Deck 13: Cardiovascular Disorders

Question 1

What is the genetic contribution to the development of the most common forms of atherosclerosis?

A)Variation in a variety of genes, with each exerting a small effect
B)Disordered mitochondrial function reducing energy production
C)Genetic predisposition expressed after exposure to a viral trigger
D)Single-gene mutation following autosomal-dominant inheritance

Answer 1

Variation in a variety of genes, with each exerting a small effect

Question 2

Which problem associated with Tangier disease increases the risk for coronary artery disease?

A)Low levels of triglycerides
B)High levels of triglycerides
C)Low levels of high-density lipoproteins (HDLs)
D)High levels of low-density lipoproteins (LDLs)

Answer 2

Low levels of high-density lipoproteins (HDLs)

Question 3

What term is used to describe the gene-to-gene interaction in which the action of one gene modifies the expression of a different gene?

A)Epistasis
B)Heterogeneity
C)Genomic imprinting
D)Epigenetic penetrance

Answer 3

Epistasis

Question 4

Your 40-year-old patient is hospitalized for a myocardial infarction, but her lipid levels are normal. She says that she would like to have a genetic test to see whyshe was affected at such a young age. What do you say?

A)"Heart attacks seem to be caused by a combination of many affected genes working together as well as environmental factors. There is no single gene test that will be able to identify why this happened to you."
B)"Let's talk with your nurse practitioner about scheduling a test for familial hypercholesterolemia."
C)"You really shouldn't be concerned about your genetic risk. Because you are female, it is very low."
D)"It was just bad luck combined with the fact that you were once a smoker."

Question 5

Why is determining the genetic contribution to the onset of stroke difficult?

A)Stroke classification and phenotype remain heterogeneous.
B)Comorbidities mask the symptoms and delay the diagnosis.
C)Environmental risk factors have equal contribution to the problem.
D)Often the person with a stroke cannot provide accurate family information.

Question 6

The process in which gene variants interact with other gene variants to cause disease can be described by what word/phrase?

A)Phenotype variation
B)Reduced penetrance
C)Epistasis
D)Variable expressivity

Question 7

Which health problem is the most frequent cause of sudden cardiac death among young athletes?

A)Atrial fibrillation
B)Hypertrophic cardiomyopathy
C)Familial hypercholesterolemia type 1
D)Romano-Ward form of long QT syndrome

Question 8

Why is the mitochondrial disease MELAS, which results in stroke-like episodes in addition to encephalopathy and lactic acidosis, only transmitted by a motherand not by an affected father?

A)The mitochondria are in the cytoplasm, and virtually all the cytoplasm comes from the egg and is thus maternally inherited.
B)This is an X-linked-recessive condition, so the father can only transmit the gene to his daughters and not to his sons.
C)Mitochondria are in the cytoplasm and are not equally divided during gamete formation in meiosis.
D)MELAS reduces the percentage of Y-carrying sperm in affected males.

Question 9

Why is factor V Leiden disorder considered a form of thrombophilia?

A)Platelet activity is impaired.
B)Blood clots form more easily.
C)Atherosclerosis development is accelerated.
D)Excessive bleeding episodes occur in response to minor trauma.

Question 10

How does factor V Leiden increase the likelihood of stroke?

A)Factor V Leiden activates protein C.
B)Factor V Leiden increases thrombin formation.
C)People affected with factor V Leiden have increased blood viscosity.
D)Affected people have a type of factor V that is resistant to activated protein C.

Question 11

Which condition or factor for coronary artery disease (CAD) suggests a greater genetic contribution than environmental contribution to its development?

A)When a person develops CAD 5 years after quitting smoking
B)When CAD occurs in a person who has normal blood pressure
C)When CAD is diagnosed in a person who is younger than 50 years
D)When low-density lipoprotein levels can be reduced by dietary changes alone

Question 12

What is the most accurate classification of the common forms of coronary artery disease and hypertension?

A)Secondary disorders caused by lifestyle choices
B)Sequential genetic disorders related to age, ethnicity, and gender
C)Complex disorders resulting from gene-environment interactions
D)Primary disorders with an autosomal-dominant pattern of inheritance

Question 13

Your patient has been diagnosed with long QT syndrome (LQTS). What do you know about this heart rhythm problem?

A)LQTS is a congenital genetic disease that will be evident during the first 2 years of life.
B)It is relatively rare and often caused by private mutations.
C)LQTS is treated in the same way, no matter the cause.
D)Deafness always accompanies LQTS.

Question 14

For patients who have familial hypercholesterolemia, what should be the focus of teaching for blood cholesterol reduction?

A)Eliminating animal fats from the diet
B)Increasing the amount of fruit in the diet
C)Exercising at least 4 to 5 hours every week
D)Taking the lipid-lowering drug as prescribed

Question 15

Which ethnic group is at higher risk for stroke caused by factor V Leiden?

A)Ashkenazi Jews
B)African Americans
C)Caucasians from Northern Europe
D)French Canadians from the Quebec area

Question 16

Which lysosomal storage disease is associated with an increased risk for stroke?

A)Fabry disease
B)Gaucher disease
C)Hurler syndrome
D)Tay-Sachs disease

Question 17

What is true about the gene variants that cause hypertension?

A)A few genes with major contributions have been identified.
B)Genes that code for proteins in the RAAS pathways are often involved.
C)Hypertension is always secondary to another genetic disease.
D)Polymorphisms have little or no impact on the hypertensive phenotype.

Question 18

Which total plasma cholesterol levels are most likely to be present in people who are homozygous for an allele that causes familial hypercholesterolemia?

A)100 mg/dL to 200 mg/dL
B)200 mg/dL to 300 mg/dL
C)400 mg/dL to 500 mg/dL
D)600 mg/dL to 1,200 mg/dL

Question 19

Which variable in a person with coronary artery disease (CAD) increases the likelihood of a strong genetic influence in its expression?

A)The disorder is not present in the person's dizygotic twin.
B)The disorder is present in a woman whose father had CAD.
C)The affected person has eaten a vegetarian diet for the past 5 years.
D)The disorder is present in about 5% of the person's maternal family members.

Question 20

Which physical finding in a 30-year-old man suggests the possibility of familial hypercholesterolemia?

A)Lipomas
B)Xanthomas
C)Osteoarthritis
D)Hemangiomas

Question 21

Which lethal cardiac arrhythmia can occur as a complication of long QT syndrome?

A)Atrial node reentry tachycardia
B)Prolonged atrial fibrillation
C)Mitral valve prolapse
D)Torsade de pointes

Question 22

Which statement about atrial fibrillation is correct?

A)It is the most common genetic cardiac disorder worldwide.
B)A variety of different genes can contribute to its expression.
C)It is found exclusively in adults over 60 years old.
D)When severe, it leads to long QT syndrome.

Question 23

What do the known monogenic disorders that result in the expression of hypertension have in common?

A)An error in the ability of vascular smooth muscle to contract
B)An error in the ability of vascular smooth muscle to relax
C)Excessive kidney reabsorption of sodium
D)Excessive kidney excretion of potassium