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 is the tx for mitral valve prolapse?
Reperfusion injury
Valve replacement
Type I
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome

2. What maintains patency of the PDA?
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'
Tender lesions on fingers or toes.
PGE
Libman - Sacks endocarditis

3. What is the cause of restrictive cardiomyopathy in children?
Tender lesions on fingers or toes.
LAD
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Endocardial fibroelastosis (rare)

4. What are the complications of aortic stenosis?
Large vegetations of S aureus
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Arrhythmia - CHF - angina - syncope - microangiopathic hemolytic anemia
Rhadbomyoma - benign

5. Lower extremity cyanosis in infants? In adults?
Preductal - post aortic arch
S epidermidis
Amyloidosis - sarcoidosis - hemochromatosis - and Loeffler syndrome
Infantile coarctation of the aorta PDA

6. What congenital heart defect often is present with infantile coarctation of the aorta?
Turner syndrome
Prinzmetal angina - cocaine
PDA
Myxoid degeneration

7. What is the most common cause of endocarditis in IV drug users?
Systolic ejection click followed by crescendo - decrescendo murmur
S aureus
Breast and lung carcinoma - melanoma - lymphoma
1-3 days

8. What causes prinzmetal angina?
Infectious endocarditis - arrythmias - severe mitral regurg no
SLE
Coronary artery vasospasm
Bacterial M protein resembles proteins in human tissue - 'molecular mimicry'

9. Vegetations on surface and undersurface of mitral valve.
Pump failure
Libman - Sacks endocarditis
Circumflex
Group A beta - hemolytic streptococci

10. With what developmental disorder is VSD associated?
VSD
Erythematous nontender lesions on palms and soles.
Fetal alcohol syndrome
Bacterial endocarditis

11. What is the most common cause of infectious endocarditis?
Isolated root dilation - valve damage (infective endocarditis) - aortic root dilation (syphilitic aneurysm or aortic dissection)
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema
Stretched muscle loses contractility
Streptococcus viridans

12. What effect does dilated cardiomyopathy have on the heart?
Mitral and tricuspid regurg - arrhythmia
Pump failure
Systolic dysfx leading to biventricular CHF
Spontaneous

13. What does a biopsy of hypertrophic cardiomyopathy look like?
Squatting - increased systemic resistence decreases LV emptying
Prinzmetal angina
Endocardial fibroelastosis
Myofiber hypertrophy with disarray

14. What is the characteristic murmurr of mitral stenosis?
Coexisting mitral stenosis and fusion of commisures exist
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Circumflex
Opening snap followed by diastolic rumble

15. What is the most common cause of myocarditis?
Prinzmetal angina
Transesophageal echo
Increased arterial resistence decreases shunting - allowing more blood to reach lungs
Coxsackie A or B

16. Which congenital heart defect is associated with congenital rubella?
PDA
Within the first day
3-8 wks
1) migratory polyarthritis 2) pancarditis 3) subcutaneous nodules 4) erythema marginatum 5) Syndenham chorea

17. What causes the dependent pitting edema in RHF?
When a bacterial protein resembles a protein in human tissue
Increased hydrostatic pressure
Kawasaki disease
4-7 days macrophage infiltration

18. What is the characteristic finding on CXR in tetralogy of fallot?
Preductal - post aortic arch
1 day: coag necr 1 wk: inflammation (neutrophils and macrophages) 1 mo: scar
Posterior wall of LV - posterior septum - papillary muscles
Boot shaped heart

19. How does dilated cardiomyopathy cause LHF?
Stable angina
Bounding pulse
Harmartoma
Stretched muscle loses contractility

20. What is molecular mimicry?
Migratory polyarthritis
Right side - serotonin and other secretory products detoxified in the lung
Coronary artery vasospasm - emboli - vasculitis
When a bacterial protein resembles a protein in human tissue

21. Which angina is relieved by Ca channel blockers?
Split S2 on auscultation
Prinzmetal
Prophylactic abx during dental procedures
LHF - left - to - right shunt - chronic lung disease (cor pulmonale)

22. What is the most common form of cardiomyopathy?
Colon cancer
45%
Dilated
Stable and unstable prinzmetal

23. Early - blowing diastolic murmur - bounding pulse - pulsating nail bed - and head bobbing.
Day 1-7
Aortic regurg
Maternal diabetes
Endocardial fibroelastosis (rare)

24. What areas of the heart does the LAD supply?
Anterior wall of LV and anterior septum
PDA
Ischemic heart disease
Inability to maintain systemic pressure w/lack of O2 to vital organs

