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. What artery is the 2nd most often occluded in an MI?
Pericarditits
LV dilation and eccentric hypertrophy
Endocarditis of prosthetic valves
RCA

2. What distinguishes stenosis caused by chronic rheumatic heart disease from wear and tear aortic stenosis?
Plump fibroblasts - collagen - blood vessels
Troponin I
Coexisting mitral stenosis and fusion of commisures exist
Increased hydrostatic pressure

3. What is the characteristic murmurr of mitral stenosis?
Opening snap followed by diastolic rumble
Hypertophy of RV atrophy of LV
CHF
First 4 hours

4. Which congenital heart defect is associated with maternal diabetes?
Migratory polyarthritis
Transposition of the great vessels
Troponin I
Limits thrombosis

5. What are other (not atherosclerotic) causes of MI?
Heart can't fill
Ehlers - Danlow and Marfan syndrome
Return of O2 and inflammatory cells cause FR generation - further damaging myocytes
Coronary artery vasospasm - emboli - vasculitis

6. What areas of the heart does the RCA supply?
Systolic ejection click followed by crescendo - decrescendo murmur
Posterior wall of LV - posterior septum - papillary muscles
Papillary muscle - free wall - IV septum
Trisomy 21

7. What are heart failure cells?
Within the first day
Hemosiderin laden macrophages
Evidence of prior group A beta - hemolytic strep plus major and minor criteria
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia

8. What type of shunt results in cyanosis at birth?
Ostium primum
Loeffler syndrome
Right to left
Pedunculated mass in the LA that causes syncope due to obstruction of MV

9. What vavular defect results from acute rheumatic fever?
Autoimmune pericarditis 6-8 wks post MI
Regurg vs stenosis
Mitral regurgitation due to vegetations
Nitroglycerin

10. What effect does transposition of the great vessels have on the ventricles?
Hypertophy of RV atrophy of LV
PGE
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
LV dilation and eccentric hypertrophy

11. Systolic ejection click followed by crescendo - decrescendo murmur.
Aortic stenosis
Systolic ejection click followed by crescendo - decrescendo murmur
Mid - systolic click followed by regurgitation murmur
Mitral stenosis

12. In which chamber of the heart are rhabdomyomas found?
Ventricle
Shunt - PGE to maintain PDA until surgical repair can be performed
Aspirin and/or heparin - supplemental O2 - nitrates - beta blocker - ACE inhibitor - fibrinolysis or angioplasty
Reperfusion injury

13. Tx for PDA?
Infectious endocarditis - arrythmias - severe mitral regurg no
Gelatinous - abundant ground substance
Indomethacin - decreases PGE
Mitral regurg

14. Why would cardiac enzymes continue to increase after the initial MI?
Prinzmetal
Reperfusion injury
RHF
Asymptomatic

15. What drugs can cause dilated cardiomyopathy?
Stretched muscle loses contractility
Paradoxical emboli
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
Doxorubicin - cocaine

16. What bug causes acute rheumatic fever?
Group A beta - hemolytic streptococci
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Libman - Sacks endocarditis

17. What is Loeffler syndrome?
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Mitral and tricuspid regurg - arrhythmia
Eisenmenger syndrome
Atria and RV

18. Which artery is most often occluded in an MI?
LAD
Ostium secundum (90%)
Coxsackie A or B
Loss of LV fx

19. How does contraction band necrosis occur?
Reperfusion of irreversibly damaged cells results in Ca influx - leading to hypercontraction of myofibrils
Granulation tissue
Yellow pallor macrophages
Paradoxical emboli

20. What is the most comon cause of aortic regurg? What are the other causes?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Left -->right
Mitral valve prolapse
Low voltage EKG w/diminished QRS amplitude

21. Dilated cardiomyopathy is a late complication of what illness?
Infectious endocarditis - arrythmias - severe mitral regurg no
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Myocarditis
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse

22. What determines the extent of shunting and cyanosis in tetralogy of fallot?
Group A beta - hemolytic streptococci
Degree of pulmonary artery stenosis
Aneurysm - mural thrombus - Dressler syndrome
Rupture of free wall - IV septum - or papillary muscle

23. How does stable angina present?
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Wear and tear
Chest pain <20 min brought on by exertion or emotional stress
Valve scarring that arises as a consequence of rheumatic fever

24. Poor myocardial fx due to chronic ischemic damage?
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
Atria and RV
Chronic ischemic heart disease
Yellow pallor neutrophils

