[MCQ] Valvular Heart Disease- Part 2

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Valvular Heart Disease- Part 2

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Congratulations - you have completed Valvular Heart Disease- Part 2. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following about Kerley’s A lines is false ?

A	Linear opacities on CxR chest
B	Extend from periphery to hila
C	Caused by distention of anastomotic channels between peripheral & central lymphatics
D	None of the above

Question 1 Explanation:

Kerley’s A lines are linear opacities extending from periphery to hila caused by distention of anastomotic channels between peripheral & central lymphatics

Question 2

Which of the following about Kerley’s B lines is false ?

A	Short horizontal lines on CxR chest
B	Situated perpendicularly to pleural surface at lung base
C	Represent edema of interlobular septa
D	None of the above

Question 2 Explanation:

Kerley’s B lines are short horizontal lines situated perpendicularly to pleural surface at lung base. They represent edema of the interlobular septa.

Question 3

Which of the following about Kerley’s C lines is false ?

A	Reticular opacities at lung base
B	Represent Kerley’s B lines en face
C	Suggest cardiogenic pulmonary edema
D	None of the above

Question 3 Explanation:

Kerley’s C lines are reticular opacities at the lung base, representing Kerley’s B lines en face suggesting cardiogenic pulmonary edema

Question 4

Which of the following is false about Austin Flint murmur ?

A	Apical
B	Mid-diastolic
C	Not intensified in presystole
D	None of the above

Question 4 Explanation:

Apical mid-diastolic murmur associated with severe AR (Austin Flint murmur) is differentiated from MS because it is not intensified in presystole & becomes softer with administration of amyl nitrite.

Question 5

Which of the following features differentiates atrial septal defect from MS ?

A	Absence of LA enlargement
B	Absence of Kerley B lines
C	Fixed splitting of S2
D	All of the above

Question 5 Explanation:

Atrial septal defect may be mistaken for MS as in both conditions there is clinical, ECG, and chest x-ray evidence of RV enlargement and accentuation of pulmonary vascularity. Absence of LA enlargement and of Kerley B lines and the demonstration of fixed splitting of S2 with a grade 2 or 3 mid-systolic murmur at the mid to upper left sternal border all favor atrial septal defect over MS.

Question 6

Auscultatory findings change markedly with body position in which of the following ?

A	Mitral Stenosis
B	Tricuspid Stenosis
C	Left atrial myxoma
D	Atrial septal defect

Question 6 Explanation:

The auscultatory findings in left atrial myxoma change markedly with body position

Question 7

Levels of which of the following is elevated in left atrial myxoma ?

A	Interleukin 2 (IL-2)
B	Interleukin 4 (IL-4)
C	Interleukin 6 (IL-6)
D	Interleukin 8 (IL-8)

Question 7 Explanation:

In LA myxoma, elevated levels of serum IgG and interleukin 6 (IL-6) are found.

Question 8

Anticoagulants are administered for how long to MS patients who have suffered systemic and/or pulmonary embolization ?

A	At least 3 months
B	At least 6 months
C	At least 1 year
D	Life long

Question 9

Anticoagulants should be administered for how long to patients with MS who have atrial fibrillation ?

A	At least 3 months
B	At least 6 months
C	At least 1 year
D	Life long

Question 10

In MS with AF of relatively recent origin, cardioversion should be undertaken after patient has had anticoagulant treatment for ?

A	1 week
B	2 week
C	3 week
D	4 week

Question 10 Explanation:

Cardioversion should be undertaken after the patient has had at least 3 consecutive weeks of anticoagulant treatment to a therapeutic INR.

Question 11

In patients with MS and AF, conversion to sinus rhythm is rarely sustained when ?

A	LA is enlarged
B	AF has been present for more than 1 year
C	Severe MS
D	All of the above

Question 11 Explanation:

Conversion to sinus rhythm is rarely successful or sustained in patients with severe MS, particularly those in whom the LA is especially enlarged or in whom AF has been present for more than 1 year

Question 12

Mitral valvotomy is indicated in the symptomatic patient with isolated MS whose effective orifice is less than ?

A	1.0 cm2/m2 body surface area
B	1.5 cm2/m2 body surface area
C	2.0 cm2/m2 body surface area
D	2.5 cm2/m2 body surface area

Question 12 Explanation:

Mitral valvotomy is indicated in symptomatic patients with isolated MS whose effective orifice is < ~1.0 cm2/m2 body surface area or <1.5 cm2 in normal-sized adults.

Question 13

In pregnant patient with MS, percutaneous mitral balloon valvuloplasty (PMBV) is performed with ?

A	CT
B	MRI
C	TEE
D	Any of the above

Question 13 Explanation:

In the pregnant patient with MS not responding to intensive medical treatment, PMBV is the preferred strategy and is performed with TEE and no or minimal x-ray exposure.

