Harry T Harper Jr., M.D. School of Cardiac and Vascular Technology
A Program of University Hospital’s Georgia Heart Institute
DIS 150 Registry Review
WEEK 5
1.
Elevation of _______ a wave with LV failure reflects the increased filling pressure required with
elevated LV diastolic pressure.
a. PA
b. PCW
c. RV
d. RA
2.
__________ is the cardinal sign of right ventricular failure.
a. Pallor
b. Pulmonary edema
c. Elevated venous pressure
d. Syncope
3. The following pressures indicate:
RA
6/5/4
RV
20/10/4
PA
30/15/15
a. LV failure
PAW
30
LV
AO
200/30
200/120/120
b. RV failure
c. Pericarditis
d. Tamponade
4.
In constrictive pericardial disease the PAW a and v waves are elevated and either the ___
descent of the __ & __ descent are equal, giving an M pattern to the PAW pressure waveform.
a. X, x’ & y
b. Y, x’ & y
c. X, x & y
d. Y, x & y
5.
Constrictive cardiac pathology seen in acute cardiac tamponade shows reduced:
a. Systolic ejection
b. RV diastolic filling
c. Heart rate
d. LV contractility
6.
The following asymptomatic 80 Year Old patient has MR with Atrial Fibrillation, massive enlarged
and dilated LA, normal Pulmonary Vascular Resistance, Forward Cardiac Output of 3.5 L/min,
and regurgitation of 1.1 L/min.
heart cath?
a. PAW= -/18/15
b. PAW=- /47/29
What wedge pressure readings would be likely to be found at
c. PAW= 15/12/10
d. PAW= 28/14/35
7.
Which type of angiogram would best define a “Flail Mitral Valve Leaflet” or ruptured chordae
tendinea:
a. Aortic root, LAO angiogram
b. Aortic root, RAO angiogram
c. Left ventriculogram, LAO view
d. Left ventriculogram, RAO view
8.
In severe aortic regurgitation the presystolic apical rumble (sounding like an MS murmur)
commonly heard is termed a/an:
a. Austin Flint murmur
b. Diamond shaped ejection murmur
c. Graham Steel murmur
d. Bruit murmur
9.
Insufficiency in atrial pressures are seen as:
a. Peaked a wave
b. Absence of a dicrotic notch
c. Significant gradient found when simultaneous pressures present
d. Peaked v wave
10.
Insufficiency in PA or AO pressure are shown as:
a. Peaked a wave
b. Absence of a dicrotic notch
c. Significant gradient found when simultaneous pressures present
d. Peaked v wave
11.
The actual amount of O2 carried in blood (vol%) is defined as the oxygen:
a.
b.
c.
d.
12.
What element in the hemoglobin molecule combines chemically with oxygen?
a.
b.
c.
d.
13.
Sympathomimetic
Cholinergic
Vagal blocker
Beta blocker
The greatest heart rate increase comes by stimulating the _______ autonomic nerve
receptors.
a.
b.
c.
d.
e.
15.
Globulin
Hydroxyl (OH-)
Benzine ring (carbon)
Iron (Fe)
Identify the class of the autonomic drug Propranolol (Inderol)?
a.
b.
c.
d.
14.
Content
Capacity
Saturation
Dissociation
Alpha adrenergic
Beta-1 adrenergic
Beta-2 adrenergic
Parasympathetic
Dopinergic
Pulmonary hypertension would be most increased with inhalation of _______gas.
16.
a. 15% O2
b. 100% O2
c. 0% CO2
d. 5% CO2
Which drug below is can decrease pain and pulmonary congestion?
a.
b.
c.
d.
e.
17.
Patients taking NPH insulin have an increased sensitivity to which of the following:
a.
b.
c.
d.
18.
Cut 50% for patients coming to cath lab NPO in early morning
Cut 25% for patients coming to cath lab NPO in early morning
Skipped
Taken immediately following cath
When premedicating a patient with Demerol or Morphine, a narcotic antagonist such as
_______ should be available.
a.
b.
c.
d.
20.
Benadryl
Protamine
Demerol
Heparin
For patients taking subcutaneous insulin (NPH, regular) before cardiac cath an overnight
fast with their normal dose of insulin will cause hypoglycemia. The dose of insulin
should be:
a.
b.
c.
d.
19.
Demerol
Valium or versed
Atropine
Morphine
Benadryl
Protamine
Benadryl
Narcain
Phenergan
Beta Blockers such as ________ can be used to control recurring episodes of PSVT.
a.
b.
c.
d.
Propranolol
Diazepam
Aramine
Diltiazem
21.
