Question 1

A 52-year-old female is diagnosed with coronary artery disease. She would be expected to suffer from myocardial:

Accepted Answer

Coronary artery disease leads to reduced blood flow to the heart muscle, causing myocardial ischemia, which is a lack of oxygen supply to the heart tissue.

Question 2

A 28-year-old female presents to the ER complaining of severe chest pain that worsens with respirations or lying down. She has a fever, tachycardia, and a friction rub. The most likely cause of these symptoms is:

Accepted Answer

The symptoms of severe chest pain that worsens with respirations or lying down, fever, tachycardia, and a friction rub are classic signs of acute pericarditis, an inflammation of the pericardium. Myocardial infarction and stable angina present with different symptoms, and pericardial effusion may cause chest pain and shortness of breath but typically does not worsen with respirations or lying down.

Question 3

A 56-year-old male presents to his physician for a checkup. Physical exam reveals edema, hepatomegaly, and muffled heart sounds. Which of the following is a concern?

Accepted Answer

The clinical presentation of edema, hepatomegaly, and muffled heart sounds is suggestive of cardiac tamponade, which is a medical emergency. The accumulation of fluid in the pericardial sac puts pressure on the heart, impeding its function, and can result in serious complications, such as heart failure and cardiac arrest. Immediate medical attention is required to drain the fluid and relieve the tamponade. Exudate, an abnormal buildup of fluid with high protein content in the tissues or cavities of the body, is a possible cause of edema but is less likely to cause muffled heart sounds and hepatomegaly. Aneurysm, an abnormal bulge or ballooning of a blood vessel, may cause symptoms such as pain or rupture but is not typically associated with the clinical signs in this case. Pulsus paradoxus, an abnormal drop in blood pressure during inhalation, may be seen in some cases of cardiac tamponade, but it is not a primary concern in the context of the presented scenario.

Question 4

Superior vena cava syndrome is a progressive _____ of the superior vena cava that leads to venous distention of the upper extremities and head.

Accepted Answer

Superior vena cava syndrome is caused by obstruction, usually by a tumor or thrombosis, that leads to venous distention in the upper extremities and head.

Question 5

A 55-year-old male died of myocardial infarction. Autopsy would most likely reveal:

Accepted Answer

Myocardial infarction is typically caused by the blockage of a coronary artery due to a blood clot formed as a result of platelet aggregation within an atherosclerotic plaque. This is the most likely finding on autopsy. Embolization of plaque from the aorta (A) can lead to stroke but is less likely to cause myocardial infarction. Decreased ventricular diastolic filling time (B) may contribute to heart failure but is not the primary cause of myocardial infarction. Smooth muscle dysplasia in the coronary artery (D) is a rare cause of myocardial infarction.

Question 6

A 49-year-old male presents to his physician complaining of chest pain. EKG reveals ST elevation. He is diagnosed with myocardial ischemia. Which of the following interventions would be most beneficial?

Accepted Answer

Increasing myocardial oxygen supply would be the most beneficial intervention for myocardial ischemia. This can be achieved through measures such as administering oxygen, using antiplatelet agents, and initiating revascularization procedures such as angioplasty or bypass surgery. Decreasing ventricular volume with a diuretic, increasing heart rate, and increasing myocardial oxygen demand would not typically be helpful in this situation and may even exacerbate the ischemia.

Question 7

A 50-year-old obese male with hypertension and coronary artery disease visits a nutritionist for food counseling. He is told that _____ raise LDL levels and lower HDL levels and should be avoided.

Accepted Answer

Trans-fats are known to raise LDL (bad cholesterol) levels and lower HDL (good cholesterol) levels, which can increase the risk of cardiovascular diseases.

Question 8

A 60-year-old female had a myocardial infarction. She was brought to the hospital 30 minutes later. She survived but now has impaired ventricular function because:

Accepted Answer

When a myocardial infarction occurs, there is a decreased blood flow to the heart muscle. This ischemia leads to hypoxic injury, which can result in the death of myocardial cells. This can then lead to impaired ventricular function. Options A and C may occur in response to a myocardial infarction, but they are not the primary cause of impaired ventricular function. Option B is not a direct cause of impaired ventricular function, although chronic stress on the heart can lead to heart failure over time.

Question 9

A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would most likely influence development of this disease?

Accepted Answer

Cigarette smoking is a well-known modifiable risk factor for the development of coronary artery disease. Eating meat, geographic location of home, and exposure to infection are not established risk factors for this condition.

Question 10

Cardiac cells can withstand ischemic conditions for _____ before irreversible cell injury occurs.

Accepted Answer

The answer of Cardiac cells can withstand ischemic conditions for...

Question 11

A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The most likely manifestation of this disorder is:

Accepted Answer

The answer of A 52-year-old male presents with pooling of...

Question 12

A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following is the most likely diagnosis?

