Multiple choice questions Cardio Exam 4B djmbmcull

Terms in this set (43)

Kussmaul sign may be a key to diagnosing which of the following?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF
C
A prominent A wave in jugular pulse, bisferiens carotid pulse, triple apical impulse and loud S4 are all physical exam findings for what?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF
B
What is the most common cause of cardiomyopathy?
A) Smoking
B) systolic HTN
C) aging
D) idiopathic
E) LVH
D
The presence of both an S3 and S4 gallop as either audible or visible lifts or heaves is indicative of what disorder?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF
C
What 2 things must be present to diagnose dilated cardiomyopathy?
A) LV dilation + RV dilation
B) LV dilation + systolic dysfunction
C) RV dilation + Right atrial enlargement
D) RV dilation + severe diastolic dysfunction
B
A 55 yo african american male presents to your clinic with the following physical exam: rales, elevated JVP, S3 gallop, peripheral edema, and a holosystolic musical murmur. What are you suspecting?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF
A
Which of the following is NOT necessarily indicative of severe dilated cardiomyopathy?
A) Cheyne stokes respirations
B) cyanosis
C) ventricular ectopy
D) pallor
E) pulsus alternans
C
Which of the following ECG findings would you suspect in dilated cardiomyopathy?
A) LBBB
B) sinus bradycardia
C) mobitz type II
D) RBBB
E) mobitz type I
A

