[MCQ] Valvular Heart Disease- Part 4

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Valvular Heart Disease- Part 4

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Congratulations - you have completed Valvular Heart Disease- Part 4. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

In MVP, which of the following echocardiographic finding predicts a greater risk of severe MR ?

A	Presence of thickened leaflets
B	Posterior leaflet prolapse
C	Increased left ventricular dimensions
D	All of the above

Question 2

What percentage of adult patients with symptomatic valvular AS are male ?

A	30 %
B	50 %
C	60 %
D	80 %

Question 2 Explanation:

80% of adult patients with symptomatic valvular AS are male.

Question 3

Degenerative calcification in AS occurs most commonly over and above which of the following ?

A	Bicuspid aortic valve (BAV)
B	Chronic trileaflet aortic valve deterioration
C	Previous rheumatic inflammation of aortic valve
D	All of the above

Question 3 Explanation:

AS in adults is due to degenerative calcification of the aortic cusps and occurs most commonly on an existing disease like bicuspid aortic valve, chronic trileaflet deterioration, or previou

Question 4

Process of aortic valve deterioration and calcification shares many features with ?

A	Atherosclerosis
B	Apoptosis
C	Mitochondrial diseases
D	Neoplasia

Question 4 Explanation:

The process of aortic valve deterioration & calcification shares many features with vascular atherosclerosis, including endothelial dysfunction, lipid accumulation, inflammatory cell activation, cytokine release, and upregulation of several signaling pathways.

Question 5

Which of the following is central in the pathogenesis of aortic valve deterioration & calcification ?

A	Foam cell
B	Myofibroblast
C	Endothelial cell
D	Macrophage

Question 6

A rheumatic etiology of aortic stenosis is favored by ?

A	History of rheumatic fever
B	Rheumatic involvement of mitral valve
C	Associated AR
D	All of the above

Question 7

Which of the following is the most common congenital heart valve defect ?

A	Congenital Pulmonic stenosis
B	Bicuspid aortic valve (BAV)
C	Congenital Mitral stenosis
D	Congenital Tricuspid stenosis

Question 7 Explanation:

A bicuspid aortic valve (BAV) is the most common congenital heart valve defect and occurs in 0.5–1.4% of the population with a 2 - 4:1 male to female predominance.

Question 8

Inheritance pattern of bicuspid aortic valve disease is ?

A	Autosomal recessive with incomplete penetrance
B	Autosomal recessive with complete penetrance
C	Autosomal dominant with incomplete penetrance
D	Autosomal dominant with complete penetrance

Question 8 Explanation:

Inheritance pattern of bicuspid aortic valve disease is autosomal dominant with incomplete penetrance

Question 9

Bicuspid aortic valve disease may be associated with ?

A	Ellis-van Creveld syndrome
B	Noonan syndrome
C	Holt-Oram syndrome
D	Turner’s syndrome

Question 9 Explanation:

X-linked inheritance is suggested by prevalence of BAV disease in patients with Turner’s syndrome

Question 10

Prevalence of BAV disease among first-degree relatives of an affected individual is ?

A	~ 5 %
B	~ 10 %
C	~ 15 %
D	~ 20 %

Question 10 Explanation:

Prevalence of BAV disease among 1º relatives of an affected individual is ~10%

Question 11

Mutation in which of the following gene may be associated with BAV disease ?

A	NOTCH1
B	NOTCH2
C	NOTCH3
D	NOTCH4

Question 11 Explanation:

Mutation in NOTCH1 gene has been described in some families suffering from BAV disease.

Question 12

Which of the following occur commonly among patients with BAV disease ?

A	Aortic coarctation
B	Ascending aortic aneurysm
C	Aortic dissection
D	All of the above

Question 13

Laplace relation is ?

A	Systolic wall stress = Pressure x Radius / Wall thickness
B	Systolic wall stress = Pressure x Wall thickness / Radius
C	Systolic wall stress = Wall thickness x Radius / Pressure
D	Systolic wall stress = Pressure + Radius / Wall thickness

Question 13 Explanation:

Systolic stress developed by myocardium is predicted by Laplace relation (S = Pr/h, where S = systolic wall stress, P = pressure, r = radius, and h = wall thickness).

Question 14

In normal sized adults, severe obstruction to LV outflow is considered when effective aortic orifice area is ?

A	0.6 cm2/m2 body surface area
B	0.8 cm2/m2 body surface area
C	1.0 cm2/m2 body surface area
D	1.2 cm2/m2 body surface area

Question 14 Explanation:

A mean systolic pressure gradient >40 mmHg with a normal CO or an effective aortic orifice area < ~1.0 cm2 (or ~<0.6 cm2/m2 body surface area in a normal-sized adult) i.e., < ~ one-third of the normal orifice is considered to represent severe obstruction to LV outflow

Question 15

In AS, hypertrophied LV compresses coronary arteries causing ischemia of ?

