Ztri 4 - Pathology Test3

Front 1

# of new cases per 100,000 population in a year

Back 1

Incidence

Front 2

# of total cases per 100,000 at any givent time

Back 2

Prevalance

Front 3

What are the major disease of the heart?

Back 3

1)ischemic heart disease 2)Hypertensive heart disease
3)Congential heart disease
4) vavlular disease

Front 4

Most common cause of heart disease (aka coronary artery disease); usually associated with atherosclerosis

Back 4

Ischemic heart disease

Front 5

Disease of the heart associated with obesity and it's may problem is the heart has to pump against an increased peripheral resistance

Back 5

Hypertensive heart disease

Front 6

May be as a congenital or complication disease of the heart; m/c/c rheumatic fever, infective endocarditis etc

Back 6

Valvular disease

Front 7

What are the major manifestation of heart disease?

Back 7

1)pain
2) change in size
3)failure
4) arrhythmia

Front 8

__ is an increase in muscle mass of one or the other ventricle; indicates an extrinsic problem, usually systemic hypertension

Back 8

Hypertrophy

Front 9

__ the heart muscle becomes flabby and hypotonic so that the ventricle stretches and the size of the chamber enlarges

Back 9

Dilation

Front 10

What are causes of arrhythmias?

Back 10

ischemia, myocarditis (coxackie) drugs, electrolyte imbalance

Front 11

___ ___ is the inability of the heart to adequately perfuse the tissues so as to meet their metabolic demands; even with adaquate venous return

Back 11

Heart failure

Front 12

___ __ failure is usually caused by disease of the heart itself so that there is a failure of the pump itself

Back 12

Low output failure

Front 13

___ ___ failure is usually caused by disease not of the myocardium itself; diseases that increase the metabolic rate of the tissues

Back 13

High output failure

Front 14

What are causes of high output failure?

Back 14

1)anemia
2)pulmonary disease
3)endocrine
4)pheochromocytoma

Front 15

What is the m/c/c of right ventricular failure?

Back 15

Left ventricular failure

Front 16

___ ventricular failure causes blood to pool in the lungs?

Back 16

Left; increased pulmonary pressure

Front 17

___ failure is due to the failure of delivery of the correct amount of blood to the tissues thus producing effects due to hypoxia

Back 17

Forward

Front 18

___ failure is a congestion of blood in the venous system due to a failure of the heart to keep moving the blood on through the circulation

Back 18

backward

Front 19

Ischemic heart disease, hypertensive heart disease, aortic valve disease, mitral valve disease, myocarditis, cardiomyoptathy, cardiac amyloidosis can cause?

Back 19

Left ventricular failure

Front 20

Left ventricular failure, chronic pulmonary disease and pulmonary stenosis can cause?

Back 20

right ventricular failure

Front 21

Forward failure of acute LVF can cause?

Back 21

1) hypotension
2) syncope
3) cardiogenic shock
4) sudden death

Front 22

Backward failure of acute LVF can cause?

Back 22

pulmonary edema

Front 23

Forward failure of chronic LVF can cause?

Back 23

1) ischemia
2) hypoxia

Front 24

Backward failure of chronic LVF can cause?

Back 24

pulmonary congestion

Front 25

Forward failure of acute RVF can cause?

Back 25

sudden death

Front 26

Backward failure of chronic RVF can cause?

Back 26

1) swelling of the ankles
2)Congestion of the liver
3) increase jugular pressure
4)hypoxia of kidneys

Front 27

Backward failure of acute RVF can cause?

Back 27

sudden, painful swelling of the liver

Front 28

Iscdhemic heart disease is akso known as ____ and ____

Back 28

coronary heart disease; coronary artery disease

Front 29

____ is most commonly caused by reduction in the coronary artery blood flow due to narrowing of atherosclerosis

Back 29

Ischemic heart disease

Front 30

This is the single most common cause of the death in the US

Back 30

ischemic heart disease

Front 31

What are manifestations of ischemic heart disease?

Back 31

1) angina pectoris
2) chronic ischemic heart disease
3) myocardial infarction
4) sudden cardiac death

Front 32

What are the factors that determine severity of ischmia?

