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. With what virus is PDA associated?
Congenital rubella
Tender lesions on fingers or toes.
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Volume overload and LHF

2. What determines the extent of shunting and cyanosis in tetralogy of fallot?
Anterior wall of LV and anterior septum
Degree of pulmonary artery stenosis
Myocarditis in acute rheumatic heart fever
Valve replacement AFTER the onset of complications

3. What always follows necrosis?
Rhadbomyoma - benign
Acute inflammation
Months out fibrosis
LA

4. What are the sx of pericardiits?
Prinzmetal angina - cocaine
Harmartoma
Friction rub and chest pain
Increased arterial resistence decreases shunting - allowing more blood to reach lungs

5. When does the heart have dark discoloration post MI?
Opening snap followed by diastolic rumble
4-24 hours
Ostium primum
Reversible

6. What does Libman - Sacks endocarditis cause?
2-4 hours - 24 hours - 7-10 days
S viridans
Mitral regurg
Transposition of the great vessels

7. Hypertension in upper extremities - hypotension in lower extremities - notching of ribs on CXR.
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Plump fibroblasts - collagen - blood vessels
Adult coarctation of the aorta
Heart can't fill

8. What is diastolic dysfx?
Inability to fill ventricles
Rhadbomyoma - benign
Increased hydrostatic pressure
RCA

9. What increases the volume of mitral regurg murmur?
Aortic regurg
Squatting - expiration
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
Friction rub and chest pain

10. What are the two effects of ATII?
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Dilated
PDA
Hemosiderin laden macrophages

11. How do you tx prinzmetal angina?
3-8 wks
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Paradoxical emboli
NG or Ca channel blocker

12. What are the tx for MI?
Pericarditits
Increased blood in right heart delays closure of P valve
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty

13. How does asprin/heparin tx MI?
Heart transplant
Reperfusion injury
Breast and lung carcinoma - melanoma - lymphoma
Limits thrombosis

14. What is an Aschoff body?
Reperfusion injury
Type I
Atria and RV
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material

15. Which angina(s) cause subendocardial ischemia? Transmural ischemia?
S epidermidis
Bacterial endocarditis
Stable and unstable prinzmetal
Shunt

16. With what developmental disorder is VSD associated?
Rhadbomyoma - benign
Fetal alcohol syndrome
Heart transplant
Right -->left

17. How do ACE inhibitors tx MI?
Decrease in blood flow to an organ
Anitschow cell
PDA
Decreases LV dilation by decreasing volume

18. What does rupture of the IV septum cause?
Shunt
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Ventricles cannot pump
Aortic regurg

19. What are the causes of LHF?
Friction rub and chest pain
Minimizes ischemia
2-3%
Ischemia - htn - dilated cardiomyopathy - MI - restrictive cardiomyopathy

20. What is the major cause of MI?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
VSD
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

21. What causes an early - blowing diastolic murmur?
Aortic regurg
Small vegetations along the line of closure
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
ACE inhibitor

22. What are the sx/complications of myocarditis?
Cardiac tamponade
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Squatting - increased systemic resistence decreases LV emptying
Tender lesions on fingers or toes.

23. What are other (not atherosclerotic) causes of MI?
20 min
Stable and unstable prinzmetal
Pericardial effusion due to pericardial involvement
Coronary artery vasospasm - emboli - vasculitis

24. What are the complications of mitral valve prolapse? Are they common?
Low voltage EKG w/diminished QRS amplitude
Infectious endocarditis - arrythmias - severe mitral regurg no
Squatting - expiration
Coronary artery vasospasm

25. How long can cardiac myocytes be deprived of oxygen before they become irreversibly injured?
20 min
Atherosclerosis of coronary arteries
Mitral mitral+aortic
Loeffler syndrome

26. What is the most common cause of myocarditis?
PDA
Coxsackie A or B
ST- segment elevation
RBC damaged while crossing the calcified valve causing schistocytes

