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Human Pathophys HLT221 > Quiz 10 - Cardiac Disease > Flashcards

Quiz 10 - Cardiac Disease Flashcards

1
Q

Haematological issues which could theoretically cause cardiac ischaemia via decreasing the oxygen content of blood include:

a. decreased number of red blood cells.
b. decreased haemoglobin levels.
c. decreased arterial oxygen saturation.
d. all the above.

A

d. all the above.

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2
Q

A 67-year-old female was previously diagnosed with rheumatic heart disease. Tests reveal lipoprotein deposition with chronic inflammation that impairs blood flow from the left ventricle into the aorta. Which of the following is the most likely diagnosis?

a. aortic sclerosis
b. aortic stenosis
c. valvular regurgitation
d. valvular stenosis

A

b. aortic stenosis

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3
Q

All the following are risk factors for cardiovascular disease, EXCEPT:

a. high levels of physical activity.
b. obesity.
c. cigarette smoking.
d. high blood cholesterol.

A

a. high levels of physical activity.

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4
Q

A true aneurysm involves:

a. the tunica intima only.
b. the tunica media only.
c. the tunica externa only.
d. all three layers of the vessel wall.

A

d. all three layers of the vessel wall.

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5
Q

The complications of uncontrolled hypertension include all the following EXCEPT:

a. cardiac hypertrophy
b. coronary artery disease
c. various conduction system diseases
d. anaemia.

A

d. anaemia.

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6
Q

A 52-year-old female is diagnosed with coronary heart disease. She would be expected primarily to suffer from myocardial:

a. hypertrophy.
b. ischaemia.
c. necrosis.
d. dilation.

A

b. ischaemia.

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7
Q

As left heart failure progresses:

a. left ventricular preload increases.
b. systemic vascular resistance decreases.
c. left end-diastolic volume decreases.
d. pulmonary vascular resistance decreases.

A

a. left ventricular preload increases.

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8
Q

A 32-year-old female presents with lower leg pain and redness. An ultrasound reveals venous thrombus. Which of the following would be most likely to have caused her condition?

a. vascular injury and inflammation.
b. heart valve damage.
c. bacterial infection.
d. atherosclerosis.

A

a. vascular injury and inflammation.

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9
Q

Heart disease was responsible for approximately what percentage of overall mortality in 2015?

a. 25 %
b. 12 %
c. 20 %
d. 5 %

A

b. 12 %

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10
Q

Hypertensive heart disease results in which of the following pathophysiological changes?

a. left ventricular hypertrophy and reduced chamber size
b. coronary artery disease
c. various conduction system diseases
d. all the above

A

d. all the above

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11
Q

A 53-year-old male was admitted to the emergency department after experiencing shortness of breath, weakness, cardiac arrhythmias, and chest pain that did not subside after nitroglycerin therapy. Laboratory tests revealed the patient had an elevated serum CK-MB and Troponin. ECG tracings revealed a prominent Q wave and an elevated ST segment. The most probable diagnosis is:

a. a transient ischaemic attack.
b. an attack of unstable angina pectoris.
c. an acute myocardial infarct.
d. coronary artery vasospasm.

A

c. an acute myocardial infarct.

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12
Q

Chamber volume increase is observed in __________________ cardiomyopathy.

a. dilated
b. hypertrophic
c. restrictive
d. all the above

A

a. dilated

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13
Q

Pulmonary symptoms, such as dyspnoea and cough, common to left heart failure are a result of:

a. inflammatory pulmonary oedema.
b. hypoxaemia.
c. pulmonary vascular congestion.
d. bronchoconstriction.

A

c. pulmonary vascular congestion.

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14
Q

Abnormal ECG traces are indicative of injured, dying and dead cardiac muscle cells because:

a. injured myocytes do not fully depolarise.
b. dying myocytes do not fully depolarise.
c. dead myocytes cannot conduct an impulse.
d. all the above.

A

d. all the above.

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15
Q

Increased right ventricular afterload occurs in:

a. chronic obstructive pulmonary disease (COPD).
b. cystic fibrosis (CF.)
c. adult respiratory distress syndrome (ARDS).
d. all the above.

A

d. all the above.

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16
Q

Beta-adrenergic blockers can be used as part of a treatment strategy post-myocardial infarction. These agents work to;

a. reduce heart rate.
b. stimulate parasympathetic activity.
c. increase heart contractility.
d. stimulate acetylcholine release.

A

a. reduce heart rate.

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17
Q

A 53-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. The pain he experiences occurs when:

a. cardiac output has fallen below normal levels.
b. the myocardial oxygen supply has fallen below demand.
c. myocardial stretch has exceeded the upper limits.
d. the vagus nerve is stimulated.

