Week 4

Question 1

Condition where an acyanotic heart defect initially causes a left to right shunt which over time leads to pulmonary hypertension, leading to a reversal of the shunt resulting in cyanosis is known as:

Ebstein’s Anomaly
Ventricular septal defect
Eisenmenger syndrome
Tricuspid atresia

Answer 1

Eisenmenger syndrome

Question 2

In which cyanotic congenital heart defect do the aorta and pulmonary artery switch location?

Ebstein’s anomaly
Transposition of the great vessels
Eisenmenger syndrome
Tetralogy of Fallot

Answer 2

Transposition of the great vessels

Question 3

Which cyanotic congenital heart defect has the pulmonary veins draining into the right atrium instead of the left atrium?

Transposition of the great vessels
Total anomalous pulmonary venous return
Tricuspid atresia
Pulmonary stenosis

Answer 3

Total anomalous pulmonary venous return

Question 4

Which cyanotic congenital heart defect is characterized by an overriding aorta, ventricular septal defect, pulmonary stenosis and right ventricular hypertrophy?

Patent ductus arteriosus
Transposition of the great vessels
Tetralogy of Fallot
Hypoplastic left ventricle

Answer 4

Tetralogy of Fallot

Question 5

Which defect is often present with truncus arteriosus?

Atrial septal defect
Overriding aorta
Ventricular septal defect
Pulmonary atresia

Answer 5

Ventricular septal defect

Question 6

Which is the most common cyanotic congenital heart defect?

Transposition of the great vessels
Tetralogy of Fallot
Ventricular septal defect
Tricuspid atresia

Answer 6

Tetralogy of Fallot

Question 7

Which rare cyanotic heart defect has only one vessel leading out of the myocardium, instead of a separate pulmonary artery and aorta?

Tricuspid atresia
Truncus arteriosus
Transposition of the great vessels
Ebstein’s anomaly

Answer 7

Truncus arteriosus

Question 8

Which statement best describes Ebstein’s Anomaly?

Downward displacement of the mitral valve into the right ventricle
Downward displacement of the tricuspid valve into the right ventricle
Absence of the pulmonic valve
Absence of the tricuspid valve

Answer 8

Downward displacement of the tricuspid valve into the right ventricle

Question 9

Which statement best describes Hypoplastic Left Heart Syndrome?

Underdeveloped left ventricle, mitral valve, aortic valve, ascending aorta

Overdeveloped left ventricle, mitral valve, aortic valve, ascending aorta

Underdeveloped left ventricle, tricuspid valve, pulmonary valve

Rigid myocardium lacking contractility

Answer 9

Underdeveloped left ventricle, mitral valve, aortic valve, ascending aorta

Question 10

Which statement best describes the shunt in cyanotic defects?

Right to left
Left to right
Antegrade
Bidirectional

Answer 10

Right to left

Question 11

Choose the MOST common condition that heart failure results from, approximately how many new cases are diagnosed per year in the U.S., and the most common symptoms.

a. Fatigue, shortness of breath, volume overload
b. Chest pain and edema
c. Dizziness, pedal pain, unexplained headaches
d. Any condition of impaired right ventricular function
e. 500 000
f. 200 000
g. Any condition of impaired left ventricular function
h. Diabetes mellitus
i. 1 000 000

Answer 11

Any condition of impaired left ventricular function,
500 000,
Fatigue, shortness of breath, volume overload

Question 12

Excess renin secretion leads to formation of:

a. Endothelin-1

b. B-type natriuretic peptide

c. Angiotensin II

d. Antidiuretic hormone

Answer 12

c. Angiotensin II

Question 13

What is the earliest visual presentation of an atherosclerotic lesion?

a. Fatty streak

b. Plaque

c. Thrombus

d. Emboli

Answer 13

a. Fatty streak

Question 14

Signs and symptoms of this congenital condition may include: differential cyanosis (upper body well perfused, lower half under-perfused especially during exertion), claudication in lower extremities only, weak and delayed femoral pulses, elevated BP in upper body, mid-systolic ejection murmur.

a. Pulmonic stenosis
b. Tetralogy of Fallot
c. Transposition of the Great Arteries
d. Coarctation of the aorta

Answer 14

d. Coarctation of the aorta

Question 15

What do the listed conditions all have in common?

