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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. Which coronary artery supplies the posterior wall of the LV and posterior septum?
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Anterior wall of LV and anterior septum
RCA
2. What areas of the heart does the LAD supply?
Positive blood cultures anemia of chronic disease
Anterior wall of LV and anterior septum
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Nonspecific - eg fever and elevated ESR
3. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
Inability to maintain systemic pressure w/lack of O2 to vital organs
ASD - R-->L
Small vegetations along the line of closure
Infectious endocarditis - arrythmias - severe mitral regurg no
4. What is the etiology of S viridans endocarditis?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Migratory polyarthritis
Valve replacement once LV dysfx develops
Backward LHF pulm htn and RHF - afib and associated mural thombis
5. What is the main cause of MV regurg? What are other causes?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Rupture of plaque with w/thrombus and incomplete occlusion of coronary artery
RCA
Small vegetations along the line of closure
6. Systolic ejection click followed by crescendo - decrescendo murmur.
Fetal alcohol syndrome
Wear and tear
Myofiber hypertrophy with disarray
Aortic stenosis
7. What valves are involved in rhuematic endocarditis?
Nonspecific - eg fever and elevated ESR
Mitral mitral+aortic
Shunt
Spontaneous
8. What increases the volume of mitral regurg murmur?
PDA
Haemophilus - Actinobacillus - Cardiobacterium - Eikenella - Kingella endocarditis w/negative blood culture
Tricuspid
Squatting - expiration
9. What increases the risk for chronic rheumatic heart disease?
Decreased forward perfusion pulmonary congestion
Stable and unstable prinzmetal
Myocarditis
Repeat exposure to group A beta - hemolytic strep that results in relapse of the acute phase
10. Vegetations on surface and undersurface of mitral valve.
Systemic venous congestion
Fetal alcohol syndrome
Libman - Sacks endocarditis
Open blocked vessels
11. What distinguishes stenosis caused by chronic rheumatic heart disease from wear and tear aortic stenosis?
PDA
Aortic stenosis
Coexisting mitral stenosis and fusion of commisures exist
Within the first day
12. Swelling and pain in a large joint that resolves within days and migrates to involve another large joint.
Migratory polyarthritis
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)
Mitral regurgitation due to vegetations
Mitral insufficiency
13. What is the most common cause of mitral stenosis?
Fusion of the commissures with 'fish mouth' appearence - aortic stenosis
Bacterial endocarditis
Boot shaped heart
Chronic rheumatic heart disease
14. What are the complications of mitral valve prolapse? Are they common?
Congested central veins
Prinzmetal angina - cocaine
Libman - Sacks endocarditis
Infectious endocarditis - arrythmias - severe mitral regurg no
15. What is the basic principle of CHF?
Pump failure
Colon cancer
Left -->right
Ischemic heart disease
16. Is scar tissue or myocardium stronger?
PDA
1-3 days
Fetal alcohol syndrome
Myocardium
17. Pericarditis 6-8 wks post MI.
Months out fibrosis
Dressler syndrome
Transesophageal echo
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
18. In what pt population does S aureus commonly cause valvular disease?
IV drug users
R-->L
Concentric hypertrophy - can't oxygenate full wall - ischemic damage
Holosystolic machine like murmur
19. What is the definition of ischemia?
Pulsating nail bed
PDA
4-7 days macrophage infiltration
Decrease in blood flow to an organ
20. What does chronic ischemic heart disease progress to?
Right side - serotonin and other secretory products detoxified in the lung
Friction rub and chest pain
Dark discoloration coagulative necrosis
CHF
21. How does adult coarctation of the aorta present?
Htn in upper extremities - hypotn in lower extremities - notching of ribs on CXR
Slow HR - decreasing O2 demand and risk for arrhythmia
Transposition of the great vessels
Endocardial fibroelastosis (rare)
22. What effect does aortic regurg have on the pulse pressure? Why?
4-7 days macrophage infiltration
Widens it diastolic pressure decreases due to regurgitation while systolic pressure increases due to increased stroke volume
Valve replacement AFTER the onset of complications
Intercostal arteries enlarged due to collateral circulation
23. Infects predamaged valves after transient bacteremia?
S viridans
ACE inhibitor
VSD
Loss of fx
24. How long after pharyngitis does acute rheumatic fever occur?
Boot shaped heart
Friction rub and chest pain
2-3 weeks
Anitschow cell
25. In which chamber of the heart are rhabdomyomas found?
Pump failure
Ventricle
Mitral insufficiency
1-3 days out
26. What effect does mitral stenosis have on the heart chambers?
LA dilation
LHF
ST- segment depression
Months out fibrosis
27. What are the sx of cardiac myxoma?
Systemic venous congestion
Pedunculated mass in the LA that causes syncope due to obstruction of MV
Atherosclerosis of coronary arteries
Hemosiderin laden macrophages
28. What causes microangiopathic hemolytic anemia in aortic stenosis?
Erythematous nontender lesions on palms and soles.
