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M3 > Cardio - cmpathy HCM > Flashcards

Cardio - cmpathy HCM Flashcards

1
Q

dilation and impaired contraction of the left ventricle or both ventricles

A

dilated cardiomyopathy

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2
Q

left and/or right ventricular hypertrophy often asymmetric which usually involves interventricular septum

A

hypertrophic cardiomyopathy

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3
Q

restricted filling and reduced diastolic size of either ventricle or both ventricles with normal or near normal systolic function

A

restrictive cardiomyopathy

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4
Q

progressive fibrofatty replacement of the right and to some degree the left, ventricular myocardium

A

arrhythmogenic right ventricular cardiomyopathy

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5
Q

diseases that do not fit readily into any category include systolic dysfunction with minimal dilation, mitochondrial disease and fibroelastosis

A

unclassified cardiomyopathy

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6
Q

arises as dilated cardiomyopathy with depressed ventricular function not explained y the extent of coronary artery obstructions or ischemic damage

A

ischemic cardiomyopathy

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7
Q

arises as ventricular dysfunction that is out of proportion to the abnormal loading conditions produced by the vlavular stenosis and or regurgitation

A

valvular cardiomyopathy

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8
Q

Arises with left ventricular hypertrophy with features of cardiac failure related to systolic or diastolic dysfunction

A

hypertensive cardiomyopathy

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9
Q

cardiac dysfunction as a consequence of myocarditis

A

inflammatory cardiomyopathy

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10
Q

includes a wide variety of causes including endocrine abnormalities, glycogen storage disease deficienceies such as hypokalemia and nutritional disorders

A

metabolic cardiomyopathy

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11
Q

includes connective tissue disorders and infiltrative diseases such as sarcoidosis and leukemia

A

general systemic disease

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12
Q

includes duchenne, becker-type and myotonic dystrophies

A

muscular dystrophies

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13
Q

includes friedreich ataxia noonan syndrome and lentiginosis

A

neuromuscular disorders

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14
Q

includes reactions to alcohol, catecholamines, anthracyclines, irradiation and others

A

sensitivity and toxic reactions

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15
Q

first becomes manifested in the peripartum period but is probably a heteregenous group

A

peripartum cardiomyopathy

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16
Q

Congestive heart failure, particularly left sided

fatigue and weakness

systemic or pulmonary emboli

a. dilated cardiomyopathy
b. restrictive cardiomyopathy
c. hypertrophic cardiomyopathy

A

A

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17
Q

Dyspnea, angina pectoris fatigue, syncope, palpitations

A

Hypertrophic

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18
Q

dyspnea, fatigue, right sided conetive heart failure, signs and symptoms of systemic disease e.g. amyloidosis, iron storage disease

A

Restrictive

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19
Q

mild cardiomegaly

a. dilated cmpathy
b. restrictive
c. hypertrophic

A

C

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20
Q

mild to moderate cardiomegaly

a. dilated cmpathy
b. restrictive
c. hypertrophic

A

B

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21
Q

moderate to severe cardiomegaly

a. dilated cmpathy
b. restrictive
c. hypertrophic

A

A

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22
Q

in dilated cmpathy:

a. S3
b. S4
c. both
d. neither

A

C

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23
Q

Av valve regurgitation

a. dilated cmpathy
b. restrictive
c. hypertrophic
d. A and B
e. B and C
f. A B and C

A

D

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24
Q

AV valve regurgitation especially mitral

a. dilated cmpathy
b. restrictive
c. hypertrophic
d. A and B
e. B and C
f. A B and C

A

A

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25
Q

kussmaul sign

a. dilated cmpathy
b. restrictive
c. hypertrophic
d. A and B
e. B and C
f. A B and C

A

B

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26
Q

Apical systolic thrill and heave, brisk carotid upstroke, S4, systolic murmur that increases with Valsalva maneuver

a. dilated cmpathy
b. restrictive
c. hypertrophic
d. A and B
e. B and C
f. A B and C

A

C

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27
Q

CXR: pulmonary venous hypertension

a. dilated cmpathy
b. restrictive
c. hypertrophic
d. A and B
e. B and C
f. A B and C

A

D

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28
Q

Left atrial enlargement

a. dilated cmpathy
b. restrictive
c. hypertrophic
d. A and B
e. B and C
f. A B and C

A

C

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29
Q 
ECG:
sinus tachycardia
Atrial and ventricular arrhythmias
St segment and T wave abnormalities
Intraventricular conduction defects

a. dilated cmpathy
b. restrictive
c. hypertrophic

A

A

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30
Q

ECG: low voltage, intraventricular conduction defects
atrioventricular conduction defects

a. dilated cmpathy
b. restrictive
c. hypertrophic

A

B

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31
Q 
ECG:
left ventricular hypertrophy
ST-segment and T wave abnormalities
Abnormal Q waves
Atrial and ventricular arrhthmias

a. dilated cmpathy
b. restrictive
c. hypertrophic

A

C

32
Q

Echo:
left ventricular dilation and dysfunction
abnormal diastolic mitral valve motion secondary to abnormal compliance and filling pressures
a. dilated cmpathy
b. restrictive
c. hypertrophic

A

A

33
Q 
Asymmetric septal hypertrophy
narrow left ventricular outflow tract
systolic anterior motion of the mitral valve
small or normal sized left ventricle
a. dilated cmpathy
b. restrictive
c. hypertrophic
A

C

34
Q 
EchoL increased LV wall thickness and mass
small or normal size LV cavity
normal systolic function
pericardial effusion
a. dilated cmpathy
b. restrictive
c. hypertrophic
A

