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BCR 1 > Pathology - Left ventricular dysfunction and failure > Flashcards

Pathology - Left ventricular dysfunction and failure Flashcards

1
Q

the volume of blood pumped around the body in 1 minute is known as

a. stroke volume
b. heart rate
c. cardiac output
d. ejection fraction
e. afterload

A

c.cardiac output

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2
Q

cardiac stretch and inotropic status determine..

a. stroke volume
b. cardiac output
c. heart rate

A

a.stroke volume

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3
Q

end diastolic - systolic volume / end diastolic volume x 100 gives which value?

a. cardiac output
b. ejection fraction
c. stroke vol
d. left ventricular ejection fraction

A

d. left ventricular ejection fraction

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4
Q

arterial pressure/ peripheral resistance gives

a. stroke vol
b. cardiac output
c. ventricular ejection fraction

A

b. cardiac output

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5
Q

a reduction in the hearts ability to pump enough blood to support physiological circulation is known as?

a. heart failure
b. left ventricular dysfunction
c. embolism
d. aneurysm

A

a.heart failure

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6
Q

HF-REF is the most common type of heart failure it refers to what type of failure ?

a. diastolic failure of the right ventricle
b. systolic failure of the left ventricle
c. diastolic failure of the left ventricle
d. systolic failure of the right ventricle

A

b.systolic failure of the left ventricle

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7
Q

what is reduced in HF-REF?

a. preload
b. afterload
c. ejection fraction
d. heart rate

A

c.ejection fraction

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8
Q

BP / CO is threatened in HF-REF in order to overcome this compensatory mechanisms are activated

a. true
b. false

A

a.true

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9
Q

in order to increase cardiac output in HF-REF what happens to HR and SV?

a. both increase
b. heart rate increase, stroke vol decrease
c. both decrease

A

a.both increase

but so do cardiac work and o2 demand

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10
Q

what is the correct equation for blood pressure?

a. SV x HR
b. CO x PVR
c. CO/ PVR

A

b. CO x PVR

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11
Q

failure to provide adequate perfusion to tissues resulting in hypoxia/tachycardia is known as

a. forward failure
b. backward failure

A

a.forward failure

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12
Q

pressure increase in the cardiac chambers resulting in alterations to vascular haemodynamics is known as..

a. forward failure
b. backward failure

A

b.backward failure

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13
Q

tachycardia occurs as a result of which type of failure?

a. forward failure
b. backward failure

A

a.forward failure

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14
Q

oedema occurs as a result of which type of failure ?

a. forward
b. backward

A

b.backward

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15
Q

according to the neurohormonal hypothesis what happens to the firing rate of baroreceptors in heart failure?

a. increase
b. decrease
c. no change

A

b.decrease

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16
Q

according to the neurohormonal hypothesis what happens to the sympathetic outflow from the CNS vasomotor centre in heart failure?

a. increase
b. decrease
c. no change

A

a.increase

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17
Q

what effect does the initial sympathetic activation by baroreceptors in heart failure have on heart rate, blood pressure ?

a. increase, increase
b. increase, decrease
c. decrease,decrease

A

a.increase, increase

bp increased by RAAS activation

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18
Q

which of these happens as a result of persistent sympathetic activation in HF?

a. heart muscle cell atrophy
b. heart muscle cell dystrophy
c. heart muscle cell hypertrophy

A

c. heart muscle cell hypertrophy

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19
Q

hypertrophy, apoptosis, necrosis, fibrosis and synthesis of ECM scar tissue happen as a result of what response to HF?

a. increased parasympathetic activation
b. RAAS deactivation
c. increased sympathetic activation

A

c.increased sympathetic activation

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20
Q

true or false persistent sympathetic activation leads to increased contractile dysfunction , arrhythmias and sudden cardiac death

a. true
b. false

A

a.true

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21
Q

levels of which substance predict symptomatic HF and subsequent mortality?

a. adrenaline
b. noradrenaline
c. choline

A

b.noradrenaline

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22
Q

which of these factors doe not cause increased renin release?

a. ischaemia
b. renal hypoperfusion
c. decrease blood presure
d. renal hyperperfusion

A

d.renal hyperperfusion

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23
Q

which of these does not give evidence of systolic dysfunction?

a.ECG
b, brain natiuretic peptide
c. angiography
d. echocardiogram

A

c. angiography

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24
Q

tachycardia , displaced apex beat , gallop rhythm and crepitations are signs of which type of heart failure ?

a. left sided
b. right sided

A

a. left sided

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25
Q

gallop rhythm involves which extra heart sounds?

