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NBCE Part II/III. General Diagnosis (Irene Gold Associates) > Pages: 12-15 (Heart) - 7% > Flashcards

Pages: 12-15 (Heart) - 7% Flashcards

1
Q

Measures the pressure of the right side of the heart. Can be made more pronounced when congestive heart failure is present by applying pressure to the liver (hepatojugular reflex)…?

a. ) Echocardiogram
b. ) Doppler
c. ) Jugular venous pulsations
d. ) EKG

A

c.) Jugular venous pulsations

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2
Q

Vibrations produced by turbulent blood flow within the heart (murmurs)…?

a. ) Arrhythmia
b. ) Thrills
c. ) Heaves
d. ) Stridor

A

b.) Thrills

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3
Q

When the ventricles contract it is called _____?

A.) Diastole
B.) Systole

A

B.) Systole

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4
Q

When the ventricles rest they are filling and this is called _____?

A.) Diastole
B.) Systole

A

A.) Diastole

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5
Q

Auscultation

Closure of the semilunar (pulmonary and aortic) valves…?

A.) S1
B.) S2
C.) S3
D.) S4

A

B.) S2

  • pulmonary and aortic valves (semilunar valves)
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6
Q

Auscultation

Closure of AV (mitral and tricuspid) valves…?

A.) S1
B.) S2
C.) S3
D.) S4

A

A.) S1

  • mitral and tricuspid valves (AV valves)
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7
Q

Auscultation

Is related to stiffness of the ventricular myocardium to rapid filling. Also known as “Atrial Gallop”…?

A.) S1
B.) S2
C.) S3
D.) S4

A

D.) S4

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8
Q

Auscultation

Normal in children, young adults, and athletes. AN early sign of CHF is seen in adults greater than 40 y/o. Also known as “Ventricular Gallop”…?

A.) S1
B.) S2
C.) S3
D.) S4

A

C.) S3

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9
Q

Locations for Cardiac Auscultation

Left sternal border at the 2nd intercostal space…?

A.) Aortic Valve
B.) Pulmonic Valve
C.) Erb's Point
D.) Tricuspid Valve
E.) Mitral Valve
A

B.) Pulmonic Valve

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10
Q

Locations for Cardiac Auscultation

Left sternal border at the 4th or 5th intercostal space…?

A.) Aortic Valve
B.) Pulmonic Valve
C.) Erb's Point
D.) Tricuspid Valve
E.) Mitral Valve
A

D.) Tricuspid Valve

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11
Q

Locations for Cardiac Auscultation

Left sternal border at the 3rd intercostal space…?

A.) Aortic Valve
B.) Pulmonic Valve
C.) Erb's Point
D.) Tricuspid Valve
E.) Mitral Valve
A

C.) Erb’s Point

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12
Q

Locations for Cardiac Auscultation

Right sternal border at the 2nd intercostal space…?

A.) Aortic Valve
B.) Pulmonic Valve
C.) Erb's Point
D.) Tricuspid Valve
E.) Mitral Valve
A

A.) Aortic Valve

  • Best auscultated with the patient seated, leaning forward, and exhaling.
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13
Q

Locations for Cardiac Auscultation

Mid-clavicular line at the 5th intercostal space…?

A.) Aortic Valve
B.) Pulmonic Valve
C.) Erb's Point
D.) Tricuspid Valve
E.) Mitral Valve
A

E.) Mitral Valve

  • Best auscultated in the left lateral decubitus position.
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14
Q

Valve is insufficient and blood seeps or squirts back into the chamber. This murmur has a high pitch and is best heard with the diaphragm of the stethoscope…?

A.) Stenosis
B.) Regurgitation

A

B.) Regurgitation

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15
Q

Valve has trouble opening and blood swirls through a narrow opening. This murmur has a low pitch and is best heard with the bell of the stethoscope…?

A.) Stenosis
B.) Regurgitation

A

A.) Stenosis

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16
Q

What is the mnemonic for heart murmurs, which occur in diastole…?

A

ARMS and PRTS

AORTIC
Regurgitation
MITRAL
Stenosis

PULMONIC
Regurgitation
TRICUSPID
Stenosis

17
Q

Congenital Heart Defects

Extraposition/overriding of the aorta, right ventricular hypertrophy, interventricular septal defect, and pulmonic stenosis. Creates a loud ejection murmur during systole and severe cyanosis…?

A.) Patent Ductus Arteriosus
B.) Tetralogy of Fallot
C.) Coarctation of the Aorta
D.) Subclavian Steal Syndrome

A

B.) Tetralogy of Fallot

18
Q

Congenital Heart Defects

Constriction of the descending aorta (usually distal to the left subclavian). Causes a higher blood pressure in the upper extremity by 20mmHG (diagnostic) when compared to the lower extremity…?

A.) Patent Ductus Arteriosus
B.) Tetralogy of Fallot
C.) Coarctation of the Aorta
D.) Subclavian Steal Syndrome

A

C.) Coarctation of the Aorta

19
Q

Congenital Heart Defects

Failure of shunt to close between the aorta and left pulmonary artery. Creates a continuous/machinery like murmur that can be heard in both phases of the heart cycle…?

A.) Patent Ductus Arteriosus
B.) Tetralogy of Fallot
C.) Coarctation of the Aorta
D.) Subclavian Steal Syndrome

A

A.) Patent Ductus Arteriosus

20
Q

Congenital Heart Defects

Proximal stenosis of the subclavian artery. Seen in younger females who faint (syncope/drop attacks) while exercising…?

