CVPGI Final/Exam 2
Atherosclerotic obstruction is LEAST likely to occur, in which artery? a. LAD b. LCX c. RCA d. PDA
PDA
The most common congenital heart malformation is... a. Tricuspid atresia b. Aortic stenosis c. Patent ductus arteriosus d. Ventricular septal defect
Ventricular septal defect
A 56-year-old man reports reduced exercise tolerance over the past 5 years. In the past year, he has noted chest pain after ascending a flight of stairs. He smokes 2 packs of cigarettes per day. On examination, he has a blood pressure of 155/95 mm Hg. His body mass index is 30. Laboratory findings include a total serum cholesterol of 25 mg/dL with an HDL cholesterol of 22 mg/dL. Which of the following vascular abnormalities is he most likely to have? a. Hyperplastic arteriolosclerlerosis b. Medial calcific sclerosis c. Atherosclerosis d. Plexiform arteriopathy
Atherosclerosis
Irreversible pulmonary hypertension is least likely in______ a. Ventricular septal defect b. Atrial septal defect c. Persistent truncus arteriosus d. Tetralogy of Fallot
Atrial septal defect
The congenital heart defect in which all four chambers of the heart are in communication with each other is known as; a. Tetralogy of fallot b. Complete atrioventricular septal defect c. Transposition of the great vessels d. Coarctation of the aorta
Complete atrioventricular septal defect
In coarctation of the aorta, there is hypertension in the lower extremities. a. True b. False
False
Myocardial infarction or angina always precede sudden cardiac death. a. True b. False
False
Cardiac disease; is found in 20% to 40% of patients with longstanding crippling rheumatoid arthritis. Which of the following is the most common cardiac disease encountered in patients who have rheumatoid arthritis? a. Vavular endocarditis b. Mural endocarditis c. Valvular calcifications d. Fibrinous pericarditis
Fibrinous pericarditis
What are Aschoff bodies? a. Calcific deposits found in the mitral or aortic valves. b. Fibrous deposits on atherosclerotic plaques c. Focal inflammatory lesions found in all layers of the heart d. Vegetations on the aortic valve
Focal inflammatory lesions found in all layers of the heart
Thick myocardial wall, small chamber size, and abnormal diastolic filling often due to genetic inheritance of abnormal sarcomere proteins. a. Dilated cardiomyopathy b. Hypertrophic cardiomyopathy c. Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
A 50-year-old man with chronic alcoholism was hospitalized for congestive heart failure. The left ventricular ejection fraction was 35%, and the heart appeared enlarged on radiographs. Myocardial biopsy was performed, and the biopsy specimen most likely showed: a. Infiltrates of eosinophils b. Foci of cardiac cell necrosis surrounded by neutrophils c. Hypertrophy of cardiac myocytes and interstitial fibrosis d. Foci of chronic inflammation containing plasma cells and lymphocytes
Hypertrophy of cardiac myocytes and interstitial fibrosis
A 53-year-old man has the sudden onset of chest pain. He is found to have high cardiac enzymes. A year later he has reduced exercise tolerance. He then experiences a transient ischemic attack (TIA). Thrombus formation involving which of the following locations is most likely to have put him at greatest risk for the TIA? a. Vertebral artery b. Superior vena cava c. Left ventricle d. Coronary artery
Left ventricle
Mitral valve disease a. Left-sided CHF b. Right-sided CHF
Left-sided CHF
Systemic hypertension a. Left-sided CHF b. Right-sided CHF
Left-sided CHF
Pulmonary congestion and edema are characteristic of... a. Right ventricular hypertrophy b. Left-sided congestive heart failure c. Right-sided congestive heart failure d. Ventricular septal defect
Left-sided congestive heart failure
The left AV valve leaflet is described as "balloon-like" or "hooded" in: a. Infective endocarditis b. Restrictive cardiomyopathy c. Mitral valve prolapse d. Libman-stacks endocarditis
Mitral valve prolapse
The most common cause of sudden cardiac death, defined as occurring within 1 hour after onset of the first symptoms, in a 50-year-old man is a. Aortic valve stenosis b. Mitral valve prolapse c. Myocardial ischemia d. Cardiomyopathy
Myocardial ischemia
Characteristics of angina pectoris do NOT include. a. Constricting, squeezing knife-like chest pain b. Myocyte damage c. Relieved by nitroglycerin d. Transient, recurrent episodes
