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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. When is a post - MI pt at highest risk for a mural thrombus? With what microscopic change is this complication associated?
Myxoid degeneration
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy
Months out fibrosis
LV dilation and eccentric hypertrophy
2. What causes the dependent pitting edema in RHF?
Transesophageal echo
Membrane damage
Increased hydrostatic pressure
2-4 hours - 24 hours - 7-10 days
3. How do ACE inhibitors tx MI?
Transesophageal echo
Turner syndrome
Decreases LV dilation by decreasing volume
Elevated ASO anti - DNase B titers
4. What areas of the heart does the LAD supply?
Months out fibrosis
Coexisting mitral stenosis and fusion of commisures exist
Anterior wall of LV and anterior septum
PDA
5. What is the most common cause of RHF? What are others?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Transesophageal echo
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Inability to maintain systemic pressure w/lack of O2 to vital organs
6. Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - pitting edema.
Indomethacin - decreases PGE
RHF
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Mitral regurg
7. With what disease is infantile coarctation of the aorta associated?
>60 years - bicuspid aortic valve
Holosystolic machine like murmur
Turner syndrome
2-4 hours - 24 hours - 7-10 days
8. How does subendocardial MI/ischemia present on EKG?
Transposition of the great vessels
ST- segment depression
Metastasis
Subendocardial
9. What congenital heart defect does indomethacin tx?
PDA
Coronary artery vasospasm
Congenital rubella
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
10. Why would cardiac enzymes continue to increase after the initial MI?
Contraction band necrosis
Circumflex
Reperfusion injury
Hemosiderin laden macrophages
11. What genetic conditions predispose a pt to mitral valve prolapse?
Ehlers - Danlow and Marfan syndrome
Left -->right
Yellow pallor neutrophils
Decreases LV dilation by decreasing volume
12. How does dilated cardiomyopathy cause LHF?
Annular - non pruritic rash w/erythematous borders trunks and limbs
Decrease in blood flow to an organ
Stretched muscle loses contractility
LHF
13. What is the characteristic murmur of aortic stenosis?
Systolic ejection click followed by crescendo - decrescendo murmur
Rhabdomyoma
Shunt - PGE to maintain PDA until surgical repair can be performed
Indomethacin - decreases PGE
14. How does adult coarctation of the aorta present?
2-3 weeks
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Posterior wall of LV - posterior septum - papillary muscles
Ehlers - Danlow and Marfan syndrome
15. What artery is the 2nd most often occluded in an MI?
RCA
Subendocardial
Mitral valve prolapse
Infectious endocarditis - arrythmias - severe mitral regurg no
16. What iis the tx for aortic regurg?
Restrictive cardiomyopathy
Valve replacement once LV dysfx develops
Congested central veins
Preductal - post aortic arch
17. With what developmental disorder is VSD associated?
Mid - systolic click followed by regurgitation murmur
Cyanosis - RV hypertrophy - polycythemia - clubbing
Myocarditis
Fetal alcohol syndrome
18. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
>60 years - bicuspid aortic valve
LAD
MI
Stable and unstable prinzmetal
19. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Prinzmetal angina - cocaine
Transposition of the great vessels
RCA
Mitral mitral+aortic
20. EKG for stable angina?
PDA
Cardiogenic shock - CHF - arrhythmia
1-3 days
ST- segment depression
21. What is the major cause of MI?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Prinzmetal angina - cocaine
Pericarditits
VSD
22. What are the major criteria of the Jones criteria?
Large vegetations of S aureus
SLE
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
23. What is the tx for mitral valve prolapse?
Myxoid degeneration
PDA
Valve replacement
Minimizes ischemia
24. How does restrictive cardiomyopathy cause LHF?
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25. What is chronic rheumatic heart disease?
