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Pathophysiology > Exam 2 Cardio > Flashcards

Exam 2 Cardio Flashcards

GET AN A ON THIS EXAM HEIDI. YOU CAN DO IT.

1
Q

When does diastole begin?

a. when mitral valve closes
b. when mitral valve opens
c. when aortic valve opens
d. when aortive valve closed

A

b. when mitral valve opens

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2
Q

Normally, the capillary wedge pressure is how much?

A

5mmHg

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2
Q

What is capillary wedge pressure a measure of?

A

Left atrial pressure

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3
Q

Rhematic fever is the cause of this disease 99% of the time:

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. Mitral Valve Prolapse

A

c. Mitral Stenosis

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4
Q

Which heart vlave is most POSTERIOR in nature?

A

mitral valve

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5
Q

Which of the valve conditions has the BEST prognosis?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis

A

c. Mitral Stenosis

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6
Q

This valvular disorder is characterized by a diastolic gradient causing a mid-diastolic murmur and an opening snap.

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis

A

c. Mitral Stenosis

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7
Q

During what part of the cardiac cycle do you hear S1?

A

During the closure of the AV valves

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8
Q

During what part of the cardiac cycle do you hear S2?

A

During the closure of the semilunar valves

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9
Q

In this valvular condition, S1 is accentuated.

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis

A

c. Mitral stenosis

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10
Q

A patient’s chest x-ray presents with straightening of hte left heart border, a butterfly like pattern, Kerley’s B-lines, and massive left atrial enlargement. What valvular disease does she most likely have?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis

A

c. Mitral stenosis

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11
Q

When the left atrium enlarges, what do you see on an x-ray?

a. enlarged LA anterior and right
b. enlarged LA anterior and left
c. enlarged LA posterior and right
d. enlarged LA anterior and left
e. You see no change on the x-ray of a patient with an enlarged left atrium

A

c. enlarged LA posterior and right

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12
Q

What valvular disease has a hyperdynamic left ventricle?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. A and B

A

E. Both regurgs because of the flowback of blood into the chamber

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13
Q

At what point does pulmonary edema ensue?

a. when the LVEDP is > 25mmHg
b. When the LAEDP is >25 mmHg
c. When the RVEDP is >25 mmHg
d. When the RAEDP is >25mmHg

A

A.

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14
Q

This valvular disorder is characterized by a giant CV wave, a pansystolic regurgitant murmur and left atria and ventricular cardiomegaly.

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis

A

A. Mitral Regurgitation

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15
Q

Which of the following is not assoicated with MVP?

a. Marfanoid habitus
b. Straight-back syndrome
c. Pectus excavatum
d. Low arched palate
e. Abnormal fingerprints

A

d. Low arched palate

Pts with MVP have a high arched palate

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16
Q

This valvular disorder is characterized by a late systolic “ejection click” that moves towards S2

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

e. MVP

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17
Q

Would birth of a child better or worsen the symptoms of a 29 y/o female with MVP?

A

Worsen because of decrease in ventricle diameter due to decreased volume load = signs and symptoms worse

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18
Q

This murmur is associated with turbulence under the leaflet of the valve in the ventricular cavity.

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

e. MVP murmur: late systolic!

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19
Q

This valvular disorder is characterized by a diamond shape crescendo-decrescendo murmur

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

d. Aortic Stenosis

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20
Q

Which of the following valvular disorders resut in a SMALLER pulse pressure?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

d. Aortic Stenosis

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21
Q

With which of the valvular disorders do you commonly see pulmonary edema?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

d. Aortic Stenosis

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22
Q

When do you treat pts with aortic stenosis?

A

When they have 3 symptoms arise: angina, syncope, heart failure

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23
Q

A pt will die within 5 years if you dont treat what symptom?

a. angina
b. syncope
c. heart failure
d. MI

A

angina

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24
Q

A pt will die within 2 years if you dont treat what symptom?

A

heart failure

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25
Q

A pt will die within 3 years if you dont treat what symptom?

A

syncope

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26
Q

In which valvular disorder is in CONTRAINDICATED to exercise?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

c. Mitral stenosis

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27
Q

With what valvular disorder do you see a markedly increased systolic gradient?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

d. Aortic stenosis

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28
Q

Which of the valvular disorders do you see the largest hearts of anyone?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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29
Q

Cor Bovinum is associated with which valvular disorder?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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30
Q

Which of the valvular disorders has a high volume + pressure?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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31
Q

This valvular disorder is characterized by a very long blowing murmur “bum-bum, swooosh”.