27. What are the sx of hypertrophic cardiomyopathy?
Opening snap followed by diastolic rumble
SLE
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Tricuspid

28. What are the complications that occur months after an MI?
Concentric LV hypertophy
Left -->right
Limits thrombosis
Aneurysm - mural thrombus - Dressler syndrome

29. What gross and microscopic changes occur months after an MI?
Mitral stenosis
White scar fibrosis
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Migratory polyarthritis

30. Large vegetations on tricuspid valve?
Yellow pallor macrophages
Concentric LV hypertophy
S aureus
Prinzmetal stable and unstable

31. How does O2 tx MI?
Rhadbomyoma - benign
Preductal - post aortic arch
Minimizes ischemia
Hypercoagulable state or underlying adenocarcinoma

32. L- to - R shunt switching to R- to - L shunt.
Eisenmenger syndrome
Aortic stenosis
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Regurg vs stenosis

33. When do macrophagess infiltrate the myocardium post MI?
Streptococcus bovis/
4-7 days
Sterile vegetations on mitral valve along lines of closure
Myocardium

34. What is the gross and microscopic appearance of cardiac myxomas?
Gelatinous - abundant ground substance
Low voltage EKG w/diminished QRS amplitude
S viridans
ASD - R-->L

35. Dilated cardiomyopathy is a late complication of what illness?
Myocarditis
Troponin I
4-24 hours
Coexisting mitral stenosis and fusion of commisures exist

36. What type of shunt does a VSD cause?
Chest pain <20 min brought on by exertion or emotional stress
>60 years - bicuspid aortic valve
Sudden cardiac death
L->R

37. What drugs can cause dilated cardiomyopathy?
Doxorubicin - cocaine
RCA
Low voltage EKG w/diminished QRS amplitude
Mitral regurg

38. Are most congenital heart defects spontaneous or inherited?
Spontaneous
Myocarditis
Mitral regurg
Coronary artery vasospasm - emboli - vasculitis

39. What are complications of dilated cardiomyopathy?
Boot shaped heart
Streptococcus bovis/
R-->L
Mitral and tricuspid regurg - arrhythmia

40. What is the characteristic murmurr of mitral stenosis?
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Intercostal arteries enlarged due to collateral circulation
Opening snap followed by diastolic rumble
Decreased forward perfusion pulmonary congestion

41. How does transmural MI/ischemia present on EKG?
ST- segment elevation
RCA
Hypertophy of RV atrophy of LV
Granulation tissue

42. With what disease is infantile coarctation of the aorta associated?
Hypercoagulable state or underlying adenocarcinoma
PDA
Loss of fx
Turner syndrome

43. What are the four defects in tetralogy of fallot?
R-->L
LHF
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Left -->right

44. What is the most common tumor of the heart?
Metastasis
Erythematous nontender lesions on palms and soles.
>60 years - bicuspid aortic valve
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR

45. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
ASD - R-->L
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint
Hemosiderin laden macrophages
4-6 hours - 24 hours - 72 hours

46. What tests show prior group A beta - hemolytic strep infection?
Elevated ASO anti - DNase B titers
Right side - serotonin and other secretory products detoxified in the lung
Mid - systolic click followed by regurgitation murmur
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material

47. What is the murmur of mitral regurg?
Shunt - PGE to maintain PDA until surgical repair can be performed
Holosystolic blowing murmur
Right -->left
Right to left

48. Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - pitting edema.
Rhadbomyoma - benign
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
RHF
Yellow pallor neutrophils

49. What is the gold standard blood marker for MI?
Transposition of the great vessels
1-3 days out
Constrict peripheral arterioles - increasing TPR - release aldosterone - increasing blood volume
Troponin I

50. What is the cause of the red border around granulation tissue?
Large vegetations of S aureus
Chronic rheumatic heart disease
Months out fibrosis
Blood vessels coming in from normal tissue