Term
Atherosclerosis raises the systolic blood pressure by:
A. increaseing arterial distensiblity and vessel lumen radius or diameter
b. increasin arterial distensiblity and decreasing vessel lumnen radius or diameter
c. decreasing arterial distensibility and increasing vessel lumen radius or diameter
d. decreasing arterial distensibility and lumen radius or diameter |
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Definition
| D.decreasing arterial distensibility and lumen radius or diameter |
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Term
Events in the development of atherscelerotic plaque include all of the follwoing except
a. oxidation of LDL
b. smooth muscle proliferation
c. decreased antihrombolytics
d. fibrous plaques overlies foam cells
e. complement activation |
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Definition
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Term
G.P. is a 50-yr old man who was referred for evaluation of boo pressure. If he had a high diastolic blood pressure, which of the following readings would reflect that?
a. 140/82
b. 160/72
c. 130/95
d. 95/68
e. 140/72 |
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Definition
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Term
The complications of uncontrolled HTN include all of the following except
a. CVA
b. anemia
c renl injury
d. cardiac hypertrophy |
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Definition
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Term
Primary HTN:
a. is essentially idiopathic mediated by a host of nuerohumoral effects
b. can be caused by renal disease
c. can be caused by hormone imbalance
d. results from arterial coarctation |
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Definition
| A. is essentially idiopathic mediated by a host of nuerohumoral effects |
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Term
Orthostatic hypotension is caused by all except
a. increased age
b. increase blood volume
c. autonomi nervous system dysfx
d. bed rest
e. severe varicos veins |
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Definition
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Term
Adipnectin is
a. an enzyme
b. increased in obesity
c. antiaterogenic
d. inflammatory |
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Definition
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Term
Transmural myocaridal infarction
a. displays non-STEMI
b. occurs when infarction is limited to part of the heart wall
c. is categorized as STEMI
d. displays t-wave inversion |
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Definition
| C. is categorized as STEMI |
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Term
A 76-year-old man came to the ED after expriencing chest pain while shoveling sknow. Lab test reveal essentially normal bloods levels f SGOT or AST, CPK, and LDH ensymes. The chest was relieved following bed rest and nirtorgycerin therarpy. The most probable dx is
a. MI
b. emphysema
c. stable angina
d. hepatic cirrhosis
e acute pancrestitis |
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Definition
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Term
In pericaridal effusion
a. fibrotic lesions obliterate teh pericaridial cavity
b. there is assoicated theumatoid arthiritis
c. tamponade compresses the rightheart before affecting other structures
d. arterial blood pressure during inspiration exceeds that during expiration |
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Definition
| C. tamponade compresses the rightheart before affecting other structures |
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Term
Incrased chamber siz is observed in _________ cariomyopathy
a. dilated
b hypertrophic
c. restrictive
d. constrictive |
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Definition
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Term
Which of the following i not an expected finding in acute rheumatic fever?
a. hx of a pharyngeal infection
b. elevated ASO titer (anti-stretolysin O)
c. leukopenia
d. fever |
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Definition
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Term
In unstable angina
a. pronounced Q waves are evident
b. transient ST elevation occurs
c. vasosasm occurs
d. T-wave inversion occurs |
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Definition
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Term
Secondary HTN is caused by
a. sodium retention
b. renovascular disease
c. genetics
d. decreased cardic contractibility
e. increased ventricular preload |
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Definition
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Term
Which of the followin sttements abot HTN is incorrect?
a. malignan HTN is character by a diastolic pressure of more than 140mmg
b. approx 90% of HTN cases are of the essential or primary type
c. HA is the most reliable symptomd
d. when left untx, the major risks include CVAs and cardiac hypertophy |
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Definition
| C. HA is a more reliabel symptom |
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Term
Life-threatening consquences of corornary artery disease include
a. angina
b. cardiomegaly
c. endorcarditis
d. heart failure |
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Definition
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Term
Which accompanies an infarcted myocardium?
a. unconsciousness.
b. transient ST elevation
c. left ventricular hypertrophy
d. arrhythias |
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Definition
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Term
The most serious complication of infective endocarditis is
a. valvular deformity
b. septic emboli
c. regurgitated blood by mitral valve
d. myocardial hypertrophy |
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Definition
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Term
Pts with only left side heart failure would exhibit
a. hepatomegaly
b. ankle swelling
c. pulmonary edema
d. peripheral edema |
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Definition
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Term
In CHF, there is
a. GI disturbances
b. elevated venous pressure
c. decreased UOP
d. ascites |
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Definition
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Term
In right-side heart failure, there is
a. nocturnal dyspnea
b. dependent edema
c. blood-tinged sputum
d. rales |
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Definition
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Term
| The initial consquence of tricuspid regurgitation is |
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Definition
| C. right artril hypertrophy |
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Term
| The initial consequence of mitral stenosis is |
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Definition
| E. left atrial/right ventricular hypertrophy |
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Term
| The initial consequence of mirtral regurgitation is |
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Definition
| F. right and left venricular atrial hypertrophy. |
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Term
Which of the following is a factor that leads to aortic aneurysm?