A.) Patent Ductus Arteriosus
B.) Tetralogy of Fallot
C.) Coarctation of the Aorta
D.) Subclavian Steal Syndrome

A

D.) Subclavian Steal Syndrome

21
Q

A.) The most common cause of LEFT-sided heart failure is _____?
B.) The 2nd most common cause of LEFT-sided heart failure is _____?
C.) The most common cause of RIGHT-sided heart failure is _____?
D.) The most common cause of MITRAL STENOSIS is _____?

A

A.) Hypertension (35-55 y/o)
B.) Aortic stenosis
C.) Left-sided heart failure
D.) Rheumatic fever (ASO-Titer)

22
Q

This condition is when the right side of the heart fails by itself (lung condition that causes right-sided heart failure)…?

A.) Left-sided heart failure
B.) Cor Pulmonale
C.) Right-sided heart failure

A

B.) Cor Pulmonale

23
Q

This condition leads to edema and fluid in the extremities and is associated with jugular venous distention (SVC), liver/spleen enlargement, + hepatojular reflex, ascites (fluid in abdomen cause by portal hypertension), caput medusa/spider angioma, pitting edema and stasis dermatitis…?

A.) Left-sided heart failure
B.) Cor Pulmonale
C.) Right-sided heart failure

A

C.) Right-sided heart failure

  • Increased heart rate, S3 gallop, and decreased blood pressure.
  • Backs up to SVC and down to IVC
24
Q

This condition collects fluid in the costophrenic angles and is associated with pulmonary edema (fluid in the lungs) causing shortness of breath (exertion dyspnea) and orthopnea…?

A.) Left-sided heart failure
B.) Cor Pulmonale
C.) Right-sided heart failure

A

A.) Left-sided heart failure

25
Q

An interruption of the intimate allowing blood into the vessel wall with immediate “tearing” pain. Acute surgical emergency. Associated with Hypertension/Arteriosclerosis (Descending Aorta) and Marfan’s Syndrome (Ascending Aorta)…?

A.) Myocardial Infarction
B.) Aneurysm
C.) Marfan's Syndrome
D.) Aortic Dissection
E.) Angina-Pectoris
A

D.) Aortic Dissection

26
Q

This is an inherited connective tissue disorder with ventricular weakening and enlargement. Patient present with tall, long fingers/limbs, lens subluxation, cardiovascular and lung problems…?

A.) Myocardial Infarction
B.) Aneurysm
C.) Marfan's Syndrome
D.) Aortic Dissection
E.) Angina-Pectoris
A

C.) Marfan’s Syndrome

27
Q

This is an abnormal widening that involves all 3 layers; defect in elastic-media tissues.

A.) Myocardial Infarction
B.) Aneurysm
C.) Marfan's Syndrome
D.) Aortic Dissection
E.) Angina-Pectoris
A

B.) Aneurysm

28
Q

Comes on with EXERTION and is relieved by vasodilators under tongue (usually nitroglycerin)…?

A.) Myocardial Infarction
B.) Aneurysm
C.) Marfan's Syndrome
D.) Aortic Dissection
E.) Angina-Pectoris
A

E.) Angina-Pectoris (aka: Coronary Vasospasm)

  • Printzmetal angina comes on with rest (atypical)
29
Q

Comes on with REST and is caused by Atherosclerosis…?

A.) Myocardial Infarction
B.) Aneurysm
C.) Marfan's Syndrome
D.) Aortic Dissection
E.) Angina-Pectoris
A

A.) Myocardial Infarction

  • Acute heart failure
  • CK-MB is elevated, increased LDH, and increased SGOT
30
Q

Normal ECG

Repolarization of the papillary muscles…?

A.) P Wave
B.) QRS Complex
C.) T Wave
D.) U Wave

A

D.) U Wave

31
Q

Normal ECG

Repolarization of the ventricles…?

A.) P Wave
B.) QRS Complex
C.) T Wave
D.) U Wave

A

C.) T Wave

32
Q

Normal ECG

Normal atrial depolarization…?

A.) P Wave
B.) QRS Complex
C.) T Wave
D.) U Wave

A

A.) P Wave

33
Q

Normal ECG

Depolarization of the ventricles. Repolarization of the atria hidden here…?

A.) P Wave
B.) QRS Complex
C.) T Wave
D.) U Wave

A

B.) QRS Complex

34
Q

Abnormal ECG

Complete heart block (No ventricular contraction)…?

A.) Increased PR interval
B.) Two P waves before QRS
C.) No QRS pattern
D.) ST segment

A

C.) No QRS pattern

  • Atrial repolarization is hidden under the QRS complex
35
Q

Abnormal ECG

Weinkbochs-block of bundle of HIS (Secondary heart block)…?

A.) Increased PR interval
B.) Two P waves before QRS
C.) No QRS pattern
D.) ST segment

A

B.) Two P waves before QRS

36
Q

Abnormal ECG

Enlarged or inverted = MI (acute heart failure)…?

A.) Increased PR interval
B.) Two P waves before QRS
C.) No QRS pattern
D.) ST segment

A

D.) ST segment

37
Q

Abnormal ECG

Prolonged AV nodal delay (Primary heart block)…?

A.) Increased PR interval
B.) Two P waves before QRS
C.) No QRS pattern
D.) ST segment

A

A.) Increased PR interval

38
Q

This a diagnostic tool used to evaluate heart valves…?

a. ) EKG
b. ) Cardiac magnetic resonance imaging
c. ) Echocardiogram
d. ) Cardiac catheterization

A

c. ) Echocardiogram (aka: ECG)

- also Doppler

39
Q

What LABS are elevated with MYOCARDIAL INFARCTION?

A

Increased: CK-MB, LDH, SGOT

NBCE Part II/III. General Diagnosis (Irene Gold Associates) (16 decks)

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