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Amanda CRNA > Valley Quiz - Valvular Lesions > Flashcards

Valley Quiz - Valvular Lesions Flashcards

1
Q

Which of the following valvular lesions can be a complication of rheumatic fever? (Select 3)

a. Aortic regurgitation
b. Aortic stenosis
c. Mitral regurgitation
d. Mitral stenosis
e. Bicuspid aortic valve
f. IHSS (HOCUM)

A

b. Aortic stenosis
c. Mitral regurgitation
d. Mitral stenosis

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2
Q

Symptoms of mitral stenosis will begin to manifest when the mitral valve area is less than __ cm2?

a. 2
b. 3
c. 4
d. 5

A

a. 2

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3
Q

Your patient with mitral stenosis has a hoarse voice. This has most likely resulted from an enlarged left
atrium applying pressure to which nerve?
a. Right recurrent laryngeal
b. Left recurrent laryngeal
c. Internal branch of superior laryngeal nerve
d. External branch of superior laryngeal nerve

A

b. Left recurrent laryngeal

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4
Q

Mitra! stenosis will usually result in which of the following? (Select 3)

a. Embolic events and atrial fibrillation
b. Atrial fibrillation
c. Aortic stenosis
d. Right ventricular failure
e. Decreased pulmonary artery pressure
f. Decreased pulmonary capillary wedge pressure

A

a. Embolic events and atrial fibrillation
b. Atrial fibrillation
d. Right ventricular failure

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5
Q

You would expect to see which of the following in a patient with mitral regurgitation?

a. Decreased SVR
b. Decreased left ventricular end-diastolic volume
c. Reduction in forward stroke volume
d. Left ventricular pressure overload

A

c. Reduction in forward stroke volume

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6
Q

In a patient with mitral regurgitation, the left ventricle will compensate by increasing end-diastolic
volume while initially maintaining normal end-systolic volume. These compensations are explained by
which law or principle?
a. Laplace
b. Frank Starling
c. Fick’s
d. Bernoulli’s

A

b. Frank Starling

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7
Q

Mitral regurgitation has a regurgitant volume that is based on all except:

a. Mitral valve size
b. Heart rate
c. Pressure gradient between atria and ventricle
d. Aortic diastolic pressure

A

d. Aortic diastolic pressure

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8
Q

Mitral regurgitation management includes which of the following?

a. Slow heart rate
b. Maintain or increase stroke volume
c. Maintain or slightly increase preload
d. Maintain or decrease contractility

A

c. Maintain or slightly increase preload

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9
Q

Aortic stenosis is associated with which of the following?

a. Maintained stroke volume because of ventricular concentric hypertrophy
b. Maintained stroke volume because of ventricular eccentric hypertrophy
c. Reduced stroke volume
d. Increased stroke volume

A

a. Maintained stroke volume because of ventricular concentric hypertrophy

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10
Q

Which of the following statements about aortic stenosis are correct? (Select 3)

a. Critical aortic stenosis occurs when the aortic valve area is 0.5- 0.8 cm2
b. Normal aortic valve area is 4-6 cm2
c. Critical aortic stenosis occurs when the aortic valve area is 1.0- 1.5 cm2
d. Severe aortic stenosis occurs when the aortic valve area is 0.5- 0.8 cm2
e. Normal aortic valve area is 2.5-3.5 cm2
f. Severe aortic stenosis occurs when the aortic valve area is 0.8-1.0 cm2

A

a. Critical aortic stenosis occurs when the aortic valve area is 0.5- 0.8 cm2
e. Normal aortic valve area is 2.5-3.5 cm2
f. Severe aortic stenosis occurs when the aortic valve area is 0.8-1.0 cm2

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11
Q

The classic triad of symptoms for aortic stenosis are: (Select 3)

a. Bounding peripheral pulses
b. Syncope
c. Dyspnea
d. Concentric LV hypertrophy
e. Angina
f. Notched P waves

A

b. Syncope
c. Dyspnea
e. Angina

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12
Q

Your patient has severe aortic stenosis. Where would you expect to see the effects of concentric hypertrophy on the 12-lead ECG?

a. Pwave
b. Twave
c. Qwave
d. Rwave

A

d. Rwave

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13
Q

Your patient with aortic regurgitation will have which of the following?

a. Increased forward stroke volume
b. Increased arterial diastolic pressure
c. Pressure overload of the left ventricle
d. Volume overload of the left ventricle

A

d. Volume overload of the left ventricle

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14
Q

Acute aortic regurgitation presents with a sudden onset of pulmonary edema and:

a. Hypertension
b. Hypotension
c. Congestive heart failure
d. None of the above

A

b. Hypotension

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15
Q

Which statement about aortic regurgitation is correct?

a. Systolic murmur, best heard at right sternal border.
b. Diastolic murmur, best heard at left sternal border.
c. Systolic murmur, best heard at left sternal border.
d. Diastolic murmur, best heard at right sternal border.

A

b. Diastolic murmur, best heard at left sternal border.

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16
Q

Aortic regurgitation is termed minimal when the regurgitant volume is:

a. >40% of stroke volume
b. >60% of stroke volume
c. <40% of stroke volume
d. <60% stroke volume

A

c. <40% of stroke volume

17
Q

Contractility– indicate how you would manage your patient with hypertrophic obstructive cardiomyopathy by matching the parameter with the direction of change ( a orb).

a. Increase
b. Decrease

A

b. Decrease

18
Q

Preload – indicate how you would manage your patient with hypertrophic obstructive cardiomyopathy by matching the parameter with the direction of change ( a orb).

a. Increase
b. Decrease

A

a. Increase

19
Q

Afterload – – indicate how you would manage your patient with hypertrophic obstructive cardiomyopathy by matching the parameter with the direction of change ( a orb).

a. Increase
b. Decrease

A

a. Increase

20
Q 
Which of the following medications or interventions will worsen the obstruction in your patient with
IHSS? (Select 3)
a. Beta-adrenergic antagonists
b. Nitroglycerin
c. Positive end-expiratory pressure
d. Phenylephrine
e. Digoxin
f. Fluids
A

b. Nitroglycerin
c. Positive end-expiratory pressure
e. Digoxin

21
Q

What will a magnet do to a pacemaker/I CD in a patient with hypertrophic obstructive cardiomyopathy?

a. Turn pacemaker off, turn ICD off
b. No change to pacemaker, turn ICD off
c. Asynchronous pacing, turn ICD off
d. Turn pacemaker off, no change to ICD

A

c. Asynchronous pacing, turn ICD off

22
Q

Where would you expect to see hypertrophy in a patient with IHSS?

a. Free wall of left ventricle
b. Left atrium
c. Ventricular septum
d. Right ventricle

A

c. Ventricular septum

23
Q

When does the obstruction peak in a patient with hypertrophic cardiomyopathy?

a. Early diastole
b. Mid- to late diastole
c. Early systole
d. Mid- to late systole

A

d. Mid- to late systole

Amanda CRNA (8 decks)

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