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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 is the most common cause of aortic stenosis?
LA
Wear and tear
Small vegetations along the line of closure
Hypercoagulable state or underlying adenocarcinoma
2. With what endocarditis is S epidermidis associated?
Endocarditis of prosthetic valves
LV dilation and eccentric hypertrophy
ST- segment depression
Aschoff bodies
3. What is the most common type of endocarditis?
Infectious
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Bicuspid aortic valve
Pts w/previously damaged valves
4. What causes a mid - systolic click followed by a regurgitation murmur?
Mitral valve prolapse
Prinzmetal stable and unstable
Myxoid degeneration
Mitral regurg
5. When is a post - MI pt at highest risk for Dressler syndrome? With what microscopic change is this complication associated?
S aureus
Months out fibrosis
Intercostal arteries enlarged due to collateral circulation
Prophylactic abx during dental procedures
6. Large vegetations on tricuspid valve?
S aureus
Yellow pallor macrophages
RCA
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
7. What coronary arterysupplies the lateral wall of the LV?
Mid - systolic click followed by regurgitation murmur
Small vegetations along the line of closure
Split S2 on auscultation
Circumflex
8. Is injury due angina reversible or irreversible?
Cyanosis - RV hypertrophy - polycythemia - clubbing
Reversible
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
9. What are the major criteria of the Jones criteria?
3-8 wks
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
Decrease in blood flow to an organ
10. How do you prevent S viridans endocarditis?
Prophylactic abx during dental procedures
Systemic venous congestion
Metastasis
Valve replacement
11. Pericarditis 6-8 wks post MI.
Cardiogenic shock - CHF - arrhythmia
Months out fibrosis
R-->L
Dressler syndrome
12. What are the clinical features of RHF due to?
1-3 days out
3-8 wks
Systemic venous congestion
LA
13. When would arrhythmia occur after MI?
Ostium primum
Group A beta - hemolytic streptococci
Acute inflammation
Within the first day
14. Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - pitting edema.
Inability to fill ventricles
PDA
RHF
Decrease preload -->lowers myocardial stress
15. What is diastolic dysfx?
Dilated
Papillary muscle - free wall - IV septum
Metastasis
Inability to fill ventricles
16. At what point in development do congenital heart defects arise?
Pulsating nail bed
PDA
Pts w/previously damaged valves
3-8 wks
17. What is Loeffler syndrome?
Congested central veins
20 min
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Valve replacement AFTER the onset of complications
18. What type of vegetations are associated with Libman - Sacks endocarditis?
Ventricular arrhythmia
Prinzmetal angina - cocaine
Circumflex
Sterile vegetations on surface and undersurface on mitral valve
19. What is the characteristic murmurr of mitral stenosis?
Colon cancer
Decreased forward perfusion pulmonary congestion
Coronary artery vasospasm
Opening snap followed by diastolic rumble
20. Low voltage EKG w/diminished QRS amplitude.
MI
Reperfusion injury
Restrictive cardiomyopathy
AD mutation in sarcomere proteins
21. What causes the dependent pitting edema in RHF?
Low voltage EKG w/diminished QRS amplitude
Increased hydrostatic pressure
Mitral valve prolapse
Prinzmetal stable and unstable
22. What are the complications of aortic stenosis?
Hypertophy of RV atrophy of LV
Degree of pulmonary artery stenosis
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
23. Reactive histiocyte with slender - wavy 'caterpillar' nucleus.
Shunt - PGE to maintain PDA until surgical repair can be performed
Anitschow cell
Months out fibrosis
Increased hydrostatic pressure
24. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
ST- segment depression
Reperfusion injury
VSD
Boot shaped heart
25. What is the effect of acute vs chronic rheumatic disease off the mitral valve?
Regurg vs stenosis
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
RHF
Small vegetations along the line of closure
26. What gross and microscopic changes occur months after an MI?
Decreased forward perfusion pulmonary congestion
White scar fibrosis
Group A beta - hemolytic streptococci
RHF
27. What is the tx for LHF?
Friction rub and chest pain
ACE inhibitor
Red border granulation tissue
Anitschow cell
28. Which angina is relieved by Ca channel blockers?
Prinzmetal
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Chronic rheumatic heart disease
CHF
29. When is an MI pt at greatest risk for cardiogenic shock?
Nitroglycerin
Systolic dysfx leading to biventricular CHF
First 4 hours
Plump fibroblasts - collagen - blood vessels
30. What are the HACEK organisms? With what condition are they associated?
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Janeway lesions
ASD - R-->L
Aortic regurg
31. What effect does transposition of the great vessels have on the ventricles?
Hypertophy of RV atrophy of LV
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Right -->left
Reperfusion injury
32. What is the most common cause of death during the acute phase of rheumatic fever?
LHF
ACE inhibitor
Myocarditis
PDA
33. What is eythema marginatum? What parts of the body does it commonly involve?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
LAD
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Annular - non pruritic rash w/erythematous borders trunks and limbs
34. How does transmural MI/ischemia present on EKG?
Ventricles cannot pump
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
Endocardial fibroelastosis
ST- segment elevation
35. At What age does wear and tear aortic stenosis present? What congenital disease hastens the onset?
S aureus
>60 years - bicuspid aortic valve
Regurg vs stenosis
Pulsating nail bed
36. What are the sx of hypertrophic cardiomyopathy?
Right -->left
Coxsackie A or B
Mitral mitral+aortic
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
37. What is chronic rheumatic heart disease?
Pulsating nail bed
Valve scarring that arises as a consequence of rheumatic fever
>70%
PDA
38. Opening snap followed by diastolic rumble.
Mitral stenosis
2-3 weeks
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
Slow HR - decreasing O2 demand and risk for arrhythmia
39. What is the most common cause of endocarditis in IV drug users?
Cardiogenic shock - CHF - arrhythmia
Concentric LV hypertophy
S aureus
>70%
40. What causes the split S2 in ASD?
Increased blood in right heart delays closure of P valve
Intercostal arteries enlarged due to collateral circulation
Atria and RV
Chronic ischemic heart disease
41. What congenital heart defect does indomethacin tx?
Dilated
Nitroglycerin
Positive blood cultures anemia of chronic disease
PDA
42. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Wear and tear
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
43. 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.
Tetralogy of fallot
Pancarditis
Tender lesions on fingers or toes.
Stable angina
44. What typically causes hypertrophic cardiomyopathy?
Dilation of all four chambers of the heart
Concentric LV hypertophy
AD mutation in sarcomere proteins
Mitral mitral+aortic
45. What % stenosis causes stable angina?
>70%
Holosystolic machine like murmur
Anitschow cell
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
46. How does fibrinolysis/angioplasty tx MI?
Adult coarctation of the aorta
Congestive heart failure
Open blocked vessels
Mid - systolic click followed by regurgitation murmur
47. What are the sx of aortic regurg?
Contraction band necrosis - reperfusion injury
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Myocarditis
48. What is a complication of chronic rheumatic heart disease?
Yellow pallor macrophages
45%
Harmartoma
Infectious endocarditis
49. What type of collagen is involved in fibrosis?
Janeway lesions
Prophylactic abx during dental procedures
Type I
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. When does the heart have dark discoloration post MI?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
LAD
2-3 weeks
4-24 hours