[MCQ] Valvular Heart Disease- Part 5

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Valvular Heart Disease- Part 5

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Question 1

Following onset of symptoms in AS, which of the following leads to early death ?

A	Angina pectoris
B	Syncope
C	Congestive heart failure
D	None of the above

Question 1 Explanation:

After onset of symptoms in AS, life expectancy in angina pectoris & syncope is 3 years, dyspnea - 2 years and congestive heart failure - 1.5 to 2 years.

Question 2

Severe LV hypertrophy is present when a wall thickness is ?

A	> 5 mm
B	> 10 mm
C	> 15 mm
D	> 20 mm

Question 2 Explanation:

Severe LV hypertrophy is present when a wall thickness is > 15 mm.

Question 3

Which of the following is the cause of aortic regurgitation due to primary valve disease ?

A	Aortic dissection
B	Hypertension
C	Ankylosing spondylitis
D	Marfan’s syndrome

Question 4

Which of the following is the cause of aortic regurgitation due to primary valve disease ?

A	Aortic dissection
B	Hypertension
C	Ankylosing spondylitis
D	Marfan’s syndrome

Question 5

Which of the following is the cause of aortic regurgitation due to both primary valve disease & primary aortic root disease ?

A	Aortitis
B	Bicuspid aortic valve
C	Marfan’s syndrome
D	Marfan’s syndrome

Question 5 Explanation:

Causes of AR due to primary valve disease include congenital (bicuspid), endocarditis, rheumatic fever, myxomatous (prolapse), traumatic, syphilis and ankylosing spondylitis. Causes of AR due to primary aortic root disease include aortic dissection, cystic medial degeneration (Marfan’s syndrome, bicuspid aortic valve, nonsyndromic familial aneurysm), aortitis and hypertension

Question 6

Coexistence of hemodynamically significant AS with AR occurs in which of the following ?

A	Congenital AR
B	Syphilis
C	Marfan’s syndrome
D	All of the above

Question 6 Explanation:

Coexistence of hemodynamically significant AS with AR occurs almost exclusively in patients with rheumatic or congenital AR.

Question 7

Which of the following is the cause of aortic regurgitation due to both primary valve disease & primary aortic root disease ?

A	Syphilis
B	Bicuspid aortic valve
C	Ankylosing spondylitis
D	All of the above

Question 7 Explanation:

Both syphilis & ankylosing spondylitis affect aortic valves. They may also be associated with cellular infiltration & scarring of media of thoracic aorta, leading to aortic dilation, aneurysm formation, & severe aortic regurgitation.

Question 8

Which of the following condition predisposes to AR ?

A	Marfan syndrome
B	Ankylosing spondylitis
C	Ventricular septal defect
D	All of the above

Question 8 Explanation:

Conditions that predispose to AR are Marfan syndrome, ankylosing spondylitis & VSD.

Question 9

At autopsy, heart of which of the following lesions is heaviest ?

A	Chronic AS
B	Chronic AR
C	HOCM
D	Dilated cardiomyopathy

Question 9 Explanation:

At autopsy, hearts of patients with chronic AR may be among the largest encountered sometimes weighing >1000 grams.

Question 10

Early sign of LV dysfunction in chronic AR is ?

A	Elevation of LA pressure
B	Reduction in LVEF
C	Elevation of PA wedge pressure
D	Elevation of LV end-diastolic pressure

Question 10 Explanation:

In chronic AR, both LV preload & afterload increase. When adaptive measures fail, LV function deteriorates, end-diastolic volume rises further and the forward stroke volume and EF decline. An early sign of LV dysfunction is a reduction in the EF. Deterioration of LV function often precedes the development of symptoms.

Question 11

A large fraction of coronary blood flow occurs during ?

A	Systole
B	Diastole
C	Systole + diastole
D	Any of the above

Question 11 Explanation:

A large fraction of coronary blood flow occurs during diastole

Question 12

Myocardial ischemia occurs in AR because of ?

A	LV dilation
B	Elevated LV systolic tension
C	Low arterial pressure
D	All of the above

Question 12 Explanation:

Myocardial ischemia, particularly of the subendocardium, occurs in AR because of myocardial oxygen requirements are elevated by LV dilation, hypertrophy, and elevated LV systolic tension, and coronary blood flow may be compromised due to low arterial pressure

Question 13

Which of the following is a cause of acute severe AR ?