the most common ECG findings in dilated cardiomyopathy are LBBB, ventricular and atrial arrhythmias, and sinus tachycardia
What is the diagnostic tool of choice to diagnose a dilated cardiomyopathy?
A) chest xray
B) CBC
C) Echocardiogram
D) Electrocardiogram
C
What is the diagnostic tool of choice for diagnosing infiltrative disease that may cause dilated cardiomyopathy?
A) Electrocardiogram
B) chest radiograph
C) cardiac MRI
D) cardiac catheterization
C
In which disease do you have an increased chance of sudden death?
A) hypertrophic cardiomyopathy
B) dilated cardiomyopathy
C) mitral regurgitation
D) restrictive cardiomyopathy
A
You are reviewing the following echocardiogram results: septal hypertrophy with systolic anterior motion of the mitral valve. What are you suspecting?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
B
Which of the following physical exam findings is commonly seen in hypertrophic cardiomyopathy?
A) atrial arrhythmias
B) ventricular arrhythmias
C) loud diastolic murmur
D) cyanosis
B
Which of the following drugs may worsen the obstruction in hypertrophic cardiomyopathy?
A) beta blockers
B) CCB's
C) digoxin
D) diuretics
C
Which valvular disorder typically accompanies hypertrophic cardiomyopathy?
A) mitral regurgitation
B) mitral stenosis
C) aortic regurgitation
D) aortic stenosis
A
T or F? Stress tests are indicated in diagnosing hypertrophic cardiomyopathy
TRUE! assesses for ventricular arrhythmias and BP response
What is the most common cause of restrictive cardiomyopathy?
A) Sarcoidosis
B) Aging
C) Amyloidosis
D) Systolic HTN
E) left ventricular hypertrophy
C
Which of the following is considered a high risk group in hypertrophic cardiomyopathy?
A) diagnosed after the age of 60
B) preexisting scoliosis
C) diagnosed before the age of 20
D) history of illicit drug abuse
C
What diagnostic study is used to confirm the amyloid protein present in restrictive cardiomyopathy?
A) cardiac catheterization
B) echocardiogram
C) chest radiograph
D) electrocardiogram
E) myocardial biopsy
E
Cardiac catheterization results show left ventricular dilation and presence of the square root sign. What are you suspecting?
A) dilated cardiomyopathy
B) hypertrophic cardiomyopathy
C) restrictive cardiomyopathy
D) myocardial infarction
E) right sided HF
C
How can you distinguish restrictive cardiomyopathy from dilated cardiomyopathy?
A) there is no change in PMI and no hypotension seen in dilated cardiomyopathy
B) there is no change in PMI and no hypotension seen in restrictive cardiomyopathy
C) only dilated cardiomyopathy affects the heart
D) dilated cardiomyopathy is congenital whereas restrictive cardiomyopathy is acquired
B
what is the most common cause of heart failure?
A) diabetes
B) systolic hypertension
C) isolated elevated diastolic pressures
D) mitral regurgitation
E) aging
E
What is a crucial part in the diagnosis and treatment of heart failure?
A) assessment of LV function
B) assessment of RV function
C) assessment of pulmonary gradient pressure
D) assessment of right atrial enlargement
A
What is the most common cause of systolic heart failure in developing countries?
A) chronic LVH
B) hypertension
C) chronic syncope
D) coronary artery disease
D
Which of the following is not a risk factor for developing CHF?
A) high salt diet
B) smoking
C) HTN
D) high HDL
E) limited physical activity
D
Which of the following is the correct sequence of left sided heart failure?
A) dyspnea at rest -> paroxysmal nocturnal dyspnea -> dyspnea with exertion -> orthopnea
B) exertional dyspnea -> orthopnea -> paroxysmal nocturnal dyspnea -> dyspnea at rest
C) orthopnea -> exertional dyspnea -> paroxysmal nocturnal dyspnea -> dyspnea at rest
D) orthopnea -> exertional dyspnea -> dyspnea at rest -> paroxysmal nocturnal dyspnea
B
You have a patient who is symptomatic while watching a game of tennis. What will their NYHA classification be?
A) stage I
B) stage II
C) stage III
D) stage IV
D
You have a patient who is symptomatic while walking to the mailbox. How would you classify them according to NYHA guidelines?
A) stage I
B) stage II
C) stage III
D) stage IV
C
You have a patient who is symptomatic while riding their bike. How would you classify them according to the NYHA guidelines?
A) stage I
B) stage II
C) stage III
D) stage IV
B
What is the most common cause of diastolic cardiac dysfunction?
A) RVH
B) LVH
C) right atrial enlargement
D) left atrial enlargement
B
What does stage C represent in CHF?
A) pt's at risk for CHF
B) pts with clinical heart failure
C) pts with heart failure but without sxs
D) pts who are refractory to therapy
B
What does stage B represent in CHF?
A) pt's at risk for CHF
B) pts with clinical heart failure
C) pts with heart failure but without sxs
D) pts who are refractory to therapy
C
What are symptoms caused by in right ventricular failure?
A) fluid overload
B) pressure overload
C) ischemia
D) mitral stenosis
A
What is not a common symptom of right sided heart failure?
A) fluid retention
B) edema
C) loss of appetite
D) exertional dyspnea
E) hepatic congestion
D
How do the majority of patients with CHF generally present?
A) in distress at rest
B) in cardiac arrest
C) comfortable at rest
D) dyspneic and cyanotic at rest
C
Which of the following lab tests is used to distinguish the cause of dyspnea in CHF?
A) troponin
B) BNP
C) creatinine
D) urinalysis
B
Which of the following tests would be the LEAST helpful in determining whether someone has CHF?
A) renal function tests
B) serum electrolytes
C) thyroid function tests
D) testosterone levels
D
Which of the following test results would NOT necessarily be an indicator that your patient has CHF?
A) decreased nitrogen levels
B) hypokalemia
C) hyperkalemia
D) thyrotoxisis
A
What is the MOST effective means of providing systematic relief to patients with moderate to severe heart failure?
A) digoxin
B) diuretics
C) beta blockers
D) aspirin
B
What is an appropriate NON-pharmacological treatment for CHF?
A) biventricular pacing
B) anticoagulation
C) statins
D) Ivabradine
E) eplerenone
A
Which of the following lab findings would indicate a poor prognosis in CHF?
A) leukocytosis
B) leukopenia
C) anemia
D) hyponatremia
E) C or D
F) A or B
E
Which of the following is NOT a cardinal cardiac exam finding for heart failure?
A) enlarged/sustained LV impulse
B) parasternal lift
C) S3 gallop
D) palpable thrill
E) diminished first heart sound
D
Which of the following is a very common physical exam finding in CHF?
A) history of syncope
B) hyponatremia
C) pitting edema
D) thyrotoxisis
E) mallor flush
C
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