Valvular Disease
Questions and Answers
- 1.
Less than what cm is considered in Mitral stenosis where hemodynamic changes becomes clinically appearant?
- A.
2
- B.
4
- C.
5
- D.
7
Correct Answer
A. 2Explanation
normal is 4-6 cmRate this question:
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- 2.
Which of the following is associated with increase in LA pressure, pulmonary venous capillary pressure, transudation of plasma into the lung interstitum and alveoli. Pt is in risk for Pulmonary HTN, CHF, and LA enlargement
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
An increase in LA pressure, pulmonary venous capillary pressure, and transudation of plasma into the lung interstitium and alveoli are all associated with pulmonary congestion. This can lead to pulmonary hypertension (PH), congestive heart failure (CHF), and left atrial (LA) enlargement. Therefore, the statement "True" is an accurate representation of the given information.Rate this question:
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- 3.
Left Atrium enlargement in mitral stenosis can cause this time of arrythmia (most common)?
- A.
A fib
- B.
Ischemia
- C.
V-tach
Correct Answer
A. A fibExplanation
irregularly irregularRate this question:
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- 4.
Myxomatus degenration of MV, rheumatic fever, infective endocarfitis, calcification of mitral annulus associated with HTN/DM, and hypertrophic cardiomyopathy, can cause this kind of valvular problem
- A.
, mitral stenosis
- B.
Mitral regurgitation chronic
- C.
Aortic stenosis
- D.
Tricuspid steonis
- E.
Mitral regurgitaytion acute
Correct Answer
B. Mitral regurgitation chronicExplanation
acute MR can be caused by idiopathic rupture of chordae tendenae, and papillary muscle dysfunction secondary to MIRate this question:
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- 5.
What kind of symptom can chronic MR present?
- A.
Decreased CO
- B.
Fatigue and weakness with exertion
- C.
LV failure causing dyspnea
- D.
RV failure causing peripheral edema
- E.
Pulmonary edema which is a medical emergency
- F.
All of the above except D
Correct Answer
F. All of the above except DExplanation
RA is connected with Vena cava
Pulmonary edema is part of Acute MR since heart doesn't have time to compensate, the buildup affects pulmonary vessels from LA right away.Rate this question:
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- 6.
What are the consequences of MR?
- A.
Elevation of LA and pressure
- B.
Reduction of forward CO
- C.
Volume related stress on the LV because the regurgitated volume returns to the LV during diastole with normal venous return
- D.
LV stroke volume increases to eject the volume
- E.
All of the above
Correct Answer
E. All of the aboveExplanation
The consequences of MR include elevation of LA and pressure, reduction of forward CO, volume-related stress on the LV because the regurgitated volume returns to the LV during diastole with normal venous return, and an increase in LV stroke volume to eject the volume.Rate this question:
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- 7.
All of the following can impact forward CO except
- A.
Size of mitral orifice
- B.
Systolic pressure gradient between LA and LV
- C.
Systemic vascular resistance opposing LV flow
- D.
LA compliance
- E.
RA compliance
- F.
Duration of regurgitation with each systolic contraction
Correct Answer
E. RA complianceExplanation
RA compliance refers to the ability of the right atrium to expand and accommodate blood volume. It is not directly related to forward CO (cardiac output), which is the amount of blood pumped by the left ventricle per minute. Factors such as the size of the mitral orifice, systolic pressure gradient between the left atrium and left ventricle, systemic vascular resistance opposing left ventricular flow, LA compliance, and duration of regurgitation with each systolic contraction can all impact forward CO. Therefore, RA compliance is the only option that does not affect forward CO.Rate this question:
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- 8.
This is often seen with chronic MR
- A.
RA dilation
- B.
LA dilatation
- C.
RA dilatation
- D.
None of the above
Correct Answer
B. LA dilatationExplanation
inadequated forward output increased LA volume and thus increasing the size of LA. The Pulmonary pressure and LA pressure stays the sameRate this question:
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- 9.
In chronic MR which of the following is most commonly heard?
- A.
An ejection click
- B.
An apical holosystolic murmer that radiates to the axilla
- C.
A crescende decrescendo murmer that radiates to the carotid
- D.
Diastolic rumble
- E.
All of the above
Correct Answer
B. An apical holosystolic murmer that radiates to the axillaExplanation
diastolic rumber is heard with mitral stenosisRate this question:
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- 10.
Clenched fist will intensify this kind of murmur
- A.
MR
- B.
MS
- C.
AS
- D.
AR
Correct Answer
A. MRExplanation
When the question mentions that a clenched fist will intensify a certain kind of murmur, it is referring to the murmur caused by mitral regurgitation (MR). Mitral regurgitation is a heart condition where the mitral valve does not close properly, causing blood to flow back into the left atrium. When a person clenches their fist, it increases the systemic vascular resistance, which in turn increases the left ventricular afterload. This increased afterload causes the regurgitant flow to become more pronounced, intensifying the murmur associated with MR.Rate this question:
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- 11.