B

35
Q

characterized by a thickned but non dilated LV in the absence of other cardiac or systemic conditions

A

hypertrophic cardiac myopathy

36
Q 
Genetic transmission of hypertrophic cardiac myopathy
A. AR
B. AD
C. X-linked R
D. X-linked D
A

B

37
Q

eleven mutated genes accounting for about 50% of patients, most commonly (2)

A

Beta myosin heavy chain

myosin binding protein C

38
Q

non-sarcomeric protein mutations cause

A

storage diseases

39
Q

clinical diagnosis of HCM is usually made with

A

2DEcho

40
Q

the ff statements are true about role of MRI in diagnosis of HCM EXCEPT

a. clarify ambiguous LV wall thickness
b. visualize areas of segmental hypertrophy in the anterolateral free wall
c. depict pathologic changes in apical region
d. gold standard for diagnosis

A

D

41
Q

T/F typically, one or more regions of the LV wall are of greater thickness than other areas

A

T

42
Q

wall thickening is limited to the most

a. distal
b. proximal
c. both
d. neither

A

A

43
Q

represents a morphologic form of HCM characterized by a spade deformity of the distal L ventrical

a. apical HCM
b. basal HCM
c. lateral HCM
d. proximal HCM

A

A

44
Q

T/F in HCM, there are peaked T waves on ECG and this is due to mutations in proteins of cardiac sarcomere

A

F; marked T wave negativity

45
Q

The following are HCM anatomic variants

a. HOCM
b. midventricular obstruction
c. apical HCM
d. LV free wall hypertrophy
e. basal HCM
f. Concentric LVH

A

E

46
Q

Histopathology of HCM EXCEPT

a. decreased transverse diameter
b. bizarre shapes
c. often maintaining intercellular connections with adjacent cells
d. NOTA

A

A, increased

47
Q

Longstanding LV outflow tract obstructioon (basal gradient: _____mmHg

A

30mmHg

48
Q

strong determinant of HCM related progressive heart failure symptoms and cardiovascular death

A

longstanding LV outflow tract obstruction

49
Q

subaortic obstruction in HCM represents

A

true mechanical impedance to LV outflow

50
Q

In most patients, obstruction is produced in the proximal left ventricle by the

A

systolic anterior motion of mitral valve and midsystolic ventricular septal contact

51
Q

in HCM, swuatitng, isometric handgrip, phenylephrine

a. increase auscultation sounds
b. decrease/abolish auscultation sounds

A

B

52
Q

heart sounds are augmented in HCM with the ff EXCEPT

a. valsalva maneuver
b. hand grip
c. nitroglycerin or amyl nitrite administration
d. blood loss

A

B

53
Q

Reduce or abolish heart sounds in HCM EXCEPT

a. squatting,
b. isometric handgrip
c. phenylephrine
d. infusion of isoproterenol

A

D

54
Q

T/F consumption of a heavy meal or small amounts of alcohol can also permanently increase subaortic gradient and produce dyspnea

A

F; transient

55
Q

favors ususual patterns of LV hypertrophy

a. athlete’s heart
b. HCM
c. both
d. neither

A

B

56
Q

LV cavity <45mm

a. athlete’s heart
b. HCM
c. both
d. neither

A

B

57
Q

LV cavity measurement in athlete’s heart

A

> 55mm

58
Q

left atrial enlargement

a. athlete’s heart
b. HCM
c. both
d. neither

A

C

59
Q

Bizarre ECG patterns

a. athlete’s heart
b. HCM
c. both
d. neither

A

C

60
Q

Abnormal LV filling

a. athlete’s heart
b. HCM
c. both
d. neither

A

B

61
Q

Female gender

a. athlete’s heart
b. HCM
c. both
d. neither

A

B

62
Q

Decrease thickness with deconditioning

a. athlete’s heart
b. HCM
c. both
d. neither

A

A

63
Q

family history of HCM

a. athlete’s heart
b. HCM
c. both
d. neither

A

B

64
Q

Athlete’s heart affect wide range of ages but most commonly in ___ to ____ years of age

A

<30 to 35

65
Q

arrhythmia in athlete’s heart caused by primary ____ and ____

A

Vtach and V Fib

66
Q

what is the most common cardiovascular cause of athletic field deaths

A

HCM

67
Q

Presence of 1 or more of these 3 justifies consideration of ICD

A

familial sudden death
unexplained syncope
massive LVH

68
Q

improves symptoms and exercise capacity, probably because of its beneficial effect on ventricular relaxation and filling

A

verapamil

69
Q

this is a good third option in combination with a beta blocker

A

disopyramide

70
Q

this reduce pulmonary congestion and LV filling pressures

A

Diuretic

71
Q

Initially, what should you administer (HCM)

A

betablockers or verapamil

72
Q

what is the most common sustained arrhythmia in HCM

A

Atrial fibrillation

73
Q

AF, either paroxysmal or chronic occurs about ___% of HCM patients

A

20%

74
Q

what is the preferred treatment option for HCM?

A

surgical septal myectomy

75
Q

The ff statements are true regarding surgical septal myectomy EXCEPT

a. it is for px with severe drug-refractory heart failure symptoms
b. NYHA III and IV are indications
c. associated with obstruction to LV outflow under basal conditions or with physiologic exercise gradent >=50mmHg
d. AOTA

A

D

76
Q

T/F dual chamber pacing has a modest reduction in subaortic gradient and thus comparable results with myectomy or alcohol ablation

A

F; modest reduction but inconsistent benefit thus results not comparable

77
Q

T/F alcohol septal ablation is an alternative to myectomy only in selected patients

A

T

M3 (66 decks)

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