A	Subendocardium
B	Myocardium
C	Epicardium
D	All of the above

Question 15 Explanation:

Hypertrophied LV in AS causes an increase in myocardial oxygen requirements. Capillary density is reduced relative to wall thickness, compressive forces are increased, and the elevated LV end-diastolic pressure reduces the coronary driving pressure. Subendocardium is especially vulnerable to ischemia by this mechanism.

Question 16

Cardinal symptom in aortic stenosis is ?

A	Exertional dyspnea
B	Angina pectoris
C	Syncope
D	All of the above

Question 16 Explanation:

Exertional dyspnea, angina pectoris and syncope are the three cardinal symptoms in patients with pure or predominant AS.

Question 17

Which of the following excludes the possibility of pure or predominant severe aortic stenosis ?

A	Atrial fibrilation
B	Absence of systolic thrill
C	Bisferiens pulse
D	All of the above

Question 17 Explanation:

AF in AS suggests the possibility of associated mitral valve disease.

Question 18

In aortic stenosis, systolic thrill is generally present at ?

A	Base of heart
B	In suprasternal notch
C	Along carotid arteries
D	All of the above

Question 18 Explanation:

Systolic thrill is present at the base of heart, in suprasternal notch & along carotid arteries (more commonly left).

Question 19

Which of the following is false about aortic stenosis murmur ?

A	High pitched
B	Rough & rasping in character
C	Ejection systolic
D	Loudest in second right intercostal space

Question 19 Explanation:

Loudest in second right intercostal space

Question 20

In Gallavardin effect, murmur of AS radiates to which of the following ?

A	Apex
B	Carotids
C	Back
D	None of the above

Question 20 Explanation:

None of the above

Question 21

Intensity of a cardiac murmur is graded (1-6) according to ?

A	Morrison scale
B	Mogagni scale
C	Levine scale
D	Osler scale

Question 21 Explanation:

The intensity of a cardiac murmur is graded according to the Levine scale

Question 22

Aortic stenosis is called “mild”, when the aortic valve area is ?

A	1.0 cm2 - 1.5 cm2
B	1.5 cm2 - 2.0 cm2
C	2.0 cm2 - 2.5 cm2
D	2.5 cm2 - 3.0 cm2

Question 23

Aortic stenosis is called “moderate”, when the aortic valve area is ?

A	1.0 cm2 - 1.5 cm2
B	1.5 cm2 - 2.0 cm2
C	2.0 cm2 - 2.5 cm2
D	2.5 cm2 - 3.0 cm2

Question 23 Explanation:

Mitral stenosis is called “moderate”, when the mitral valve orifice is 1.0 cm2 - 1.5 cm2

Question 24

Aortic stenosis is called “severe”, when aortic valve area is ?

A	< 1.5 cm2
B	< 1.0 cm2
C	< 0.5 cm2
D	< 0.2 cm2

Question 25

Aortic sclerosis is defined echocardiographically as focal thickening or calcification of valve cusps with a peak Doppler transaortic velocity of ?

A	<=2.5 meters/second
B	<=3.5 meters/second
C	<=4.5 meters/second
D	<=5.5 meters/second

Question 25 Explanation:

Aortic sclerosis is defined echocardiographically as focal thickening or calcification of the valve cusps with a peak Doppler transaortic velocity of <=2.5 meters/second at a peak gradient <25 mmHg

Question 26

Which of the following Chest X-Ray findings indicate that valvular AS is not severe ?

A	Little overall cardiac enlargement
B	Proximal ascending aorta not dilated
C	Absence of valvular calcification
D	Absence of pulmonary congestion

Question 26 Explanation:

In chest X-Ray, absence of valvular calcification in adults suggests that severe valvular AS is not present.

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

1.In MVP, which of the following echocardiographic finding predicts a greater risk of severe MR ?
A. Presence of thickened leaflets
B. Posterior leaflet prolapse
C. Increased left ventricular dimensions
D. All of the above

2. What percentage of adult patients with symptomatic valvular AS are male ?
A. 30 %
B. 50 %
C. 60 %
D. 80 %

3. Degenerative calcification in AS occurs most commonly over and above which of the following ?
A. Bicuspid aortic valve (BAV)
B. Chronic trileaflet aortic valve deterioration
C. Previous rheumatic inflammation of aortic valve
D. All of the above

4. Process of aortic valve deterioration and calcification shares many features with ?
A. Atherosclerosis
B. Apoptosis
C. Mitochondrial diseases
D. Neoplasia