In chronic MR, the LV undergos gradual compensatory dilatation in response to the volume overload, through eccentric hypertrophy.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
In chronic MR (mitral regurgitation), the left ventricle (LV) gradually dilates in response to the increased volume of blood flowing back into the left atrium. This compensatory dilatation helps to accommodate the excess blood and maintain cardiac output. Additionally, the LV undergoes eccentric hypertrophy, which means that the muscle fibers of the LV elongate and thicken to adapt to the increased workload. This response helps to maintain the pumping function of the heart despite the regurgitation of blood through the mitral valve. Therefore, the statement "In chronic MR, the LV undergoes gradual compensatory dilatation in response to the volume overload, through eccentric hypertrophy" is true.Rate this question:
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- 12.
What is the best treat for chronic MR?
- A.
Vasodilator
- B.
Diuretics
- C.
Reconstruction of native valve
- D.
Mitral valve replacement
Correct Answer
C. Reconstruction of native valveExplanation
mitral valve replacement has higher operative mortality ratesRate this question:
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- 13.
This is sometimes accompanied by MR
- A.
AS
- B.
Tricuspid Stenosis
- C.
MV prolapse
Correct Answer
C. MV prolapseExplanation
The given answer, MV prolapse, suggests that the statement "This is sometimes accompanied by MR" refers to mitral valve prolapse. Mitral valve prolapse is a condition where the valve between the left atrium and left ventricle doesn't close properly, causing blood to leak backward into the atrium (mitral regurgitation). This condition can sometimes be accompanied by mitral regurgitation, which is the abnormal flow of blood back into the left atrium during ventricular contraction. Therefore, the answer MV prolapse aligns with the statement provided.Rate this question:
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- 14.
Functional capacity is a measurement of structural lesions in the heart
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Estimate of what the pt's heart will allow the pt to do, it can help determine when surgery is needed.Rate this question:
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- 15.
Select the true statement
- A.
Mitral and tricuspid stenosis is part of diastolic murmer
- B.
Mitral abd tricuspid regurgitation is part of diastolic mumer
- C.
Aortic and oulmonic stenosis is part of diastolic murmer
- D.
Aortic and pulmonic regurgitation is part of systolic murmer
Correct Answer
A. Mitral and tricuspid stenosis is part of diastolic murmerExplanation
mitral abd tricuspid regurgitation is part of systolic murmer
aortic and oulmonic stenosis is part of systolic murmerRate this question:
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- 16.
This Imaging is best for evaluting valcular diseases
Correct Answer
DopplerExplanation
Doppler imaging is the best technique for evaluating vascular diseases because it uses sound waves to measure the movement of blood through blood vessels. It can detect abnormalities such as blockages, narrowing, or leakage in the vessels, providing valuable information about the blood flow and identifying any potential issues. Doppler imaging is non-invasive, safe, and highly accurate, making it an ideal choice for diagnosing and monitoring vascular diseases.Rate this question:
- 17.
The following describes which of the following?A common and usually asymptomatic condition consisting of billowing of the mitral leaflets into the LA during systole
- A.
MR
- B.
Mitral valve Prolapse
- C.
AS
Correct Answer
B. Mitral valve ProlapseExplanation
Mitral valve prolapse is a condition where the mitral valve leaflets bulge or billow into the left atrium during systole. It is a common condition that is usually asymptomatic. This condition is characterized by the abnormal movement of the mitral valve leaflets, which can sometimes result in regurgitation of blood back into the left atrium.Rate this question:
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- 18.
What are the possible causes of mitral valve prolapse?
- A.
Autosomal dominant disorder
- B.
Myxomatous degeration of the valve
- C.
In association with CT disorder
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
Mitral valve prolapse can be caused by multiple factors. One possible cause is an autosomal dominant disorder, which means that it can be inherited from a parent. Another cause is myxomatous degeneration of the valve, which refers to the abnormal changes in the valve tissue. Additionally, mitral valve prolapse can also be associated with connective tissue disorders. Therefore, all of the above options are possible causes of mitral valve prolapse.Rate this question:
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- 19.
What kind of murmer is associated with mitral valve prolapse
- A.
Mid systolic click and late systolic murmer heard at apex
- B.
Mid diastolic click and late diastolic murmer heard at apex
- C.
Only mid diastolic click
- D.
Diastolic rumble
- E.
Holosystolic murmer
Correct Answer
A. Mid systolic click and late systolic murmer heard at apexExplanation
Mitral valve prolapse is a condition where the mitral valve doesn't close properly, causing blood to leak back into the left atrium. The characteristic finding in mitral valve prolapse is a mid-systolic click, which occurs when the valve billows back into the left atrium during systole. Additionally, a late systolic murmur can be heard at the apex due to the regurgitation of blood. This combination of a mid-systolic click and late systolic murmur heard at the apex is specific to mitral valve prolapse.Rate this question:
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- 20.
