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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 areas of the heart does the RCA supply?
Systolic ejection click followed by crescendo - decrescendo murmur
Endocardial fibroelastosis
Posterior wall of LV - posterior septum - papillary muscles
Hypertrophic cardiomyopathy
2. How does dilated cardiomyopathy cause LHF?
Dilated
Slow HR - decreasing O2 demand and risk for arrhythmia
Stretched muscle loses contractility
Decrease in blood flow to an organ
3. When does the heart have a yellow pallor post MI?
Open blocked vessels
S epidermidis
Day 1-7
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
4. How does aortic regurg affect the heart chambers?
Preductal - post aortic arch
LV dilation and eccentric hypertrophy
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Systolic ejection click followed by crescendo - decrescendo murmur
5. What are the two effects of ATII?
Mitral mitral+aortic
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
LAD
6. At what point in development do congenital heart defects arise?
Dense layer of elastic and fibrotic tissue in the endocardium - children
Reperfusion injury
LAD
3-8 wks
7. Dyspnea - PND - orthopnea - crackles - fluid rentention - heart failure cells.
Membrane damage
Elevated ASO anti - DNase B titers
45%
LHF
8. What is the characteristic murmurr of mitral stenosis?
Left -->right
Sudden cardiac death
Stretched muscle loses contractility
Opening snap followed by diastolic rumble
9. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Migratory polyarthritis
Left -->right
Infantile coarctation of the aorta PDA
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
10. What are the complications of aortic stenosis?
1-3 days
RCA
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
11. What are the sx of hypertrophic cardiomyopathy?
Anterior wall of LV and anterior septum
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Fibrosis and dystrophic calcification
12. What bug causes acute rheumatic fever?
Aortic regurg
Dense layer of elastic and fibrotic tissue in the endocardium - children
S aureus
Group A beta - hemolytic streptococci
13. With what developmental disorder is VSD associated?
Fetal alcohol syndrome
Transposition of the great vessels
Ostium primum
Left -->right
14. What is the most common cause of death during the acute phase of rheumatic fever?
Myocarditis
CK- MB
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Autoimmune pericarditis 6-8 wks post MI
15. Which angina is relieved by Ca channel blockers?
LAD
Aortic stenosis
Prinzmetal
Hemosiderin laden macrophages
16. What drug relieves stable angina?
Ventricle
Nitroglycerin
LA
Fetal alcohol syndrome
17. When do macrophagess infiltrate the myocardium post MI?
Hemosiderin laden macrophages
4-7 days
Infectious endocarditis
Granulation tissue
18. What iis the tx for aortic regurg?
Valve replacement once LV dysfx develops
Chronic rheumatic heart disease
Mitral insufficiency
Ventricular arrhythmia
19. What is the tx for LHF?
Dilation of all four chambers of the heart
Contraction band necrosis
Fibrinous pericarditis
ACE inhibitor
20. What congenital heart defect presents later in life with lower extremity cyanosis?
Valve replacement once LV dysfx develops
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
PDA
Troponin I
21. Lower extremity cyanosis later in life - holostystolic machine like murmur.
PDA
Aortic regurg
Myofiber hypertrophy with disarray
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
22. What does a biopsy of hypertrophic cardiomyopathy look like?
Myofiber hypertrophy with disarray
S viridans
ACE inhibitor
ST- segment depression
23. How does adult coarctation of the aorta present?
RBC damaged while crossing the calcified valve causing schistocytes
Myxoid degeneration
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Hypertrophic cardiomyopathy
24. What are the cancers that most commonly metastasize to the heart?
LA
Breast and lung carcinoma - melanoma - lymphoma
Myofiber hypertrophy with disarray
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
25. What are Janeway lesions?
RCA
Erythematous nontender lesions on palms and soles.
Squatting - increased systemic resistence decreases LV emptying
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
26. What are the complications of mitral valve prolapse? Are they common?
Dressler syndrome
Thickening of chrodae tendinae and cusps - mitral stenosis
Infectious endocarditis - arrythmias - severe mitral regurg no
Aortic stenosis
27. What type of shunt results in cyanosis at birth?
Right to left
Decreases LV dilation by decreasing volume
RCA
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
28. How does stable angina present?
Streptococcus viridans
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
S aureus
Chest pain <20 min brought on by exertion or emotional stress
29. What type of valvular vegetations does S aureus cause?
Infectious
Large - destructive vegetations
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
RCA
30. How do you tx prinzmetal angina?
Squatting - increased systemic resistence decreases LV emptying
ST- segment depression
NG or Ca channel blocker
PDA
31. What causes heart failure cells?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Split S2 on auscultation
Coexisting mitral stenosis and fusion of commisures exist
32. What causes a mid - systolic click followed by a regurgitation murmur?
LAD
Day 1-7
Mitral valve prolapse
Dilation of all four chambers of the heart
33. What is the major cause of MI?
Small vegetations along the line of closure
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
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
34. What maintains patency of the PDA?
PGE
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Blood vessels coming in from normal tissue
Mitral valve prolapse
35. What is the gold standard blood marker for MI?
Anitschow cell
Fibrinous pericarditis
Troponin I
Mitral and tricuspid regurg - arrhythmia
36. 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
Infantile coarctation of the aorta PDA
Mitral mitral+aortic
Sterile vegetations on mitral valve along lines of closure
37. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Stretched muscle loses contractility
Bicuspid aortic valve
Libman - Sacks endocarditis
Adult coarctation of the aorta
38. What type of shunt dose PDA cause?
Squatting - increased systemic resistence decreases LV emptying
Left -->right
Trisomy 21
Pts w/previously damaged valves
39. What type of vegetations form in nonbacterial thrombotic endocarditis?
Sterile vegetations on mitral valve along lines of closure
2-3 weeks
VSD
4-6 hours - 24 hours - 72 hours
40. Tender lesions on fingers or toes.
Osler nodes (ouch - ouch Osler)
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Doxorubicin - cocaine
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
41. What valves are most commonly involved in chronic rheumatic heart disease?
CHF
Ehlers - Danlow and Marfan syndrome
Mitral mitral+aortic
PDA
42. What is the most common tumor of the heart?
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
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
Metastasis
Plump fibroblasts - collagen - blood vessels
43. Turner syndrome is associated with which congenital heart defect?
Pump failure
CK- MB
Infantile coarctation of the aorta
LA dilation
44. What type of endocarditis is associated with SLE?
CHF
Libman - Sacks endocarditis
Coexisting mitral stenosis and fusion of commisures exist
Pedunculated mass in the LA that causes syncope due to obstruction of MV
45. What effect does chronic rheumatic heart disease have the mitral valve?
Thickening of chrodae tendinae and cusps - mitral stenosis
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Right to left
>70%
46. Lower extremity cyanosis in infants? In adults?
Infantile coarctation of the aorta PDA
Large - destructive vegetations
Inability to maintain systemic pressure w/lack of O2 to vital organs
Kawasaki disease
47. What is eythema marginatum? What parts of the body does it commonly involve?
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
Myocardium
Annular - non pruritic rash w/erythematous borders trunks and limbs
MI
48. Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material.
Decreases LV dilation by decreasing volume
Aneurysm - mural thrombus - Dressler syndrome
Nitroglycerin
Aschoff bodies
49. What is a Quincke pulse?
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
2-3%
Heart transplant
Pulsating nail bed
50. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Prinzmetal angina - cocaine
Systolic ejection click followed by crescendo - decrescendo murmur
Aortic regurg
Nitroglycerin