Question 14

Successful mitral valvotomy is defined as a reduction in the mean mitral valve gradient by ?

A	10 %
B	20 %
C	30 %
D	50 %

Question 14 Explanation:

Successful mitral valvotomy is defined by a 50% reduction in the mean mitral valve gradient and a doubling of the mitral valve area.

Question 15

Operative mortality is maximum in which of the following ?

A	Aortic valve replacement with coronary artery bypass
B	Mitral valve replacement with coronary artery bypass
C	Mitral valve replacement
D	Aortic valve replacement

Question 16

Operative mortality is maximum in which of the following ?

A	Aortic valve repair
B	Mitral valve repair
C	Tricuspid valve surgery
D	Pulmonic valve replacement

Question 17

Which of the following is a component of mitral valve apparatus ?

A	Chordae tendineae
B	Papillary muscles
C	Subjacent myocardium
D	All of the above

Question 17 Explanation:

Five functional components of the mitral valve apparatus are leaflets, annulus, chordae tendineae, papillary muscles, and subjacent myocardium. Dysfunction in any of these may cause MR.

Question 18

Acute MR can occur in which of the following ?

A	Infective endocarditis
B	Acute myocardial infarction with papillary muscle rupture
C	Blunt chest wall trauma
D	All of the above

Question 18 Explanation:

Acute MR can occur in infective endocarditis, papillary muscle rupture (post Acute MI), following blunt chest wall trauma, and rupture of chordae tendineae in MVP & IE.

Question 19

Chronic MR can result from all except ?

A	Ankylosing spondylitis
B	Hypertrophic obstructive cardiomyopathy (HOCM)
C	Mitral valve prolapse (MVP)
D	Dilated cardiomyopathy

Question 19 Explanation:

Chronic MR can result from rheumatic disease, mitral valve prolapse (MVP), extensive mitral annular calcification, congenital valve defects, hypertrophic obstructive cardiomyopathy (HOCM), and dilated cardiomyopathy

Question 20

MR occurs universally in patients with nonischemic forms of dilated cardiomyopathy when left ventricular end-diastolic dimension is ?

A	3.0 cm
B	4.0 cm
C	5.0 cm
D	6.0 cm

Question 20 Explanation:

Annular dilatation and ventricular remodeling contribute to MR that occurs universally among patients with nonischemic forms of dilated cardiomyopathy once the left ventricular end-diastolic dimension reaches 6.0 cm

Question 21

In severe chronic MR, enlargement of LA places tension on ?

A	Anterior mitral leaflet
B	Posterior mitral leaflet
C	Chordae tendineae
D	All of the above

Question 21 Explanation:

Chronic severe MR is progressive since enlargement of LA places tension on posterior mitral leaflet, pulling it away from the mitral orifice & thereby aggravating valvular dysfunction.

Question 22

Which of the following defines severe MR ?

A	Regurgitant volume >=60 mL/beat
B	Regurgitant fraction (RF) >=50%
C	Effective regurgitant orifice area >=0.40 cm2
D	All of the above

Question 22 Explanation:

Severe nonischemic MR is defined by a regurgitant volume >=60 mL/beat, regurgitant fraction (RF) >=50%, and effective regurgitant orifice area >=0.40 cm2. Severe ischemic MR is usually associated with an effective regurgitant orifice area of >0.3 cm2

Question 23

Acute severe MR & chronic severe MR are differentiated by ?

A	v wave in the LA pressure pulse
B	Frequency of pulmonary edema
C	Configuration of systolic murmur
D	All of the above

Question 23 Explanation:

In acute severe MR, v wave in LA pressure pulse is prominent. Acute pulmonary edema is common. Murmur is early in timing and decrescendo in configuration. In chronic severe MR, LA v wave is relatively less prominent. Murmur is classically holosystolic in timing and plateau in configuration

Question 24

In mitral regurgitation due to papillary muscle dysfunction, the systolic murmur commences in ?

A	Early systole
B	Midsystole
C	Late systole
D	All of the above

Question 25

Which of the following is not ordinarily heard with isolated MR ?