A	Infective endocarditis
B	Aortic dissection
C	Nonpenetrating cardiac injury
D	All of the above

Question 13 Explanation:

Acute severe AR results from infective endocarditis, aortic dissection, or trauma (Nonpenetrating cardiac injury leading to rupture or avulsion of the aortic valve).

Question 14

Which of the following about AR is false ?

A	3/4th of patients with predominant valvular AR are men
B	Primary valvular AR with rheumatic mitral valve disease more common in women
C	Exertional dyspnea is the first symptom of diminished cardiac reserve
D	None of the above

Question 15

Which of the following is a symptom of chronic severe AR ?

A	Vomiting
B	Gait disturbance
C	Vertigo
D	Diaphoresis

Question 15 Explanation:

Exertional dyspnea is followed by orthopnea, paroxysmal nocturnal dyspnea, and excessive diaphoresis. Nocturnal angina that does not respond satisfactorily to sublingual nitroglycerin may be accompanied by marked diaphoresis.

Question 16

Diaphoresis is a predominant symptom of which of the following valvular heart disease ?

A	AS
B	AR
C	MS
D	MR

Question 17

In free AR, booming “pistol-shot” sound heard over femoral arteries is called ?

A	Corrigan’s pulse
B	Quincke’s pulse
C	Traube’s sign
D	Duroziez’s sign

Question 17 Explanation:

In free AR, booming “pistol-shot” sound heard over femoral arteries is termed as Traube’s sig

Question 18

Large-volume ‘collapsing’ water hammer peripheral pulse seen in AR is named after ?

A	Corrigan
B	Watson
C	de Musset
D	Duroziez

Question 18 Explanation:

Large-volume ‘collapsing’ water hammer peripheral pulse seen in AR is named after Watson. Other peripheral signs of AR include Corrigan’s pulse (rapid upstroke & collapse of carotid artery pulse), de Musset’s sign (head nodding in time with heart beat), Quincke’s sign (pulsation of capillary bed in nails), Traube’s sign (systolic & diastolic murmurs described as ‘pistol shots’ heard over femoral artery when it is gradually compressed), Duroziez’s sign (a double sound heard over femoral artery when it is compressed distally), Lighthouse sign (blanching & flushing of forehead), Landolfi’s sign (alternating constriction & dilatation of pupil), Becker’s sign (pulsations

Question 19

The murmur of AR is typically heard best in ?

A	II left ICS parasternally
B	III left ICS parasternally
C	IV left ICS parasternally
D	V left ICS parasternally

Question 19 Explanation:

V left ICS parasternally

Question 20

When murmur of AR is heard best along right sternal border, it suggests that AR is ?

A	Accompanied by significant MS
B	Accompanied by Infective endocarditis
C	Due to aneurysmal dilatation of aortic root
D	Due to severe hypertension

Question 20 Explanation:

When murmur of AR is heard best along right sternal border, it suggests that AR is caused by aneurysmal dilatation of aortic root.

Question 21

Austin Flint (1812-86) was a physician of which country ?

A	American
B	United Kingdom
C	Australia
D	Canada

Question 21 Explanation:

Canada

Question 22

Which of the following murmur is heard in chronic AR ?

A	Decrescendo diastolic murmur
B	Mid-systolic ejection murmur
C	Mid-to-late diastolic murmur
D	All of the above

Question 23

Which of the following is a feature of acute severe AR ?

A	Soft S1
B	Pulse pressure not wide
C	Soft, short, early diastolic murmur of AR
D	All of the above

Question 24

Most common pathologic condition associated with aortic aneurysm is ?

A	Syphilis
B	Atherosclerosis
C	Tuberculosis
D	Marfan’s syndrome

Question 25

In ECG of patient with AR, which of the following findings usually signify a poor prognosis ?

