Pathophysiology Week 5 Questions: Chap. 17-19

How would a clinician calculate the ejection fraction? A. Subtract the right atrial pressure from the aortic blood pressure B. Divide the stroke volume by the end diastolic volume C. Multiply stroke volume by the heart rate D. Add together adenosine diphosphate and creatine phosphate

B. Divide the stroke volume by the end diastolic volume

What factor causes a congenital heart disease to produce cyanosis? A. Left-to-right shunting of blood. B. Right-to-left shunting of blood. C. Ventricular septal obstruction. D. Atrial septal defect.

B. Right-to-left shunting of blood.

Myocarditis should be suspected in a patient who presents with: A. chest pain and ST elevation. B. acute onset of left ventricular dysfunction C. murmur and abnormal valves on an echocardiogram. D. family history of cardiomyopathy.

B. acute onset of biventricular failure.

Which of the following will cause an increase in cardiac output? A. Decreased preload B. Decreased heart rate C. Decreased afterload D. Decreased contractility

C. Decreased afterload

A clinician needs to record a patient's heart rhythm for 48 hours. Which diagnostic test should be used? A. Holter monitor B. Magnetic resonance imaging C. Echocardiography D. Nuclear cardiography

Correct Answer: A This is accomplished by continuous ambulatory monitoring (e.g., Holter monitoring) over a 24- to 48-hour period. Magnetic resonance imaging (MRI) and computed tomography (CT) are useful for imaging cardiac structures. Echocardiography uses reflected sound waves (ultrasound) to provide an image of cardiac structure and motion within the chest. Radioactive substances injected into the bloodstream can be used to trace the patterns of blood flow in the heart when using nuclear cardiography.

Which plaque is most prone to rupture? A. Contains significant collagen and fibrin B. Has a large lipid core with a thin cap C. Contains high-density lipoproteins D. Has areas of ischemia and necrosis

Correct Answer: B Older plaques have significant collagen and fibrin, which form a cap and tend to make the plaque more stable. High-density lipoproteins, on the other hand, have been correlated with a decreased risk of atherosclerosis. Ischemia and necrosis occur with MIs, not plaque.

Patent ductus arteriosus is accurately described as a(n): A. Opening between the atria B. stricture of the aorta that impedes blood flow. C. communication between the aorta and the pulmonary artery. D. cyanotic heart defect associated with right-to-left shunt.

Correct Answer: C

Reperfusion therapy is indicated for the patient with: A. hypotension and dysrhythmias. B. unstable angina and elevated serum markers. C. chest pain and ST segment elevation. D. stenosis and regurgitation.

Correct Answer: C Chest pain and ECG evidence of acute ischemia (ST elevation) are candidates for reperfusion therapy. Hypotension and dysrhythmias are not indications for reperfusion. Unstable angina and elevated serum markers are candidates for antiplatelet therapy. Failure of a valve to open completely is termed stenosis and regurgitation (insufficiency) refers to the inability of a valve to close completely. These do not determine reperfusion therapy.

An example of an acyanotic heart defect is: A. tetrology of Fallot. B. transposition of the great arteries. C. ventricular septal defect. D. all right-to-left shunt defects.

Correct Answer: C Tetralogy of Fallot is a cyanotic congenital defect. Rheumatic heart disease is an uncommon but serious consequence of rheumatic fever; it is not a congenital defect. Patent ductus arteriosus is an acyanotic congenital defect. Cardiac tamponade refers to external compression of the heart chambers such that filling is impaired; it is not a congenital defect.