[MCQ] Valvular Heart Disease- Part 3

I. Start the exam by click the “Start” button

Valvular Heart Disease- Part 3

Please wait while the activity loads.
If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled.

If loading fails, click here to try again

Start

Congratulations - you have completed Valvular Heart Disease- Part 3. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

Systolic murmur of MR, transmitted to base of heart indicates primary involvement of ?

A	Anterior mitral leaflet
B	Posterior mitral leaflet
C	Both mitral leaflets
D	Mitral valve annulus

Question 1 Explanation:

in patients with ruptured chordae tendineae or primary involvement of the posterior mitral leaflet with prolapse or flail, regurgitant jet is eccentric, directed anteriorly, & strikes LA wall adjacent to aortic root. In this situation, systolic murmur is transmitted to base of heart. In patients with ruptured chordae tendineae, systolic murmur may have a cooing or “sea gull” quality, while a flail leaflet may cause a murmur with a musical quality. Systolic murmur of chronic MR not due to MVP is intensified by isometric exercise (handgrip) but is reduced during the strain phase of the Valsalva maneuver

Question 2

Rheumatic heart disease is the cause of chronic MR in what percentage of cases ?

A	25 %
B	33 %
C	50 %
D	66 %

Question 2 Explanation:

Rheumatic heart disease is the cause of chronic MR in only about one-third of cases and occurs more frequently in males.

Question 3

Which of the following best relates to Cabot - Locke murmur ?

A	Hyperthyroidism
B	Anemia
C	Pericarditis
D	Endocarditis

Question 3 Explanation:

Cabot - Locke murmur is a diastolic murmur heard best at the left sternal border. It sounds similar to aortic insufficiency but does not have a decrescendo. Murmur resolves with treatment of anemia. Richard Cabot was an American physician and Frank Locke was his colleague.

Question 4

Barlow’s syndrome refers to ?

A	Bicuspid aortic stenosis
B	Atrial myxoma
C	Mitral valve prolapse
D	HOCM

Question 4 Explanation:

MVP is also termed systolic click-murmur syndrome, Barlow’s syndrome, floppy-valve syndrome, and billowing mitral leaflet syndrome

Question 5

John Barlow belonged to which country ?

A	South Africa
B	United Kingdom
C	Australia
D	Canada

Question 5 Explanation:

South African physician John Barlow first submitted his work on mitral-valve prolapse to the journal Circulation, but the manuscript was refused for its “overstated conclusion.” After considerable abbreviation of the paper, it was finally accepted & published in 1968 by British Heart Journal.

Question 6

Which of the following statements about MVP is false ?

A	Reduced production of type III collagen
B	Increased concentrations of acid mucopolysaccharide
C	Posterior leaflet is more affected than anterior
D	None of the above

Question 7

Mitral valve prolapse has association with heritable disorder like ?

A	Down syndrome
B	Osteogenesis imperfecta
C	Turner syndrome
D	Hemophilia

Question 7 Explanation:

MVP is a frequent finding in patients with heritable disorders of connective tissue, including Marfan syndrome, osteogenesis imperfecta & Ehler-Danlos syndrome

Question 8

Mitral valve prolapse (MVP) may occur as a sequel to ?

A	Acute rheumatic fever
B	Ischemic heart disease
C	Various cardiomyopathies
D	All of the above

Question 8 Explanation:

MVP may occur as a sequel to acute rheumatic fever, in ischemic heart disease, and in various cardiomyopathies

Question 9

Mitral valve prolapse (MVP) is associated with which of the following ?

A	Ostium primum atrial septal defect
B	Ostium secundum atrial septal defect
C	Ventricular septal defect
D	Patent ductus arteriosus

Question 9 Explanation:

Mitral valve prolapse (MVP) is associated with 20% of patients with ostium secundum ASD

Question 10

Ventricular arrhythmias in MVP result from stress placed on ?

A	Mitral annulus
B	Posterior mitral leaflet
C	Chordae tendineae
D	Papillary muscles

Question 10 Explanation:

MVP causes ventricular arrhythmias due to excessive stress on papillary muscles which lead to dysfunction & ischemia of papillary muscles and subjacent ventricular myocardium.

Question 11

Which of the following valvular heart disease is more common in male ?

A	Rheumatic MR
B	Mitral stenosis (MS)
C	MVP
D	AR with associated mitral valve disease

Question 12

Which of the following valvular heart disease is more common in female ?

