Chapter 55 Flashcards
WhichofthefollowingisTRUEregardingmyocarditis?
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A. Myocarditis is an inflammation that can be found after any form of injury to the heart, including ischemic damage, mechanical trauma, and genetic cardiomyopathies
B. Classic myocarditis occurs asa result of exposure to either discrete external antigens, such as viruses, bacteria, parasites, toxins, or drugs, or internal trigger such as autoimmune activation
C. Other causes of myocarditis include drug hypersensitivity and toxic drug reactions, other infections, and peripartum cardiomyopathy
D. ALL are TRUE
D. ALL are TRUE
More than 20 viruses have been associated with myocarditis. Which among the following is/are the most frequent cause of myocarditis?
A. Parvovirus B19
B. HIV
C. Human herpesvirus 6
D. Both A & C
E. All of the above
D. Both A & C
. On epidemiology of myocarditis, which of the following is FALSE?
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A. As estimated in the 2019 Global Burden of Disease study prevalence of myocarditis in 2019, the prevalence rate is 9.21 per 100,000
B.Death rate from myocarditis is lower in the first year of life than between ages 1 and 14 years for both males and females
C. After age 15 years, the number of deaths and death rates due to myocarditis are higher in males than females
D. Myocarditis is responsible for sudden cardiovascular death in approximately 2% of infants, 5% of children, and 5% to 14% of young athletes
B.Death rate from myocarditis is lower (HIGHER) in the first year of life than between ages 1 and 14 years for both males and females
What is the histologic criteria used to help define myocarditis ?
Dallas
Myocardial involvement with Corynebacterium diphtheriae is a serious complication and is the most common cause of death in diphtheria. What causes cardiac damage thru inhibiting protein synthesis by interfering with host translational mechanisms?
A. Exotoxins
B. Endotoxins
C. Both
D. Neither
B. Endotoxins
- The most commonly detected cardiac complication after beta-hemolytic streptococcal infection is acute rheumatic fever, which is followed by rheumatic valve disease in approximately 60% of affected patients. What is/are the common ECG abnormalities seen in such infection?
A. ST elevation
B. Prolonged PR interval
C. Prolonged QT interval
D. All of the above
E. A and B
D. All of the above
Drug-induced hypersensitivity syndrome may involve the heart and be associated with myocarditis. This usually emerges within 8 weeks from initiation of a new drug but can occur at anytime after drug consumption. Which of the following is/are the common agent/s associated with eosinophilic myocarditis?
A. antiepileptics
B. antimicrobials
C. allopurinol
D. Dobutamine
E. All of the above
E. All of the above
Radiation therapy can lead to a variety of cardiac complications that arise long after the completion of the therapy. What is the most common site of clinical involvement with findings of chronic pericardial effusion or pericardial constriction?
A. Myocardium
B. Pericardium
C. Epicardium
D. Endocardium
B. Pericardium
Which among the following physical agent/s can cause myocarditis?
A. Radiation
B. Heat stroke
C. Hypothermia
D. All of the above
E. Only A and B
D. All of the above
This type of immunity is an antigen-specific response that is directed to a single antigen and is mediated by T and B cells.
A. Acquired Immunity
B. Innate Immunity
C. Both
D. Neither
A. Acquired Immunity
This type of immunity is the major immune mechanism responsible for inhibiting viral infection and replication during the first 4 to 5 days after infection.
A. Acquired Immunity
B. Innate Immunity
C. Both
D. Neither
B. Innate Immunity
One of the classic and best characterized examples of innate immunity is the activation of IFN. The two broad classes of IFNs use different receptors: Type I IFNs binds to IFN-a and IFN-B, whereas IFN-y is the sole type II IFN member.
What type of IFN/s is/are effective at limiting viral replication when added to infected cells ?
A.Type I
B.Type II
C.Both
D. Neither
C.Both
This is a macromolecular complex that is activated during myocardial injury and stimulates processing of IL-1β and IL-18, which are important in the innate immune response against viral infection.
A. Inflammasome
B. MAC
C. TLR
D. Helper T-cell
A. Inflammasome
All of the following are TRUE regarding the clinical syndrome of myocarditis EXCEPT:
A. Chest pain from myocarditis may resemble typical angina and be accompanied by ECG changes, including ST-segment elevation
B. Myopericarditis has the worst
C. Myocarditis typically has a bimodal distribution in terms of age in the population, with the acute or fulminant presentation common in young children and teenagers.
D. None of the above
B. Myopericarditis has the worst
Myocarditis typically has a bimodal distribution in terms of age in the population. Which among the age population commonly presents with acute or fulminant myocarditis?
A. Infants
B. Young children and teenagers-
C. Older adult population
D. All of the above
B. Young children and teenagers
Patients with myocarditis present with non specific symptoms related to the heart. In a recent series of 245 patients with clinically suspected myocarditis, which was the most common symptom?
A. fatigue
B. arrhythmias
C. chest pain at rest
D. fever
A. fatigue
This type of myocarditis occurs in approximately 10% of patients with biopsy-proven myocarditis. It is characterized by an abrupt onset, usually within 2weeks of a viral illness associated with hemodynamic compromise.
A. Giant Cell myocarditis
B. Eosinophilic myocarditis
C. Fulminant myocarditis
D. Chronic active myocarditis
C. Fulminant myocarditis
The eosinophil may be associated with myocardial inflammation in three distinct forms. This type of eosinophilic myocarditis is caused by a hypersensitivity reaction to a foreign antigen, almost always a drug.
A. Fulminant necroticmyocarditis
B. Systemic eosinophilic myocarditis
C. Allergic eosinophilic myocarditis
D. None of the above
C. Allergic eosinophilic myocarditis
What is the primary noninvasive imaging modality of choice for assessment of myocardial inflammation in patients with suspected myocarditis?
A. Cardiovascular Magnetic Resonance imaging (CMR)
B. Echocardiography
C. Positron Emission Tomography
D. Cardiac Computed Tomography
A. Cardiovascular Magnetic Resonance imaging (CMR)
UsingtheLakeLouiseConsensusCriteriaonCMRDiagnosisofMyocarditis.Findingsareconsistentwithmyocardialinflammation,ifatleasttwoofthefollowingcriteriaarepresentEXCEPT:
A. Regional or global myocardial SI increase in T2-weighted images
B. Increased global myocardial early gadolinium enhancement ratio between myocardium and skeletal muscle in gadolinium-enhanced T1-weighted images
C. There is at least one focal lesion with nonischemic regional distribution in IR-prepared gadolinium-enhanced T1-weighted images (“Early gadolinium enhancement”)
D. None the above
C. There is at least one focal lesion with nonischemic regional distribution in IR-prepared gadolinium-enhanced T1-weighted images (“Early gadolinium enhancement”)
Examples of cancer therapeutics that causes coronary artery vasospasm: (7)
5-fluorouracil (5-FU), capecitabine, paclitaxel, cisplatin, bleomycin, VEGF inhibitors such as sorafenib, and Bcr-Abl inhibitors such as dasatinib
treatment: Nitrates, calcium-channel blocker (CCB)
Onset after cancer therapy: days to weeks
Causes of accelerated atherosclerosis in cancer patients:
most commonly associated with radiation therapy but has received attention with the use of Bcr-Abl inhibitors such as nilotinib and ponatinib in recent years; it may also be seen with VEGF inhibitors and cisplatin