There is no treatment indicated for this valvular disease.
- A.
MR
- B.
AS
- C.
Mitral Valve Prolapse
Correct Answer
C. Mitral Valve ProlapseExplanation
Mitral Valve Prolapse is the correct answer because the statement suggests that there is no treatment indicated for a valvular disease. Mitral Valve Prolapse is a condition where the valve between the left atrium and left ventricle doesn't close properly. In most cases, treatment is not necessary for this condition unless it causes severe symptoms or complications. Therefore, the statement aligns with the fact that no treatment is indicated for Mitral Valve Prolapse.Rate this question:
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- 21.
This valve is most likely to get calcified due to aging and cause this kind of valvular disease.
- A.
MS
- B.
AS
- C.
MR
- D.
TS
Correct Answer
B. ASExplanation
The valve most likely to get calcified due to aging and cause a valvular disease is the aortic valve (AS). Calcification of the aortic valve is a common occurrence in older individuals and can lead to a condition known as aortic stenosis. Aortic stenosis is characterized by the narrowing of the aortic valve opening, which restricts blood flow from the heart to the rest of the body. This can result in symptoms such as chest pain, shortness of breath, and fatigue. Therefore, AS is the correct answer in this case.Rate this question:
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- 22.
Aortic valve stenosis can occur due to calcified valve due to aging, rheumatic fever, bicuspid aortic valve
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Aortic valve stenosis is a condition where the aortic valve becomes narrowed, impeding the flow of blood from the heart to the rest of the body. This narrowing can occur due to various factors, including calcification of the valve with age, rheumatic fever, and having a bicuspid aortic valve. These factors can cause the valve to become stiff and less flexible, leading to stenosis. Therefore, the statement that aortic valve stenosis can occur due to calcified valve due to aging, rheumatic fever, and bicuspid aortic valve is true.Rate this question:
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- 23.
This weight loss drug promoted a lot of valvular disease
Correct Answer
Fen-phenExplanation
MR, AR, tricuspid valve diseaseRate this question:
- 24.
Both LV and LA hypertrophy is seen in this kind of valve disease
- A.
MS
- B.
AS
- C.
MR
Correct Answer
B. ASExplanation
LV due to higher systolic pressure gets hypertrophied--> reduces wall stress and compliance, then LA gets higher pressure during diastoleRate this question:
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- 25.
AS can cause the followng
- A.
Angina
- B.
Syncope
- C.
Congestive Heart Failure
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
angina- increase oxygen demand(hypertrophied muscle) decreased supply (elevated LV diastolic pressure reduces coronary perfusion
exertional syncope-orifice can't expand with exertion and decreases cerebral perfusion- causing dizziness and unconciousness
Congestive Heart failure- as afterload increases, LV can't cope with greater and greater afterload. Left diastolic pressure increases, left atrial pressure increases, then there is increased pulmonary pressure, and then there is pulmonary congestionRate this question:
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- 26.
What kind of murmer is associated with mitral stenosis?
- A.
May have an S4 due to stiffened ventricle
- B.
Ejection murmer-crescendo-decrescendo
- C.
Weakened delayed upstroke of carotid artery
- D.
Opening snap
- E.
Diastolic rumble
- F.
All of the above
- G.
A, B, C
Correct Answer
E. Diastolic rumbleExplanation
Mitral stenosis is a condition characterized by the narrowing of the mitral valve, which separates the left atrium and left ventricle of the heart. This narrowing can lead to several associated findings, including an S4 heart sound due to a stiffened ventricle, an ejection murmur with a crescendo-decrescendo pattern, a weakened and delayed upstroke of the carotid artery, and an opening snap sound. Therefore, all of the options A, B, and C are correct and associated with mitral stenosis.Rate this question:
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- 27.
Which of the following is associated with mitral stenosis?
- A.
Diastolic rumble
- B.
Opening snap
- C.
Loud S1
- D.
Murmer increase with exercise
- E.
All of the above
Correct Answer
E. All of the aboveExplanation
Mitral stenosis is a condition characterized by the narrowing of the mitral valve, which affects the flow of blood from the left atrium to the left ventricle. This narrowing can cause several associated symptoms. A diastolic rumble is a low-pitched sound heard during diastole due to turbulent blood flow across the stenotic mitral valve. An opening snap is an early diastolic sound that occurs when the stiffened mitral valve opens abruptly. A loud S1 is a characteristic finding in mitral stenosis due to the increased pressure in the left atrium. The murmur associated with mitral stenosis can increase with exercise. Therefore, all of the above symptoms are associated with mitral stenosis.Rate this question:
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- 28.
