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Cardio Quiz Bowl > Harrisons > Flashcards

Harrisons Flashcards

1
Q 
CAD is the most common cause of HF in industrialised countries. It accounts for how many percent?
A. 30-40 %
B. 50-60 %
C. 60 - 65 %
D. 60 - 75 %
A

D. 60 - 75%

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2
Q 
Hypertension accounts for how many percent of HF?
A 60%
B 65%
C 70%
D 75%
A

D. 75%

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3
Q 
How many percent of patinents with HF have unkonown etiologies?
A. 10 - 20
B. 20 - 30
C. 30 - 40
D. 40 - 50
A

B. 20 - 30%

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4
Q 
Most forms of familial diatlated cardiomyopathy are inherited in what form?
A. X - linked
B. autosomal dominant
C. autosomal recessive 
D. AOTA
A

B autosomal dominant

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5
Q 
Dilated cardiomyopathy is associated with which of the following conditions?
A Duchenn’s disease
B Down’s syndrome
C Prader wili
D Cerebral palsy
A

Duchenne’s
Becker’s
Limb-girdle muscular dystrophy

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6
Q 
The following are causes of HF with high output states except?
A thyrotixicosis
B Beriberi
C AV shunting
D hemochromatosis
A

D. Hemochromatosis

Review table 279-1

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7
Q 
NYHA classification for a patient comfortable at rest with fatigue at ordinary physical activity
A FC 1
B FC 2
C FC 3
D FC 4
A

B. FC 2

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8
Q 
Major Cause of HF in Africa and Asia?
A  Chagas
B RHD
C Dengue
D typhpoid
A

B. RHD

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9
Q 
How many percent of HF patients die within one year of diagnosis?
A 30 - 40
B 40 - 50
C 50 - 60
D NOTA
A

A. 30 - 40%

60-70% die within 5 years

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10
Q

Annual mortality rate of patients with NYHA class IV ?

A

30 - 70%

5-10% for NYHA class II

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11
Q 
The following are vasodilatory molecules for HF compensation except?
A. ANP and BNP
B. Nitric oxide
C. PGI2
D. NOTA
A

D NOTA

PGE2 also vasodilatory

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12
Q 
An increase in neurohormonal, adrenergic, and cytokine system leading to adaptive changes within the myocardium is known as? 
A. LV compensation
B. LV remodeling
C. LV adaptation
D. LV function
A

B. LV remodeling

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13
Q

The following are changes that occur in heart failure except?
A myocyte hyepertrophy
B alterations in contractile properties of myocytes
C reorganization of the intracellular matrix leading to interstitial collagen matrix
D progressive loss of myocytes

A

C. Extracelllular matrix leading to interstitial collagen matrix

Other changes
> Beta adrenergic desensitization
> Abnormal myocardial energetics and metabolism

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14
Q 
A powerful vasoconstrictor that increases permiability of the renal collecting ducts leading to reabsorption of free water
A Angiotensin II
B AVP
C Angiotensin I
D Aldosterone
A

B AVP or antidiuretic hormone

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15
Q

This receptor is vital for calcium uptake in the sarcoplasmic reticulum

A

SERCA2A

Sarcoplasmic reticulum calcium adenosine triphosphate

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16
Q

Changes that occur in the corss- bridges of myocytes include?
A increased Alpha myosin heavy chain and increased beta myosin heavy chain expression
B decreased Alpha myosin heavy chain and increased beta myosin heavy chain expression
C increased Alpha myosin heavy chain and decreased beta myosin heavy chain expression
D decreased Alpha myosin heavy chain and decreased beta myosin heavy chain expression

A

B

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17
Q 
Increase in wall thinning and increase in afterload leads to what phenomenon?
A preload mismatch
B afterload mismatch
C hypotension
D syncope
A

Afterload mismatch

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18
Q 
The following are stretch -activated genes except?
A angiotensin 2
B endothelin
C TNF
D aldosterone
A

D. Aldosterone

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19
Q

The following are cardinal symptoms of HF?

A orthopnea
B Fatigue and shortness of breath
C increased JVP
D Tachycardia

A

B

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20
Q 
these receptors are responsible for stimulating rapid shallow breathing characteristic of dyspnea in HF patients
A juxtacapillary J receptors
B Baroreceptors
C Type C fibers
D SERCA2
A

A.

21
Q

dyspnea occuring in recumbent position is known as?

A

orthopnea

22
Q

orthopnea is due to?

A

redistribution of splanchnic circulation and LE to the central circulation

23
Q 
PND is defined as severe shortness of breath and coughing that occurs at night awakening the patient from sleep. this usually occurs when?
A 1-3 hrs
B 2-3 hrs
C 3-4 hrs
D 1 - 2 hrs
A

A 1- 3 hrs

24
Q 
this form of breathing is seen in upto 40% of HF patients with advanced HF and is associated with low cardiac output
A Ataxic breathing
B kussmaul breating
C cheyne - stokes respiration
D tachypnea
A

C - cheyne-stoke

25
Q

cheyne - stoke breathing is due to?

