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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
kussmaul sign a. dilated cmpathy b. restrictive c. hypertrophic d. A and B e. B and C f. A B and C
B
26
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
C
27
CXR: pulmonary venous hypertension a. dilated cmpathy b. restrictive c. hypertrophic d. A and B e. B and C f. A B and C
D
28
Left atrial enlargement a. dilated cmpathy b. restrictive c. hypertrophic d. A and B e. B and C f. A B and C
C
29
``` ECG: sinus tachycardia Atrial and ventricular arrhythmias St segment and T wave abnormalities Intraventricular conduction defects ``` a. dilated cmpathy b. restrictive c. hypertrophic
A
30
ECG: low voltage, intraventricular conduction defects atrioventricular conduction defects a. dilated cmpathy b. restrictive c. hypertrophic
B
31
``` ECG: left ventricular hypertrophy ST-segment and T wave abnormalities Abnormal Q waves Atrial and ventricular arrhthmias ``` a. dilated cmpathy b. restrictive c. hypertrophic
C
32
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
33
``` 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 ```
C
34
``` 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 ```
B
35
characterized by a thickned but non dilated LV in the absence of other cardiac or systemic conditions
hypertrophic cardiac myopathy
36
``` Genetic transmission of hypertrophic cardiac myopathy A. AR B. AD C. X-linked R D. X-linked D ```
B
37
eleven mutated genes accounting for about 50% of patients, most commonly (2)
Beta myosin heavy chain | myosin binding protein C
38
non-sarcomeric protein mutations cause
storage diseases
39
clinical diagnosis of HCM is usually made with
2DEcho
40
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
D
41
T/F typically, one or more regions of the LV wall are of greater thickness than other areas
T
42
wall thickening is limited to the most a. distal b. proximal c. both d. neither
A
43
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
44
T/F in HCM, there are peaked T waves on ECG and this is due to mutations in proteins of cardiac sarcomere
F; marked T wave negativity
45
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
E
46
Histopathology of HCM EXCEPT a. decreased transverse diameter b. bizarre shapes c. often maintaining intercellular connections with adjacent cells d. NOTA
A, increased
47
Longstanding LV outflow tract obstructioon (basal gradient: _____mmHg
30mmHg
48
strong determinant of HCM related progressive heart failure symptoms and cardiovascular death
longstanding LV outflow tract obstruction
49
subaortic obstruction in HCM represents
true mechanical impedance to LV outflow
50
In most patients, obstruction is produced in the proximal left ventricle by the
systolic anterior motion of mitral valve and midsystolic ventricular septal contact
51
in HCM, swuatitng, isometric handgrip, phenylephrine a. increase auscultation sounds b. decrease/abolish auscultation sounds
B
52
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
B
53
Reduce or abolish heart sounds in HCM EXCEPT a. squatting, b. isometric handgrip c. phenylephrine d. infusion of isoproterenol
D
54
T/F consumption of a heavy meal or small amounts of alcohol can also permanently increase subaortic gradient and produce dyspnea
F; transient
55
favors ususual patterns of LV hypertrophy a. athlete's heart b. HCM c. both d. neither
B
56
LV cavity <45mm a. athlete's heart b. HCM c. both d. neither
B
57
LV cavity measurement in athlete's heart
>55mm
58
left atrial enlargement a. athlete's heart b. HCM c. both d. neither
C
59
Bizarre ECG patterns a. athlete's heart b. HCM c. both d. neither
C
60
Abnormal LV filling a. athlete's heart b. HCM c. both d. neither
B
61
Female gender a. athlete's heart b. HCM c. both d. neither
B
62
Decrease thickness with deconditioning a. athlete's heart b. HCM c. both d. neither
A
63
family history of HCM a. athlete's heart b. HCM c. both d. neither
B
64
Athlete's heart affect wide range of ages but most commonly in ___ to ____ years of age
<30 to 35
65
arrhythmia in athlete's heart caused by primary ____ and ____
Vtach and V Fib
66
what is the most common cardiovascular cause of athletic field deaths
HCM
67
Presence of 1 or more of these 3 justifies consideration of ICD
familial sudden death unexplained syncope massive LVH
68
improves symptoms and exercise capacity, probably because of its beneficial effect on ventricular relaxation and filling
verapamil
69
this is a good third option in combination with a beta blocker
disopyramide
70
this reduce pulmonary congestion and LV filling pressures
Diuretic
71
Initially, what should you administer (HCM)
betablockers or verapamil
72
what is the most common sustained arrhythmia in HCM
Atrial fibrillation
73
AF, either paroxysmal or chronic occurs about ___% of HCM patients
20%
74
what is the preferred treatment option for HCM?
surgical septal myectomy
75
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
D
76
T/F dual chamber pacing has a modest reduction in subaortic gradient and thus comparable results with myectomy or alcohol ablation
F; modest reduction but inconsistent benefit thus results not comparable
77
T/F alcohol septal ablation is an alternative to myectomy only in selected patients
T

M3 (66 decks)

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