Myocyte damage
Sterile vegetations, myocarditis, amd fifbrinous pericarditis are associated with... a. Valve disease following a dental procedure b. IV drug abuse c. Congenitally bicuspid aortic valve d. Pancarditis of rheumatic fever
Pancarditis of rheumatic fever
Non-ST-segment myocardial infarction (NSTEMI) is associated with a. Partial thickness damage to the myocardium b. Transmural damage c. Coronary artery disease with thrombosis d. Normal ECG
Partial thickness damage to the myocardium
Many congenital heart defects cause a murmur. Which one is described as "machine-like"? a. Atrial septal defect b. Ventricular septal defect c. Patent ductus arteriosus d. Atrioventricular septal defect
Patent ductus arteriosus
Coughing or sneezing (but not at other times) may cause a mild shunt from the right atrium to the left atrium in ... a. Patent foramen ovale b. Atrial septal defect c. Patent truncus arteriosus d. Atrioventricular septal defect
Patent foramen ovale
Which is NOT part of the tetralogy of fallot? a. Pulmonary stenosis b. Right ventricular hypertrophy c. Overriding aorta d. Patent foramen ovale
Patent foramen ovale
In heart failure, the term "backward failure" is referring to what observation? a. Decreased cardiac output b. Pooling of blood in the venous circulation c. Decreased kidney perfusion d. Left heart faiure's tendency
Pooling of blood in the venous circulation
Complete obstruction of an airway leads to what type of atelectasis? a. Compression b. Contraction c. Resorption d. Atretic
Resorption
Chronic obstructive pulmonary disease a. Left-sided CHF b. Right-sided CHF
Right-sided CHF
Severe asthma a. Left-sided CHF b. Right-sided CHF
Right-sided CHF
Which of these lesions refers to red patches in the fundus (retina) in patients with infective endocarditis? a. Roth spots b. Petechial rash c. Splinter hemorrhage d. Osler's nodes
Roth spots
The most common location of atrial septal defects is in the area of the a. Secundum b. Sinus venosus c. Primum d. Coronary sinus
Secundum
A 75-year-old man develops angina, has no history of coronary artery disease, nor rheumatic fever. Imaging and examination show heaped up calcified masses on the aortic valve. What is the likely diagnosis? a. Senile calcific aortic stenosis b. Post-streptococcal valve disease c. Mitral annular calcification d. Calcific mitral of bicuspid aortic valve
Senile calcific aortic stenosis
Physiologic hypertrophy due to "cardio" exercise differs from pathologic hypertrophy in what way? Physiologic hypertrophy... a. Has extensive fibrosis b. Shows an increase in myocyte length more than width c. Occurs more in the right heart than the left heart d. Has less abundant capillary growth
Shows an increase in myocyte length more than width
Stable angina, the most common form of angina pectoris, is caused by a. Stenosis of coronary arteries b. Lipid-rich atheromas c. Ruptured atheromas d. Thrombi overlying partially ruptured atheromas
Stenosis of coronary arteries
Features of hypertrophic cardiomyopathy include all the following except a. Harsh systolic ejection murmur b. The presence of mitochondrial anomalies c. Atrial fibrillation d. Mural thrombus formation and embolization
The presence of mitochondrial anomalies
Transposition of the great vessels is incompatible with life unless.. a. There is also a ventricular septal defect b. If the foramen ovale closes at birth c. If the ductus arteriosus closes at birth d. There is also a pulmonary stenosis
There is also a ventricular septal defect
Which congenital disorder exhibits a hypoplastic left atrium, but a normal left ventricle, and a PFO or an ASD? a. Ventricular septal defect b. Total anomalous pulmonary venous connection c. Right ventricular hypertrophy d. Coarctation of the aorta
Total anomalous pulmonary venous connection
Select the right to left shunt. a. Transposition of the great vessels b. Ventricular septal defect c. Patent ductus arteriosus d. Atrial septal defect
Transposition of the great vessels
In Restrictive Cardiomyopathy, there is diastolic dysfunction. a. True b. False
True
Most infarcts become transmural a. True b. False
True
Select a change that is typical of an aging heart. a. Decreased epicardial fat b. Valvular and annular calcification c. Increased ventricular size d. Decreased collagen connective tissue
Valvular and annular calcification