Heart Disease Review Questions
Fill-In-The-Blank:
these statements are conceptual; as such there may be other correct answers in addition to the ones provided.
Primary hypertension is also known as
essential
hypertension.
Blood pressure above 180/120 is called
malignant
hypertension.
Severe hypertensive injury to the optic disc is called
papilledema
.
Excess serum levels of
LDL
particles can lead to atherosclerosis.
Macrophages that have become engorged on LDL are called
foam cells or foamy macrophages
.
The accumulation of lipids and macrophages in the vessel wall is referred to as
atheroma
or
plaque
.
Atherosclerosis tends to occur around areas of
arterial bifurcation / turbulent flow
.
Smoking, obese fat, and autoimmune diseases promote the
oxidation
of LDL.
End stage heart disease can also be called
congestive heart failure
.
The abdominal aorta is a common location for
aneurysms
to develop.
Infarcts can be caused by either
plaque rupture
or
thrombo-embolism (a.k.a. athero-embolism)
.
Idiopathic regurgitation of the mitral valve in young adults is called
mitral valve prolapse
.
Bacterial infections of the heart valves (a.k.a. infective endocarditis) are referred to as
vegetations
.
Patients with bicuspid aortic valves are at great risk of
age-related valve dysfunction
.
A cause of sudden death in young athletes is called
hypertrophic cardiomyopathy
.
Valve dysfunctions can be divided into two conditions:
regurgitation
and
stenosis
.
Multiple Choice Questions:
1) Clinically, physicians often talk to patients about "lowering their cholesterol" as a means of decreasing their risk for atherosclerosis. What they really mean is that they want to lower the patients amount of:
A
LDL
B
HDL
C
Fibrin
D
Platelets
Explanation: Cholesterol is a significant component of both LDL and HDL; however, lowering of serum LDL reduces the risk of atherosclerosis, whereas HDL is protective.
2) You are a pathologist performing an autopsy on a 72 year old patient that died suddenly at home, Which of the following is a likely cause:
A
Hemorrhagic stroke
B
Embolic stroke
C
Coronary artery plaque rupture
D
Pulmonary embolus
E
All of the above
Explanation: All of these are common causes of sudden death in adults. In younger patients you might also consider hypertrophic cardiomyopathy or a genetic conduction defect.
3) You see a patient who smokes cigarettes. You talk about strategies to reduce their smoking, while pointing out the benefits of quitting smoking in terms of lung function, lung cancer, and cardiovascular health. Which of the following is a reason tobacco increases the risk of atherosclerotic cardiovascular disease?
A
Smoking creates reactive oxygen species (ROS) that oxidize LDL
B
Nicotine increases platelet aggregation, promoting thrombosis
C
Nicotine increases hypertension by stimulating the sympathetic nervous system
D
All of the above
Explanation: Tobacco +/- nicotine has multiple effects that promote atherosclerosis. All three are correct.
4) You see an elderly patient with severe aortic stenosis; which of the following, is the most likely cause?
A
Aortic root dilation due to syphilitic aneurysm
B
Marfan syndrome associated aortic valve insufficiency
C
Rheumatic fever as a child
D
Bicuspid aortic valve
Explanation: Although bicuspid aortic valves are only found in 1-2% of the population, they may up >50% of cases of severe aortic stenosis in the elderly. Rheumatic fever as a child would be a good second choice. Syphilitic aneurysm (these days) and Marfan syndrome are quite uncommon.
5) You see a patient with an abdominal aortic aneurysm. On ultrasound the aneurysm is greater than 5cm in diameter. You are concerned because of an increased risk of:
A
Aneurysm rupture
B
Thromboembolism leading to a pulmonary embolus
C
Plaque embolism causing a a cerebral infarct
Explanation: As aneurysms expand the risk of rupture goes up significantly. Although thromboembolic events from the clotted material in an aneurysm might lead to a distal embolic event, the abdominal aorta does not feed either the lungs or the brain (just the feet).
Email
a question, comment, or concern:
robert.camp@yale.edu