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NUR251 - Medical Surgical III > Chapter 40: Inflammatory and Structural Heart Disorders- Cardiomyopathy > Flashcards

Chapter 40: Inflammatory and Structural Heart Disorders- Cardiomyopathy Flashcards

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USMLE® Step 1 flashcards
1
Q

A patient presents with chest pain, ST segment elevation on ECG, and elevated cardiac biomarkers. Cardiac catheterization reveals no significant coronary artery disease. Which type of cardiomyopathy is MOST likely?

A) Dilated cardiomyopathy
B) Hypertrophic cardiomyopathy
C) Restrictive cardiomyopathy
D) Takotsubo cardiomyopathy

A

D) Takotsubo cardiomyopathy

Rationale: The question describes the classic presentation of Takotsubo cardiomyopathy: mimicking an acute coronary syndrome (ACS) with chest pain, ST elevation, and elevated cardiac biomarkers, but without significant coronary artery disease on catheterization.

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2
Q

Which of the following is a characteristic of primary cardiomyopathy?

A) It is caused by another disease process.
B) It involves only the heart muscle.
C) It always leads to heart failure.
D) It is always treatable with medication.

A

B) It involves only the heart muscle.

Rationale: The text defines primary cardiomyopathy as idiopathic (of unknown cause) and affecting only the heart muscle. Secondary cardiomyopathy, in contrast, is caused by another disease process.

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3
Q

Which of the following are considered major types of cardiomyopathy?(SATA)

A) Dilated cardiomyopathy
B) Hypertrophic cardiomyopathy
C) Ischemic cardiomyopathy
D) Restrictive cardiomyopathy
E) Takotsubo cardiomyopathy

A

A) Dilated cardiomyopathy
B) Hypertrophic cardiomyopathy
D) Restrictive cardiomyopathy

Rationale: The text explicitly names dilated, hypertrophic, and restrictive cardiomyopathies as the three major types. Ischemic cardiomyopathy is a consequence of coronary artery disease, not a primary type. Takotsubo cardiomyopathy is a specific syndrome, not one of the three major types.

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4
Q

A patient with cardiomyopathy is experiencing significant cardiomegaly and heart failure. What is a potential treatment option for this patient, as mentioned in the text?

A) Anticoagulation therapy
B) Heart transplant
C) Supportive care only
D) Immediate coronary artery bypass grafting (CABG)

A

B) Heart transplant

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5
Q

A postmenopausal woman presents with symptoms consistent with Takotsubo cardiomyopathy. Which of the following treatments is MOST likely to be initiated?

A) Aggressive statin therapy
B) Coronary artery stenting
C) Supportive care
D) Surgical myectomy

A

C) Supportive care

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6
Q

What is the most common type of cardiomyopathy?

a. Hypertrophic cardiomyopathy
b. Restrictive cardiomyopathy
c. Dilated cardiomyopathy
d. Arrhythmogenic right ventricular cardiomyopathy

A

c. Dilated cardiomyopathy

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7
Q

Which clinical finding is most indicative of dilated cardiomyopathy?

a. Hypertrophy of the ventricular walls
b. Atrial enlargement
c. Rapid weight gain
d. Decreased jugular venous distension (JVD)

A

b. Atrial enlargement

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8
Q

Which of the following are symptoms of dilated cardiomyopathy? (SATA)

a. Decreased exercise capacity
b. Paroxysmal nocturnal dyspnea
c. Jugular venous distension (JVD)
d. Hyperactive bowel sounds
e. Pitting edema

A

a. Decreased exercise capacity
b. Paroxysmal nocturnal dyspnea
c. Jugular venous distension (JVD)
e. Pitting edema

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9
Q

A patient with dilated cardiomyopathy is at risk for sudden cardiac death (SCD) primarily due to:

a. Severe mitral valve regurgitation
b. Left ventricular hypertrophy
c. High blood pressure
d. Ventricular dysrhythmias

A

d. Ventricular dysrhythmias

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10
Q

Which diagnostic test is commonly used to diagnose dilated cardiomyopathy?

a. Electrocardiogram (ECG)
b. Echocardiography
c. Chest x-ray
d. Coronary angiography

A

b. Echocardiography

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11
Q

Which of the following medications are used to manage heart failure in dilated cardiomyopathy? (SATA)

a. ACE inhibitors
b. Beta-blockers
c. Calcium channel blockers
d. Diuretics
e. Antiplatelet agents

A

a. ACE inhibitors
b. Beta-blockers
d. Diuretics

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12
Q

Which intervention is most appropriate for a patient with dilated cardiomyopathy and symptoms of heart failure?

a. Monitoring daily weights
b. Encouraging fluid intake
c. Providing a high-sodium diet
d. Limiting physical activity

A

a. Monitoring daily weights

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13
Q

A patient with dilated cardiomyopathy presents with a new onset of confusion and disorientation. What is the most likely cause?

