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