25. With what disease is infantile coarctation of the aorta associated?
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
Aortic regurg
Turner syndrome
Endocarditis of prosthetic valves

26. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Open blocked vessels
VSD
Chest pain <20 min brought on by exertion or emotional stress
RCA

27. What are the HACEK organisms? With what condition are they associated?
Indomethacin - decreases PGE
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
When a bacterial protein resembles a protein in human tissue
Rhadbomyoma - benign

28. What is a water - hammer pulse?
Wear and tear
3-8 wks
Bounding pulse
Janeway lesions

29. When is an MI patent at highest risk for fibrionous pericarditis?
S aureus
Dense layer of elastic and fibrotic tissue in the endocardium - children
1-3 days out
Positive blood cultures anemia of chronic disease

30. What coronary artery supplies the mitral valve papillary muscles?
Chronic rheumatic heart disease
Months out fibrosis
RCA
When a bacterial protein resembles a protein in human tissue

31. What complication occurs 1-3 days post MI?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Migratory polyarthritis
Fibrinous pericarditis
Minimizes ischemia

32. What are the clinical features of RHF due to?
Increased O2 demand during exercise but can't increase CO b/c of narrowed valve
Pancarditis
Systemic venous congestion
S aureus

33. What effect does aortic regurg have on the pulse pressure? Why?
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Increased hydrostatic pressure
Backward LHF pulm htn and RHF - afib and associated mural thombis
VSD

34. What is the most common cause of dilated cardiomyopathy? What are other causes?
Systolic dysfx leading to biventricular CHF
Myocardium
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Chest pain <20 min brought on by exertion or emotional stress

35. How does dilated cardiomyopathy cause LHF?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Stretched muscle loses contractility
Migratory polyarthritis
S viridans

36. What causes notching of the ribs in adult coarctation of the aorta?
Stretched muscle loses contractility
Erythematous nontender lesions on palms and soles.
Intercostal arteries enlarged due to collateral circulation
Large - destructive vegetations

37. When is an MI pt at greatest risk for cardiogenic shock?
MI
Squat in response to cyanotic spell
First 4 hours
Posterior wall of LV - posterior septum - papillary muscles

38. When do troponin levels rise - peak - and return to normal?
IV drug users
2-4 hours - 24 hours - 7-10 days
Metastasis
LHF

39. What are the sx/complications of myocarditis?
Valve replacement once LV dysfx develops
Chest pain - arrhythmia - sudden death - heart failure - dilated cardiomyopathy
S viridans
Mitral stenosis

40. What type of shunt dose PDA cause?
Left -->right
S epidermidis
Mid - systolic click followed by regurgitation murmur
Stable and unstable prinzmetal

41. What disesase has Aschoff bodies?
1-3 days
Paradoxical emboli
Pts w/previously damaged valves
Myocarditis in acute rheumatic heart fever

42. What side of the heart do carcinoid tumors affect? Why?
Right side - serotonin and other secretory products detoxified in the lung
Blood vessels coming in from normal tissue
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Right to left

43. What type of vegetations does nonbacterial thrombotic endocarditis (marantic endocarditis) cause?
R-->L
Increased hydrostatic pressure
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Fetal alcohol syndrome

44. What cardiac disease is associated with tuberous sclerosis?
Rhabdomyoma
AD mutation in sarcomere proteins
Shunt - PGE to maintain PDA until surgical repair can be performed
Reperfusion injury

45. What gross and microscopic changes occur 4-7 days after an MI?
Infectious endocarditis - arrythmias - severe mitral regurg no
Yellow pallor macrophages
Osler nodes (ouch - ouch Osler)
Decrease in blood flow to an organ

46. Friction rub and chest pain.
Pericarditits
ST- segment elevation
Elevated ASO anti - DNase B titers
Ostium primum

47. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Aortic regurg
Fetal alcohol syndrome
Heart can't fill
Tetralogy of fallot

48. What are the clinical features of LHF due to?
Erythematous nontender lesions on palms and soles.
Transposition of the great vessels
Decreased forward perfusion pulmonary congestion
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

49. What is the tx for VSD?
Surgical closure small defects may close spontaneously
AD mutation in sarcomere proteins
Prophylactic abx during dental procedures
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)

50. What does rupture of a papillary muscle cause?
Right side - serotonin and other secretory products detoxified in the lung
2-3 weeks
Mitral insufficiency
Infantile coarctation of the aorta PDA