A	Rheumatic MR
B	MVP
C	Adult patients with symptomatic valvular AS
D	Patients with pure or predominant valvular AR

Question 13

Which of the following valvular heart disease is more common in female ?

A	Rheumatic MR
B	Tricuspid Stenosis
C	Adult patients with symptomatic valvular AS
D	Patients with pure or predominant valvular AR

Question 14

Which of the following valvular heart disease is more common in female ?

A	Rheumatic MR
B	Tricuspid Stenosis
C	Adult patients with symptomatic valvular AS
D	Patients with pure or predominant valvular AR

Question 15

In MVP, nonejection systolic click occurs how many seconds after S1 ?

A	0.11 seconds
B	0.12 seconds
C	0.13 seconds
D	0.14 seconds

Question 15 Explanation:

In MVP, the mid- or late (nonejection) systolic click occurs 0.14 seconds or more after S1 and is due to sudden tensing of slack, elongated chordae tendineae or due to prolapsing mitral leaflet when it reaches its maximum excursion.

Question 16

Which of the following about MVP is false ?

A	Systolic clicks may be multiple
B	High-pitched, late systolic crescendo-decrescendo murmur
C	Late systolic murmur heard best at apex
D	None of the above

Question 16 Explanation:

In MVP, the late systolic murmur is high-pitched, crescendo-decrescendo configuration (“whooping” or “honking”) and is heard best at the apex

Question 17

Systolic click & murmur of MVP occur earlier in all of the following except ?

A	Standing
B	Squatting
C	During the strain phase of Valsalva maneuver
D	All of the above

Question 17 Explanation:

In MVP, systolic click & murmur occur earlier with standing, during strain phase of Valsalva maneuver, and with any intervention that decreases LV volume. Conversely, squatting & isometric exercises, which increase LV volume, diminish click-murmur complex of MVP thus moving it away from S1

Question 18

Most frequent serious sequelae of mitral valve prolapse is ?

A	Infective endocarditis
B	Sudden cardiac death
C	Severe mitral regurgitation
D	None of the above

Question 18 Explanation:

None of the above

Question 19

Which view in echocardiography is best to diagnose mitral valve prolapse ?

A	Parasternal long-axis view
B	Parasternal short-axis view
C	Four-chamber view
D	All of the above

Question 20

“Classic” mitral valve prolapse is defined as ?

A	Prolapse of mitral valve
B	Prolapse > 2 mm beyond long-axis annular plane
C	Thickening of the valve leaflets
D	All of the above

Question 20 Explanation:

Echocardiographic definition of MVP is systolic displacement (in the parasternal long axis view) of mitral valve leaflets by at least 2 mm into LA superior to the plane of the mitral annulus.

Question 21

Which of the following is true in mitral valve prolapse syndrome ?

A	Expansion of spongiosa layer by proteoglycans
B	Structural alterations of collagen in all components of leaflet
C	Structurally abnormal chordae tendinae
D	Structurally abnormal chordae tendinae

Question 22

Non-prolapse related systolic clicks are documented in ?

A	Bicuspid aortic stenosis
B	Atrial myxoma
C	Pericarditis
D	All of the above

Question 23

Which of the following echocardiographic parameters is useful to risk stratify patients with mitral valve prolapse ?

A	Leaflet thickness
B	Redundancy
C	Increased left-ventricular diameter
D	All of the above

Question 24

Transthoracic echocardiography (TTE) does not exclude ?

A	Medial scallop prolapse
B	Middle scallop prolapse
C	Lateral scallop prolapse
D	None of the above

Question 25

Patients with mitral valve prolapse at increased risk of complications are ?

A	Depressed left ventricular systolic function
B	Moderate-severe mitral regurgitation
C	Mitral leaflet thickness greater than 5 mm
D	All of the above

Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results

There are 25 questions to complete.

←

List

→

Return

Shaded items are complete.

