
22. What are the two effects of ATII?
Mid - systolic click followed by regurgitation murmur
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Shunt
RCA
23. Holosystolic blowing murmur that increases w/expiration?
RHF
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Mitral regurg
24. Unexpected death due to cardiac disease w/o sx or <1hr after sx arise?
Louder - increased systemic resistence decreases LV emptying
LV dilation and eccentric hypertrophy
Nitroglycerin
Sudden cardiac death
25. Erythematous nontender lesions on palms and soles.
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Janeway lesions
Erythematous nontender lesions on palms and soles.
Pts w/previously damaged valves
26. What structures are susceptible to rupture post MI?
Squat in response to cyanotic spell
Endocardial fibroelastosis
Hypercoagulable state or underlying adenocarcinoma
Papillary muscle - free wall - IV septum
27. What is the most common form of cardiomyopathy?
Chronic ischemic heart disease
Chest pain <20 min brought on by exertion or emotional stress
Dilated
Kawasaki disease
28. What effect does aortic stenosis have on the chambers of the heart?
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Concentric LV hypertophy
Breast and lung carcinoma - melanoma - lymphoma
Decrease preload -->lowers myocardial stress
29. What % stenosis causes stable angina?
Osler nodes (ouch - ouch Osler)
Libman - Sacks endocarditis
>70%
Ostium secundum (90%)
30. How do beta blockers tx MI?
Slow HR - decreasing O2 demand and risk for arrhythmia
Infectious endocarditis - arrythmias - severe mitral regurg no
Congestive heart failure
ST- segment elevation
31. What is the most common cause of sudden cardiac death? What are less common causes of sudden cardiac death?
Pulsating nail bed
Congested central veins
R-->L
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
32. What areas of the heart does the RCA supply?
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
Shunt
Minimizes ischemia
Posterior wall of LV - posterior septum - papillary muscles
33. What is an important complication of ASD?
PDA
Paradoxical emboli
Infectious endocarditis
Restrictive cardiomyopathy
34. Low voltage EKG w/diminished QRS amplitude.
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Concentric LV hypertophy
L->R
Restrictive cardiomyopathy
35. What is the murmur of mitral regurg?
Systolic ejection click followed by crescendo - decrescendo murmur
Contraction band necrosis
Holosystolic blowing murmur
RHF
36. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
Stable and unstable prinzmetal
Limits thrombosis
4-6 hours - 24 hours - 72 hours
Months out fibrosis
37. When would arrhythmia occur after MI?
Small vegetations along the line of closure
Within the first day
Tuberous sclerosis
LV dilation and eccentric hypertrophy
38. What is the only Jones criteria that doesn't resolve with time?
Pancarditis
Reperfusion injury
Mitral mitral+aortic
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
39. How does subendocardial MI/ischemia present on EKG?
ST- segment depression
Sterile vegetations on surface and undersurface on mitral valve
Bounding pulse
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
40. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Left -->right
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
ASD - R-->L
Trisomy 21
41. What is the tx for mitral valve prolapse?
Myofiber hypertrophy with disarray
1%
Valve replacement
Valve replacement AFTER the onset of complications
42. Episodic chest pain unrelated to exertion due to coronary vasospasm. ST- segment elevation. Relieved by NG or Ca channel blockers.
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
Prinzmetal angina
45%
Reactive histiocyte with caterpillar nucleus
43. What does rupture of the LV free wall cause?
Mitral regurg
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Large vegetations of S aureus
Cardiac tamponade
44. How does aortic regurg affect the heart chambers?
Loeffler syndrome
LV dilation and eccentric hypertrophy
White scar fibrosis
Adult coarctation of the aorta
45. What causes wear and tear aortic stenosis?
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Stable and unstable prinzmetal
Inability to maintain systemic pressure w/lack of O2 to vital organs
Fibrosis and dystrophic calcification
46. What type of collagen is involved in fibrosis?
Rupture of free wall - IV septum - or papillary muscle
Endocardial fibroelastosis (rare)
Anitschow cell
Type I
47. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Reversible
RHF
RCA
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
48. What is the tx for VSD?
PDA
Hypertophy of RV atrophy of LV
R-->L
Surgical closure small defects may close spontaneously
49. What are the clinical features of RHF due to?
Atria and RV
Increased blood in right heart delays closure of P valve
Systemic venous congestion
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
50. What is the most common cause of death during the acute phase of rheumatic fever?
Myocarditis
Osler nodes (ouch - ouch Osler)
Mitral valve prolapse
Inability to maintain systemic pressure w/lack of O2 to vital organs