A

b. the myocardial oxygen supply has fallen below demand.

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18
Q

As left heart failure progresses:

a. left ventricular preload increases.
b. systemic vascular resistance decreases.
c. left end-diastolic volume decreases.
d. pulmonary vascular resistance decreases.

A

a. left ventricular preload increases.

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19
Q

Which of the following is NOT a primary clinical manifestation of congestive heart failure?

a. high exercise tolerance
b. coughing up frothy, pink sputum
c. shortness of breath
d. fluid retention and swelling

A

a. high exercise tolerance

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20
Q

Following myocardial ischaemia, myocytes switch to anaerobic metabolism due to lack of:

a. glycogen.
b. ATP.
c. oxygen.
d. electrolytes.

A

c. oxygen.

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21
Q

A 60-year-old female was diagnosed with mitral stenosis. As a result, she has incomplete emptying of the:

a. right atrium.
b. right ventricle.
c. left atrium.
d. left ventricle.

A

c. left atrium.

22
Q

Which of the following is NOT a benefit of coronary artery bypass surgery?

a. increases oxygen to the heart muscle
b. alters coronary artery disease progress
c. relieves symptoms of angina
d. improves blood flow and heart function

A

b. alters coronary artery disease progress

23
Q

Myocardial infarction causes variable damage to the myocardium depending on:

a. the coronary artery occluded.
b. extent and duration of disruption to blood flow.
c. amount of myocardium supplied by the occluded vessel.
d. all the above.

A

d. all the above.

24
Q

Chamber volume increase is observed in __________________ cardiomyopathy.

a. dilated
b. hypertrophic
c. restrictive
d. all the above

A

a. dilated

25
Q

The most common cause of myocardial ischaemia is:

a. idiopathic vasospasm.
b. arterial emboli from heart valve vegetation.
c. atherosclerosis.
d. venous emboli.

A

c. atherosclerosis.

26
Q

How much oxygen is extracted from the coronary circulation at rest by the healthy myocardium?

a. 20 – 40 %
b. 40 – 60 %
c. 60 – 80 %
d. 80 – 100 %

A

c. 60 – 80 %

27
Q

Pulmonary symptoms, such as dyspnoea and cough, common to left heart failure are a result of:

a. inflammatory pulmonary oedema.
b. hypoxaemia.
c. pulmonary vascular congestion.
d. bronchoconstriction.

A

c. pulmonary vascular congestion.

28
Q

The backward effect of left ventricular failure leads to:

a. systemic oedema.
b. ascites.
c. pulmonary oedema.
d. increased cardiac output.

A

c. pulmonary oedema.

29
Q

The process of growing new blood vessels, that is stimulated by hypoxia and vascular endothelial growth factor, is:

a. angiography.
b. anastomoses.
c. angiogenesis.
d. angioplasty.

A

c. angiogenesis.

30
Q

Management of heart failure can involve all of the following EXCEPT:

a. angiotensin-converting enzyme (ACE) inhibitor treatment.
b. improving ventricular relaxation.
c. exercise.
d. increased consumption of foods high in low density lipoproteins (LDL)

A

d. increased consumption of foods high in low density lipoproteins (LDL)

31
Q

As left heart failure progresses:

a. left ventricular preload increases.
b. systemic vascular resistance decreases.
c. left end-diastolic volume decreases.
d. pulmonary vascular resistance decreases.

A

a. left ventricular preload increases.

32
Q

A 75-year-old male presents with severe chest pain. Laboratory tests in hospital reveal elevated levels of creatine kinase and troponin. These elevated levels indicate probable:

a. Raynaud’s disease.
b. myocardial infarction.
c. orthostatic hypertension.
d. varicose veins.

A

b. myocardial infarction.

33
Q

A 65-year-old male with a history of untreated hypertension is now experiencing left heart failure. The most likely reason is:

a. ventricular dilation and wall thinning.
b. myocardial hypertrophy and ventricular remodelling.
c. inhibition of renin and aldosterone.
d. alterations in alpha and beta receptor function.

A

b. myocardial hypertrophy and ventricular remodelling.

34
Q

A 50-year-old male visits the cardiologist for an ECG. Results indicate he has no P-R interval and a variable rate QRS with rhythm irregularity. Which of the following is the most likely diagnosis?

a. atrial tachycardia.
b. atrial fibrillation.
c. sinus dysrhythmia.
d. idioventricular rhythm.

A

b. atrial fibrillation.

35
Q

A 72-year-old female has a history of hypertension and atherosclerosis. An echocardiogram reveals backflow of blood into the left ventricle. Which of the following is the most likely diagnosis?

