Practical Session Heart and Vessels

Thursday January 6, 2011

THURSDAY READINESS QUIZPlease remove all writing materials from your desks

except a pencil and your scantron sheet. Note that the questions begin with number 101 (reverse side of scantron).

Please remember to fill in your NAME (Last, First) and Student ID # (left-aligned, no leading zeroes) M2 students fill in MED, Path Assists fill in GRAD

Do not take notes until discussion of Readiness Quiz is complete.

After RQ is over (including discussion) notes are fine.

THURSDAY READINESS QUIZ• The first five questions are pictorial and are based

on projections.• For each of the five pictorial questions, there will

be three projections:– A thumbnail (miniature) view showing the illustration

and the question together– A larger version of the illustration by itself– A larger version of the question by itself

• The remainder of questions are non-pictorial in nature.

Question No. 101In its subacute form, this lesion

involving the mitral valve would most likely be seen in which of the following patients?

A. A young woman with a characteristic butterfly rash.

B. A middle-aged woman with a history of mitral stenosis secondary to rheumatic heart disease.

C. A 67-year old man with carcinoma of the pancreas.

D. A middle-aged woman with sclerodactyly.

E. An immune compromised patient with a virulent staph infection.

Question No. 101

Question No. 101In it's subacute form, this lesion involving the mitral

valve would most likely be seen in which of the following patients?

A. A young woman with a characteristic butterfly rash.

B. A middle-aged woman with a history of mitral stenosis secondary to rheumatic heart disease.

C. A 67-year old man with carcinoma of the pancreas.

D. A middle-aged woman with sclerodactyly.E. An immune compromised patient with a virulent

staph infection.

Question No. 102Which of the following histories is

most consistent with the aortic valve lesion shown here?

A. 50 year old woman with history of rheumatic heart disease

B. 75 year old man with degenerative changes in the valve

C. 45 year old man with a congenital abnormality of the valve

Question No. 102

Question No. 102Which of the following histories is most

consistent with the aortic valve lesion shown here?

A. 50 year old woman with history of rheumatic heart disease

B. 75 year old man with degenerative changes in the valve

C. 45 year old man with a congenital abnormality of the valve

Question No. 103At what interval following

myocardial infarction is the patient at greatest risk for development of the complication shown here?

A. 0 to 24 hoursB. 4 to 7 daysC. 10 to 14 daysD. after 2 weeksE. after 3 month

Tues Question 103

Question No. 103At what interval following myocardial

infarction is the patient at greatest risk for development of the complication shown here?

A. 0 to 24 hoursB. 4 to 7 daysC. 10 to 14 daysD. after 2 weeks

E. after 3 months

Question No. 104Which of the following is most

characteristic of the disorder pictured here?

A. fatty infiltration of the right ventricular wall.

B. excessive thickening of the heart muscle, especially involving the interventricular septum, with potential for ventricular outflow tract obstruction

C. dilation of all chambers of the heart.D. diffuse fibroelastic thickening of

the mural endocardium.E. multifocal endomyocardial necrosis

and infiltrate of eosinophils.

Question No. 104

Question No. 104Which of the following is most characteristic of the

disorder pictured here?A. fatty infiltration of the right ventricular wall.B. excessive thickening of the heart muscle, especially

involving the interventricular septum, with potential for ventricular outflow tract obstruction

C. dilation of all chambers of the heart.D. diffuse fibroelastic thickening of the mural

endocardium.E. multifocal endomyocardial necrosis and infiltrate of

eosinophils.

Question No. 105Which of the following statements are

true?A. pulmonary hypertension is less

common in patients with this disease than in patients with ventricular septal defect.

B. patients with this disease are usually cyanotic from birth.

C. if one excludes bicuspid aortic valve and persistent ductus associated with prematurity this is the most common congenital cardiac anomaly.

D. in patients with this disorder, paradoxical emboli often give rise to venous thrombosis of the lower extremity.

E. this disorder usually is associated an early right-to-left shunt which turns into a left-to-right shunt.

Thurs Question 105

Question No. 105Which of the following is true of the lesion shown

here?A. pulmonary hypertension less common than with

atrial septal defectB. usually manifests as cyanosis from birthC. one of the most common congenital cardiac

anomaliesD. often leads to paradoxical emboli that arrest in

veins of lower extremitiesE. usually manifest by early right-to-left shunt

which later reverses to left-to-right.

Questions 106 through 110 are not illustrated

Question No. 106Which valves are most likely to be affected in

rheumatic heart disease?A. aortic and pulmonaryB. aortic and mitralC. aortic and tricuspidD. mitral and tricuspidE. pulmonary and tricuspid

Question No. 107

The underlying condition associated with Libman-Sacks endocarditis is:

A. Loeffler syndromeB. pancreatic carcinomaC. rheumatic feverD. rheumatoid arthritisE. SLE

Question No. 108

Which of the following cardiac conditions is associated with alcoholism?

A. dilated cardiomyopathyB. restrictive cardiomyopathyC. hypertrophic cardiomyopathyD. non-bacterial thrombotic endocarditisE. Libman-Sacks endocarditis

Question No. 109Which of the following is most

characteristically a manifestation of rheumatic heart disease?

A. mitral stenosisB. mitral valve prolapse (floppy valve)C. acute infectious endocarditisD. endocarditis of tricuspid valveE. Libman-Sacks endocarditis

Question No. 110

Which of the following congenital heart defects is most often associated with rib notching due to pressure erosion by enlarged intercostal arteries?

A. ventricular septal defectB. atrial septal defectC. tetralogy of FallotD. coarctation of aortaE. ductus arteriosus

This slide is purposely left blank

• End of Readiness Quiz• After discussion of quiz, OK to take notes.

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