25. What complication occurs 1-3 days post MI?
LA dilation
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
Fetal alcohol syndrome
Fibrinous pericarditis

26. What structures are susceptible to rupture post MI?
Type I
1-3 days out
Papillary muscle - free wall - IV septum
Transesophageal echo

27. What endocarditis is commonly found in patients with colon cancer?
Open blocked vessels
Streptococcus bovis/
Doxorubicin - cocaine
LAD

28. What is the effect of mitral regurg on the heart?
R-->L
1-3 days out
Indomethacin - decreases PGE
Volume overload and LHF

29. What causes notching of the ribs in adult coarctation of the aorta?
Mitral mitral+aortic
Shunt
Intercostal arteries enlarged due to collateral circulation
Large vegetations of S aureus

30. What type of shunt does a VSD cause?
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture
Rupture of capillaries leading to intraalveolar hemorrhage - sx of LHF
L->R
4-6 hours - 24 hours - 72 hours

31. What is Loeffler syndrome?
Rupture of atherosclerotic plaque and complete occlusion of the coronary artery
Aortic regurg
Endomyocardial fibrosis w/eosinophilic infiltrate and eosinophilia
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

32. What increases the volume of mitral regurg murmur?
Prinzmetal
Mid - systolic click followed by regurgitation murmur
Squatting - expiration
Membrane damage

33. What is the gold standard blood marker for MI?
Stable angina
Troponin I
Louder - increased systemic resistence decreases LV emptying
Infantile coarctation of the aorta

34. Which artery is most often occluded in an MI?
RCA
LAD
Indomethacin - decreases PGE
Kawasaki disease

35. How does squating decrease hypoxemia in tetralogy of fallot?
Nonbacterial thrombotic endocarditis (marantic endocarditis)
Gelatinous - abundant ground substance
Decrease in blood flow to an organ
Increased arterial resistence decreases shunting - allowing more blood to reach lungs

36. What are the clinical features of RHF?
Myocarditis
R-->L
Harmartoma
Jugular venous distension - painful hepatosplenomegaly w/nutmeg liver - cardica cirrhosis - dependent pitting edema

37. Is scar tissue or myocardium stronger?
Regurg vs stenosis
Myocardium
Mitral stenosis
Ostium secundum (90%)

38. What causes angina and syncope in aortic stenosis?

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

39. What effect does chronic rheumatic heart disease have the mitral valve?
LA dilation
Acute ischemia - mitral valve prolapse - cardiomyopathy - cocaine abuse
Aschoff bodies
Thickening of chrodae tendinae and cusps - mitral stenosis

40. What murmur ccan be heard in PDA?
Right -->left
Autoimmune pericarditis 6-8 wks post MI
Holosystolic machine like murmur
PDA

41. What is the most common cause of death during the acute phase of rheumatic fever?
Myocarditis
Infantile coarctation of the aorta
Small vegetations along the line of closure
Doxorubicin - cocaine

42. What are the forward and backward sx of LHF?
LA
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
Valve replacement once LV dysfx develops
Autoimmune pericarditis 6-8 wks post MI

43. What type of ischemia does stable angina cause?
Blood vessels coming in from normal tissue
Pericardial effusion due to pericardial involvement
Subendocardial
Colon cancer

44. With what condition are rhabdomyomas associated?
MI
Tuberous sclerosis
Circumflex
Pericarditits

45. Poor myocardial fx due to chronic ischemic damage?
ASD - R-->L
RHF
Chronic ischemic heart disease
Boot shaped heart

46. What causes acute endocarditis?
Small - sterile fibrin deposits randomly arranged on closure of valve leaflets
Systolic dysfx leading to biventricular CHF
Transesophageal echo
Large vegetations of S aureus

47. With what virus is PDA associated?
Congenital rubella
Restrictive cardiomyopathy
CHF
Hypertrophic cardiomyopathy

48. What is the main cause of MV regurg? What are other causes?
Inability to fill ventricles
Annular - non pruritic rash w/erythematous borders trunks and limbs
Migratory polyarthritis
MV prolapse LV dilation - infective endocarditis - acute rheumatic heart disease - papillary muscle rupture

49. What gross and microscopic changes occur 4-24 hours after an MI?
1) damaged endocardial surface develops thrombotic vegetations 2) transient bacteremia leads to trapping of bacteria in the vegetations
Atria and RV
Dark discoloration coagulative necrosis
Myocarditis

50. With what other congenital heart defect is tricuspid atresia associated? What type of shunt is present?
ASD - R-->L
Months out fibrosis
Left -->right
Arthritis in a large joint (wrist - knees - ankles) that resolves within days and migrates to another large joint