A. Lack of atherosclerosis
B. Deficiencies in wall collagen
C. Excessive elastin
D. Decreased oxygen radicals |
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Definition
B. Deficienccies in wall collagen
Atherosclerosis is a common cause of aneurysms. Aortic aneurysms are associated with genetic markers, deficiencies in wall collagen, elastin failure, inflammation, increased oxygen radicals, and mechanical shear forces. |
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Term
A young woman presents with pallor, numbness, and a sensation of cold temperature of her digits. Which of the following is the most likely cause?
A. Raynaud phenomenon
B. Thromboangiitis obliterans
C. Peripheral vascular disease
D. Varicose veins |
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Definition
A. Raynaud phenomenon
Raynaud phenomenon is characterized by attacks of vasospasm in the small arteries of the fingers. It is characterized by cold, numb digits. Thromboangiitis obliterans tends to occur in young men who are heavy smokers; it is an inflammatory disease of the peripheral arteries. Arteries occlude in the feet and hands. Peripheral vascular disease is a result of atherosclerosis. Varicose veins have pooled blood. |
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Term
Which of the following is TRUE regarding hypertension?
A. Approximately 65% of Americans older than the age of 60 have hypertension.
B. Less than two thirds of those with hypertension have it controlled.
C. It is defined as a systolic pressure of greater than 90 mmHg.
D. It is systolic pressure of 140 mmHg or greater. |
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Definition
D. It is systolic pressure of 140 mmHg or greater.
Approximately 65% of Americans older than the age of 60 have hypertension and less than two thirds of those have adequately controlled hypertension. Hypertension is defined as a diastolic pressure of 90 mmHg or greater or a systolic pressure of 140 mmHg or greater. |
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Term
A person experiences an elevated systolic pressure accompanied by normal diastolic pressure (less than 90 mmHg). Which of the following is the correct term for this condition?
A. Primary hypertension
B. Secondary hypertension
C. Tertiary hypertension
D. Isolated systolic hypertension |
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Definition
D.Isolated systolic hypertension
Isolated systolic hypertension is an elevated systolic pressure with a normal diastolic pressure. Primary hypertension has no known cause. Secondary hypertension is caused by altered hemodynamics associated with a primary disease. There is no tertiary hypertension. |
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Term
Which of the following is NOT associated with hypertension?
A. Family history positive for hypertension
B. Asian race
C. High dietary sodium
D. Glucose intolerance |
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Definition
B. Asian race
Hypertension is associated with positive family history, gender (men younger than 55 and women after menopause), black race, high dietary sodium, glucose intolerance, cigarette smoking, obesity, heavy alcohol consumption, and low dietary intake of minerals. |
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Term
Which of the following complications occurs secondary to hypertension?
A. Cardiovascular muscle atrophy
B. Hypoglycemia
C. Congestive heart failure
D. Decreased demand for coronary perfusion |
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Definition
C. Congestive heart failure
Complications of hypertension include left ventricular hypertrophy, angina pectoris, congestive heart failure, coronary artery disease, myocardial infarction, and sudden death. |
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Term
Which of the following is TRUE regarding atherosclerosis?
A. Atherosclerosis is an acute process of heart muscle degeneration.
B. Atherosclerosis is thickening and hardening of the vessel wall.
C. A plaque is caused by neutrophils.
D. Fatty streaks and foam cells are identical. |
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Definition
B. Atherosclerosis is thickening and hardening of the vessel wall.
Arteriosclerosis is a chronic degeneration of blood vessel walls. A plaque is caused by collagen over a fatty streak. Fatty streaks are composed of a large number of lipid-laden foam cells that deposit on the vessel wall. |
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Term
Which of the following pairs regarding dyslipidemia is correct?
A. High-density lipoprotein–triglycerides and fat packages
B. Very low-density lipoproteins–triglycerides and proteins
C. Low-density lipoproteins–phospholipids and proteins
D. Chylomicrons–triglycerides and phospholipids |
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Definition
B. Very low-density lipoproteins–triglycerides and proteins
VLDL is associated with triglycerides and protein. LDL is associated with cholesterol and protein. HDL is phospholipids and protein. Chylomicrons are dietary fat packages. |
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Term
A woman presents with chest pain that occurs at rest. She is found to have abnormal vasospasm of her coronary arteries. Which of the following is the BEST description of this case?
A. Stable angina
B. Prinzmetal angina
C. Silent ischemia
D. Angina pectoris |
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Definition
B. Prinzmetal angina
Prinzmetal angina is an abnormal vasospasm of the coronary vessels. It typically produces pain at rest and is common in women. Stable angina occurs with activity and is often limited and resolves with rest. Silent ischemia is occlusion of the coronary arteries without pain. Angina pectoris is chest pain, usually substernal chest discomfort. |
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Term
Which of the following is NOT a sign of atherosclerosis?
