Robbins

Question 1

component of the conduction system that has a gatekeeper function

Answer 1

AV node

Question 2

what pattern of hypertrophy -new sarcomeres are predominantly assembled in parallel to the long axes of cells, expanding the cross-sectional area of myocytes in ventricles and causing a concentric increase in wall thickness.

Answer 2

pressure-overload hypertrophy

Question 3

what pattern of hypertrophy?
-is characterized by new sarcomeres being assembled in series within existing sarcomeres

Answer 3

volume-overload hypertrophy

Question 4

best measure of hypertrophy in dilated hearts

Answer 4

heart weight

Question 5

T/F myocyte hypertrophy is accompanied by a proportional increase in capillary numbers

Answer 5

False

Question 6

____ is associated with volume-load hypertrophy accompanied by increases in capillary density

Answer 6

aerobic exercise

Question 7

what physiologic mechanism?
Increased filling volumes dilate the heart, thereby increasing actin-myosin cross-bridge formation, and enhancing contractility and stroke volume.

Answer 7

Frank-Starling mechanism

Question 8

the most common known genetic cause of CHD is

Answer 8

trisomy 21 (Down syndrome)

Question 9

deletion of chromosome 22q11.2 casuse CHD in a syndrome called

Answer 9

DiGeorge syndrome

Question 10

deletion of this transcription factor gene in DiGeorge syndrome causes CHD

Answer 10

TBX1

Question 11

pathway associated with a variety of congenital heart defects

Answer 11

Notch pathway

Question 12

gene mutation in bicuspid aortic valve

Answer 12

NOTCH1

Question 13

gene mutations in tetralogy of Fallot (2)

Answer 13

JAG1 and NOTCH2

Question 14

right-to-left shunts cause (5)

Answer 14

hypoxemia and cyanosis
paradoxical emobolism
polycythemia
clubbing
hypertrophic osteoarthropathy

Question 15

Most important right-to-left shunts (5)

Answer 15

-tetralogy of Fallot (TOF)
-transposition of the great arteries (TGA)
-persistent truncus arteriosus
-tricuspid atresia
-total anomalous pulmonary venous connection

Question 16

left-to-right shunts increase _____ blood flow

Answer 16

pulmonary

Question 17

In left-to-right shunts, pulmonary vascular resistance eventually approaches systemic levels, and the shunt becomes a right-to-left shunt that introduces poorly oxygenated blood into the systemic circulation. This is called ______ syndrome

Answer 17

Eisenmenger syndrome

Question 18

left-to-right shunts (3)

Answer 18

ASD
VSD
PDA

Question 19

CHD category where there is abnormal narrowing of chambers, valves, or blood vessels

Answer 19

obstructive

Question 20

obstructive CHDs (3)

Answer 20

coarctation of the aorta
aortic valvular stenosis
pulmonary valvular stenosis

Question 21

the most common CHD category

Answer 21

left-to-right shunt

Question 22

most common type of ASD

Answer 22

Secundum ASD

Question 23

Left-to-right shunt that is usually asymptomatic until adulthood

Answer 23

ASD

Question 24

patent foramen ovale closes permanently in ~80% by age

Answer 24

2

Question 25

most common form of CHD

Answer 25

VSD

Question 26

what causes irreversible obstructive pulmonary vascular disease

Answer 26

prolonged pulmonary arterial vasoconstriction stimulates the development of irreversible obstructive intimal lesions analogous to the arteriolar changes seen in systemic hypertension

Question 27

ductus arteriosus constricts and and closes in response to (3)

Answer 27

-increased arterial oxygenation -decreased pulmonary vascular resistance -declining local levels of prostaglandin E2

Question 28

the most common right-to-left shunt

Answer 28

TOF

Question 29

four cardinal features of TOF

Answer 29

vsd subpulmonic stenosis overiding aorta right ventricular hypertrophy

Question 30

CHD that produces ventriculoarterial discordance (the ventricle outflow going to the wrong outflow vessel)

Answer 30

Transposition of the Great Arteries (TGA)

Question 31

the aorta arises from the right ventricle, and the pulmonary artery emanates from the left ventricle (ventriculoarterial discordance). The atrium-to-ventricle connections are normal (concordant), with the right atrium joining the right ventricle and the left atrium emptying into the left ventricle.