Tetralogy of Fallot
Ebstein’s Anomoly
Tricuspid Atresia
Pulmonary Atresia
Transposition of the Great Arteries
Total Anomalous Pulmonary Venous Return
Hypoplastic Left Heart Syndrome
Truncous Arteriosus
Double-Outlet Right Ventricle

a. They are all acyanotic lesions
b. They all have increased pulmonary blood flow
c. They all have decreased pulmonary blood flow
d. They are all cyanotic lesions

Answer 15

d. They are all cyanotic lesions

Question 16

What percentage of patients with PAD have clinically significant CAD?

a. 10%
b. 20%
c. 40%
d. 90%

Answer 16

c. 40%

Question 17

Characteristics of a true aortic aneurysm:

a. Dilation of at least 2 layers of the vessel
b. Diameter of a portion of the aorta has increased by at least 50%
c. Dilation of all 3 layers of the vessel
d. Occur most commonly in the abdominal aorta
e. Diameter of a portion of the aorta has increased by at least 80%
f. Always fusiform

Answer 17

Diameter of a portion of the aorta has increased by at least 50%,
Dilation of all 3 layers of the vessel,
Occur most commonly in the abdominal aorta

Question 18

TRUE or FALSE

An uncomplicated ASD causes volume overload and enlargement of the left atrium and left ventricle.

Answer 18

False

Question 19

Raynaud Phenomenon most commonly presents in:

a. Women aged 20-40
b. Children
c. Women aged 60-80
d. Men aged 40-60

Answer 19

a. Women aged 20-40

Question 20

TRUE or FALSE

VSDs can cause Eisenmenger syndrome.

Answer 20

TRUE

Question 21

Which congenital syndromes are associated with aortic aneurysms and aortic dissections?
Choose all that apply.

a. Patent Ductus Arteriosus
b. Tetralogy of Fallot
c. Marfan Syndrome
d. Familial Hypercholesterolemia
e. Transposition of the Great Arteries
f. Vascular type of Ehler’s Danlos Syndrome

Answer 21

Vascular type of Ehler’s Danlos Syndrome,
Marfan Syndrome

Question 22

What is the name of the group of predisposing factors for venous thrombosis?

a. Cardiac Cachexia
b. Pulsus Paradoxus
c. Beck’s Triad
d. Metabolic Syndrome
e. Virchow’s Triad

Answer 22

e. Virchow’s Triad

Question 23

TRUE or FALSE

Systolic blood pressure predicts cardiovascular events more accurately than diastolic pressure.

Answer 23

True

Question 24

During a normal cardiac cycle, blood flow through the coronary arteries is limited by:

a. O2 level in the blood
b. Depolarization
c. Lack of resistance during diastole
d. Myocardial contraction/systole

Answer 24

d. Myocardial contraction/systole

Question 25

Pulmonary embolism is most often caused by a thrombosis that travels from: a. A deep vein b. An abdominal aortic aneurysm c. The left atrium d. Within the lung itself

Answer 25

a. A deep vein

Question 26

Eisenmenger syndrome characteristics: Choose all that apply. a. Begins with chronic left to right shunting from a congenital cardiac defect b. Can cause digital clubbing c. ECG and echo show left ventricular and left atrial hypertrophy d. Can cause cyanosis e. Apical displacement of the septal and posterior tricuspid valve leaflets f. People are born with Eisenmenger syndrome

Answer 26

Begins with chronic left to right shunting from a congenital cardiac defect, Can cause cyanosis, Can cause digital clubbing

Question 27

Risk factors for developing varicose veins include: Choose all that apply. a. Female gender b. Prolonged standing c. Frequent walking d. Obesity e. Male gender f. Pregnancy g. Genetic component h. Grapefruit consumption

Answer 27

Female gender, Prolonged standing, Pregnancy, Obesity, Genetic component

Question 28

Match the degree of coronary artery stenosis with the most likely symptoms 60% 70% 80% 90% Angina at rest No symptoms Angina with light activity Angina with significant exertion such as hills, stairs, exercise

Answer 28

60% → No symptoms, 70% → Angina with significant exertion such as hills, stairs, exercise, 80% → Angina with light activity, 90% → Angina at rest

Question 29

Match the equations: Ejection fraction= Stroke volume= Cardiac output= Blood pressure= CO x TPR EDV – ESV SV/EDV HR x SV

Answer 29

Ejection fraction= → SV/EDV Stroke volume= → EDV – ESV, Cardiac output= → HR x SV, Blood pressure= → CO x TPR,

Question 30

Patent foramen ovale characteristics: Choose all that apply. a. Known cause of intra-atrial thrombus b. Occurs in approximately 20% of the population c. Extremely dangerous due to blood flow between atria being constant d. Occurs in approximately 60% of the population e. Usually clinically silent due to blood flow through the PFO only occurring during right to left shunting f. Known cause of paradoxical embolism

Answer 30

Occurs in approximately 20% of the population, Usually clinically silent due to blood flow through the PFO only occurring during right to left shunting, Known cause of paradoxical embolism

Question 31

Ninety percent of myocardial ischemia is caused by: a. Arteriosclerosis b. Emboli c. Atherosclerosis d. Hypovolemia

Answer 31

c. Atherosclerosis