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28 Cards in this Set
- Front
- Back
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Which of the following statements are true about CHD epidemiology?
a. CHD is the second leading cause of death in developing countries b. Deaths from congestive heart failure have decreased steadily over the last 10 years as treatment modalities such as ACE inhibitors, digoxin, and β-blockers have been more widely applied. c. Women experience myocardial infarction on average 10 years later than men d. Age adjusted CHD mortality is higher in blacks than in whites e. CHD mortality has decreased strikingly in eastern European countries over the last decade |
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b-F c-T d-T e-F |
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Which of the following statements correctly characterize major determinants of cardiac performance?
a. Stroke volume increases with increasing afterload b. Ventricular preload describes the load against which the ventricle must contract when it ejects blood c. In normal hearts, ventricular inotropic state increases with increasing heart rate because of changes in Ca availability d. Hypoxia, ischemia and acidosis decrease cardiac contractility e. In failing hearts, right atrial pressure as as assessed from the jugular venous pulse is a good indicatior of left ventricular filling pressure |
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b-f c-t d-t e-f |
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Which of the following statements correctly characterize symptoms of congestive heart failure?
a. Disordered breathing, such as cheyne-stokes respiration or nocturnal oxygen desaturation, is common in congestive heart failure b. Nocturnal cough is due to increased pulmonary venous pressure in the recumbent position c. Exercise intolerance occurs only in patients with increased pulmonary venous pressures. d. Digestive disturbances are common in congestive heart failure e. Patients with congestive heart failure may present with signs of liver dysfunction |
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Which of the following statements are true about echocardiography?
a. In patients with tricuspid regurgitation, Doppler echocardiography can determine systolic pulmonary arterial pressure b. Echocardiography can distinguish systolic and diastolic dysfunction c. Ejection fraction can be calculated using formulas and validated in coronary angiography d. Transthoracic echocardiography is ideally suited to diagnose vegetations on the mitral valve e. Echocardiography is ideally suited for serial noninvasive follow up of patients with valvular heart disease |
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Which of the following statements correctly characterize physical findings in congestive heart failure?
a. A prominent S3 gallop is present in the majority of patients with congestive heart failure as a result of systolic dysfunction b. Mitral regurgitation on examination is pathognomonic for congestive heart failure as a result of primary valvular disease c. Jugular venous distention is an early sign of mild left ventricular dysfunction d. The absence of pulmonary rales is very helpful in excluding a diagnosis of congestive heart failure e. A pulsatile liver is a sign of severe tricuspid regurgitation |
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Which statements about these cardiac imaging modalities are correct?
a. Aortic dissection can be assessed by computed tomography, aortography, magnetic resonance imaging, and echocardiography b. Electron beam computed tomography (EBCT) visualizes coronary calcification and has been used to screen asymptomatic individuals for coronary artery disease c. Cardiac catheterization is mandatory in all patients with aortic valve disease who are being considered for aortic valve replacement d. Radionuclide angiography can reliably assess myocardial wall thickness, wall motion, and global left ventricular ejection fraction. e. Magnetic resonance imaging can identify cardiomyopathy resulting from hemochromatosis |
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Which of the following statements are true about treatment modalities in congestive heart failure?
a. Diuretics may increase neurohumoral activation in patients with congestive heart failure b. ACE inhibitors potentiate kinins c. Lower doses of ACE inhibitors are as effective as higher doses used in the congestive heart failure mortality trials and are better tolerated d. Hypokalemia is a common side effect of ACE inhibitors e. In patients who experience angioedema in response to a short acting ACE inhibitor, a long acting ACE inhibitor can be safely substituted |
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b-t c-f d-f e-f |
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Which of the following medications have been shown to improve mortality in congestive heart failure?
a. ACE inhibitors b. Β-adrenergic blocking agents c. Prazosin d. Hydralazine\nitrate combination therapy e. Digoxin |
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b-t c-f d-t e-f |
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Which of the following statements are true about treatment modalities in congestive heart failure?
a. Aldosterone antagonists increase mortality in congestive heart failure and should be avoided, especially in patients with class IV symptoms b. Digitalis toxicity occurs only when digoxin serum levels exceed 2 ng\mL c. Beneficial effects of digoxin may in part be mediated by diminished activation of the neurohormonal system d. β-blocker therapy should be reserved for patients with class IV congestive heart failure symptoms e. premature ventricular contractions, even if asymptomatic, diminish cardiac output in patients with congestive heart failure and should be suppressed pharmacologically |
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Which statements about neurohumoral activation in heart failure are true?