A	Holosystolic murmur
B	S3
C	S4
D	Presystolic murmur

Question 25 Explanation:

In chronic MR, S1 is generally absent, soft, or buried in the holosystolic murmur. In severe MR

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See all quizzes of the Valvular Heart Disease- Part at here:

1.Which of the following about Kerley’s A lines is false ?
A. Linear opacities on CxR chest

B. Extend from periphery to hila
C. Caused by distention of anastomotic channels between
peripheral & central lymphatics
D. None of the above

2. Which of the following about Kerley’s B lines is false ?
A. Short horizontal lines on CxR chest
B. Situated perpendicularly to pleural surface at lung base
C. Represent edema of interlobular septa
D. None of the above

3. Which of the following about Kerley’s C lines is false ?
A. Reticular opacities at lung base
B. Represent Kerley’s B lines en face
C. Suggest cardiogenic pulmonary edema
D. None of the above

4. Which of the following is false about Austin Flint murmur ?
A. Apical
B. Mid-diastolic
C. Not intensified in presystole
D. None of the above

5. Which of the following features differentiates atrial septal defect from MS ?
A. Absence of LA enlargement
B. Absence of Kerley B lines
C. Fixed splitting of S2
D. All of the above

6. Auscultatory findings change markedly with body position in which of the following ?
A. Mitral Stenosis
B. Tricuspid Stenosis
C. Left atrial myxoma
D. Atrial septal defect

7. Levels of which of the following is elevated in left atrial myxoma ?
A. Interleukin 2 (IL-2)

B. Interleukin 4 (IL-4)
C. Interleukin 6 (IL-6)
D. Interleukin 8 (IL-8)

8. Anticoagulants are administered for how long to MS patients who have suffered systemic and/or pulmonary embolization ?
A. At least 3 months
B. At least 6 months
C. At least 1 year
D. Life long
9. Anticoagulants should be administered for how long to patients with MS who have atrial fibrillation ?
A. At least 3 months
B. At least 6 months
C. At least 1 year
D. Life long
10. In MS with AF of relatively recent origin, cardioversion should be undertaken after patient has had anticoagulant treatment for ?
A. 1 week
B. 2 week
C. 3 week
D. 4 week

11. In patients with MS and AF, conversion to sinus rhythm is rarely sustained when ?
A. LA is enlarged
B. AF has been present for more than 1 year
C. Severe MS
D. All of the above

12. Mitral valvotomy is indicated in the symptomatic patient with isolated MS whose effective orifice is less than ?
A. 1.0 cm2/m2 body surface area
B. 1.5 cm2/m2 body surface area
C. 2.0 cm2/m2 body surface area
D. 2.5 cm2/m2 body surface area

13. In pregnant patient with MS, percutaneous mitral balloon valvuloplasty (PMBV) is performed with ?
A. CT
B, MRI

C. TEE
D. Any of the above

14. Successful mitral valvotomy is defined as a reduction in the mean mitral valve gradient by ?
A. 10 %
B. 20 %
C. 30 %
D. 50 %

15. Operative mortality is maximum in which of the following ?
A. Aortic valve replacement with coronary artery bypass
B. Mitral valve replacement with coronary artery bypass
C. Mitral valve replacement
D. Aortic valve replacement
16. Operative mortality is maximum in which of the following ?
A. Aortic valve repair
B. Mitral valve repair
C. Tricuspid valve surgery
D. Pulmonic valve replacement
17. Which of the following is a component of mitral valve apparatus ?
A. Chordae tendineae
B. Papillary muscles
C. Subjacent myocardium
D. All of the above

18. Acute MR can occur in which of the following ?
A. Infective endocarditis
B. Acute myocardial infarction with papillary muscle rupture
C. Blunt chest wall trauma
D. All of the above

19. Chronic MR can result from all except ?
A. Ankylosing spondylitis
B. Hypertrophic obstructive cardiomyopathy (HOCM)
C. Mitral valve prolapse (MVP)
D. Dilated cardiomyopathy

20. MR occurs universally in patients with nonischemic forms of dilated cardiomyopathy when left ventricular end-diastolic dimension is ?
A. 3.0 cm
B. 4.0 cm
C. 5.0 cm
D. 6.0 cm

21. In severe chronic MR, enlargement of LA places tension on ?
A. Anterior mitral leaflet
B. Posterior mitral leaflet
C. Chordae tendineae
D. All of the above

22. Which of the following defines severe MR ?
A. Regurgitant volume >=60 mL/beat
B. Regurgitant fraction (RF) >=50%
C. Effective regurgitant orifice area >=0.40 cm2
D. All of the above

23. Acute severe MR & chronic severe MR are differentiated by ?
A. v wave in the LA pressure pulse
B. Frequency of pulmonary edema
C. Configuration of systolic murmur
D. All of the above

24. In mitral regurgitation due to papillary muscle dysfunction, the systolic murmur commences in ?
A. Early systole
B. Midsystole
C. Late systole
D. All of the above
25. Which of the following is not ordinarily heard with isolated MR ?
A. Holosystolic murmur
B. S3
C. S4
D. Presystolic murmur

Valvular Heart Disease

[MCQ] Valvular Heart Disease- Part 2

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Valvular Heart Disease- Part 2

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[MCQ] Valvular Heart Disease- Part 3

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