Exam 2 Valvular (Student Questions)

Question 1

Which of the following statements regarding mitral valve stenosis is false?

A. It is associated with a decreased left ventricular volume
B. It is associated with a decreased left atrial pressure and increased right atrial pressure
C. It can cause right ventricular failure
D. It can result in pulmonary edema

Answer 1

B. It is associated with a decreased left atrial pressure and increased right atrial pressure

Question 2

Which of the following statements regarding aortic stenosis is true?
A. Aortic stenosis is associated with an increase in left ventricular compliance
B. Myocardial oxygen demand is not altered in aortic stenosis
C. Aortic stenosis is associated with diastolic dysfunction
D. Aortic stenosis does not alter arterial flow to the myocardium

Answer 2

C. Aortic stenosis is associated with diastolic dysfunction

Question 3

Common causes of left ventricular diastolic dysfunction include all of the following EXCEPT: (Pick 3)
A.	 Chronic hypotension
B.	Pressure-overload hypertrophy
C.	Volume-overload hypertrophy
D.	Restrictive cardiomyopathy
E.	Age > 50
F.	Acute myocardial ischemia
G.	Chronic use of Coreg (carvedilol)

Answer 3

Answer: A,E,G.

Question 4

5.  Which of the following terms refers to myocardial relaxation or diastole?
A. Inotropy
B. Chronotropy
C. Dromotropy
D. Lusitropy

Answer 4

D. Lusitropy

Question 5

Which alteration would be most likely to produce congestive heart failure or hypotension in the patient with aortic stenosis?
A. New onset of Afib
B. PVCs, at a rate of 6-8/min
C. New onset of right bundle branch block
D. Decrease in heart rate from 70 bpm to 50 bpm

Answer 5

A. New onset of Afib

Question 6

Which of the following interventions would be appropriate for a patient with mitral regurgitation, but NOT for a patient with mitral stenosis?
A. Increase the heart rate
B. Maintain normal sinus rhythm
C. Avoid an increase in pulmonary vascular resistance
D. Increase preload slightly

Answer 6

A. Increase the heart rate

Question 7

The classic triad of symptoms associated with severe aortic stenosis include all of the following except:
A.	 Angina
B.	Syncope
C.	Midsystolic click during auscultation
D.	Congestive heart failure

Answer 7

C. Midsystolic click during auscultation

Question 8

What is the most common cause of mitral stenosis?
A.	 Congestive heart failure
B.	Pulmonary hypertension
C.	Ebstein’s anomaly 
D.	Rheumatic fever

Answer 8

D. Rheumatic fever

Question 9

Which of the following decreases in mitral stenosis?

A. Left atrial pressure
B. Left ventricular volume
C. Pulmonary artery pressure
D. Aortic valve surface area

Answer 9

B. Left ventricular volume

Question 10

1. ) Less common causes of adult valvular disease include (select 2):
   a. ) sclerosis
   b. ) influenza
   c. ) cerebral vascular accident
   d. ) fibrosis

Answer 10

A,D

Question 11

2. ) In valvular incompetence, which chamber(s) is/are involved?
   a. ) proximal to the regurgitant flow
   b. ) distal to the regurgitant flow
   c. ) the chambers are unaffected
   d. ) both chambers proximal and distal to the regurgitant flow

Answer 11

D

Question 12

3. ) The greatest patient risk for non-cardiac surgery is posed by?
   a. ) severe pulmonic stenosis
   b. ) severe triscupid stenosis
   c. ) severe aortic stenosis
   d. ) severe mitral stenosis

Answer 12

C

Question 13

4.) The regurgitant factor for the mitral valve is determined by which of the following factors
(Select 4)
a.) Size of the regurgitant valve orifice
b.) Pressure gradient between the RA and RV
c.) Time available for regurgitation
d.) Inotropic state of the LV
e.) Aortic outflow impedance SVR

Answer 13

ACDE