A. Xanthelasmas
B. Arcus senilis
C. Atrial septal defect
D. Extra-rapid heart sounds |
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Definition
C.Atrial septal defect
Xanthelasmas are small fat deposits around the eyes. Arcus senilis is a yellow lipid ring around the cornea. These both suggest dyslipidemia, which is associated with atherosclerosis. Extra-rapid heart sounds such as a left ventricular gallop indicate impaired left ventricular function during an ischemic attack |
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Term
Which of the following is TRUE regarding cellular injury of the myocardium?
A. Cardiac cells can withstand ischemic conditions for about 60 minutes.
B. ECG changes are visible after approximately 120 seconds.
C. Myocardial cells remain viable if blood flow returns within 20 minutes.
D. After 20 seconds of decreased blood flow, myocardial cells become cooler. |
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Definition
C. Myocardial cells remain viable if blood flow returns within 20 minutes
Cardiac cells can withstand ischemic conditions for about 20 minutes. ECG changes are visible after 30 to 60 seconds of hypoxia. After 8 to 10 seconds of blood flow, the myocardial cells are already cyanotic and cooler |
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Term
Which of the following is NOT a functional change expected from acute myocardial infarction?
A. Decreased contractility
B. Decreased stroke volume
C. Increased ejection fraction
D. Increased left ventricular compliance |
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Definition
C. Increased ejection fraction
There is a decreased ejection fraction. |
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Term
A person is being transferred from another medical facility with a diagnosis of acute myocardial infarction. Which of the following is NOT a typical symptom of acute myocardial infarction?
A. Cough
B. Diaphoresis
C. Absence of pain
D. Crushing pain |
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Definition
A. Cough
A person may experience substernal chest pressure or pain. Some have no pain at all. Nausea, vomiting, abdominal pain, or indigestion also may occur. Sweating and cool and clammy skin are typical. |
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Term
Which of the following is NOT an enzyme released by the myocardial muscle?
A. CK-MB
B. LDH
C. AST
D. Troponin I |
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Definition
C. AST
AST is a liver enzyme that indicates damage to the liver cells. The other three are indicators of myocardial damage. Although LDH is also measured in liver function, it also has a purpose for acute myocardial infarction. |
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Term
Which of the following is the MOST common complication of AMI?
A. Dressler postinfarction syndrome
B. Dysrhythmia
C. Pericarditis
D. Congestive heart failure |
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Definition
B. Dysrhythmia
All of these choices are true complications of AMI; however, the most common is dysrhythmia |
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Term
An individual is experiencing an acute myocardial infarction. Which of the following medications would NOT be expected on the admission orders?
A. Beta-blockers
B. Aspirin
C. Nitrates
D. Calcium chloride |
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Definition
D. Calcium chloride
Beta-blockers, aspirin, nitrates, and some calcium channel blockers are appropriate inpatient orders. Calcium chloride is not routinely used in AMI. |
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Term
A 23-year-old presents with severe chest pain that worsens with respiratory movements and with lying down. On exam, there is a friction rub. Which of the following treatments is the most appropriate for this condition?
A. Analgesics
B. Percutaneous coronary intervention
C. CABG
D. Beta-blockers |
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Definition
A. Analgesics
Analgesics are the correct choice; this individual has pericarditis. The other choices are appropriate for AMI |
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Term
A person has been diagnosed with a pericardial effusion that is frank blood. Which of the following is associated with a bloody effusion?
A. Tuberculosis
B. Coagulation defect
C. Neoplasm
D. Left heart failure |
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Definition
B. Coagulation defect
Coagulation defect, trauma, and aneurysms are associated with bloody effusion |
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Term
Which of the following medical conditions is NOT associated with pericardial effusion?
A. Renal failure
B. Breast cancer
C. Aortic stenosis
D. Open heart surgery |
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Definition
C. Aortic stenosis
Renal failure, cancer, radiation therapy, certain medications, and previous open heart surgery have been associated with pericardial effusion. |
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Term
A person has impaired blood flow from the left atrium to the left ventricle. Which of the following valvular problems does this describe?
A. Mitral stenosis
B. Mitral regurgitation
C. Aortic stenosis
D. Aortic regurgitation |
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Definition
A. Mitral stenosis
Mitral stenosis is due to a mitral valve that inhibits adequate blood flow from the left atrium to the left ventricle. Mitral regurgitation occurs secondary to blood flowing backward from the left ventricle to the left atrium. Aortic stenosis results in diminished blood flow from the left ventricle into the aorta. Aortic regurgitation results from blood from the aorta flowing back into the left ventricle during diastole. |
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Term
A man has rheumatic fever. Which of the following valves is most commonly affected?
A. Aortic
B. Tricuspid
C. Pulmonic
D. Mitral |
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Definition
D. Mitral
The mitral valve is the most commonly affected in rheumatic heart disease |
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