Accepted Answer

The symptoms of edema and venous distention in the upper extremities and face are consistent with superior vena cava syndrome (SVCS). This is a medical emergency that occurs when the superior vena cava, a large vein that carries blood from the upper body to the heart, is partially or completely obstructed. In this case, the obstruction is likely due to the bronchogenic cancer compressing the vein. Thromboembolism and deep vein thrombosis could also cause edema and venous distention, but they would typically be localized to one limb, whereas SVCS affects the upper body. Chronic venous insufficiency does not cause acute symptoms like edema and venous distention.

Question 13

A 51-year-old male is at his health clinic for an annual physical exam. After walking from the car to the clinic, he developed a substernal pain. He also reported discomfort in his left shoulder and his jaw, lasting 2 to 3 minutes and then subsiding with rest. He indicates that this has occurred frequently over the past few months with similar exertion. He is most likely experiencing:

Accepted Answer

The characteristic symptoms of stable angina include chest discomfort or pain that typically occurs with exertion or emotional stress and is relieved by rest or nitroglycerin. The pain may radiate to the left arm, shoulder, or jaw. This patient's symptoms are consistent with stable angina as they occur with exertion and subside with rest, and they have been occurring frequently over the past few months. Unstable angina is characterized by symptoms that occur at rest or with minimal exertion and are severe and prolonged or new onset. Prinzmetal angina is a type of angina caused by vasospasm of the coronary arteries, often occurring at rest, and is typically treated with calcium channel blockers. Myocardial infarction occurs when there is prolonged and severe ischemia leading to irreversible damage to the heart muscle, and is characterized by a similar substernal pain but is not relieved by rest, and may have associated symptoms such as nausea, vomiting, and diaphoresis.

Question 14

The most common cause of myocardial ischemia is:

Accepted Answer

Atherosclerosis is the most common cause of myocardial ischemia, as it causes narrowing and obstruction of the coronary arteries that supply blood to the heart muscle. Idiopathic vasospasm, arterial emboli from heart valve vegetation, and venous emboli can also cause myocardial ischemia, but they are less common causes.

Question 15

A 53-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. The pain he experiences occurs when:

Accepted Answer

Angina pectoris is typically caused by a reduced myocardial oxygen supply in relation to demand. This often occurs during exertion or stress, when oxygen demands increase and the coronary arteries are unable to provide adequate blood flow to the heart muscle.

Question 16

Many valvular stenosis and regurgitation disorders in adults have a common etiology. Which of the following can result in both types of valve dysfunction?

Accepted Answer

Rheumatic fever or heart disease can lead to both valvular stenosis and regurgitation disorders.

Question 17

A 62-year-old male presents to his physician complaining of chest pain at rest and with exertion. He does not have a history of coronary artery disease and reports that the pain often occurs at night. He is most likely experiencing which type of angina?

Accepted Answer

The symptoms described suggest that the patient is experiencing Prinzmetal angina, which is also known as variant angina. This type of angina occurs due to spasm of the coronary arteries, which leads to a decrease in blood supply to the heart. It often occurs at rest, during sleep, or in the early morning hours. Stable angina typically occurs with exertion or stress, while unstable angina occurs at rest or with minimal exertion and is considered a medical emergency. Silent angina is asymptomatic and typically only detected by diagnostic tests.

Question 18

A 68-year-old male presents to the ER complaining of chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:

Accepted Answer

The presentation of chest pain in a patient with a history of stable angina that is now unstable suggests that the patient is likely experiencing an impending myocardial infarction. This is a serious and potentially life-threatening condition that requires immediate medical attention. Mild to moderate atherosclerosis, electrical conduction problems in the heart, and decreased myocardial oxygen demand may all contribute to the development of unstable angina, but they would not necessarily explain the sudden onset of chest pain in this patient.

Question 19

A 42-year-old female is diagnosed with constrictive pericarditis. She would also have a decreased cardiac output because of:

Accepted Answer

Constrictive pericarditis involves fibrosis and calcification of the pericardial layers, which can restrict cardiac filling and decrease cardiac output. Pericardial effusions, cardiomyopathy, and hemorrhage in the pericardial cavity may all potentially affect cardiac output, but they are not the primary cause of decreased cardiac output in constrictive pericarditis.

Question 20

A 75-year-old male has severe chest pain and dials 911. Lab tests at the hospital reveal elevated levels of creatinine phosphate and lactic dehydrogenase. These elevated levels indicate:

Accepted Answer

Elevated levels of creatinine phosphate and lactic dehydrogenase are indicative of myocardial infarction, as they are markers of cardiac muscle damage. Raynaud disease is characterized by vasospasms in the fingers and toes, and is not associated with elevated levels of these lab values. Orthostatic hypertension refers to a drop in blood pressure upon standing, and is not related to these lab values. Varicose veins are caused by malfunctioning valves in the veins, and do not typically result in elevated levels of creatinine phosphate or lactic dehydrogenase.

Quiz 23: Alterations of Cardiovascular Function