Deck 18: Alterations in Cardiac Function

Question 1

A patient with a history of myocardial infarction continues to complain of intermittent chest pain brought on by exertion and relieved by rest.The likely cause of this pain is

A) stable angina.
B) myocardial infarction.
C) coronary vasospasm.
D) unstable angina.

Answer 1

stable angina.

Question 2

Hypotension, distended neck veins, and muffled heart sounds are classic manifestations of

A) myocardial infarction.
B) cardiac tamponade.
C) congestive heart failure (CHF).
D) cardiomyopathy.

Answer 2

cardiac tamponade.

Question 3

Constrictive pericarditis is associated with

A) impaired cardiac filling.
B) cardiac hypertrophy.
C) increased cardiac preload.
D) elevated myocardial oxygen consumption.

Answer 3

impaired cardiac filling.

Question 4

Which serum biomarker(s)are indicative of irreversible damage to myocardial cells?

A) Elevated CK-MB, troponin I, and troponin T
B) Markedly decreased CK-MB and troponin I
C) Elevated LDL
D) Prolonged coagulation time

Question 5

The majority of cardiac cells that die after myocardial infarction do so because of

A) cell rupture.
B) insufficient glucose.
C) thrombus.
D) apoptosis.

Question 6

Patent ductus arteriosus is accurately described as a(n)

A) opening between the atria.
B) stricture of the aorta that impedes blood flow.
C) communication between the aorta and the pulmonary artery.
D) cyanotic heart defect associated with right-to-left shunt.

Question 7

A patient with significant aortic stenosis is likely to experience

A) syncope.
B) hypertension.
C) increased pulse pressure.
D) peripheral edema.

Question 8

While hospitalized, an elderly patient with a history of myocardial infarction was noted to have high levels of low-density lipoproteins (LDLs).What is the significance of this finding?

A) Increased LDL levels are associated with increased risk of coronary artery disease.
B) Measures to decrease LDL levels in the elderly would be unlikely to affect the progression of this disease.
C) Increased LDL levels are indicative of moderate alcohol intake, and patients should be advised to abstain.
D) Elevated LDL levels are an expected finding in the elderly and therefore are not particularly significant.

Question 9

Angina due to coronary artery spasm is called _____ angina.

A) stable
B) classic
C) unstable
D) Prinzmetal variant

Question 10

Rheumatic heart disease is most often a consequence of

A) chronic intravenous drug abuse.
B) viral infection with herpes virus.
C) b-hemolytic streptococcal infection.
D) cardiomyopathy.

Question 11

What compensatory sign would be expected during periods of physical exertion in a patient with limited ventricular stroke volume?

A) Hypotension
B) Bradycardia
C) Aortic regurgitation
D) Tachycardia

Question 12

Myocarditis should be suspected in a patient who presents with

A) chest pain and ST elevation.
B) acute onset of left ventricular dysfunction.
C) murmur and abnormal valves on echocardiogram.
D) family history of cardiomyopathy.

Question 13

Patients presenting with symptoms of unstable angina and no ST segment elevation are treated with

A) cardiac catheterization.
B) antiplatelet drugs.
C) acute reperfusion therapy.
D) cardiac biomarkers only.

Question 14

Aortic regurgitation is associated with

A) diastolic murmur.
B) elevated left ventricular/aortic systolic pressure gradient.
C) elevated systemic diastolic blood pressure.
D) shortened ventricular ejection phase.

Question 15

Primary treatment for myocardial infarction (MI)is directed at

A) protecting the heart from further ischemia.
B) decreasing myocardial oxygen demands.
C) reducing heart rate and blood pressure.
D) activating the parasympathetic system.

Question 16

Mitral stenosis is associated with

A) a prominent S₄ heart sound.
B) a pressure gradient across the mitral valve.
C) left ventricular hypertrophy.
D) a muffled second heart sound (S₂).

Question 17

An example of an acyanotic heart defect is

A) tetralogy of Fallot.
B) transposition of the great arteries.
C) ventricular septal defect.
D) all right-to-left shunt defects.

Question 18

A loud pansystolic murmur that radiates to the axilla is most likely a result of

A) aortic regurgitation.
B) aortic stenosis.
C) mitral regurgitation.
D) mitral stenosis.

Question 19

An elderly patient's blood pressure is measured at 160/98.How would the patient's left ventricular function be affected by this level of blood pressure?

A) This is an expected blood pressure in the elderly and has little effect on left ventricular function.
B) Left ventricular workload is increased with high afterload.
C) High blood pressure enhances left ventricular perfusion during systole.
D) High-pressure workload leads to left ventricular atrophy.

Question 20

The most reliable indicator that a person is experiencing an acute myocardial infarction (MI)is

A) severe, crushing chest pain.
B) ST-segment elevation.
C) dysrhythmias.
D) pain radiating to the lower legs.

Question 21

__________ is a congenital malformation that results in the formation of one large vessel that receives blood from both the right and left ventricles.

Question 22

A reduction in _________ production after birth contributes to the heart's closure and constriction in patent ductus arteriosus.

Question 23

Inflammatory disorders that may alter endothelial cell function include

A) multiple sclerosis.
B) lupus erythematosus.
C) Kawasaki syndrome.
D) rheumatoid arthritis.
E) polyarteritis nodosa.

Question 24

The cause of Prinzmetal angina is ________.

Question 25

Atherosclerotic plaques with large lipid cores are prone to

A) dislodgement.
B) binding.
C) rupture.
D) attachment.

Question 26

Diagnostic tests used to diagnose or confirm MI include

A) electrocardiogram.
B) cardiac catheterization.
C) echocardiography.
D) radionuclide scintigraphy.
E) computed tomography.

Question 27

Atherosclerotic plaque formation is due to injury to the ____________.

Question 28

Acute coronary syndrome in the presence of thrombosis may present as

A) unstable angina.
B) MI.
C) sudden cardiac arrest.
D) bleeding.
E) hypovolemia.