The “Systolic Ejection Period” for the aortic valve area calculation is measured
between
the:
a. Aortic dicrotic notch to next Aortic upstroke
b. Aortic upstroke to next dicrotic notch
c. ECG R wave to next Aortic dicrotic notch
d. Aortic dicrotic notch to next ECG R wave
22.
Central venous pressure (CVP) is the same as ______ pressure:
a. LA pressure
b. RA pressure
c. Diastolic blood pressure
d. LVEDP
23.
Which hemodynamic parameter list evaluates ventricular preload?
a. Cardiac output
b. PVR
c. Mean AO pressure
d. LVEDP
24.
In an AO pressure recording, a gradual upstroke with a prominent low anacrotic
indicative of:
a. Aortic Stenosis
b. Aortic Regurge
c. LV failure
d. Congestive heart failure
25.
How does mechanical ventilation and positive pressure breathing affect a patient’s
hemodynamics?
notch is
a. Decreased afterload
b. Increased preload
c. Increased contractility
d. Decreased venous return
26.
What is the result of a sustained Valsalva maneuver on the heart?
a. Increased b/p; decreased venous return
b. Increased b/p; increased venous return
c. Decreased b/p; decreased venous return
d. Decreased b/p; increased venous return
27.
Closure of the AV valves produces the:
a. First heart sound- S1
b. Second heart sound- S2
c. Third heart sound- S3
d. Fourth heart sound- S4
28.
Which of the following is a normal pressure level for the RV?
a. 7/1
b. 25/4
c. 50/10
d. 70/15
29.
What is the average normal RA and LA pressure means respectively?
(RA = _____ and LA = _____)
a. 0/2 mmHg
b. 3/8 mmHg
c. 5/15 mmHg
d. 8/20 mmHg
30.
Which heart valve is Normally the first to open and the last to close in ventricular systole?
a. Aortic
b. Mitral
c. Tricuspid
d. Pulmonic
31.
Cerebral vascular accidents and transient ischemic attacks in hypertensive patients occur at a rate
of four times those of normal individuals. Most of these “strokes” are due to:
a. Subarachnoid hemorrhage
b. Hyalinotic obstructive lesions (lacunar infarcts)
c. Cerebral micro-aneurysms (hyalinosis)
d. Cerebral embolism and infarct
32.
The vast majority of high blood pressure is caused by
a. Stress and drug side effects
b. High salt and cholesterol diets
c. Renal or endocrine disease
d. Primary and unknown factors
33.
The most widely used drugs to initiate antihypertensive therapy are:
a. Diuretics
b. Narcotics
c. Beta-blockers
d. Calcium antagonists
34.
Right ventricular dilatation and hypertrophy secondary to pulmonary hypertension is termed:
a. Cor pulmonale
b. Hyaline membrane disease
c. Asymmetric septal hypertrophy
d. Hypertrophic cardiomyopathy
35.
Isolated systolic hypertension (bp 160/80 mmhg) is associated with:
a. Oral contraceptive use
b. Renal parenchymal disease (nephritis)
c. Coarctation of the aorta
d. Elderly rigid atherosclerotic aorta
36.
Factors associated with primary hypertension are:
1. High salt diet
2. High potassium diet
3. Alcohol intake
4. Hip and thigh obesity
5. Cigarette smoking
6. Diabetes mellitus
a. 1,2,3,5
b. 1,4,5
c. 1,5,6
d. 2,4,5,6
37.
The most common cause of death in U.S. is
a. Cancer
b. Stroke
c. Trauma and suicide
d. Coronary artery disease
38.
Select the three major histological changes characteristic of the atherosclerotic fibrous plaque.
1. Smooth muscle proliferation
2. Intimal proliferation
3. Medial destruction and atrophy
4. Accumulation of collagen
5. Fatty streaks on the wall of the intima
6. Cholesterol accumulating in adventitia
7. Accumulation of fat inside the wall of intima
a. 1,4,7
b. 1,2,6
c. 2,5,7
d.2,6,7
39.
The three major risk factors associated with heart attack are:
1. Diabetes
2. Cigarette smoking
3. Stress/ type A. Behavior
4. High blood cholesterol
5. Hypertension
a. 1,2,4
b. 1,4,5
c. 2,3,4
d. 2,4,5
40.
A 2mm diameter vessel that becomes stenosed down to .8mm diameter is what percentage
diameter stenosis?
a. 20%
b. 40%
c. 60%
d. 80%
D2-D1/ D2
2-.8/2=.6x100=60%
41.
The time from the onset of the QRS complex to the peak of the R-wave in the QRS complex is
called:
a. The ventricular activation time
b. The preintrinsicoid deflection
c. All of the above
d. None of the above
42.