a. Electrolyte imbalance
b. Hypoglycemia
c. Decreased cardiac output
d. Anxiety

A

c. Decreased cardiac output

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14
Q

In dilated cardiomyopathy, the presence of a third heart sound (S3) is indicative of:

a. Hypertensive crisis
b. Left ventricular failure
c. Myocardial infarction
d. Right ventricular hypertrophy

A

b. Left ventricular failure

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15
Q

What complication is associated with blood stasis in the left ventricle of a patient with dilated cardiomyopathy?

a. Hemorrhage
b. Pericarditis
c. Aortic dissection
d. Thrombus formation

A

d. Thrombus formation

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16
Q

What is a common cause of death in patients with idiopathic dilated cardiomyopathy?

a. Cardiogenic shock
b. Ventricular dysrhythmias
c. Acute myocardial infarction
d. Heart block

A

b. Ventricular dysrhythmias

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17
Q

Which signs would a nurse expect to find in a patient with advanced dilated cardiomyopathy? (SATA)

a. Pulmonary crackles
b. Hepatomegaly
c. Bounding peripheral pulses
d. Orthopnea
e. Tachycardia

A

a. Pulmonary crackles
b. Hepatomegaly
d. Orthopnea
e. Tachycardia

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18
Q

Which nutritional advice is most appropriate for a patient with dilated cardiomyopathy?

a. Increase intake of high-potassium foods
b. Consume high-fat meals
c. Follow a low-sodium diet
d. Restrict protein intake

A

c. Follow a low-sodium diet

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19
Q

What is the goal of palliative care for a patient with Class IV (stage D) heart failure due to dilated cardiomyopathy?

a. Improve quality of life
b. Cure the disease
c. Increase physical activity
d. Promote aggressive treatments

A

a. Improve quality of life

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20
Q

What is the most common cause of sudden cardiac death in young athletes?

a. Myocardial infarction
b. Hypertrophic cardiomyopathy
c. Dilated cardiomyopathy
d. Aortic dissection

A

b. Hypertrophic cardiomyopathy

21
Q

Which characteristic is NOT typically associated with hypertrophic cardiomyopathy?

a. Massive ventricular hypertrophy
b. Impaired diastolic function
c. Ventricular dilation
d. Obstruction to aortic outflow

A

c. Ventricular dilation

22
Q

Which symptoms are common in patients with hypertrophic cardiomyopathy? (SATA)

a. Exertional dyspnea
b. Fatigue
c. Angina
d. Syncope
e. Peripheral edema

A

a. Exertional dyspnea
b. Fatigue
c. Angina
d. Syncope

23
Q

What is a significant risk factor for hypertrophic cardiomyopathy?

a. High cholesterol
b. Genetic predisposition
c. Hypertension
d. Smoking

A

b. Genetic predisposition

24
Q

Which diagnostic tool is primarily used to confirm hypertrophic cardiomyopathy?

a. Chest x-ray
b. Electrocardiogram (ECG)
c. Echocardiogram
d. Magnetic resonance imaging (MRI)

A

c. Echocardiogram

25
Q

Which medications are typically used to manage hypertrophic cardiomyopathy? (SATA)

a. Beta-blockers
b. ACE inhibitors
c. Calcium channel blockers
d. Diuretics
e. Amiodarone

A

a. Beta-blockers
c. Calcium channel blockers
e. Amiodarone

26
Q

Which type of cardiomyopathy involves a thickened septum that obstructs blood flow from the left ventricle?

a. Restrictive cardiomyopathy
b. Dilated cardiomyopathy
c. Hypertrophic obstructive cardiomyopathy
d. Ischemic cardiomyopathy

A

c. Hypertrophic obstructive cardiomyopathy

27
Q

A patient with hypertrophic cardiomyopathy complains of chest pain and syncope. What is the likely cause of these symptoms?

a. Decreased coronary artery perfusion
b. Obstruction to aortic outflow
c. Mitral valve prolapse
d. Pulmonary hypertension

A

b. Obstruction to aortic outflow

28
Q

In hypertrophic cardiomyopathy, which finding is most likely to be detected on an ECG?

a. Ventricular hypertrophy
b. T wave inversion
c. Atrial fibrillation
d. Sinus bradycardia

A

a. Ventricular hypertrophy

29
Q

What intervention is least likely to be beneficial for a patient with hypertrophic cardiomyopathy?

a. β-blocker therapy
b. Alcohol septal ablation
c. High-intensity exercise
d. Implantable cardioverter-defibrillator (ICD)

A

c. High-intensity exercise

30
Q

Which surgical treatments are considered for severe hypertrophic cardiomyopathy? (SATA)

a. Ventriculomyotomy
b. Coronary artery bypass grafting
c. Myectomy
d. Heart transplant
e. Angioplasty

A

a. Ventriculomyotomy
c. Myectomy
d. Heart transplant

31
Q

What is the goal of treatment for hypertrophic cardiomyopathy?

a. Increase ventricular contractility
b. Decrease ventricular filling
c. Promote high sodium intake
d. Relieve left ventricular outflow obstruction