1	2	3	4	5
6	7	8	9	10
11	12	13	14	15
16	17	18	19	20
21	22	23	24	25
End

Return

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

1.Systolic murmur of MR, transmitted to base of heart indicates primary involvement of ?
A. Anterior mitral leaflet
B. Posterior mitral leaflet
C. Both mitral leaflets
D. Mitral valve annulus

2. Rheumatic heart disease is the cause of chronic MR in what percentage of cases ?
A. 25 %
B. 33 %
C. 50 %
D. 66 %

3. Which of the following best relates to Cabot – Locke murmur ?
A. Hyperthyroidism
B. Anemia
C. Pericarditis
D. Endocarditis

4. Barlow’s syndrome refers to ?
A. Bicuspid aortic stenosis
B. Atrial myxoma
C. Mitral valve prolapse
D. HOCM

5. John Barlow belonged to which country ?
A. South Africa
B. United Kingdom
C. Australia
D. Canada

6. Which of the following statements about MVP is false ?
A. Reduced production of type III collagen
B. Increased concentrations of acid mucopolysaccharide
C. Posterior leaflet is more affected than anterior
D. None of the above
7. Mitral valve prolapse has association with heritable disorder like ?
A. Down syndrome
B. Osteogenesis imperfecta
C. Turner syndrome
D. Hemophilia

8. Mitral valve prolapse (MVP) may occur as a sequel to ?
A. Acute rheumatic fever
B. Ischemic heart disease
C. Various cardiomyopathies
D. All of the above

9. Mitral valve prolapse (MVP) is associated with which of the following ?
A. Ostium primum atrial septal defect
B. Ostium secundum atrial septal defect
C. Ventricular septal defect
D. Patent ductus arteriosus

10. Ventricular arrhythmias in MVP result from stress placed on ?
A. Mitral annulus
B. Posterior mitral leaflet
C. Chordae tendineae
D. Papillary muscles

11. Which of the following valvular heart disease is more common in male ?
A. Rheumatic MR
B. Mitral stenosis (MS)
C. MVP
D. AR with associated mitral valve disease
12. Which of the following valvular heart disease is more common in female ?
Harrison’s 18th Ed. 1937
A. Rheumatic MR
B. MVP

C. Adult patients with symptomatic valvular AS
D. Patients with pure or predominant valvular AR
13. Which of the following valvular heart disease is more common in female ?
A. Rheumatic MR
B. Tricuspid Stenosis
C. Adult patients with symptomatic valvular AS
D. Patients with pure or predominant valvular AR
14. In MVP, nonejection systolic click occurs how many seconds after S 1 ?
A. 0.11 seconds
B. 0.12 seconds
C. 0.13 seconds
D. 0.14 seconds

15. Which of the following about MVP is false ?
A. Systolic clicks may be multiple
B. High-pitched, late systolic crescendo-decrescendo murmur
C. Late systolic murmur heard best at apex
D. None of the above

16. Systolic click & murmur of MVP occur earlier in all of the following except ?
A. Standing
B. Squatting
C. During the strain phase of Valsalva maneuver
D. All of the above

17. Most frequent serious sequelae of mitral valve prolapse is ?
A. Infective endocarditis
B. Sudden cardiac death
C. Severe mitral regurgitation
D. None of the above

18. Which view in echocardiography is best to diagnose mitral valve prolapse ?
A. Parasternal long-axis view
B. Parasternal short-axis view

C. Four-chamber view
D. All of the above
19. “Classic” mitral valve prolapse is defined as ?
A. Prolapse of mitral valve
B. Prolapse > 2 mm beyond long-axis annular plane
C. Thickening of the valve leaflets
D. All of the above

20. Which of the following is true in mitral valve prolapse syndrome ?
A. Expansion of spongiosa layer by proteoglycans
B. Structural alterations of collagen in all components of leaflet
C. Structurally abnormal chordae tendinae
D. All of the above
21. Non-prolapse related systolic clicks are documented in ?
A. Bicuspid aortic stenosis
B. Atrial myxoma
C. Pericarditis
D. All of the above
22. Which of the following echocardiographic parameters is useful to risk stratify patients with mitral valve prolapse ?
A. Leaflet thickness
B. Redundancy
C. Increased left-ventricular diameter
D. All of the above
23. Transthoracic echocardiography (TTE) does not exclude ?
A. Medial scallop prolapse
B. Middle scallop prolapse
C. Lateral scallop prolapse
D. None of the above
24. Patients with mitral valve prolapse at increased risk of complications are ?
A. Depressed left ventricular systolic function
B. Moderate-severe mitral regurgitation
C. Mitral leaflet thickness greater than 5 mm
D. All of the above

Valvular Heart Disease

[MCQ] Valvular Heart Disease- Part 3

I. Start the exam by click the “Start” button

Valvular Heart Disease- Part 3

Share this:

Related

[MCQ] Valvular Heart Disease- Part 2

[MCQ] Valvular Heart Disease- Part 4

You may also like

Leave a Comment Cancel Reply