Back 32

1)site
2)size of narrowed blood vessel
3)duration
4)anatomy (collateral circulation)
5)rapidity of onset
6)metabolic activity

Front 33

The blood vessell needs to be narrowed by __% for symptoms to be seen

Back 33

70

Front 34

____ is when an obstruction of one of the vessels causes pain

Back 34

Angina pectoris

Front 35

___ angina pectoris is due to vasospasm; NOT atherosclerosis

Back 35

Variant (prinzmetal's)

Front 36

___ angina pectoris is due to physical exertion or stress; caused by atherosclerosis

Back 36

Typical

Front 37

___ angina pectoris is due to atherosclerosis and a thrombus formation over the plaque

Back 37

Unstable (crescendo angina); pain at rest= flag for MI

Front 38

What are risk factors for myocardial infarction?

Back 38

1) atherosclerosis
2) smoking- vasoconstition
3) physical activity
4) emotional stress
5)hypotension
6)hypoxia

Front 39

___ is thte artery m/c affected by MI

Back 39

Left anterior descending artery (80%)

Front 40

MI causes ____ necrosis of muscle

Back 40

coagulative

Front 41

___ is a noninfectious compilation that follows a strep pharyngitis; occurs in children btw 5-15 years

Back 41

Acute Rheumatic fever

Front 42

____ is the characteristic lesion in the myocardium during mycarditis

Back 42

aschoff body

Front 43

What are congenital heart diseases without a shunt?

Back 43

1)coarctation of the aorta
2)pulmonary valve stenosis
3)aortic valve stenosis

Front 44

What are congenital heart diseases that involve a shunt?

Back 44

1)ASD
2)VSD
3)PDA
4)Tetraology of Fallot
5)eisenmenger's syndrome

Front 45

___ is pulmonary stenosis, over-riding aorta, VSD and right ventricular hypertrophy..."blue baby"

Back 45

Tetraology of Fallot

Front 46

____ is a reversal of a shunt in a previously cyanotic heart disease; allows for a paradoxical embolus to occur

Back 46

Eisenmenger's syndrome

Front 47

___ is a glycogen storage disease that produces heart failure within two years after birth; needs a heart transplant

Back 47

Pompe's disease

Front 48

___ is the most common of the congenital conditions that produce cyanosis at birth

Back 48

Tetraology of Fallot

Front 49

_____ has an over-riding aorta, pulmonary stenosis, Right ventricular hypertrophy, ventricular septal defect

Back 49

Tetralogy of fallout

Front 50

In tetralogy of fallout the shunt is from ___ to ____

Back 50

right to left; this produces cyanosis

Front 51

____ is when the aorta is sitting over top of the septum

Back 51

Juxtaposed; part of tetraology of fallot

Front 52

____ connects pulmonary trunk to that aorta; it is supposed to close at birth, becomes the ligamentum arteriosis

Back 52

Patent ductus arteriosus

Front 53

___ is particularly a problem with premature infants

Back 53

patent ductus arteriosus

Front 54

____ is the reversal of a previously cyanotic shunt thus producing cyanosis. The patient is prone to paradoxical emboli

Back 54

Eisenmenger's syndrome

Front 55

Eisenmenger's syndrome produces a ___ to ____ shunt; from a previous ___ to ___ shunt

Back 55

right to left (cyanotic); left to right (acyanotic)

Front 56

___ is the m/c tumor of the heart. Accumulation of collagenous material

Back 56

Myxoma

Front 57

___ is a typical lesion that is seen in the myocardium in acute rheumatic fever

Back 57

aschoff body

Front 58

___ the patient will have thyrotoxicosis and cardiac failure; which type of cardiac failure is this

Back 58

High-output cardiac failure

Front 59

___ is a congentital heart disease that is often associated with Turners syndrome

Back 59

Coarctation of the aorta

Front 60

In ___ the patient will present progressively less well over the last 5-6months. Low grade fever, abscessed tooth removed before the onset of symptoms and they have a congentital heart disease

Back 60

Subacute bacterial endocarditis

Front 61

___ is the m/c/c of infectious myocarditis in the US

Back 61

Coxsackie B virus

Front 62

A child reveals a low-pitched cardiac murmer, ostium secundum (ASD)...what is the abornormality of the child?