A

d. Relieve left ventricular outflow obstruction

32
Q

Which of the following is a potential complication of percutaneous transluminal septal myocardial ablation (PTSMA)?

a. Heart block
b. Stroke
c. Kidney failure
d. Pulmonary embolism

A

a. Heart block

33
Q

What lifestyle modification should a nurse emphasize to a patient with hypertrophic cardiomyopathy?

a. Avoiding strenuous activity
b. Increasing fluid intake
c. Following a high-protein diet
d. Taking cold showers

A

a. Avoiding strenuous activity

34
Q

In hypertrophic cardiomyopathy, which symptom is caused by elevated left ventricular diastolic pressure?

a. Peripheral edema
b. Exertional dyspnea
c. Nocturia
d. Cyanosis

A

b. Exertional dyspnea

35
Q

Which type of cardiomyopathy is the least common?

a. Dilated cardiomyopathy
b. Hypertrophic cardiomyopathy
c. Restrictive cardiomyopathy
d. Arrhythmogenic right ventricular cardiomyopathy

A

c. Restrictive cardiomyopathy

36
Q

What is the primary characteristic of restrictive cardiomyopathy?

a. Diastolic dysfunction
b. Systolic dysfunction
c. Ventricular dilation
d. Increased ventricular compliance

A

a. Diastolic dysfunction

37
Q

Which secondary causes can lead to restrictive cardiomyopathy? (SATA)

a. Amyloidosis
b. Sarcoidosis
c. Hypertension
d. Radiation to the thorax
e. Hyperthyroidism

A

a. Amyloidosis
b. Sarcoidosis
d. Radiation to the thorax

38
Q

Which clinical manifestation is least likely to be observed in a patient with restrictive cardiomyopathy?

a. Fatigue
b. Exercise intolerance
c. Dyspnea
d. Ventricular hypertrophy

A

d. Ventricular hypertrophy

39
Q

What is the main difference in cardiac function between restrictive cardiomyopathy and other types of cardiomyopathy?

a. Preserved systolic function
b. Increased systolic function
c. Impaired systolic function
d. Reduced diastolic function

A

a. Preserved systolic function

Rationale: In restrictive cardiomyopathy, systolic function is usually preserved, while diastolic function is impaired.

40
Q

Which symptoms are commonly associated with restrictive cardiomyopathy? (SATA)

a. Angina
b. Orthopnea
c. Peripheral edema
d. Syncope
e. Bradycardia

A

a. Angina
b. Orthopnea
c. Peripheral edema
d. Syncope

41
Q

What is a typical finding on a chest x-ray of a patient with restrictive cardiomyopathy?

a. Cardiomegaly from ventricular enlargement
b. Cardiomegaly from atrial enlargement
c. Pulmonary fibrosis
d. Pleural effusion without cardiomegaly

A

b. Cardiomegaly from atrial enlargement

42
Q

Which diagnostic tool is crucial for identifying structural changes in restrictive cardiomyopathy?

a. Electrocardiogram (ECG)
b. Echocardiography
c. Chest x-ray
d. Cardiac MRI

A

b. Echocardiography

43
Q

In restrictive cardiomyopathy, high diastolic filling pressures are required to maintain:

a. Heart rate
b. Blood pressure
c. Cardiac output
d. Ventricular compliance

A

c. Cardiac output

44
Q

Which symptom of restrictive cardiomyopathy is caused by the heart’s inability to increase cardiac output during exercise?

a. Orthopnea
b. Syncope
c. Exercise intolerance
d. Palpitations

A

c. Exercise intolerance

45
Q

What are some potential signs of heart failure in a patient with restrictive cardiomyopathy? (SATA)

a. Peripheral edema
b. Weight gain
c. Hepatomegaly
d. Hyperthermia
e. Ascites

A

a. Peripheral edema
b. Weight gain
c. Hepatomegaly
e. Ascites

46
Q

What type of dysrhythmia is most commonly associated with restrictive cardiomyopathy?

a. Atrial fibrillation
b. Ventricular tachycardia
c. Sinus bradycardia
d. Second-degree AV block

A

a. Atrial fibrillation

47
Q

Which intervention is NOT typically beneficial for patients with restrictive cardiomyopathy?

a. Heart transplant
b. High-intensity exercise
c. Conventional therapy for heart failure
d. Antidysrhythmic medications

A

b. High-intensity exercise

48
Q

Why is it important to teach patients with restrictive cardiomyopathy to avoid dehydration?

a. It decreases the risk of syncope
b. It increases systemic vascular resistance
c. It improves ventricular filling
d. It reduces diastolic pressure

A

c. It improves ventricular filling

49
Q

What is a possible treatment option for patients with severe restrictive cardiomyopathy unresponsive to medical management?

a. Left ventricular assist device (LVAD)
b. Coronary artery bypass grafting (CABG)
c. Heart transplant
d. Balloon angioplasty

A

c. Heart transplant

NUR251 - Medical Surgical III (6 decks)

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