Cardiology Lab

Which of the following statements is true about pedigree analysis? a) The purpose of pedigree analysis is to determine whether a disease is inherited and what the pattern of inheritance is. b) The purpose of pedigree analysis is to determine the paternity of a child. c) The purpose of pedigree analysis is to determine the relationships between individuals within a family spanning several generations. d) Both a and c.

a A doctor relies on information provided by family members regarding paternity and relationships between individuals within a family. It may sometimes be necessary to determine whether this information is accurate and carry out tests to establish paternity and/or maternity; however this is not the purpose of pedigree analysis. Pedigree analysis is only carried out to determine the inheritance of a specific trait within a family.

What do orange and blue colours on the blood represent in Doppler echo images? a) The colours indicate whether the blood is moving toward or away from the probe. b) Orange represents oxygenated blood, blue de-oxygenated blood. c) The colours have no meaning; they are used to visualise the blood. d) The colours describe the temperature of the blood. Orange is warm blood; blue is cooler blood.

a Doppler echocardiography detects movement of blood. It has nothing to do with oxygenation or temperature. The colours are assigned depending on whether the blood is moving toward or away from the probe.

Which of the following about MRI is true? a) MRI can show a high resolution image of the heart. b) MRI can detect minute electrical activity of the heart. c) MRI can record high fidelity sound of the heart. d) MRI can monitor blood pressure inside the heart.

a MRI is an imaging technique; it cannot measure electrical activity, sound, or pressure.

What is a murmur? a) A rumbling or blowing sound that is made by the heart, often by malfunctioning heart valves. b) A wheezing sound made by lungs, particularly during pneumonia, that may be superimposed on the heart sounds. c) A clicking sound made by artificial heart valves, especially when there is a failure in such devices. d) A low frequency sound heard as venous blood fills the atria of the heart, which is pronounced during heart attacks.

a Murmurs are often associated with problems involving the heart valves. The sound can be highly variable, from low frequency rumbles to higher pitched blowing sounds, and could occur during systole or diastole. Sometimes the murmur is caused by a valve being too narrow, and sometimes because of a leak. The other chief cause of heart murmurs is congenital holes in the heart.

Which of the following characteristics of the heart cannot be measured with echocardiography? a) The motion of the mitral valves. b) The oxygen content of the blood. c) The size of the left ventricle. d) The rate of heartbeat.

b Echocardiography can provide very good real-time images of the heart. The valve movements can be monitored, the heartbeat can be measured by observing the movements, and the size of the chambers can be calculated. It does not however, monitor chemical compositions of the blood. So it cannot measure the oxygen content.

When a doctor uses a stethoscope, what is being monitored? a) The sound made by the electricity spreading through the heart. b) The sound made by the vibration of the heart and blood as pumping occurs. c) The sound made by the contractile molecules of the muscles of the heart as they contract. d) None of the above.

b Listening to the heart through a stethoscope usually allows one to hear the two heart sounds. The first sound occurs at the moment of mitral and tricuspid valve closing, the second sound at the moment of aortic and pulmonic valve closing. Some patients with disease have additional vibrations that can lead to other discrete sounds, or they may have turbulence, caused by flow through narrow arteries, that is picked up as a murmur.

Two of the six children of two perfectly healthy parents are born with a serious genetic disease. Which of the following statements is most likely? [Hint: the two parents are second cousins] a) The disease is dominant. b) The disease is recessive. c) The disease is dominant with variable expressivity. d) The disease is most likely not inherited and due to another cause.

b Why? Recessive traits are passed on to children from both parents, although the parents can seem perfectly normal. In the case of a dominant trait, at least one parent would have to be affected. The fact that three of the children are affected with the same disease and that the parents are related suggests that the disease is inherited.

How are the echocardiography images made? a) An X-ray machine takes a series of pictures and the results are then displayed with a computer. b) Images are built by scanning the interior of the heart with a powerful fiberoptic device. c) Images are compiled from ultrasound reflected from the heart tissue. d) Images are obtained using radar.

c Echocardiography uses ultrasound emitted from a probe. The sound is then reflected back to the probe when it encounters a solid object. The results are compiled with a computer. X-rays, optical equipment or radar (using radio waves) are not used.

Which of the following is used in MRI? a) X-rays b) Light c) Magnetic field d) Ultrasound

c MRI stands for magnetic resonance imaging and the patient is placed in a magnetic field. X-rays, light, and ultrasound are not used.

In a pedigree chart, an unfilled square symbol with the numbers II3 below it represents which of the following? a) A person of unknown gender who has a genetic disease in the family being studied. b) The second individual, who is a male, in the third generation of the family. c) The second son or daughter in a family of three. d) The third individual, who is male, in the second generation of the family.

d In pedigrees males are represented by squares. Roman numerals symbolise generations and Arabic numerals symbolise birth order within a generation.

Which of the following conditions is least suitable for an MRI exam? a) Aortic aneurysm b) Atrial septal defect c) Dilated cardiomyopathy d) Arrhythmia

d MRI is most suitable for diagnosing conditions manifesting as structural problems. Aortic aneurysm, atrial septal defect, and dilated cardiomyopathy are all conditions with significant structural problems. Arrhythmia does not necessarily stem from any visible structural changes; it would be least suited for MRI.

Which of the following conditions can cause irregularities in the sound of the heart? a) Moderate bradycardia. b) Mild mitral valve regurgitation. c) Mild atherosclerosis of the coronary arteries. d) Both a and b.

d • Bradycardia is an abnormally slow heart beat rhythm. It's possible that the natural variation in the heart beat rate between different individuals or in the same person may make it difficult to diagnose a slow heart beat as a clinical condition, but in principle, this condition is detectable based purely on sound. • Mitral valve regurgitation occurs because of an inability of the mitral valve to prevent the blood from flowing back from the left ventricle to the left atrium during systole. The back flow of blood (regurgitation) creates an abnormal 'whoosh' that can easily be detected. Atherosclerosis is deposition of fatty plaques in the wall of the arteries. When it occurs in the coronary arteries, that is, the blood vessels that supply the heart muscles, it can constrict the passage of blood and cause a heart attack. However, without other secondary symptoms, atherosclerosis is not easily detectable by sound alone.