Back 62

Left-to-right shunt

Front 63

What is the first to be elevated in the bloodstream following oocclusion of a coronary artery/infarction

Back 63

Troponin

Front 64

____ could result from occupational exposure to Benzene

Back 64

Aplastic anemia

Front 65

Pulmonary stensosis, over-riding aorta, ventricular septal defect, RV hypertrophy are components of ____

Back 65

Tetralogy of Fallot

Front 66

This is a congenital heart disease that necessitates the presence of an atrial septal defect, a ventricular septal defect, or a patent ductus arteriosus to maintain life immediately after birth

Back 66

Transposition of the great vessels

Front 67

Carcinoid heart disease is MOST likely associated with _____

Back 67

Pulmonary valvular stenosis

Front 68

____ the patient is older with a sudden onset of sever headache, fever and malaise. Visible pulsating and enlarged temporal artery

Back 68

Giant cell arteritis

Front 69

___ is the m/c etiology of a restrictive type of cardiomypoathy

Back 69

Sarcoidosis

Front 70

___,___ and __ are congenital cardiac diseases that are initially acyanotic

Back 70

VSD, ASD, and PDA

Front 71

___ produces a murmur that is known as a "machinery" murmur

Back 71

Patent ductus arteriosus

Front 72

___ ___ ____ failure will produce a "nutmeg" liver

Back 72

Chronic right ventricular failure

Front 73

___ ___ the heart will be enlarged, but w/ asymmetric enlargemnt of the interventricular septum and on microscopy the fibers are found to be disorganized

Back 73

Hypertrophic cardiomyopathy

Front 74

___ m/c affects males of Middle Eastern descent that have ischemic changes in their toes and development of intermittent claudication (cig smoker)

Back 74

Buerger's disease

Front 75

___ is a neoplasm that demonstartes rapid mitotic rates "starry sky" in bones of the jaw or abdominal region

Back 75

Burkitt lymphoma

Front 76

A deficiency of folic acid produces what type of morphological type of anemia?

Back 76

Macrocytic, megaloblastic

Front 77

What is seen in the blood vessels in the kidney due to the development of malignant hypertension

Back 77

Hyperplastic arteriolosclerosis; and fibrinoid necrosis

Front 78

___ is a neurological problem in the spinal cord produced by def of B12

Back 78

Subacute combine degeneration

Front 79

__ produces "notching" of the ribs; weak femoral pulse and delayed

Back 79

Coarctation of the aorta

Front 80

___ is seen in elderly patients, associated w/ calcification of the arterial media, predominately seen in muscular arteries

Back 80

Monckeberg's arteriosclerosis

Front 81

___ is a tumor of blood vessels often associated with AIDs

Back 81

Kaposi's sarcoma

Front 82

__ __ is the bacteria that is seen in the devel of subacute bacterial endocarditis in a previously damaged, native heart valve

Back 82

Steptococcus viridians

Front 83

What is the best laboratory test for a mail experiencing chest pain and waiting 8 hours before lab testing

Back 83

CK-MB (should be elevated)

Front 84

Primary hemodynamic features of heart failure include ____ and ____

Back 84

decreased cardiac output; elevated systemic and pulmonary venous pressure

Front 85

Patient complains of transient ischmic type chest pain that occurs even at rest...related to vasospasm

Back 85

Prinzmetal's angina

Front 86

In complete transposition of the great vessels what happens?

Back 86

1) aorta arises from the right ventricle
2)pulmonary artery arises from the left ventricle
3)pulmonary artery is posterior to the aorta
4)cyanosis is apparent at birth

Front 87

What is the MOST common primary tumor of the heart in adults?

Back 87

Myxoma

Front 88

Polyarteritis nodosa of childhood, once found only in Japan (now spread), worst case MI

Back 88

Kawasaki disease

Front 89

a ___ ____ ___ is an intimal lesion consisting of a fibrous cap overlying a necrotic lipid-laden core

Back 89

Simple atherosclerotic plaque

Front 90

__ is a very small skin hemorhage

Back 90

Petechiae

Front 91

___ is the m/c complication following an acute MI and the one that most often causes death in the first 2.5 hours

Back 91

Cardiac dysrhythmia

Front 92

If a patient dies immediately following an MI what changes should be present under microscope at autopsy?

Back 92

NO visible changes

Front 93

___ ___ is abnormality of the heart valves that is typified by the presence of a "water hammer" pulse

Back 93

Aortic incompetence

Front 94

___ is a type of leukemia that has been associated with a specific abnormal chromosome (Philadelphia chromosome)

Back 94

Chronic Myeloid Leukemia

Front 95

____ causes a change in the size of the heart that is produced by systemic hypertension

Back 95

Left ventricular hypertorphy

Front 96

___ is a disease of heart muscle that is not only congentital, but also a genetic problem due to glycogen accumulation

Back 96

Pompe's

Front 97

Sever anemia and chronic pulmonary disease can cause ___ ___ ___ failure

Back 97

high output cardiac failure

Front 98

What is a result of an acute backward failure of the left ventricle

Back 98

Pulmonary edema

Front 99

What are congenital heart disease with a shunt?

Back 99

1. ASD
2. VSD
3. PDA
4. Eisenmenger's syndrome

Front 100

___ describes the m/c associated features of congenital heart disease

Back 100

Acyanotic with a shunt

Front 101

___ is a condition in which there is reversal of a previously left to right shunt thus cause cyanosis

Back 101

Eisenmenger's syndrome

Front 102

___ is the result of an acute backward failure of the left ventricle

Back 102

Pulmonary edema

Front 103

___ hemorrhage is caused by rupture of the congential aneurysm (berry aneurysm)

Back 103

Subarachnoid

Front 104

___ is the m/c valvular lesion that is found in chronic rheumatic heart disease

Back 104

Mitral stenosis

Front 105

___ is a disorder of cardiac valves that produce a "water hammer" pulse

Back 105

Aortic incompetence

Front 106

Large, hemorrhagic, friable vegtations are most likely found on the mitral valve in what disease?

Back 106

Subacute bacterial endocarditis

Front 107

___is a change in the size of the heart that is produced by systemic hypertension

Back 107

Left ventricular hypertrophy

Front 108

___ is the m/c infectious myocarditis in the US

Back 108

Coxackie B virus

Front 109

___ is the first to be elevated in the blood following an occlusion to the coronary artery/infarction

Back 109

Troponin

Front 110

Acute cardiac tamponade is a complication due to ___________

Back 110

rupture of the left ventricle

Front 111

____ and ___ will produce a saccular aneurysm

Back 111

berry and mycotic

Front 112

___ is a condition in which there is reversal of a previously left to right shunt thus causing cyanosis

Back 112

Eisenmenger's syndrome

Front 113

____ is most likely to produce a "nutmeg" liver

Back 113

Chronic right ventricular failure

Front 114

___ is the overall m/c/c of Congenital heart disease

Back 114

Idiopathic

Front 115

____ is a congenital heart disease that necessitates the presence of an atrial septal defect, a ventricular septal defect, or a patent ductus arteriosis to maintain life right after birth

Back 115

Transposition of the great vessels

Front 116

___ ___ ___ is a potential complication of syphilitic aortitis

Back 116

Aortic valve insufficiency

Front 117

__ __ of aortic arch is a complication of syphilitic aneurysm (Luetic)

Back 117

Proximal 1/3

Front 118

____ ___ is a microvascular change seen in malignant hypertension

Back 118

Hyperplastic arteriolosclerosis

Front 119

What lesion will there by large, red, friable vegitations on the heart valves?

Back 119

Acute bacterial endocarditis

Front 120

___ ___ causes lymphedma of the lower extremity (elephantitis)

Back 120

Wuchereria bancrofti

Front 121

___ ___ is a tumor of blood vessels associated with AIDs

Back 121

Kaposi's sarcoma

Front 122

Varicositiy veins are usually found in which places?

Back 122

Lower one third of the esophgus, hemorrhoidal veins, channels joining the superficial and deep veins of the legs

Front 123

Antibodies against ___ ___ cause the thorasic artery to be dilated with a "tree bark" appearance.

Back 123

Treponema pallidum (syphilitic aortitis)

Front 124

____ can produce a "machinery" murmur that is heard throughout the entire cardiac cycle

Back 124

Patent ductus arteriosus

Front 125

___ is a disease that is seen in infants and young children and commonly produces aneurysms on the coronary arteries

Back 125

Kawaski's arteritis

Front 126

___ produces an acute, necrotizing vasculitis that affects small arteries and veins esp in the upper respiratory tract, lungs and kidneys

Back 126

Wegener's granulomatosis

Front 127

__ is seen following flu-like illness in someone over 50 years old. Tender, inflamed nodule over the temporal artery.

Back 127

Giant cell arteritis

Front 128

__ is a disease that produces acute inflammatory changes in the wall of the artery that extends into the perivascular sheath and involves the whole neurovascular bundle..heavy smoker

Back 128

Buerger's disease

Front 129

__ is a chronic disease w/ acute inflammatory episodes that effects many muscular arteries anywhere in the body. The lesions will be of varying ages

Back 129

Polyarteritis nodosa

Front 130

____ and ___ are most likely to cause Chaga's disease

Back 130

Trypanosoma and toxoplasma

Front 131

___ __ __ may show "notching" of the ribs and the femoral pulse will be weak and delayed

Back 131

Coarctation of the aorta

Front 132

___ ___ is a heart that is found to be enlarged, but with asymmetric enlargment of the interventricular septum/disorganized

Back 132

Hypertrophic cardiomyopathy

Front 133

T/F every patient who has an MI have a heart attack

Back 133

false; not every MI will cause a heart attack

Front 134

___ is a tumor of blood vessels of normal luminal size that is a congenital malformation, m/c seen in skin and mucous membranes

Back 134

Capillary hemangioma

Front 135

The most common primary neoplasm found in the central nervous system are what?
A. Congenital neoplasms
B. Astrocytomas
C. Metastatic neoplasms
D. Oligodendrogliomas

Back 135

Metastatic neoplasms

Front 136

Lymphedema of an extremity (elephantiasis) can be the result of an infestation by which of the following parasites?
A. Plasmodium vivax
B. Entamoeba histolytica
C. Schistosoma mansoni
D. Wuchereria bancrofti

Back 136

D. Wuchereria bancrofti

Front 137

Which of the following is the type of congenital heart dz that is often associated with Turner's syndrome?
A. ASD
B. Marfan's syndrome
C. Transposition of the great vssels
D. Pompe's DZ
E. Coartation of the aorta

Back 137

E. Coarctation of the aorta

Front 138

The congenital heart dz that necessitates the presence of an atrial septal defect, or a patent ductus arteriosus to maintain life immediately after birth.
A. Atrial septal defect
B. Patent ductus arteriosus
C. Transposition of the great vessels
D. Ventricular septal defect
E. Tetralogy of Fallot

Back 138

C. Transposition of the great vessels

Front 139

The tumor of blood vessels that is associated with AIDS:
A. Cavernous hemangioma
B. Capillary hemangioma
C. Leiomyoma
D. Kaposi's sarcoma
E. Hemangioendothelioma

Back 139

D. Kaposi's sarcoma

Front 140

This DZ is seen mainly in infants and young children and commonly produces aneurysms on the coronary arteries, associate with myocardial infarctions.
A. Polyarteritis nodosa
B. Kawasaki's arteritis
C. Wegener's granulomatosis
D. Buerger's DZ
E. Giant cell arteritis

Back 140

B. Kawasaki's arteritis

Front 141

This produces an acute, necrotizing vasculitis that affects small arteries and veins especially in the upper respiratory tract, lungs, and kidneys
A. Polyarteritis nodosa
B. Kawasaki's arteritis
C. Wegener's granulomatosis
D. Buerger's DZ
E. Giant cell arteritis

Back 141

C. Wegener's Granulomatosis

Front 142

This is a chronic DZ with acute inflammatory episodes that effects many muscular arteries anywhere in the body. On biopsy of lesions from different organs the lesions can be shown to be of varying ages from recent through to healed (older lesions)
A. Polyarteritis nodosa
B. Kawasaki's arteritis
C. Wegener's granulomatosis
D. Buerger's DZ
E. Giant cell arteritis

Back 142

A. Polyarteritis nodosa

Front 143

This dz is commonly seen following what seems to be a flu-like illness in an individual about 50 yrs of age. On examination a tender, inflamed nodule may be felt on the temporal artery. The major risk of this condition is involvement of the ophthalamic artery and blindness.
A. Polyarteritis nodosa
B. Kawasaki's arteritis
C. Wegener's granulomatosis
D. Buerger's DZ
E. Giant cell arteritis

Back 143

E. Giant cell arteritis

Front 144

This dz produces acute inflammatory changes throughout the wall of the artery that extends into the perivascular sheath and involves the whole neurovascular bundle. This typically involves the vessels of the extremities and is seen in a young male who is a heavy cigarette smoker.
A. Polyarteritis nodosa
B. Kawasaki's arteritis
C. Wegener's granulomatosis
D. Buerger's DZ
E. Giant cell arteritis

Back 144

D. Buergers dz

Front 145

Which of the following is the etiology of the myocarditis known as Chaga's dz?
A. Acute rheumatic fever
B. Coxsackie virus infection
C. Trypanosoma cruzi infection
D. Diptheria
E. Sarcoidosis

Back 145

C. Trypanosoma cruzi infection

Front 146

Which of the following is the congenital dz of the heart that is characterized by having blood pressure in the brachial artery but low blood pressure in the femoral artery?
A. Atrial Septal Defect (ASD)
B. Ventricular Septal Defect (VSD)
C. Coarctation of the Aorta
D. Tetralogy of Fallot

Back 146

C. Coarctation of the Aorta

Front 147

Which of the following is the congenital heart dz that is the dz most commonly diagnosed in childhood?
A. Atrial septal defect
B. Tetralogy of Fallot
C. Transposition of the great vessels
D. Ventricular septal defect
E. Patent ductus arteriosus

Back 147

D. Ventricular septal defect

Front 148

Which of the following is the backward effect of sudden, acute LVF?
A. Pulmonary edema
B. Pulmonary congestion
C. Chronic passive congestion of the liver
D. Swollen ankles
E. Sudden, painful enlargement of the liver

Back 148

A. Pulmonary edema

Front 149

Which of the following produces saccular aneurysms?
A. Berry aneruysm
B. Atherosclerosis
C. Mycotic aneurysm
D. All of the above
E. A and C only

Back 149

E. A and C only

Front 150

The most serious complication of the lower extremity thrombophlebitis is:
A. Cerebral infaction
B. Myocardial ischemia
C. Renal infaction
D. Pulmonary infaction
E. Intestinal infarction

Back 150

D. Pulmonary infarction

Front 151

A 20 yo pt presents with sudden death on exertion. On exam of the heart it is found to be enlarged, but with asymmetric enlargement of the interventricular septum on microscopy the fibers are found to be disorganized. What is the msot liekly diagnosis in this patient?
A. Congestive cardiomyopathy
B. Hyertrophic cardiomyopathy
C. Myocardial infarctoin
D. Coxsackie virus myocarditis

Back 151

B. Hypertrophic cardiomyopathy

Front 152

The tumor of blood vessels of normal luminal size that is really a congenital malformation, and is seen most commonly in the skin and mucous membranes (sometimes referred to as a strawberry birthmark)?
A. Cavernous hemangioma
B. Capillary hemangioma
C. Leiomyoma
D. Kaposi's sarcoma
E. Hemangioendothelioma

Back 152

B. Capillary hemangioma

Front 153

Which of the following complications that can follow a myocardial infarction can produce mitral incompetence with regurgitation?
A. Arrhythmias
B. Rupture of a papillary muscle
C. Cardiac aneurysm
D. Thromboemolism
E. Rupture through the chamber wall

Back 153

B. Rupture of a papillary muscle

Front 154

In myelomeningocele the protrusion of the defective spinal canal contains:
A. Meninges and displaced parts of the cerebellum
B. Meninges and vertebral bodies
C. Meninges and portion of spinal cord
D. Meninges only
E. Skin only

Back 154

C. Meninges and portion of spinal cord

Front 155

Ruptured saccular congenital aneurysms, so called berry aneruysms, cause hemorrhage that is best classified as:
A. Subdural
B. Subarachnoid
C. Epidural
D. Intracerebral
E. Intraventricular

Back 155

B. Subarachnoid

Front 156

Trauma to the brain with the resultant tear of the meningeal veins and a slow venous hemorrhage is most likely to result in which of the following?
A. Subarachnoid hemorrhage
B. Subdural hematoma
C. Epidural hematoma
D. All of the above

Back 156

B. Subdural hematoma

Front 157

The most common cause of acute cor pulmonale is:
A. Myocardial infarction
B. Intravenous drug use
C. Emphysema
D. Pulmonary embolism (acute)

Back 157

D. Pulmonary embolism (acute)

Front 158

Which of the following is the most common valvular lesion that is found in the chronic Rheumatic heart dz?
A. Mitral stenosis
B. Mitral incompetence
C. Aortic stenosis
D. Aortic incompetence
E. Tricuspid stenosis

Back 158

A. Mitral stenosis

Front 159

The disorder of cardiac valves that produces a "water hammer" pulse is which of the following?
A. Mitral stenosis
B. Mitral incompetence
C. Aortic stenosis
D. Aortic incompetence

Back 159

D. Aortic incompetence

Front 160

The most common cause of an infectious myocarditis in the US is:
A. Toxoplasma gondii
B. Trypanosoma cruzi
C. Coxsackie B virus
D. Treponema pallidum
E. Streptococcus pneumoniae

Back 160

C. Coxsackie B virus

Front 161

Which of the following is the first to be elevated in the bloodstream following occlusion of a coronary artery and infarction of myocardial tissue?
A. Tropomyosin
B. AST
C. CPK-MB fraction
D. LDH
E. Troponin

Back 161

C. CPK-MB fraction

Front 162

Acute cardiac tamponade is typically a complication due to which of the following events or conditions that occurs following a myocardial infarction?
A. Rupture of papillary muscle
B. Mural thrombosis in the L ventricle
C. Ventricular aneurysm
D. Rupture of the L ventricle
E. Ventricular fibrillation

Back 162

D. Rupture of the L ventricle

Front 163

Microscopic examination of the heart from a patient who died six hours later following a myocardial infarction would be expected to show which of the following?
A. No visible change
B. Eosinophilic cytoplasm and nuclear pyknosis
C. Acute inflammatory cells
D. Granulation tissue
E. Scar tissue

Back 163

A. No visible change

Front 164

Not every patient who has a myocardial infarction has a heart attack?
A. T
B. F

Back 164

A. True

Front 165

Which of the following is associated with the development of a high output cardiac failure?
A. Ischemic heart dz
B. Myocarditis
C. Thyrotoxicosis
D. Dilated cardiomyopathy
E. Cor pulmonale

Back 165

E. Cor pulmonale

Front 166

Which of the following is not associated with an increased risk of atherosclerosis?
A. Increased serum HDL concentration
B. Hypertension
C. Diabetes mellitus
D. Sedentary lifestyle
E. Female following menopause

Back 166

A. Increased serum HDL concentration

Front 167

Which one of the following conditions is associated with paradoxical embolism?
A. Rheumatic heart dz
B. Pulmonary stenosis
C. Pulmonary hypertension
D. Eisenmenger's syndrome
E. Infective endocarditis

Back 167

D. Eisenmengers syndrome

Front 168

The type of bacteria that is associated very commonly with the development of subacute bacterial endocarditis in a previously damaged, natvie heart valve?

Back 168

Strep viridans

Front 169

What is a result of an acute backward failure of the right ventricle?

Back 169

Acute, painful hepatomegaly

Front 170

The characteristic endocardial lesion of acute rheumatic heart dz is the?

Back 170

Aschoff bodies

Front 171

The type of angina that occurs at rest and is not directly related to vasospastic event:
A. Typical, stable angina
B. Variable, unstable angina
C. Prinzmetals angina

Back 171

Variable, unstable angina

Front 172

50% of all pts dies within 1-2 hrs following a MI. The most common cause of death is___?

Back 172

Thromboembolism

Front 173

Which of the following is the most commonly associated with the development of an Eisenmenger complex?
A. ASD
B. VSD
C. PDA
D. Coarctation of the Aorta
E. Transposition of the great vessel

Back 173

A. ASD

Front 174

The usual etiology of an acute bacterial endocarditis includes:
A. Steptococcus viridans
B. Presence of staphlococcus aureus
C. Pre-existing cardiac defect
D. All of the above

Back 174

B. Presence of staphlococcus aureus

Front 175

If the myocardium ruptures following a myocardial infarction, what abnormal process occurred to cause the rupture?

Back 175

Liquefactive necrosis

Front 176

Which of the following are known to produce a restrictive type of cardiomyopathy?
A. Amyloidosis
B. Alcoholism
C. Pregnancy related

Back 176

A. Amyloidosis

Front 177

Which of the following is the overall mc cause of congenital heart dz?

Back 177

Idiopathic

Front 178

Which of the following is not a potential complication of syphilitic arotitis?
A. Aortic valve insufficiency
B. Stenosis of the orifices of the coronary arteries
C. Dissecting aneurysm of distal one third of the aorta
D. Myocardial ischemia

Back 178

D. Myocardial ischemia

Front 179

All of the following are examples of low output cardiac failure, EXCEPT:
A. Anemia
B. Congestive heart failure
C. Cardiogenic shock
D. Idiopathic dilated cardiomyopathy

Back 179

A. Anemia

Front 180

Which of thses is a congenital cardiac defect with a shunt that is cyanotic at birth?
A. VSD
B. Tetrology of Fallot
C. ASD
D. Patent Ductus Arteriosus

Back 180

B. Tetralogy of Fallot

Front 181

Rheumatic fever is a non-infectious complication following:
A. Staphlococcus pharyngitis
B. Streptococcus pharyngitis
C. Tuberculosis of the lung
D. Glomerulonephritis
E. Infective endocarditis

Back 181

B. Strep pharyngitis

Front 182

Malignant hypertension causes which change in the microvasculature of the kidney?

Back 182

Hyperplastic arteriolosclerosis

Front 183

What is a typical lesion that is seen on the heart valves in the acute bacterial endocarditis?

Back 183

Large, red, friable vegetations

Front 184

The type of vessel dz that is commonly seen as an incidental finding on radiology and that is a normal feature of aging?

Back 184

Monckeberg's medial calcific sclerosis

Front 185

Which of the following is the congenital heart dz that produces a "machinery" murmur that is heard throughout the entire cardiac cycle?
A. Atrial septal defect
B. Patent ductus arteriosus
C. Transposition of the great vessels
D. Ventricular septal defect
E. Tetralogy of Fallot

Back 185

B. Patent ductus arteriosus

Front 186

Which of the following is/are extrinsic cause(s) of hemolytic anemia?
A. Spherocytosis
B. Malaria
C. G6PD deficiency
D. All of the above are intrinsic causes of hemolytic anemia

Back 186

B. Malaria

Front 187

Which of the following features in NOT associated with the Tetralogy of Fallot?
A. Malalignment ventricular septal defect
B. Right-venricular hypertrophy
C. Pulmonary valve stenosis
D. Sinus venosus defect
E. Overriding aorta

Back 187

D. Sinus venosus defect

Front 188

The finding of a "nutmeg" pattern to the cut surface of the liver suggests which one of the following conditions?
A. Luetic (syphilitic) aortitis
B. Chronic right heart failure
C. Acquired immunodeficiency syndrome
D. Pulmonary embolus
E. Myocardial infarction

Back 188

B. Chronic right heart failure

Front 189

Physical exam of an asymptomatic 2 year old child reveals a low pitched cardiac murmur. An echocardiogram shows presence of the ostium secundum, a type of ASD, with a 1-cm diameter defect. Which of the following clinical abnormalities is most likely to be found in this child?
A. Pulmonary hypertension
B. Pericardial effusion
C. Left-to-right shunt
D. Mural thrombosis
E. Cyanosis

Back 189

A. Pulmonary hypertension

Front 190

Refers to a cyanosis occuring in adulthood due to a shunt shift from left-to-right to right-to-left

Back 190

Eisenmenger syndrome

Front 191

What is the most common congenital cardiac anomaly?

Back 191

VSD

Front 192

"machine-like" murmer

Back 192

Patent ductus areriosus

Front 193

Associated with turner syndrome

Back 193

Coarctation of aorta

Front 194

"notching of ribs"

Back 194

Coarctation of aorta

Front 195

"fish-mouth" appearance; usually caused by rheumatic heart disease

Back 195

mitral stenosis

Front 196

"water-pump" pulse

Back 196

Aortic incompetence/regurgitation

Front 197

T/F a Right to left shunt produces cyanosis

Back 197

True; the blood is going from the right side of the heart to the left= bypassing the lungs= baby turns blue

Front 198

T/F a Left to right shunt produces cyanosis

Back 198

False; it produces acyanosis

Front 199

___ ___ is caused by staph aureus or strep pyogenes

Back 199

Acute endocarditis

Front 200

__ ___ is caused by Staph epi. or strep. viridans

Back 200

Subacute endocarditis

Front 201

__ __ __ produces Aschoff bodies

Back 201

Acute rheumatic fever

Front 202

__ ___ __ produces small, pale, solid vegitations

Back 202

Acute rheumatic fever

Front 203

__ __ produces friable, infective, hemorrhagic vegetations

Back 203

Subacute endocarditis