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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32
Q

A patient presents to the ER with angina, a widened pulse pressure and an occasional head bob. What valvular condition does he most likely have?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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33
Q

This valvular disorder is most characteristic of ventricular arrhythmias:

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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34
Q

Which of the following valvular conditions does NOT have a symptom of fatigue due to the preserved output?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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35
Q

Which valvular disorder is characterized by a higher pulse pressure?

a. Mitral Regurgitation
b. Aortic Regurgitation
c. Mitral Stenosis
d. Aortic Stenosis
e. MVP

A

b. Aortic regurgitation

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36
Q

In a left ventricular volume overload, what do classically see?

a. Dilated heart
b. S3 sound in early diastole
c. S3 sound in late diastole
d. concentrically hypertrophied heart
e. A and B

A

E. A and B

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37
Q

Which of the cardiomyopathies is classically seen as a 4 chamber enlargement?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy
d. In none of the cardiomyopathies are all 4 chambers enlarged.
e. In all of the cardiomyopathies

A

A. Dilated cardiomyopathy

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38
Q

This cardiomyopathy presents with decreased stroke volume

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

a. dilated cardiomyopathy

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39
Q

In which of the following disorders are systolic gradients frequent in nature?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy
d. Aortic Stenosis
e. B and D

A

E

40
Q

This disorder presents wth a bifid arterial pulse:

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

b

41
Q

Which chromosomes are mutated in HCM?

A

14, 1, 15, 11

42
Q

What type of gradient do you see in pts with HCM?

a. systolic gradient
b. diastolic gradient
c. both
d. neither

A

a. systolic

43
Q

What is the main problem in patients with mitral regurgitation?

A

A change in the geometry of the ventricle

44
Q

What is the most acceptable etiologic hypothesis of HCM?

A

hypertrophy develops as a compensatory response to sarcoplasmic dysfunction

45
Q

What are the two physiologic conditions that we learned regarding heart conditions?

A

MVP and HCM

46
Q

What is the treatment for HCM?

a. vasodilators
b. digoxin
c. beta blockers
d. A and B

A

C. beta blockers

never give digoxin or vasodilators to a pt with HCM

47
Q

Which of the cardiomyopathies presents with a “stiff heart”?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

c

48
Q

In which of the cardiomyopathies do you hear an S4 sound?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

c

49
Q

This cardiomyopathy is related to an infiltrative process responsible for the decreased compliance of the ventricle

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

C.

50
Q

Eosinophilis is associated with which cardiomyopathy?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

C

51
Q

In this cardiomyopathy the ventricle is not hypertrophied, but it is not compliant

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

C

52
Q

Prominent x and y descents are characteristic of what?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

C

53
Q

In which cardiomyopathy do you hear a LATE S3?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

C

54
Q

In which cardiomyopathy do you have an abnormality in diastolic filling?

a. Dilated Cardiomyopathy
b. Hypertrophic Cardiomyopathy
c. Restrictive Cardiomyopathy

A

C

55
Q

All of the following are true of Restrictive cardiomyopathy EXCEPT:

a. Has an elevated end diastolic pressure
b. Has a late 3rd heart sound
c. Has a non-compliant ventricle
d. Death occurs in a few years
e. All are true

A

E

56
Q

What does the left coronery artery bifurcate into?

A

circumflex artery + left anterior descending artery

57
Q

Infarction of the lateral wall of the left ventricle is due to a blockage of which of the following arteries?

a. LAD branch
b. circumflex artery
c. right coronary artery
d. trunk of left coronary artery
e. B and D

A

E

58
Q

Infarction of the anterior wall of the left ventricle is due to a blockage of which of the following arteries?

A

LAD

59
Q

Which artery supplies the posterior wall of the heart?

A

Right coronary artery

60
Q

T/F MOST of the time if there is a lesion in the LAD, you do nothing about it unless it is 70% occluded or more.

A

True

61
Q

What is angina a result of?

A

Ischemia

62
Q

T/F Symptoms correlate with the extent of CAD disease

A

FALSE
a person with 90% occlusion can present with 0 symptoms whereas a person with only 30% occulsion can have recurrent chest pain

63
Q

What is the formula for coronary blood flow?

A

F=P/R

coronary blood flow = perfusion/ resistance

64
Q

What is perfusion a measurement of?

a. aortic diastolic pressure
b. left ventricular diastolic pressure
c. left atrial diastolic pressure
d. pulmonary valve diastolic pressure
e. right ventricular diastolic pressure

A

A.

REMEMBER: aortic regurg has VERY LOW diastolic pressure, thus there is a decreased perfusion

65
Q

What leads to an increased perfusion pressure gradient?