a. s1,s2
b. s2,s3
c. s3,s4
d. s4,s5

A

c.s3,s4

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26
Q

pleural effusion, ankle oedema, enlarged liver and ascites indicate which type of heart failure?

a. left sided
b. right sided

A

b.right sided

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27
Q

what happens to lung compliance in left ventricular failure

a. increase
b. decrease

A

b.decrease

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28
Q

bilateral basal crackles and central cyanosis are signs of which type of heart failure?

a. left ventricular
b. right ventricular

A

a.left ventricular

29
Q

patient has dyspnoea and orthopnea, on investiagtion you hear bilateral basal crackles and see central cyanosis. what type of heart failure does this indicate?

a. right ventricular
b. left ventricular

A

b.left ventricular

30
Q

patient has an elevated JVP,ankle oedema, ascites and tender hepatomegaly. which type of heart failure is this associated with?

a. left ventricular
b. right ventricular

A

b.right ventricular

all caused by an increased systemic venous pressure

31
Q

which of these symptoms of left ventricular failure is associated with the decreased cardiac output?

a. central cyanosis
b. dyspnoea
c. orthopnea
d. bilateral basal crackles
e. peripheral cyanosis

A

e.peripheral cyanosis

32
Q

which of these dymptoms of right ventricular failure is associated with a decreased cardiac output?

a. hypotension
b. elevated jvp
c. ankle oedema
d. tender hepatomegaly
e. ascites

A

a. hypotension

33
Q

which of these symptoms is caused by ventricular hypertrophy?

a. displaced apex beat
b. tachycardia
c. oedema
d. peripheral cyanosis
e. central cyanosis

A

a.displaced apex beat

34
Q

which of these symptoms indicates sympathetic compensation for heart failure?

a. bradycardia
b. tachycardia
c. displaced apex beat
d. hypotension
e. increased jvp

A

b.tachycardia

35
Q

an ECG done on a patient with symptoms of heart failure (hypotenion,fatigue,peripheral cyanosis, ankle oedema) comes back normal what does this indicate?

a. virtual exclusion of RV heart failure
b. virtual exclusion of heart failure
c. virtual exclusion of LV dysfunction
d. virtual exclusion of LV heart failure

A

c. virtual exclusion of LV dysfunction

36
Q

what does echocardiography aim to assess?

a. diastolic volume
b. systolic function
c. right ventricular function
d. diastolic function

A

b.systolic function

in order to classify and grade

37
Q

what is estimated from and echogardiograph?

a. cardiac output
b. stroke volume
c. heart rate
d. LVEF

A

d. LVEF

38
Q

the cause of impairment to which ventricle is assessed by echocardiography`?

a. right
b. left

A

b.left

39
Q

in left sided heart failure what happens to left ventricular ejection fraction?

a. increase
b. decrease
c. no change

A

b.decrease

LVEF = End diastolic volume –end systolic volume /
End diastolic volume

40
Q

what is released from thee left ventricle with increased myocyte stretch?

a. noradrenaline
b. adrenaline
c. choline
d. renin
e. BNP

A

e.BNP

41
Q

which of these leads to ventricular dysfunction?

a. myocyte stretch
b. myocyte hypoxia
c. reduced coronary blood flow

A

c.reduced coronary blood flow

42
Q

which enzyme metabolises BNP?

a. phosphodiesterase
b. neutral endopeptidase
c. cox 1
d. cox 2
e. guanylate cyclase

A

b.neutral endopeptidase

43
Q

what effect does BNP have on blood pressure?

a. increase
b. decrease

A

b.decrease

44
Q

what effect does BP have on natiuresis and diuresis?

a. increases both
b. inhibits both
c. increases natriuresis decreases diuresis

A

a.increases both

sodium and water excretion

45
Q

patient shows symptoms of HF on clinical examination , has no previous history of MI. what is the most appropriate course of action?

a. measure serum natriuretic peptides
b. specialist assessment and echocardiography within 2 weeks

A

a. measure serum natriuretic peptides

46
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. what is the most appropriate course of action?

a. measure serum natriuretic peptides
b. specialist assessment and echocardiography within 2 weeks

A

b. specialist assessment and echocardiography within 2 weeks

47
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. angiography shows no clear abnormality. what is the most appropriate course of action?

a. measure serum natriuretic peptides
b. assess severity , aetiology, type of dysfunction and correctable causes
c. investigate other diagnoses

A

a. measure serum natriuretic peptides

48
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. angiography shows clear abnormality. what is the most appropriate course of action?

a. measure serum natriuretic peptides
b. assess severity , aetiology, type of dysfunction and correctable causes
c. investigate other diagnoses

A

b. assess severity , aetiology, type of dysfunction and correctable causes

49
Q

patient shows symptoms of HF on clinical examination , has no previous history of MI. serum natriuretic peptide is raised . what is the most appropriate course of action?