Answer 31

dextro-TGA

Question 32

TGA that does not lead to cyanosis

Answer 32

levo-TGA

Question 33

2 forms of the obstructive CHD, coarctation of the aorta

Answer 33

infantile with PDA (preductal coarctation) adult (postductal coarctation)

Question 34

main abnormality in hypoplastic left heart syndrome

Answer 34

aortic stenosis or atresia

Question 35

an imbalance between myocardial supply (perfusion) and cardiac demand for oxygenated blood

Answer 35

Ischemic heart disease (IHD)

Question 36

how does tachycardia decrease oxygen functional supply to the heart

Answer 36

by decreasing the relative time spent in diastole, when cardiac perfusion occurs

Question 37

is typically cited as the threshold for symptomatic ischemia precipitated by exercise (characteristically manifesting as exertional angina).

Answer 37

critical stenosis (>70%)

Question 38

obstruction of ___% of the cross-sectional area of the lumen generally leads to inadequate coronary blood flow, even at rest.

Answer 38

90

Question 39

earliest detectable feature of myocyte necrosis

Answer 39

disruption of the integrity of the sarcolemmal membrane

Question 40

Irreversible injury of ischemic myocytes first occurs in the

Answer 40

subendocardial zone

Question 41

An infarct usually achieves its full extent within

Answer 41

3-6 hours

Question 42

Transmural infarctions occur when there is occlusion of an

Answer 42

epicardial vessel in the absence of any therapeutic intervention

Question 43

In the subendocardial infarcts that occur as a result of global hypotension, myocardial damage is often ____

Answer 43

circumferential

Question 44

time interval when dark mottling is grossly apparent after MI

Answer 44

12-24 hours

Question 45

time interval when scarring is grossly complete after MI

Answer 45

> 2 mos

Question 46

Owing to the characteristic electrocardiographic changes resulting from myocardial ischemia or necrosis in various distributions, a transmural infarct is sometimes referred to as an

Answer 46

ST-elevation myocardial infarct (STEMI)

Question 47

Owing to the characteristic electrocardiographic changes resulting from myocardial ischemia or necrosis in various distributions, a subendocardial infarct is sometimes referred to as

Answer 47

non–ST-elevation infarct (NSTEMI)

Question 48

The most common of all valvular abnormalities and is usually the consequence of age-associated “wear and tear” of either anatomically normal valves or congenitally bicuspid valves

Answer 48

Calcific Aortic Stenosis

Question 49

The characteristic anatomic change in MVP is

Answer 49

ballooning (hooding) of the mitral leaflets

Question 50

The key histologic change in MVP

Answer 50

myxomatous degeneration of spongiosa layer

Question 51

Distinctive lesions in the heart in rheumatic fever

Answer 51

aschoff bodies

Question 52

five most common tumors of the heart in descending order of frequency

Answer 52

myxomas fibromas lipomas papillary fibroelastomas rhabdomyomas

Question 53

most common primary tumor of the adult heart

Answer 53

myxomas

Question 54

About 90% of cardiac myxomas arise in the

Answer 54

atria

Question 55

favored site of origin of a myxoma in the atria

Answer 55

fossa ovalis

Question 56

usual locations of fibroelastomas

Answer 56

valves

Question 57

the most frequent primary tumor of the pediatric heart

Answer 57

rhabdomyomas

Question 58

Approximately one-half of cardiac rhabdomyomas are due to sporadic mutations; the other 50% of cases are associated with _____ with mutations in (2)

Answer 58

tuberous sclerosis, TSC1 and TSC 2

Question 59

The TSC1 and TSC2 proteins (hamartin and tuberin, respectively) function in a complex that inhibits the activity of_______ a kinase that stimulates cell growth and regulates cell size.

Answer 59

mammalian target of rapamycin (mTOR)

Question 60

Metastases can reach the heart and pericardium by

Answer 60

retrograde lymphatic extension from the mediastinum (mostly carcinomas), by hematogenous seeding (many tumors), by direct contiguous extension (of intrathoracic tumors), or by venous extension (tumors of the kidney or liver)