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

A

c. aortic regurgitation

36
Q

A 68-year-old female is experiencing left heart failure. Physical exam reveals elevated blood pressure, which is most likely caused by:

a. sympathetic nervous system compensation for decreased cardiac output.
b. stress hormones promoting increased cardiac contractility.
c. cardiotoxic effects of catecholamines and angiotensin.
d. diastolic dysfunction.

A

a. sympathetic nervous system compensation for decreased cardiac output.

37
Q

Cardiac cells can withstand ischaemic conditions for _____ before irreversible cell injury occurs.

a. 1 minute
b. 20 minutes
c. 30 minutes
d. 60 minutes

A

b. 20 minutes

38
Q

During ___________ coronary vessels are compressed, while during __________ coronary vessels are perfused.

a. systole, diastole
b. diastole, systole
c. preload, afterload
d. afterload, preload

A

a. systole, diastole

39
Q

Oxygen and other nutrients are supplied to the myocardium by:

a. blood in the coronary arteries.
b. blood in the coronary veins.
c. blood in the heat chambers.
d. blood in the vena cava.

A

a. blood in the coronary arteries.

40
Q

Percutaneous coronary intervention (PCI) can involve the following EXCEPT:

a. non-surgical intervention to treat stenosis.
b. insertion of a stent to open the vessel lumen.
c. removal of a femoral artery segment.
d. use of dye to visualize the occlusion site.

A

c. removal of a femoral artery segment.

41
Q

Mr Trump died of a myocardial infarction. Autopsy would most likely reveal:

a. embolisation of plaque from the aorta.
b. decreased ventricular diastolic filling time.
c. platelet aggregation within an atherosclerotic coronary artery.
d. smooth muscle dysplasia in the coronary artery.

A

iT’S NOT - a. embolisation of plaque from the aorta.

42
Q

A 60-year-old female was diagnosed with mitral stenosis. As a result, she has incomplete emptying of the:

a. right atrium.
b. right ventricle.
c. left atrium.
d. left ventricle.

A

c. left atrium.

43
Q

In valvular _____, the valve opening is constricted and narrowed because the valve leaflets, or cusps, fail to open completely.

a. regurgitation
b. insufficiency
c. stenosis
d. incompetence

A

c. stenosis

44
Q

Which of the following is NOT an ECG derived diagnostic indicator of a myocardial infarction?

a. pronounced Q wave
b. a PR interval of 0.12 second duration
c. T wave inversion
d. ST segment elevation

A

b. a PR interval of 0.12 second duration

45
Q

A 60-year-old female had a myocardial infarction. She was brought to hospital 30 minutes later. She survived but now has impaired ventricular function because:

a. there was a temporary alteration in electrolyte balance.
b. there was too much stress on the heart.
c. the cells became hypertrophic.
d. the resulting ischaemia led to hypoxic injury and myocardial cell death.

A

d. the resulting ischaemia led to hypoxic injury and myocardial cell death.

46
Q

A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are directly related to her right heart failure?

a. significant oedema to both lower legs and feet
b. hypertension
c. decreased urine output
d. pulmonary congestion

A

a. significant oedema to both lower legs and feet

47
Q

Haematological issues which could theoretically cause cardiac ischaemia via decreasing the oxygen content of blood include:

a. decreased number of red blood cells.
b. decreased haemoglobin levels.
c. decreased arterial oxygen saturation.
d. all the above.

A

d. all the above.

48
Q

Which of the following factors determine oxygen availability to the myocardium?

a. coronary blood flow
b. haematocrit
c. arterial oxygen saturation
d. all the above

A

d. all the above

49
Q

The complications of uncontrolled hypertension include all the following EXCEPT:

a. cardiac hypertrophy
b. coronary artery disease
c. various conduction system diseases
d. anaemia.

A

d. anaemia.

50
Q

A 65-year-old male is diagnosed with chronic pulmonary disease and elevated pulmonary vascular resistance. Which of the following heart failures generally results directly from this condition?

a. right heart failure
b. left heart failure
c. low-output failure
d. high-output failure

A

a. right heart failure

51
Q

Rheumatic heart disease has traditionally been known to be a potential direct cause of which of the following conditions?

a. valvular stenosis
b. valvular incompetence
c. myocardial infarction
d. both a and b

A

d. both a and b

52
Q

A 51-year-old male is at his health clinic for an annual physical exam. After walking from the car to the clinic, he developed a substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting two to three minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. He is most likely to be experiencing:

a. stable angina.
b. unstable angina.
c. heart failure.
d. myocardial infarction.

A

a. stable angina.

Human Pathophys HLT221 (13 decks)

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