A	No electrocardiographic abnormalities
B	ST depression & T-wave inversion in I, aVL
C	ST depression & T-wave inversion in V5 & V6
D	QRS prolongation

Question 25 Explanation:

Left axis deviation and/or QRS prolongation denote diffuse myocardial disease and signify a poor prognosis

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

1.Following onset of symptoms in AS, which of the following leads to early death ?
A. Angina pectoris
B. Syncope
C. Congestive heart failure
D. None of the above

2. Severe LV hypertrophy is present when a wall thickness is ?
A. > 5 mm
B. > 10 mm
C. > 15 mm
D. > 20 mm

3. Which of the following is the cause of aortic regurgitation due to primary valve disease ?
A. Aortic dissection
B. Hypertension
C. Ankylosing spondylitis
D. Marfan’s syndrome
4. Which of the following is the cause of aortic regurgitation due to both primary valve disease & primary aortic root disease ?
A. Aortitis
B. Bicuspid aortic valve
C. Marfan’s syndrome
D. Rheumatic fever

5. Coexistence of hemodynamically significant AS with AR occurs in which of the following ?
A. Congenital AR
B. Syphilis
C. Marfan’s syndrome
D. All of the above

6. Which of the following is the cause of aortic regurgitation dueto both primary valve disease & primary aortic root disease ?
A. Syphilis
B. Bicuspid aortic valve
C. Ankylosing spondylitis
D. All of the above

7. Which of the following condition predisposes to AR ?
A. Marfan syndrome
B. Ankylosing spondylitis
C. Ventricular septal defect
D. All of the above
8. Conditions that predispose to AR are Marfan syndrome, ankylosing spondylitis & VSD. 906 At autopsy, heart of which of the following lesions is heaviest ?
A. Chronic AS
B. Chronic AR
C. HOCM
D. Dilated cardiomyopathy

9. Early sign of LV dysfunction in chronic AR is ?
A. Elevation of LA pressure
B. Reduction in LVEF
C. Elevation of PA wedge pressure
D. Elevation of LV end-diastolic pressure

10. A large fraction of coronary blood flow occurs during ?
A. Systole
B. Diastole
C. Systole + diastole
D. Any of the above

11. Myocardial ischemia occurs in AR because of ?
A. LV dilation
B. Elevated LV systolic tension
C. Low arterial pressure
D. All of the above

12. Which of the following is a cause of acute severe AR ?
A. Infective endocarditis
B. Aortic dissection
C. Nonpenetrating cardiac injury
D. All of the above

13. Which of the following about AR is false ?
A. 3/4th of patients with predominant valvular AR are men
B. Primary valvular AR with rheumatic mitral valve disease more common in women
C. Exertional dyspnea is the first symptom of diminished cardiac reserve
D. None of the above
14. Which of the following is a symptom of chronic severe AR ?
A. Vomiting
B. Gait disturbance
C. Vertigo
D. Diaphoresis

15. Diaphoresis is a predominant symptom of which of the following valvular heart disease ?
A. AS
B. AR
C. MS
D. MR
14. In free AR, booming “pistol-shot” sound heard over femoral arteries is called ?
A. Corrigan’s pulse
B. Quincke’s pulse
C. Traube’s sign
D. Duroziez’s sign

15. Large-volume ‘collapsing’ water hammer peripheral pulse seen in AR is named after ?
A. Corrigan
B. Watson
C. de Musset
D. Duroziez

16. The murmur of AR is typically heard best in ?
A. II left ICS parasternally
B. III left ICS parasternally
C. IV left ICS parasternally
D. V left ICS parasternally

17. When murmur of AR is heard best along right sternal border, it suggests that AR is ?
A. Accompanied by significant MS
B. Accompanied by Infective endocarditis
C. Due to aneurysmal dilatation of aortic root
D. Due to severe hypertension

18. Austin Flint (1812-86) was a physician of which country ?
A. American
B. United Kingdom
C. Australia
D. Canada

19. Which of the following murmur is heard in chronic AR ?
A. Decrescendo diastolic murmur
B. Mid-systolic ejection murmur
C. Mid-to-late diastolic murmur
D. All of the above
20. Which of the following is a feature of acute severe AR ?
A. Soft S1
B. Pulse pressure not wide
C, Soft, short, early diastolic murmur of AR
D. All of the above
22. Most common pathologic condition associated with aortic aneurysm is ?
A. Syphilis
B. Atherosclerosis
C. Tuberculosis
D. Marfan’s syndrome
23. In ECG of patient with AR, which of the following findings
usually signify a poor prognosis ?

A. No electrocardiographic abnormalities
B. ST depression & T-wave inversion in I, aVL
C. ST depression & T-wave inversion in V5 & V6
D. QRS prolongation

Valvular Heart Disease

[MCQ] Valvular Heart Disease- Part 5

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Valvular Heart Disease- Part 5

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