a. Circulating Norepinephrine levels correlate with survival in heart failure b. Proinflammatory cytokines are elevated in patients with asymptomatic left ventricular dysfunction but diminish as severity of heart failure increases. c. Levels of natriuretic peptides are increased in heart failure, but response to these peptides is diminished d. Endothelin levels are increased in congestive heart failure and contribute to peripheral and pulmonary vasoconstriction e. Plasma renin levels are markedly diminished in severe congestive heart failure, resulting in hypotension |
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Which of the following statements about treatment of hypertension are true?
a. Treatment decisions are based on degree of BP elevation, presence or absence of target organ damage, and presence or absence of other risk factors for cardiovascular disease b. Drug therapy should be considered for patients with high normal BP when they are diabetic or have evidence of target organ damage c. Lifestyle modification for up to 12 months is appropriate for patients with stage 3 hypertension who do not have evidence of target organ damage d. Patients with stage 1 hypertension who have cardiovascular risk factors other than diabetes and no evidence of target or gan damage can be treated with lifestyle modifications for up to 6 months e. Lifestyle modifications is not helpful in patients with stage 3 hypertension and end organ damage |
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Which of the following statements about the relationship of BP and lifestyle are true?
a. Weight loss is closely correlated with reduction in BP b. A diet rich in fruits, vegetables and low fat dairy products can substantially lower BP in hypertensive patients c. Regular moderate intensity physical activity can lower BP in normotensive and hypertensive individuals d. Consumption of one to two alcoholic beverages daily has been shown to lower BP in normotensive and hypertensive individuals e. Sodium restriction as a means to lower BP is most effective in populations with high renin hypertension |
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Which of the following abnormalities are seen in patients with abnormalities of the chromosomal band 22q11?
a. Cardiac defects b. Abnormal facies c. Thymic hypoplasia d. Cleft palate e. hypocalcemia |
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Which of the following statements are true about pharmacologic therapy of hypertension?
a. Greater than 60% of patients achieve adequate BP control with single drug therapy b. There are convincing clinical trial data that initial use of ACE inhibitors and long acting calcium channel blockers lead to superior cardiovascular outcomes compared with diuretic and β-blocker therapy c. When choosing an antihypertensive agent, a patients comorbidities should be carefully considered d. Lack of BP control is often a result of nonadherence e. Volume overload is the most frequent cause of resistant hypertension |
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Which of the following statements are true about atrial septal defects?
a. Sinus venosus defects are often accompanied by congenital deformities of the mitral valve b. Atrial arrhythmias are common in adults with atrial septal defects c. Eisenmenger’s syndrome is a frequent complication of uncorrected secundum atrial septal defects d. Patients with atrial septal defects are at increased risk of stroke e. The systolic murmur typically heard in patients with secundum atrial septal defects is due to shunt flow across the atrial septum |
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Which of the following statements are true about comorbidities in hypertensive patients?
a. Sleep apnea and hypertension often coexist b. Hypertension is twice as common in diabetic than nonbdiabetic patients c. Good control of hypertension is less important in older patients compared with younger patients d. Tight BP controlled is contraindicated in patients with renal insufficiency because such therapy often results in worsening renal function (increase in serum creatinine) e. β-blockers are contraindicated in patients with a history of asthma |
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Pregnancy in patients with congenital heart disease warrants special considerations, including:
a. Cesarean section is the preferred mode of delivery b. Early ambulation and use of elastic stockings are essential measures to minimize the risk of postpartum thromboembolism c. Oxygen administration may predispose to epistaxis d. The incidence of congestive heart disease in children born to mothers with congestive heart disease is significantly higher than in the general population e. Patients with a secundum atrial septal defect should receive endocarditis prophylaxis |
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Which of the following statements are true about hypertensive crisis?
a. Severe hypertension (BP>200|120 mmHg) is an indication for parenteral antihypertensive therapy in an intensive care unit setting b. The drug of choice for the treatment of severe hypertension in the setting of aortic dissection is parenteral Hydralazine c. Eclampsia is best treated with diuretics d. Myocardial ischemia and severe hypertension in the setting of a cocaine overdose are best treated by β-adrenergic blocking agents e. β-antagonists are contraindicated in hypertensive emergencies complicated by acute left ventricular failure |
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Noncardiac surgery in patients with congenital heart disease warrants special considerations, including:
a. Patients with congenital complete heart block may require temporary pacing b. Patents with cyanotic congenital heart disease are at increased risk of paradoxical embolism from peripheral venous catheters c. Systemic hypotension increases the right to left shunt in cyanotic congenital heart disease d. Bleeding risk is increased in cyanotic congenital heart disease e. Patients with a bicuspid aortic valve are at increased risk of endocarditis |
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Which of the following statements are true about pulmonary hypertension?