What is the best treatment for AS?
- A.
Surgery of the valve as soon as there is stenosis
- B.
Replacement of the valve when LV progressively becomes dysfunctional
- C.
Nothing, it should go away by itself
Correct Answer
B. Replacement of the valve when LV progressively becomes dysfunctionalExplanation
The best treatment for AS is the replacement of the valve when the left ventricle (LV) progressively becomes dysfunctional. This is because aortic stenosis (AS) is a condition where the aortic valve narrows, causing the heart to work harder to pump blood. If left untreated, it can lead to LV dysfunction. Therefore, replacing the valve is necessary to restore proper blood flow and prevent further damage to the LV. Surgery of the valve is only recommended when there is stenosis, but replacement is the preferred treatment when LV dysfunction occurs.Rate this question:
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- 29.
Symptoms for AR includes uncomfortably strong heartbeat, dyspnea on exertion, fatigue, decreased exercise tolerance
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The given statement is true. Symptoms for AR (aortic regurgitation) include an uncomfortably strong heartbeat, dyspnea on exertion (shortness of breath during physical activity), fatigue, and decreased exercise tolerance. These symptoms occur due to the backflow of blood from the aorta into the left ventricle, leading to an increased workload on the heart and reduced oxygen supply to the body.Rate this question:
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- 30.
Aortic Regurgitation could be caused by which of the following?
- A.
Rheumatic fever
- B.
Bicuspid valve
- C.
Endocarditis
- D.
Aortic dissection
- E.
Aortic aneurysm
- F.
Dilatation of aortic root
- G.
All of the above
Correct Answer
G. All of the aboveExplanation
Aortic regurgitation is the backflow of blood from the aorta into the left ventricle of the heart due to a faulty aortic valve. Rheumatic fever is a known cause of aortic regurgitation as it can damage the heart valves. A bicuspid valve, which is a congenital abnormality where the aortic valve has two cusps instead of three, can also lead to aortic regurgitation. Endocarditis, an infection of the heart valves, can cause damage to the aortic valve and result in regurgitation. Aortic dissection, a tear in the inner layer of the aorta, and aortic aneurysm, a bulging of the aortic wall, can both contribute to aortic regurgitation. Dilatation of the aortic root, the widening of the aortic root, can also lead to regurgitation. Therefore, all of the mentioned conditions can cause aortic regurgitation.Rate this question:
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- 31.
LV dilation is seen with aortic regurgitation more than hypertrophy
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
In aortic regurgitation, the aortic valve does not close properly, causing blood to flow back into the left ventricle during diastole. This leads to an increased volume of blood in the left ventricle, causing it to dilate. On the other hand, hypertrophy refers to an increase in the size of the left ventricular muscle, which is typically seen in conditions like hypertension. While hypertrophy can also occur in aortic regurgitation, dilation is more commonly observed. Therefore, the statement that LV dilation is seen with aortic regurgitation more than hypertrophy is true.Rate this question:
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- 32.
Widened pulse pressure is a hallmark of what valve disease?
- A.
AS
- B.
MR
- C.
AR early stage
- D.
AR late stage
Correct Answer
C. AR early stageExplanation
LV goes thru volume overload, and it dilates, then LV stroke volume increases, producing high systolic arterial pressure, diastolic pressure drops due to dilation, causing widened pulse pressure differenceRate this question:
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- 33.
Blowing decrescendo diastolic murmer is associated with which of the following valve diease?
- A.
Mitral Valve prolapse
- B.
Mitral stenosis
- C.
Aortic regurgitaion
- D.
Pulmonic regurgitation
- E.
All of the above
- F.
Only C and D
Correct Answer
F. Only C and DExplanation
A blowing decrescendo diastolic murmur is associated with aortic regurgitation and pulmonic regurgitation. This murmur is heard during diastole, specifically during the filling phase of the ventricles when the aortic and pulmonic valves should be closed. In aortic regurgitation, the aortic valve does not close properly, causing blood to flow back into the left ventricle during diastole, creating the blowing murmur. Similarly, in pulmonic regurgitation, the pulmonic valve does not close properly, leading to blood flowing back into the right ventricle during diastole and causing the same type of murmur. Therefore, the correct answer is "only C and D."Rate this question:
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- 34.
TS causes neck vein distension and hepatomegaly
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
This statement is true because in patients with TS (Tetralogy of Fallot), there is obstruction of blood flow from the right ventricle to the lungs. This obstruction causes increased pressure in the right side of the heart, leading to backflow of blood into the veins. The neck veins become distended as a result. Additionally, the increased pressure in the right side of the heart can cause enlargement of the liver, resulting in hepatomegaly. Therefore, both neck vein distension and hepatomegaly are commonly seen in patients with TS.Rate this question:
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