A

increased sensitivity of the respiratory center to arterial PCO2

26
Q 
what is the systolic pressure in the early part of HF?
A normal or high
B low
C unchanged from baseline
D decreased from baseline
A

A normal or high

pulse pressure decreased

27
Q

normal JVP at 45 degrees tilt is expected to be?

A

less than or equal to 8 cm

28
Q 
this wave indicates presence of tricuspid regurgitation
A x descent dip
B c wave dip
C peaked a wave
D Giant v wave
A

D giant v wave

29
Q

when pleural effusion is present in heart failure they are usually located in what side?

A

right pleural space

30
Q 
this heart sound is most commonly present in patients with volume overload and tachycardia?
A S2
B S1
C protdiastolic gallop
D end diastolic click
A

C also known as S3

31
Q 
this heart sound is usually present in patients with diastolic dysfunction
A S1
B S2
C S3
D S4
A

S4

32
Q 
The following are routine laboratories requested for patients with HF except?
A FBS and lipid profile
B CBC
C Urinalysis
D BUN, creatinine
A

A

CBC, Panel of electrolytes, BUN, crea, hepatic enzymes, urinalysis

Selected patients FBS, lipid profile, thyroid function

33
Q

Routine ECG is recommended, what is the primary reason behind?

A

Assess cardiac rhythm and determine LV hypertrophy or prior MI, assess benefit of resynchronization therapy

34
Q

True or false

A normal ECG virtually excludes LV systolic dysfunction

A

True

35
Q 
The most useful test to assess LV function in patients with HF is?
A 2decho with doppler
B Cardiac MRI
C Cardiac Angiogram
D CT scan of the heart
A

A 2decho provides semi quantitative assessment of LV size and function as well as presence of wall motion abnormality

36
Q 
This examination offers a gold standard for assessment of LV mass and function?
A MRI
B CT scan
C 2d echo
D TJ 2d echo
A

A MRI - gold standard to assess LV mass and volume

37
Q

Most useful index of LV function?

A EF ejection fraction
B SV stroke volume
C CO cardiac output
D PP pulmonary pressure

A

A EF

Normal more than or equal to 50%

Significantly depressed less than 30 - 40 %

38
Q

Natriuretic peptides are usually elevated in the following conditions except?

A advanced age
B renal impairment
C men
D massive PTE

A

C

Natriuretic peptides increased in increase with age and renal impairment, are more
elevated in women, and can be elevated in right HF from any cause

Levels falsely low in obese patients

39
Q 
Stress testing with treadmill and bicycle testing are done to assess the need for cardiac transplantation in patients with HF. What is the level of peak oxygen uptake (VO2) that signifies poor prognosis and a need for cardiac transplantation?
A < 10 mL/kg
B < 12 mL/kg
C < 14 mL/kg
D< 16 ml/kg
A

C <14

40
Q

Altered RV structure and or function in the context of chronic lung disease triggered by onset of pulmonary hypertension

A

Cor pulmonale

41
Q 
This condition is responsible for approx 50% of cor pulmonale cases
A COPD
B Chronic bronchitis
C PTB
D A and B
A

D

42
Q

Normally PA pressure is approximately?

A 15 mmHg
B 20 mmHg
C 25 mmHg
D 30 mmHg

A

A 15 mmHg

43
Q

The following are triggers of cor pulmonale decompensation except?

A hypoxia
B hypercarbia and acidosis
C ventricular tachyarrhythmia
D atrial tachyarrhythmia

A

C

Triggers include worsening
hypoxia from any cause (e.g., pneumonia), acidemia (e.g., exacerbation
of COPD), acute pulmonary embolus, atrial tachyarrhythmia, hyper-
volemia, and mechanical ventilation that leads to compressive forces
on alveolar blood vessels.

44
Q

Most common symptom of cor pulmonale is?

A

Dyspnea

45
Q

Increased intensity of a murmur due to inspiration is known as?

A

Carvallo’s sign

46
Q

Most common cause of right HF

A

Left HF

47
Q

The following are ECG findings for cor pulmonale except?

A P pulmonale
B RAD
C RV hypertrophy
D Atrial fibrillation

A

D

48
Q

Best diagnostic tool for chronic PTE?

A VQ scanning
B CT angiogram
C Spiral CT scan
D HRCT of the lung

A

A

49
Q

The following are diseases of the lung parenchyma that lead to cor pulmonale excpet?

A cystic fibrosis
B Sarcoidosis
C Bronchiectasis
D kyphoscoliosis

A

D review table 279-4

Cardio Quiz Bowl (6 decks)

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