5. Which of the following is central in the pathogenesis of aortic valve deterioration & calcification ?
A. Foam cell
B. Myofibroblast
C. Endothelial cell
D. Macrophage

6. A rheumatic etiology of aortic stenosis is favored by ?
A. History of rheumatic fever
B. Rheumatic involvement of mitral valve
C. Associated AR
D. All of the above

7. Which of the following is the most common congenital heart valve defect ?
A. Congenital Pulmonic stenosis
B. Bicuspid aortic valve (BAV)
C. Congenital Mitral stenosis

D. Congenital Tricuspid stenosis

8. Inheritance pattern of bicuspid aortic valve disease is ?
A. Autosomal recessive with incomplete penetrance
B. Autosomal recessive with complete penetrance
C. Autosomal dominant with incomplete penetrance
D. Autosomal dominant with complete penetrance

9. Bicuspid aortic valve disease may be associated with ?
A. Ellis-van Creveld syndrome
B. Noonan syndrome
C. Holt-Oram syndrome
D. Turner’s syndrome

10. Prevalence of BAV disease among first-degree relatives of an affected individual is ?
A. ~ 5 %
B. ~ 10 %
C. ~ 15 %
D. ~ 20 %
.
11. Mutation in which of the following gene may be associated with BAV disease ?
A. NOTCH1
B. NOTCH2
C. NOTCH3
D. NOTCH4

12. Which of the following occur commonly among patients with BAV disease ?
A. Aortic coarctation
B. Ascending aortic aneurysm
C. Aortic dissection
D. All of the above
13. Laplace relation is ?
A. Systolic wall stress = Pressure x Radius / Wall thickness
B. Systolic wall stress = Pressure x Wall thickness / Radius
C. Systolic wall stress = Wall thickness x Radius / Pressure
D. Systolic wall stress = Pressure + Radius / Wall thickness

14. In normal sized adults, severe obstruction to LV outflow is considered when effective aortic orifice area is ?
A. 0.6 cm2/m2 body surface area
B. 0.8 cm2/m2 body surface area
C. 1.0 cm2/m2 body surface area
D. 1.2 cm2/m2 body surface area

15. In AS, hypertrophied LV compresses coronary arteries causing ischemia of ?
A. Subendocardium
B. Myocardium
C. Epicardium
D. All of the above

16. Cardinal symptom in aortic stenosis is ?
A. Exertional dyspnea
B. Angina pectoris
C. Syncope
D. All of the above

17. Which of the following excludes the possibility of pure or predominant severe aortic stenosis ?
A. Atrial fibrilation
B. Absence of systolic thrill
C. Bisferiens pulse
D. All of the above

18. In aortic stenosis, systolic thrill is generally present at ?
A. Base of heart
B. In suprasternal notch
C. Along carotid arteries
D. All of the above

19. Which of the following is false about aortic stenosis murmur ?
A. High pitched
B. Rough & rasping in character
C. Ejection systolic
D. Loudest in second right intercostal space

20. In Gallavardin effect, murmur of AS radiates to which of the following ?
A. Apex
B. Carotids
C. Back
D. None of the above

21. Intensity of a cardiac murmur is graded (1-6) according to ?
A. Morrison scale
B. Mogagni scale
C. Levine scale
D. Osler scale

22. Aortic stenosis is called “mild”, when the aortic valve area is ?
A. 1.0 cm2 – 1.5 cm2
B. 1.5 cm2 – 2.0 cm2
C. 2.0 cm2 – 2.5 cm2
D. 2.5 cm2 – 3.0 cm2
23. Aortic stenosis is called “moderate”, when the aortic valve area is ?
A. 1.0 cm2 – 1.5 cm2
B. 1.5 cm2 – 2.0 cm2
C. 2.0 cm2 – 2.5 cm2
D. 2.5 cm2 – 3.0 cm2

24. Aortic stenosis is called “severe”, when aortic valve area is ?
A. < 1.5 cm2
B. < 1.0 cm2
C. < 0.5 cm2
D. < 0.2 cm2
25. Aortic sclerosis is defined echocardiographically as focal thickening or calcification of valve cusps with a peak Doppler transaortic velocity of ?
A. <=2.5 meters/second
B. <=3.5 meters/second
C. <=4.5 meters/second
D. <=5.5 meters/second

26. Which of the following Chest X-Ray findings indicate that valvular AS is not severe ?
A. Little overall cardiac enlargement
B. Proximal ascending aorta not dilated
C. Absence of valvular calcification
D. Absence of pulmonary congestion

Valvular Heart Disease

[MCQ] Valvular Heart Disease- Part 4

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Valvular Heart Disease- Part 4

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