Coronary artery vasospasm - emboli - vasculitis
Decreased CO due to diastolic dysfx - syncope w/exercise - sudden death due to vfib
RBC damaged while crossing the calcified valve causing schistocytes
29. What is the most common cause of endocarditis in IV drug users?
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
S aureus
Loeffler syndrome
Plump fibroblasts - collagen - blood vessels
30. What does rupture of a papillary muscle cause?
Mitral insufficiency
Months out fibrosis
Atherosclerosis of coronary arteries
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
31. What is the most common primary cardiac tumor in adults? Is it malignant or benign?
Transposition of the great vessels
Myocarditis in acute rheumatic heart fever
Myxoma - benign
Kawasaki disease
32. How do ACE inhibitors tx MI?
Rhadbomyoma - benign
Coronary artery vasospasm - emboli - vasculitis
Decreases LV dilation by decreasing volume
Mitral valve prolapse
33. What % stenosis causes stable angina?
2-3%
>70%
CK- MB
Shunt - PGE to maintain PDA until surgical repair can be performed
34. What is the most common cause of myocarditis?
Valve replacement
Nitroglycerin
Coxsackie A or B
Transposition of the great vessels
35. Why would cardiac enzymes continue to increase after the initial MI?
Aortic regurg
Aneurysm - mural thrombus - Dressler syndrome
Heart can't fill
Reperfusion injury
36. What is the tx for aortic stenosis?
Squatting - increased systemic resistence decreases LV emptying
Valve replacement AFTER the onset of complications
Ischemic heart disease
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
37. Is injury due angina reversible or irreversible?
Hypertrophic cardiomyopathy
Coronary artery vasospasm
Reversible
Turner syndrome
38. What always follows necrosis?
Decrease in blood flow to an organ
ST- segment depression
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Acute inflammation
39. What are the complications of aortic stenosis?
Hypertophy of RV atrophy of LV
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Ostium secundum (90%)
45%
40. What is the characteristic finding on CXR in tetralogy of fallot?
Large - destructive vegetations
Dilated
IV drug users
Boot shaped heart
41. What does rupture of the LV free wall cause?
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
Cardiac tamponade
LV dilation and eccentric hypertrophy
Prophylactic abx during dental procedures
42. What is the most common congenital heart defect?
Loss of fx
Myxoid degeneration
VSD
Within the first day
43. What iis the tx for aortic regurg?
Small vegetations along the line of closure
Dilated
Valve replacement once LV dysfx develops
Sterile vegetations on mitral valve along lines of closure
44. What is the effect of mitral regurg on the heart?
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Volume overload and LHF
Systolic dysfx leading to biventricular CHF
Streptococcus viridans
45. What is the most common form of cardiomyopathy?
VSD
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
Dilated
Blood vessels coming in from normal tissue
46. What is an Aschoff body?
PDA
Coronary artery vasospasm - emboli - vasculitis
Inability to fill ventricles
Foci of chronic inflammation - reactive histiocytes with slender - wavy nuclei - giant cells - and fibrinoid material
47. What is the classic EKG finding of restrictive cardiomyopathy?
Bacterial endocarditis
Nonspecific - eg fever and elevated ESR
Low voltage EKG w/diminished QRS amplitude
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
48. When does the heart have dark discoloration post MI?
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
Atherosclerosis of coronary arteries
Rupture of free wall - IV septum - or papillary muscle
4-24 hours
49. What is the most common cause of dilated cardiomyopathy? What are other causes?
Idiopathic genetic mutation (AD) - myocarditis - alcohol - drugs - pregnancy
Harmartoma
Day 1-7
Decreases LV dilation by decreasing volume
50. How does subendocardial MI/ischemia present on EKG?
ST- segment depression
Left -->right
Fetal alcohol syndrome
SLE