a. specialist assessment and echocardiography in 2 weeks
b. assess severity , aetiology, type of dysfunction and correctable causes
c. investigate other diagnoses
d. specialist assessment and echocardiography in 6 weeks

A

d.specialist assessment and echocardiography in 6 weeks

50
Q

patient shows symptoms of HF on clinical examination , has no previous history of MI. serum natriuretic peptide is high . what is the most appropriate course of action?

a. specialist assessment and echocardiography in 2 weeks
b. assess severity , aetiology, type of dysfunction and correctable causes
c. investigate other diagnoses
d. specialist assessment and echocardiography in 6 weeks

A

a. specialist assessment and echocardiography in 2 weeks

51
Q

patient shows symptoms of HF on clinical examination , has no previous history of MI. serum natriuretic peptide is normal . what is the most appropriate course of action?

a. specialist assessment and echocardiography in 2 weeks
b. assess severity , aetiology, type of dysfunction and correctable causes
c. investigate other diagnoses
d. specialist assessment and echocardiography in 6 weeks

A

c.investigate other diagnoses

52
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. angiography is normal serum natriuretic peptide is raised . what is the most appropriate course of action?

a. specialist assessment and echocardiography in 2 weeks
b. assess severity , aetiology, type of dysfunction and correctable causes
c. investigate other diagnoses
d. specialist assessment and echocardiography in 6 weeks

A

c.investigate other diagnoses

53
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. angiography is normal serum natriuretic peptide is raised . after investigation of other diagnoses heart failure is confirmed. which of these diagnoses is most what is the most likely?

a. other cardiac abnormality
b. heart failure due to left ventricular systolic dysfunction
c. heart failure with preserved ejection fraction
d. heart failure unlikely

A

c.heart failure with preserved ejection fraction

54
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. angiography is normal serum natriuretic peptide is normal . which of these diagnoses is most what is the most likely?

a. other cardiac abnormality
b. heart failure due to left ventricular systolic dysfunction
c. heart failure with preserved ejection fraction
d. heart failure unlikely

A

d. heart failure unlikely

55
Q

patient shows symptoms of HF on clinical examination , has previous history of MI. angiography shows abnormality consistent with HF . which of these diagnoses is most what is the most likely?

a. other cardiac abnormality
b. heart failure due to left ventricular systolic dysfunction
c. heart failure with preserved ejection fraction
d. heart failure unlikely

A

a. other cardiac abnormality

b. heart failure due to left ventricular systolic dysfunction

56
Q

which of these reduces venous congestion and vasonconstriction so reduces preload and afterload ?

a. ACEi
b. ARBs
c. nitrates
d. diuretics

A

a.ACEi

57
Q

how do Diuretics reduce HF symptoms?

a,reduce afterload
b.reduce preload

A

b.reduce preload

reduce venous congenstion

58
Q

how do A2 receptor blockers reduce HF symptoms?

a,reduce afterload
b.reduce preload

A

b.reduce preload

reduce venous congestion

59
Q

how do mileralocorticoid receptor anatgonists reduce HF symptoms?

a,reduce afterload
b.reduce preload

A

b.reduce preload

60
Q

how do ARBs reduce HF symptoms?

a,reduce afterload
b.reduce preload

A

a,reduce afterload

reduce vasoconstriction

61
Q

how do nitrates reduce HF symptoms?

a,reduce afterload
b.reduce preload

A

a,reduce afterload

62
Q

what is reduced by reducing sympathetic NS stimulation?

a. preload
b. afterload

A

b.afterload

63
Q

what is the major effect of reducing sympathetic NS activation?

a. remodelling attenuated
b. afterload reduction
c. angina/ischaemia reduction
d. arrhythmias reduced
e. reduced heart rate

A

d.arrhythmias reduced

64
Q

what drugs are used to reduce HF hospitalisation in patients with diabetes ?

a. ARNis
b. SGLT2 inhibitors
c. ACEi
d. diuretics

A

b.SGLT2 inhibitors

65
Q

inhibition of the SGLT2i inhibitor has what effect on urinary Na+ and glucose excretion?

a. decrease
b. increase

A

b.increase

66
Q

patient with HF-REF what is recommended drug?

a. BB
c. ARNi
d. ACEi
e. MRA

A

d. ACEi

67
Q

patient with stable HF-REF what is recommended drug?

a. BB
c. ARNi
d. ACEi
e. MRA

A

a.BB

68
Q

which of these is not a common cause of systolic dysfunction?

a. MI
b. hypotension
c. hypertension

A

b.hypotension

BCR 1 (60 decks)

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