Holosystolic blowing murmur
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Valve scarring that arises as a consequence of rheumatic fever
LA dilation
26. What is the most common type of endocarditis?
Infectious
Pericarditits
Squatting - increased systemic resistence decreases LV emptying
Mitral and tricuspid regurg - arrhythmia
27. What conditions can cause nonbacterial thrombotic endocarditis?
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Positive blood cultures anemia of chronic disease
Hypercoagulable state or underlying adenocarcinoma
Spontaneous
28. What is the tx for LHF?
Tetralogy of fallot
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
ACE inhibitor
Opening snap followed by diastolic rumble
29. Boot - shaped heart on x- ray?
Boot shaped heart
Tetralogy of fallot
First 4 hours
Day 1-7
30. What effect does aortic stenosis have on the chambers of the heart?
Ostium secundum (90%)
Right side - serotonin and other secretory products detoxified in the lung
Tender lesions on fingers or toes.
Concentric LV hypertophy
31. How does restrictive cardiomyopathy present?
Troponin I
Congestive heart failure
RCA
PGE
32. If a pt has an endocarditis caused by Streptococcus bovis - what underlying condition should you test for?
Adult coarctation of the aorta
Colon cancer
Yellow pallor neutrophils
Papillary muscle - free wall - IV septum
33. What is the rate of congenital heart defects?
1%
Opening snap followed by diastolic rumble
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Restrictive cardiomyopathy
34. What causes mitral valve prolapse?
Asymptomatic
CHF
Right -->left
Myxoid degeneration
35. What is the leading cause of death in the US?
ST- segment depression
Aortic stenosis
Ischemic heart disease
MI
36. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Pts w/previously damaged valves
ASD - R-->L
Nonbacterial thrombotic endocarditis (marantic endocarditis)
1-3 days
37. What does granulation tissue contain?
Atherosclerosis of coronary arteries
Plump fibroblasts - collagen - blood vessels
Chest pain <20 min brought on by exertion or emotional stress
When a bacterial protein resembles a protein in human tissue
38. What type of valvular vegetations does S aureus cause?
Large - destructive vegetations
Stable and unstable prinzmetal
Harmartoma
Degree of pulmonary artery stenosis
39. What type of endocarditis is associated with SLE?
Opening snap followed by diastolic rumble
Limits thrombosis
Reactive histiocyte with caterpillar nucleus
Libman - Sacks endocarditis
40. What is Loeffler syndrome?
Ventricles cannot pump
Sterile vegetations on mitral valve along lines of closure
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
41. What are the complications of mitral stenosis?
Backward LHF pulm htn and RHF - afib and associated mural thombis
Squatting - expiration
Contraction band necrosis - reperfusion injury
Holosystolic blowing murmur
42. What determines the extent of shunting and cyanosis in tetralogy of fallot?
Degree of pulmonary artery stenosis
Adult coarctation of the aorta
S viridans
4-24 hours
43. What does a biopsy of hypertrophic cardiomyopathy look like?
Shunt
Myofiber hypertrophy with disarray
LA
PDA
44. What is eythema marginatum? What parts of the body does it commonly involve?
Erythematous nontender lesions on palms and soles.
Ventricle
Right to left
Annular - non pruritic rash w/erythematous borders trunks and limbs
45. What is the main cause of MV regurg? What are other causes?
Volume overload and LHF
Paradoxical emboli
Elevated ASO anti - DNase B titers
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
46. What complication occurs 1-3 days post MI?
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
Fibrinous pericarditis
Increased blood in right heart delays closure of P valve
Blood vessels coming in from normal tissue
47. What is the JOneS mneumonic?
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
Osler nodes (ouch - ouch Osler)
Degree of pulmonary artery stenosis
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
48. What is the basic principle of CHF?
Pump failure
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Spontaneous
49. What is Dressler syndrome? When does it occur?
4-7 days
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
ACE inhibitor
Autoimmune pericarditis 6-8 wks post MI
50. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Valve replacement once LV dysfx develops
Loss of fx
Aortic regurg
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR