Documente Academic
Documente Profesional
Documente Cultură
com
http://geekymedics.com/cardiac-pathology-quiz/
Want to put your knowledge of cardiac pathology to the test? Give this quiz a try!
Question 1
What are the characteristics of stable angina?
A
Rupture of an atherosclerotic plaque with thrombosis and incomplete occlusion of a coronary artery
ST segment elevation
ST segment depression
C Absent P waves
D Prolonged PR interval
Question 3 Explanation:
ST elevation is due to transmural ischemia which occurs in prinzmetal angina. Prinzmetal angina is episodic
chest pain that occurs at rest. It is due to coronary artery vasospasm.
Question 4
What is the most commonly involved coronary artery in myocardial infarction (MI)?
A
AST
LDH
C Troponin I
D CK-MB
Question 5 Explanation:
Troponin I is the gold standard for MI detection. Levels rise 2-4hrs after infarction, peak at 24hrs and return to
normal by 7-10 days. CK-MB elevations normalize within 3 days, allowing for detection of reinfarction. AST & LDH
were previously used to detect MI, prior to replacement by troponin I and CK-MB.
Question 6
Fibrinolysis and angioplasty are treatment options for MIs. An MI is usually due to rupture of an atherosclerotic
plaque with thrombosis and complete occlusion of a coronary artery. These treatments will open the blocked
vessels. What is the complication/s of fibrinolysis/angioplasty?
A
Palpitations
C Tachycardia / tachypnoea
D Hypertension
Question 6 Explanation:
Reperfusion injury occurs when there is free radical damage to myocytes. When the vessel is unblocked, there is
a flow of oxygen and inflammatory cells into the myocardium which generate the free radicals. Contraction band
necrosis is the hypercontraction of myofibrils due to the calcium influx that occurs when there is reperfusion of
irreversibly damaged cells.
Question 7
What is the key complication in the first 24 hours of an MI?
A
Fibrinous pericarditis
C Arrhythmia
D Mitral insufficiency
Question 7 Explanation:
Arrhythmia is the key complication in the first 4 to 24hrs after a MI. Coagulative necrosis is occurring (pyknosis,
karyorrhexis, karyolysis). This necrosis can damage the hearts conduction system resulting in arrhythmias.
Question 8
What gross histological change correlates with white blood cells (WBCs) invasion into cardiac tissue during the
first week after an MI?
A
Yellow pallor
Dark discolouration
C White scar
D Red border around yellow pallor
Question 8 Explanation:
The yellow pallor is indicative of inflammation characterised by neutrophils and macrophages within the
myocardium. In the first 24 hours after an MI, there is dark discolouration due to coagulative necrosis. During the
first week, there is inflammation signified by the yellow pallor. After which (1 to 3 weeks), granulation tissue
emerges marked by a red border entering from edge of infarct. Months after, white scar forms- this is due to
fibrosis.
Question 9
What is the main complication/s of the macrophage phase in 4 to 7 days after an MI?
A
Fibrinous pericarditis
Arrhythmia
thereby weakening cardiac tissue making it more susceptible to rupture. If the ventricular free wall is ruptured, a
cardiac tamponade will develop. Rupture of the interventricular septum leads to a shunt and rupture of the
papillary muscle leads to mitral insufficiency.
Question 10
What is the most common cause of right sided heart failure?
A
C Hypothyroidism
Question 10 Explanation:
Left sided heart failure (LHF) is the most common cause of right sided heart failure (RHF). There is a multitude of
causes of LHF including ischemia, hypertension, dilated cardiomyopathy, restrictive cardiomyopathy and
myocardial infarction. Chronic lung disease(B) and left to right shunt(C) are also causes of RHF.
Question 11
What is the most common cause of sudden cardiac death (SCD)?
A
Cocaine abuse
C Cardiomyopathy
D Ventricular arrhythmia
Question 11 Explanation:
SCD is unexpected death due to cardiac disease. It occurs without symptoms or within 1 hour after symptoms
arise. It is usually due to fatal ventricular arrhythmia- most patients have pre-existing severe atherosclerosis.
Question 12
Ventricular septal defect (VSD) is the most common congenital heart defect, what condition is it most likely to be
associated with?
A
Congenital rubella
Down Syndrome
Atrial septal defect (ASD), Patent ductus arteriosus (PDA), Ventricular septal defect (VSD)
Truncus arteriosus, Transposition of great vessels, Tricuspid atresia, Tetralogy of Fallot, Total anomalous
pulmonary venous return (TAPVR)
It occurs when a right to left shunt becomes left to right due to a build-up of pressure on the left side of the
heart.
Hypertrophic Cardiomyopathy
Restrictive Cardiomyopathy
C Dilated Cardiomyopathy
Question 15 Explanation:
Hereditary hypertrophic cardiomyopathy is due to autosomal dominant mutations in beta myosin heavy chain. It
causes massive hypertrophy of the left ventricle which results in diastolic dysfunction and subaortic stenois. Thus,
there is an increased risk for ventricular arrhythmias which is a common cause of sudden death in young
athletes.
Question 16
What heart condition is Marfans syndrome associated with?
A
Endocarditis
Restrictive Cardiomyopathy
C Arrhythmia
D Aortic dissection
Question 16 Explanation:
Aortic dissection begins as an intimal tear which then allows for blood to pass through the weakened media of the
aortic wall. The most common cause of aortic dissection is hypertension but it can also be caused by connective
tissue diseases such as Marfans syndrome and Ehlers-Danlos syndrome. Marfans syndrome is caused by a
gene mutation in FBN1 on chromosome 15 leading to a defect in fibrillin (a glycoprotein that forms a sheath
around elastin). It causes cystic medial necrosis of the media which is due to fragmentation of elastic laminae with
accumulation of myxoid material in aortic media leading to aortic dissection. Other cardiac pathology associations
include aortic valve incompetence and mitral valve prolapse. Other findings of the syndrome are tall stature with
long extremities, hypermobile joints, pectus excavatum, arachnodactyly and upward & temporal subluxation of
lenses.
Question 17
What heart condition is Turners syndrome associated with?
A
Tricuspid atresia
Truncus arteriosus
What is the most frequent etiologic agent of acute infective endocarditis in IV drug abusers?
A
Streptococcus viridans
Staphylococcus aureus
C Staphylococcus epidermidis
D Streptococcus bovis
Question 19 Explanation:
Staph aureus is the most common causative agent of endocarditis in IVDUs. It is highly virulent and affects
native, undamaged valves, especially the tricuspid. It creates large vegetations that destroy the valves, often
leading to tricuspid regurgitation. Strep viridans is the most common overall cause of endocarditis; it is low
virulence and infects previously damaged valves. Staph epidermidis infects prosthetic valves. Strep bovis causes
endocarditis in patients with underlying colon cancer.
Question 20
What is the most common cause of mitral stenosis?
A