A

Increased aortic diastolic pressure

decreased LVDP

66
Q

What are factors that lead to decreased coronary resistance?

a. Metabolic factors
b. Neural factors
c. Pharmalogical factors
d. ALl of hte above
e. None of hte above

A

D

67
Q

When does atherosclerosis begin to develop?

a. Early 20s
b. Mid 40s
c. Late 60s
d. Depends on the person’s food choices
e. At birth

A

A

68
Q

what is the FIRST sign of development of an atherosclerotic plaque?

a. atheroma
b. fatty streak
c. heart disease
d. PVD
e. angina

A

B.

69
Q

According to the Framingham study, which of the following is NOT included in the three most important modifiable risk factors for developing CAD?

a. Hypertension
b. Obesity
c. Hyperlipidemia
d. Smoking

A

B. Obesity (#5)

70
Q

Which plaques are more dangerous?

A

Soft: can rupture and embolize

71
Q

What is the most common cause of an MI?

a. Hypertension
b. Arrhythmias
c. Hyperlipidemia
d. HCM
e. Age

A

b. Arrhythmias

72
Q

Which of hte following complications does NOT occur 7 days post MI?

a. papillary muscle rupture
b. ventricular rupture
c. ventricular tachycardia
d. ischemic VSD
e. cardiac tamponade

A

C. VTACH bc arrhythmias are considered immediate!!!

73
Q

A papillary muslce rupture will most likely result in which of hte follwing valvular dysfunctions?

a. mitral regurg
b. mitral stenosis
c. aortic regurg
d. aortic stenosis

A

A mitral regurg

74
Q

How do you distinguish a papillary muscle rupture from a ventricular septal defect?

A

Patients with ischemic VSD do not have an increased LVEDP or pulmonary edema

75
Q

Which of the early MI complications has the best prognosis?

A

Ischemic VSD

papillary muscle/cardiac tamponade pts will probably die

76
Q

What are the late complications of an MI?

A

cardiac dilation and ventricular aneurysm

77
Q

Which of the following cardiac enzymes is elevated on the 4th day post MI?

a. CK-MB
b. Myoglobin
c. LDH
d. Troponin T
e. Troponin I

A

c. LDH

78
Q

Which of hte following cardaic enzymes is the first to have a spike post MI?

a. CK-MB
b. Myoglobin
c. LDH
d. Troponin T
e. Troponin I

A

b. Myoglobin

79
Q

The term “widow-maker” most likely refers to which of the following?

a. an atheroma in the left coronary artery before it bifurcates
b. an atheroma in the right coronary artery
c. an atheroma in the circumflex artery
d. an atheroma in the LAD artery

A

a.

80
Q

All of the following are contraindications to an exercise stress test EXCEPT:

a. A person having an MI
b. A person with unstable angina
c. A person with aortic stenosis
d. A person with a history of CAD
e. A person with uncontrolled arrhythmias

A

D.

81
Q

What are the indications for administering an exercise stress test?

A

Anyone with atypical chest pain and or anyone with a history of CAD

82
Q

When should you STOP an exercise stress test?

a. When there is an arrhythmia
b. When there is an ST segment depression
c. When the patient phsyically cant do it anymore
d. All of the above

A

D

83
Q

ST segment depression is most related to:

a. MI
b. Stable angina
c. Unstable angina
d. Ischemia
e. Hyperkalemia

A

D.

84
Q

In which of the following tests will you see “holes” in dead myocardial tissue?

a. echocardiography
b. coronary arteriography
c. radionuclide studies
d. LV angiography

A

C

85
Q

What are the contraindictions to doing a coronary arteriography?

A 
SEAM
Soft atheroma
Extensive scarring
Acute MI
Metastatic cancer
86
Q

A pt walks into your office with a single vessel disease. What is teh BEST treatment to do?

A

PTCA

87
Q

What is the indication for CABG?

A

Left Main Stenosis

88
Q

What is the most important factor and major prognostic determinants in patients iwth CAD?

a. Extent of CAD
b. Degree of LV dysfunction
c. Recent ischemic events
d. Objective severity of ischemia

A

B

90
Q

What is the P wave?

A

atrial depolarization

91
Q

What is the QRS

A

ventricle depolarization

92
Q

What is hte T wave?

A

ventricular repolarization

93
Q

What is the a wave?

A

atrial contraction

94
Q

What is the c wave?

A

ventricular contraction

95
Q

What is the v wave?

A

venous filling

96
Q

T/F The opening of a valve is only heard if the valve is damaged

A

True

97
Q

Which of the following valvular disorders has a normal chest x-ray?

A

Aortic Stenosis

98
Q

Which of the valvular disorders does not present with shortness of breath or fainting?

A

aortic regurgitation

99
Q

Enlargement of the left atrial appendage is seen with which valvular disorder?

A

Mitral stenosis

Pathophysiology (6 decks)

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