ETP- cardiology quiz

Question 1

A patient is diagnosed with 3rd degree heart block after he presents with multiple episodes of syncope and generalized fatigue. Which of the following statements are most consistent with 3rd degree heart block?

Question 1 Answer

a.
Patient’s with 3rd degree heart block have frequent premature ventricular contractions (PVCs)

b.
Patients with 3rd degree heart block often exhibit tachycardia associated with reentry from the ventricle to the atria

c.
The major ECG finding with 3rd degree heart block is an prolonged P-R interval

d.
The atrial heart rate could be normal, but the ventricular rate is slower than the atrial rate.

Answer 1

d.
The atrial heart rate could be normal, but the ventricular rate is slower than the atrial rate.

Question 2

A 38-year-old woman with a 2-year history of severe menorrhagia due to multiple uterine leiomyomas presents to her physician with complaints of exhaustion and dizziness when rising from a lying or sitting position. She reports that she has been bleeding more heavily than usual during her current menstrual period. Vital signs are as follows: heart rate is 106 beats/min at rest, respiratory rate is 20 breaths/min, blood pressure is 124/82 mm Hg seated, oxygen saturation is 97%, temperature is 37.2 Celsius.

Choose the true statement regarding baroreceptors.

Question 2 Answer

a.
In response to low pressures, carotid baroreceptors will increase their firing rate

b.
Afferents from carotid baroreceptors are carried by the glossopharyngeal nerve (CN IX)

c.
The most physiologically relevant baroreceptors are found at the junction of the carotid and subclavian arteries.

d.
The carotid baroreceptors are found in structures known as carotid bodies

Answer 2

b.
Afferents from carotid baroreceptors are carried by the glossopharyngeal nerve (CN IX)

Question 3

A 17-year-old high school basketball player collapses during a game and is unresponsive for 5 minutes until she is revived on the court. She is taken to the Emergency Room, and she is found to have a laterally displaced cardiac apex (5th intercostal space, anterior axillary line) as well as a systolic murmur. An echocardiogram reveals cardiomegaly and a thickened myocardium, particularly in the ventricular septum.

What is the most likely diagnosis?

Question 3 Answer

a.
Rheumatic heart disease

b.
Hypertrophic obstructive cardiomyopathy (HOCM)

c.
Dilated cardiomyopathy

d.
Congenital left ventricular hypertrophy

Answer 3

b.
Hypertrophic obstructive cardiomyopathy (HOCM)

Question 4

A 62-year-old man presents to the Emergency Room with a 23-minute history of progressively worsening mid-sternal chest pain. The pain is crushing in character with a steadily increasing severity such that he rates his pain as a 9/10, even though he has been at rest for the last 8 minutes. The pain radiates to his jaw and he is diaphoretic and nauseous. An ECG reveals 4 mm S-T depression in leads I, aVL, and precordial leads V3 - V6.

Which coronary vessel is most likely to be occluded during a myocardial infarction?

Question 4 Answer

a.
Left circumflex artery, a branch of the left coronary artery

b.
Posterior interventricular artery, a branch of the right coronary artery

c.
Anterior intraventricular artery, a branch of the left coronary artery

d.
Right marginal artery, a branch of the right coronary artery

Answer 4

c.
Anterior intraventricular artery, a branch of the left coronary artery