The ECG in an acute anteroseptal MI is characterized by ST segment elevation in the following
facing leads:
a. Leads II, III, and aVF
b. Leads V1-V4
c. Leads I, aVL, and V1-V6
d. Leads V5-V6
43.
A delay of progression of the electrical impulse through the AV node or Bundle of His would
show on the ECG as a(an):
a. Prolonged QRS complex
b. Peaked T wave
c. Elevated ST segment
d. Prolonged PR interval
44.
Myocardial ischemia, acute MI, excess serum potassium, and administration of
procainamide
can cause an abnormal________ on the ECG.
a. P wave
b. QRS complex
c. T wave
d. U wave
45.
The diagnosis of left ventricular hypertrophy is based on the ECG characteristics of increased
amplitude or depth of the R and S waves in specific limb and precordial leads and:
a. A QRS axis greater than -15RRQWK5.971
b. ST segment elevation
c. All of the above
d. None of the above
46.
Which echocardiographic view is best when looking for the presence of an ASD or VSD?
a. Apical 4 chamber
b. Apical long axis
c. Parasternal long axis
d. Subcostal long axis
47.
There are 3 steps to reading a colorflow image. Which of the following is the correct
read a colorflow image?
1. Determine what the color map setting is
2. Determine where the transducer is
3. Determine the timing and direction of flow
a. 3,1,2
b. 2,1,3
c. 1,2,3
d. 1,3,2
order to
48.
When taking M-Mode measurements it is important to do all of the following EXCEPT:
a. Make several measurements and average them together
b. Make all measurements from leading edge to leading edge
c. Measure any PVC’s and include in the average
d. Make sure the recording is obtainedfrom the correct position or “window”
49.
A patient is undergoing a stress test. The patient is placed on a treadmill with the starting speed
of 1.7 mph and a grade of 10%. The patient then progresses to a maximum capacity at 3 minute
intervals. This is the most popular protocol which is called:
a. Continuous protocol
b. Intermitent protocol
c. Bruce protocol
d. Harvard step protocol
50.
All of the following are relative contraindications to stress testing EXCEPT:
a. Locomotion problems
b. Suspected left main disease
c. CHF
d. Severe hypertension
51.
Which prosthetic heart valve should be used in the tricuspid position?
a.
Starr-Edwards, Smeloff, Braunwald-Cutter
b.
Hufnagel, Kay-Shiley, Beall valve
52.
c.
St. Jude, Duromedics valve
d.
Lillehei-Kaster, Bjork-Shiley, Onmiscience, Omnicarbon
e.
Carpentier-Edwards, Hancock, porcine valve
What type of bypass conduit would be surgically implanted in an EMERGENCY right Coronary
artery bypass procedure?
53.
54.
55.
a.
Saphenous veins
b.
Dacron grafts
c.
Rt. IMA
d.
Lt. IMA
Compared to saphenous vein CABGs the IMA-coronary grafts tend to:
a.
develop more atherosclerosis
b.
develop intimal hyperplasia
c.
be a closer size match to coronary vessels
d.
have no better patency rate
Which type of CABG surgery patient has the highest intraoperative mortality rate?
a.
small female patients
b.
patients with LV dysfunction (EF 40%)
c.
Mainstream coronary stenosis (70% narrowing)
d.
Re-operation patients (X3)
Currently the overall intra-operative mortality rate in the USA for CABG surgery averages:
a.
5%
b.
10%
56.
c.
15%
d.
20%
In normal anatomy the right pulmonary artery is positioned
positioned
57.
58.
59.
to the SVC and the left PA is
to the descending AO.
a.
Anterior, Anterior
b.
Anterior, Posterior
c.
Posterior, Posterior
d.
Posterior, Anterior
Congenital heart defects are usually caused by pathological:
a.
atherosclerosis
b.
rheumatic fever
c.
bacterial infections
d.
embryological development
Compared to an older child or adult, the heart of a fetus or newborn infant has high:
a.
diastolic reserve (to increase preload)
b.
inotropic reserve (to increase contractility)
c.
Heart rate reserve
d.
O2 consumption/M2
The most common congenital heart defect found at a full term birth is:
a.
ASD
b.
VSD
c.
PDA
d.
60.
Ductus Venosus
Which of the following is considered to be an “Acyanotic” congenital heart lesion?
a.
Transposition (TGV)
b.
Tetralogy of Fallot
c.
Common ventricle
d.
Tricuspid Atresia
e.
Total Anomalous Venous Return (TAPVR)
f.
Truncus Arteriosus