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. Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material.
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
Large vegetations of S aureus
Aschoff bodies
Prophylactic abx during dental procedures

2. What side of the heart do carcinoid tumors affect? Why?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Right side - serotonin and other secretory products detoxified in the lung
L->R
Reperfusion injury

3. What causes unstable angina?
Myocarditis
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Yellow pallor neutrophils
Endocardial fibroelastosis

4. What are the forward and backward sx of LHF?
Pericardial effusion due to pericardial involvement
Indomethacin - decreases PGE
Paradoxical emboli
Backward: dyspnea - PND - orthopnea - crackles (pulmonary congestion and edema) - heart failure cells forward: fluid retention due to decreased flow to kidneys leading to activation of RAA

5. Return of O2 and inflammatory cells cause FR generation - further damaging myocytes.
Limits thrombosis
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Reperfusion injury
Chronic ischemic heart disease

6. What type of ASD is associated w/Down syndrome?
Ostium primum
Membrane damage
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF

7. Ostium primum ASD is associated with what congenital disorder?
Contraction band necrosis - reperfusion injury
Trisomy 21
IV drug users
Myxoma - benign

8. In which chamber of the heart are rhabdomyomas found?
Ventricle
Myocardium
L->R
2-3%

9. What complications occur 4-7 days post MI?
Rupture of free wall - IV septum - or papillary muscle
LV dilation and eccentric hypertrophy
Sterile vegetations on mitral valve along lines of closure
Infectious

10. With what congenital heart defect is ADULT coarctation of the aorta associated?
Congestive heart failure
Bicuspid aortic valve
Yellow pallor neutrophils
Small vegetations along the line of closure

11. What is the rate of mitral valve prolapse in the US?
2-3%
Ventricular arrhythmia
Prinzmetal angina
Heart can't fill

12. What cardiac enzyme is useful for detecting reinfarction?
Posterior wall of LV - posterior septum - papillary muscles
Cyanosis - RV hypertrophy - polycythemia - clubbing
Bacterial endocarditis
CK- MB

13. Which chambers of the heart are generally spared in an MI?
Atria and RV
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Ostium primum
Coexisting mitral stenosis and fusion of commisures exist

14. What type of vegetations form in nonbacterial thrombotic endocarditis?
Cardiac tamponade
4-24 hours
Sterile vegetations on mitral valve along lines of closure
Colon cancer

15. With what condition are rhabdomyomas associated?
S epidermidis
Cyanosis - RV hypertrophy - polycythemia - clubbing
Increased blood in right heart delays closure of P valve
Tuberous sclerosis

16. When does the heart have a yellow pallor post MI?
Split S2 on auscultation
Valve replacement AFTER the onset of complications
Day 1-7
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve

17. What are the sx of aortic regurg?
Inability to maintain systemic pressure w/lack of O2 to vital organs
PDA
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Backward: dyspnea - PND - orthopnea - crackles (pulmonary congestion and edema) - heart failure cells forward: fluid retention due to decreased flow to kidneys leading to activation of RAA

18. What is the most comon cause of aortic regurg? What are the other causes?
Dressler syndrome
Aschoff bodies
Mitral insufficiency
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)

19. What is the murmur of mitral valve prolapse?
Decrease preload -->lowers myocardial stress
Mid - systolic click followed by regurgitation murmur
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Thickening of chrodae tendinae and cusps - mitral stenosis

20. What are the sx/complications of myocarditis?
Restrictive cardiomyopathy
RHF
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
Streptococcus bovis/

21. What causes endocarditis of prosthetic valves?
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Congestive heart failure
S epidermidis

22. What is an important complication of ASD?
Mitral regurgitation due to vegetations
Paradoxical emboli
Granulation tissue
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)

23. What imaging test is useful for detecting lesions on valves?
Prinzmetal angina - cocaine
Transesophageal echo
Harmartoma
LA dilation

24. What are the sx of cardiac myxoma?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
NG or Ca channel blocker
Stretched muscle loses contractility
Opening snap followed by diastolic rumble

25. What is the most common type of endocarditis?
Coexisting mitral stenosis and fusion of commisures exist
Infectious
Streptococcus viridans
Cardiogenic shock - CHF - arrhythmia