a. Sleep apnea may lead to pulmonary arteriolar vasoconstriction b. Bronchiectasis may lead to pulmonary hypertension c. Primary pulmonary hypertension is characterized by very high pulmonary venous pressures d. Pulmonary hypertension resulting from scleroderma is characterized by increased pulmonary flow with normal pulmonary vascular resistance e. Pulmonary hypertension in chronic obstructive pulmonary disease (COPD) is multifactorial in origin |
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Which of the following are characteristics of a vulnerable plaque?
a. Thick fibrous cap b. Large lipid core c. High content of metalloproteinases d. Large numbers of inflammatory cells e. Exposure to repetitive mechanical stress |
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Which of the following are true statements about lipoproteins?
a. High density lipoprotein (HDL) particles have antioxidant properties b. Small dense low density lipoproteins (LDL) particles are believed to be particulary atherogenic c. Lipoproteins in diabetic patients may function abnormally because of glycation d. Postprandial hyperlipidemia is frequently seen in patients with coronary artery disease e. Because LDL cholesterol levels are easily calculated by the Friedewald formula, there is no need for expensive direct measurements of LDL cholesterol |
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Which statements are correct about coronary artery bypass grafting (CABG)?
a. CABG prolongs survival in patients with > 70% left main stenosis, independent of angina symptoms b. CABG prolongs survival in patients with three vessel coronary artery disease and left ventricular systolic dysfunction c. Diabetic patients with multivessel coronary artery disease have a better prognosis with multivessel angioplasty than with CABG d. Woment have lower perioperative mortality than men e. Internal mammary grafts remain patent longer than saphenous vein grafts. |
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Which statements about angina pectoris are correct?
a. Walk through angina is defined as angina that occurs with exercise but disappears with continued exertion b. Postprandial angina occurs in response to increased oxygen demand in the splanchnic bed after meals c. Stable exertional angina is due to intermittent thrombotic occlusion of the culprit vessel d. Nocturnal angina is due to increased venous return as the patient assumes a supine position e. New onset angina is a subtype of unstable angina |
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Which statements are correct about cardiac transplantation?
a. Contraindications to transplantation include advanced physiologic age, irreversible pulmonary hypertension, irreversible renal dysfunction, diabetes mellitus with significant end organ involvement, and peripheral vascular disease b. The most common cause of heart failure leading to transplantation is ischemic heart disease c. Only 1- to 20% of suitable harvestable hearts are procured from brain dead patients d. Some statin drugs have been shown to decrease allograft vasculopathy and the incidence of rejection and may prolong posttransplant survival e. Diltiazem reduces cyclosporine blood levels and should be avoided in transplant patients. |
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When evaluating a patient with angina pectoris, which of the following conditions should be considered in the differential diagnosis?
a. Atherosclerotic coronary artery disease b. Aortic stenosis c. Aortic insufficiency d. Hypertrophic cardiomyopathy e. Syndrome X |
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Which of the following statements are true about medical therapy of angina pectoris?
a. Antiplatelet therapy decreases the risk of myocardial infarction b. Clopidogrel and ticlopidine inhibit the adenosine diphosphate receptors of platelets c. It is important to maintain stable nitrate blood levels throughout the 24 hour period to avoid tachyphylaxis d. β-blockade is contraindicated in patients with angina pectoris and low ejection fraction e. angioplasty is preferred over medical therapy in patients with single vessel coronary artery disease because it lowers mortality and morbidity |
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Which statements are correct about acute myocardial infarction?
a. Up to 25% of myocardial infarctions in elderly patients may be silent b. Routine prophylactic use of Lidocaine is associated with increased mortality c. Right ventricular myocardial infarction may be associated with cyanosis d. Right bundle brance block is very common in inferior myocardial infarctions because in most patients the right bundle branch is supplied by the right coronary artery e. Complex ventricular ectopy after myocardial infarction is associated with increased mortality; suppression of such ectopy is thus important in improving prognosis |
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