1. Practical Session Heart and Vessels Thursday January 6, 2011

2. THURSDAY READINESS QUIZ Please remove all writing materials from your desks except a pencil and your scantron sheet. Note that the questions begin with number 101 (reverse side of scantron). Please remember to fill in your NAME (Last, First) and Student ID # (left-aligned, no leading zeroes) M2 students fill in MED, Path Assists fill in GRAD Do not take notes until discussion of Readiness Quiz is complete. After RQ is over (including discussion) notes are fine.

3. THURSDAY READINESS QUIZ The first five questions are pictorial and are based on projections. For each of the five pictorial questions, there will be three projections: –A thumbnail (miniature) view showing the illustration and the question together –A larger version of the illustration by itself –A larger version of the question by itself The remainder of questions are non-pictorial in nature.

4. Question No. 101 In its subacute form, this lesion involving the mitral valve would most likely be seen in which of the following patients? A.A young woman with a characteristic butterfly rash. B.A middle-aged woman with a history of mitral stenosis secondary to rheumatic heart disease. C.A 67-year old man with carcinoma of the pancreas. D.A middle-aged woman with sclerodactyly. E.An immune compromised patient with a virulent staph infection.

5. Question No. 101

6. In it's subacute form, this lesion involving the mitral valve would most likely be seen in which of the following patients? A.A young woman with a characteristic butterfly rash. B.A middle-aged woman with a history of mitral stenosis secondary to rheumatic heart disease. C.A 67-year old man with carcinoma of the pancreas. D.A middle-aged woman with sclerodactyly. E.An immune compromised patient with a virulent staph infection.

7. Question No. 102 Which of the following histories is most consistent with the aortic valve lesion shown here? A.50 year old woman with history of rheumatic heart disease B.75 year old man with degenerative changes in the valve C.45 year old man with a congenital abnormality of the valve

8. Question No. 102

9. Which of the following histories is most consistent with the aortic valve lesion shown here? A.50 year old woman with history of rheumatic heart disease B.75 year old man with degenerative changes in the valve C.45 year old man with a congenital abnormality of the valve

10. Question No. 103 At what interval following myocardial infarction is the patient at greatest risk for development of the complication shown here? A.0 to 24 hours B.4 to 7 days C.10 to 14 days D.after 2 weeks E.after 3 month

11. Tues Question 103

12. Question No. 103 At what interval following myocardial infarction is the patient at greatest risk for development of the complication shown here? A. 0 to 24 hours B. 4 to 7 days C. 10 to 14 days D. after 2 weeks E. after 3 months

13. Question No. 104 Which of the following is most characteristic of the disorder pictured here? A.fatty infiltration of the right ventricular wall. B.excessive thickening of the heart muscle, especially involving the interventricular septum, with potential for ventricular outflow tract obstruction C.dilation of all chambers of the heart. D.diffuse fibroelastic thickening of the mural endocardium. E.multifocal endomyocardial necrosis and infiltrate of eosinophils.

14. Question No. 104

15. Which of the following is most characteristic of the disorder pictured here? A.fatty infiltration of the right ventricular wall. B.excessive thickening of the heart muscle, especially involving the interventricular septum, with potential for ventricular outflow tract obstruction C.dilation of all chambers of the heart. D.diffuse fibroelastic thickening of the mural endocardium. E.multifocal endomyocardial necrosis and infiltrate of eosinophils.

16. Question No. 105 Which of the following statements are true? A.pulmonary hypertension is less common in patients with this disease than in patients with ventricular septal defect. B.patients with this disease are usually cyanotic from birth. C.if one excludes bicuspid aortic valve and persistent ductus associated with prematurity this is the most common congenital cardiac anomaly. D.in patients with this disorder, paradoxical emboli often give rise to venous thrombosis of the lower extremity. E.this disorder usually is associated an early right-to-left shunt which turns into a left-to-right shunt.

17. Thurs Question 105

18. Question No. 105 Which of the following is true of the lesion shown here? A.pulmonary hypertension less common than with atrial septal defect B.usually manifests as cyanosis from birth C.one of the most common congenital cardiac anomalies D.often leads to paradoxical emboli that arrest in veins of lower extremities E.usually manifest by early right-to-left shunt which later reverses to left-to-right.

19. Questions 106 through 110 are not illustrated

20. Question No. 106 Which valves are most likely to be affected in rheumatic heart disease? A.aortic and pulmonary B.aortic and mitral C.aortic and tricuspid D.mitral and tricuspid E.pulmonary and tricuspid

21. Question No. 107 The underlying condition associated with Libman-Sacks endocarditis is: A.Loeffler syndrome B.pancreatic carcinoma C.rheumatic fever D.rheumatoid arthritis E.SLE

22. Question No. 108 Which of the following cardiac conditions is associated with alcoholism? A.dilated cardiomyopathy B.restrictive cardiomyopathy C.hypertrophic cardiomyopathy D.non-bacterial thrombotic endocarditis E.Libman-Sacks endocarditis

23. Question No. 109 Which of the following is most characteristically a manifestation of rheumatic heart disease? A.mitral stenosis B.mitral valve prolapse (floppy valve) C.acute infectious endocarditis D.endocarditis of tricuspid valve E.Libman-Sacks endocarditis

24. Question No. 110 Which of the following congenital heart defects is most often associated with rib notching due to pressure erosion by enlarged intercostal arteries? A. ventricular septal defect B. atrial septal defect C. tetralogy of Fallot D. coarctation of aorta E.ductus arteriosus

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26. End of Readiness Quiz After discussion of quiz, OK to take notes.

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