26. How does asprin/heparin tx MI?
Limits thrombosis
L->R
Low voltage EKG w/diminished QRS amplitude
Friction rub and chest pain

27. What are the minor critera of the Jones criteria?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Loeffler syndrome
Nonspecific - eg fever and elevated ESR
Colon cancer

28. What creates the immune reaction in acute rhuematic fever?

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

29. Episodic chest pain unrelated to exertion due to coronary vasospasm. ST- segment elevation. Relieved by NG or Ca channel blockers.
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Prinzmetal angina
Maternal diabetes

30. What is typically the mechanims of sudden cardiac death?
Ventricular arrhythmia
Paradoxical emboli
PDA
L->R

31. What does chronic ischemic heart disease progress to?
Hypercoagulable state or underlying adenocarcinoma
Ventricle
CHF
Troponin I

32. How does fibrinolysis/angioplasty tx MI?
Open blocked vessels
Tricuspid
Gelatinous - abundant ground substance
Trisomy 21

33. What two things cause coronary artery vasospasm?
Prinzmetal angina - cocaine
Small - nondestructive vegetations (subacute endocarditis)
Increased blood in right heart delays closure of P valve
Papillary muscle - free wall - IV septum

34. What effect does aortic regurg have on the pulse pressure? Why?
Mitral and tricuspid regurg - arrhythmia
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Nonspecific - eg fever and elevated ESR

35. Opening snap followed by diastolic rumble.
Mitral stenosis
Endocardial fibroelastosis
4-24 hours
Mitral mitral+aortic

36. What type of endocarditis is associated with SLE?
Shunt
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Libman - Sacks endocarditis
1%

37. What causes notching of the ribs in adult coarctation of the aorta?
2-3 weeks
Annular - non pruritic rash w/erythematous borders trunks and limbs
Intercostal arteries enlarged due to collateral circulation
Preductal - post aortic arch

38. What gross and microscopic changes occur 1-3 days after an MI?
Squat in response to cyanotic spell
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Ventricular arrhythmia
Yellow pallor neutrophils

39. Lower extremity cyanosis later in life - holostystolic machine like murmur.
Valve replacement
PDA
Preductal - post aortic arch
Adult coarctation of the aorta

40. Dense layer of elastic and fibrotic tissue in the endocardium.
Endocardial fibroelastosis
Nitroglycerin
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
SLE

41. Which congenital heart defect is associated with congenital rubella?
Anitschow cell
PDA
Cardiogenic shock - CHF - arrhythmia
Coronary artery vasospasm

42. What is the most common tumor of the heart?
Cardiac tamponade
Anterior wall of LV and anterior septum
Metastasis
LA dilation

43. What causes acute endocarditis?
Yellow pallor macrophages
Mitral mitral+aortic
Maternal diabetes
Large vegetations of S aureus

44. What causes heart failure cells?
LAD
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
LV dilation and eccentric hypertrophy
Posterior wall of LV - posterior septum - papillary muscles

45. What does nonbacterial thrombotic endocarditis cause?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Mitral regurg
Limits thrombosis
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture

46. What is the most common cause of RHF? What are others?
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Mitral stenosis
Ventricular arrhythmia
Inability to maintain systemic pressure w/lack of O2 to vital organs

47. What effect does chronic rheumatic heart disease have the mitral valve?
Posterior wall of LV - posterior septum - papillary muscles
Spontaneous
Thickening of chrodae tendinae and cusps - mitral stenosis
Libman - Sacks endocarditis

48. How does adult coarctation of the aorta present?
Dark discoloration coagulative necrosis
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Infectious endocarditis
Myocarditis in acute rheumatic heart fever

49. What are the complications that occur months after an MI?
RCA
Pump failure
stenosis of RV outflow tract - RV hypertrophy - VSD - aorta that overrides the VSD
Aneurysm - mural thrombus - Dressler syndrome

50. Systolic ejection click followed by crescendo - decrescendo murmur.
Early - blowing diastolic murmur bounding pulse - pulsating nail bed - and head bobbing
Ventricular arrhythmia
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Aortic stenosis