Deck 10: Heart

Question 1

A transplanted heart must be monitored periodically to detect rejection. Accordingly, the patient must have periodic tests performed. Which is the most reliable test for detecting cardiac transplantation rejection?

A) Endomyocardial catheter biopsy
B) Cytologic thin needle aspiration biopsy through the pericardium
C) Electrocardiography
D) Serologic testing for T and B cells in blood
E) Testing for troponin I

Answer 1

Endomyocardial catheter biopsy

Question 2

Which of the following vascular tumors is classified as an intermediate grade (low-grade malignant) neoplasm?

A) Capillary hemangioma
B) Lymphangioma
C) Hemangioendothelioma
D) Angiosarcoma
E) Glomus tumor

Answer 2

Hemangioendothelioma

Question 3

The most common genetic mutation found in congenital hypertrophic cardiomyopathy involves the gene encoding

A) troponin T
B) troponin I
C) α-tropomyosin
D) myosin-binding protein C
E) ß-myosin heavy chain

Answer 3

ß-myosin heavy chain

Question 4

Stable angina, the most common form of angina pectoris, is caused by

A) stenosis of coronary arteries
B) Lipid-rich atheromas
C) ruptured atheromas
D) thrombi overlying partially ruptured atheromas
E) no pathologic changes in the coronary arteries

Question 5

At what time interval after the onset of infarction will the occlusive coronary artery thrombus most likely be seen by angiography?

A) 4 hours
B) 8 hours
C) 12 hours
D) 24 hours
E) 48 hours

Question 6

A 50-year-old man with chronic alcoholism was hospitalized for congestive heart failure. The left ventricular ejection fraction was 35%, and the heart appeared enlarged on radiographs. Myocardial biopsy was performed, and the biopsy specimen most likely showed

A) hypertrophy of cardiac myocytes and interstitial fibrosis
B) massive deposition of amyloid
C) foci of cardiac cell necrosis surrounded by neutrophils
D) infiltrates of eosinophils
E) foci of chronic inflammation containing plasma cells and lymphocytes

Question 7

Which of the following is the most important and most common complication of prosthetic heart valve implantation?

A) Hemolysis
B) Infective endocarditis
C) Thromboembolic complications
D) Structural deterioration of prostheses
E) Coronary heart disease

Question 8

Sudden death within the first hours after the onset of a myocardial infarction is most often caused by

A) ventricular fibrillation
B) rupture of the ventricle
C) rupture of the papillary muscles
D) rupture of the interventricular septum
E) pulmonary embolism

Question 9

A 55-year-old man presented with fever, fatigue, and flu-like symptoms. Murmurs were heard in the pericardial area, and ultrasonography revealed lesions on the mitral valve. The patient suddenly developed right flank pain. Several hours later, urinalysis showed hematuria. Which of the following is the most likely diagnosis?

A) Nonbacterial thrombotic endocarditis
B) Acute bacterial endocarditis
C) Rheumatic endocarditis
D) Fungal endocarditis
E) Atrial fibrillation with thrombus formation in the left auricle

Question 10

The most common location of atrial septal defects is in the area of the

A) fossa ovalis
B) sinus venosus
C) septum primum
D) coronary sinus
E) supravalvular endocardium

Question 11

The most common cause of sudden cardiac death, defined as occurring within 1 hour after onset of the first symptoms, in 50-year-old men is

A) aortic valve stenosis
B) mitral valve prolapse
C) atherosclerotic coronary heart disease
D) cardiomyopathy
E) hypertensive heart disease

Question 12

Which marker of myocardial necrosis is elevated first in the blood of a patient with a myocardial infarction?

A) Aspartate aminotransferase
B) Creatine kinase
C) Creatine kinase M-B fraction
D) Troponin T
E) Lactate dehydrogenase

Question 13

The most common cause of aortic stenosis in the elderly is

A) bicuspid aortic valve
B) rheumatic endocarditis
C) bacterial endocarditis
D) calcific aortic stenosis
E) trauma

Question 14

Cardiac disease is found in 20% to 40% of patients with longstanding crippling rheumatoid arthritis. Which of the following is the most common cardiac disease encountered in patients who have rheumatoid arthritis?

A) Valvular endocarditis
B) Mural endocarditis
C) Valvular calcifications
D) Myocarditis
E) Pericarditis

Question 15

Bacillary angiomatosis is typically found in AIDS patients and is caused by

A) herpesvirus type 8
B) herpesvirus type 3
C) herpesvirus type 6
D) Bartonella henselae
E) measles virus

Question 16

The most common cause of mitral stenosis in adults is

A) floppy mitral valve
B) rheumatic endocarditis
C) bacterial endocarditis
D) mitral annular calcification
E) nonbacterial thrombotic endocarditis