[MCQ] Valvular Heart Disease- Part 6

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

Valvular Heart Disease- Part 6

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 6. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Question 1

On Echocardiogram, which of the following can be found in a patient of AR ?

A	Increased systolic excursion of posterior LV wall
B	High-frequency diastolic fluttering of anterior mitral leaflet
C	Dilatation of aortic annulus
D	All of the above

Question 1 Explanation:

A rapid, high-frequency fluttering of the anterior mitral leaflet produced by the impact of the regurgitant jet is a characteristic finding in 2D echocardiogram of AR patient.

Question 2

Which of the following findings in color flow Doppler imaging suggest severe AR ?

A	Central jet width > 65 % of left ventricular outflow tract
B	Regurgitant volume > 60 mL/beat
C	Regurgitant fraction > 50%
D	All of the above

Question 2 Explanation:

With severe AR, central jet width assessed by color flow Doppler imaging exceeds 65% of left ventricular outflow tract, regurgitant volume is >=60 mL/beat, regurgitant fraction is >=50%, and diastolic flow reversal in the proximal descending thoracic aorta is seen.

Question 3

Which of the following is contraindicated in the treatment of acute aortic regurgitation ?

A	Intravenous diuretics
B	Vasodilators (sodium nitroprusside)
C	Intraaortic balloon counterpulsation
D	Surgery

Question 3 Explanation:

Patients with acute severe AR may respond to IV diuretics and vasodilators like sodium nitroprusside. Surgery is the treatment of choice and is usually necessary within 24 hours of diagnosis. Intraaortic balloon counterpulsation is contraindicated. Beta blockers are also best avoided as they may reduce CO further.

Question 4

In AR, which of the following drugs can delay the need for surgery ?

A	Digitalis glycosides
B	Diuretics
C	Nondihydropyridine calcium channel blockers
D	Long-acting nifedipine

Question 5

In AR, operation should be carried out in ?

A	LVEF < 50%
B	LV end-systolic volume > 55 mL/m2
C	Acute, severe AR
D	All of the above

Question 5 Explanation:

Surgery should be carried out in asymptomatic patients with severe AR and progressive LV dysfunction defined by an LVEF <50%, an LV end-systolic dimension >55 mm or end-systolic volume >55 mL/m2, or an LV diastolic dimension >75 mm.

Question 6

Which of the following about tricuspid stenosis is false ?

A	Generally congenital in origin
B	More common in women than men
C	Does not occur as an isolated lesion
D	Rheumatic TS commonly associated with TR

Question 6 Explanation:

Tricuspid stenosis (TS) is generally rheumatic in origin and more common in women than men. It does not occur as an isolated lesion and is usually associated with MS. Rheumatic TS is commonly associated with some degree of TR. Nonrheumatic causes of TS are rare.

Question 7

Systemic venous congestion sets in when mean RA - RV diastolic pressure gradient is ?

A	1 mm Hg
B	2 mm Hg
C	3 mm Hg
D	4 mm Hg

Question 7 Explanation:

A diastolic pressure gradient between the RA and RV defines TS. A mean diastolic pressure gradient of 4 mmHg is usually sufficient to elevate the mean RA pressure to levels that result in systemic venous congestion (hepatomegaly, ascites, edema).

Question 8

In Tricuspid stenosis (TS), jugular veins may show ?

A	Giant ‘a’ wave
B	Less conspicuous ‘v’ wave
C	Slow ‘y’ descent
D	All of the above

Question 8 Explanation:

In TS with sinus rhythm, jugular veins are distended with giant “a” waves. “v” waves are less conspicuous with a slow “y” descent.

Question 9

Which of the following statements is false ?

A	Development of MS precedes that of TS
B	Presence of TS can mask clinical features of MS
C	TS is almost always accompanied by significant TR
D	None of the above

Question 9 Explanation:

Presence of TS can mask hemodynamic & clinical features of MS. Development of MS generally precedes that of TS. TS is almost always accompanied by significant TR

Question 10

Murmur of which of the following valvular heart disease is heard best over the xiphoid process ?

A	TS
B	TR
C	VSD
D	All of the above

Question 10 Explanation:

Murmur of TS is best heard along left lower sternal margin and over xiphoid process.

Question 11

In sinus rhythm, murmur of TS is most prominent during ?

A	Early diastole
B	Mid systole
C	Presystole
D	All of the above

Question 11 Explanation:

Murmur of TS is most prominent during presystole in patients with sinus rhythm. It is augmented during inspiration, reduced during expiration and during the strain phase of Valsalva maneuver.

Question 12

Which of the following is false about combined MS & TS ?

A	Absence of ECG evidence of RVH
B	Prominence of RA & SVC without enlarged PA on CxR
C	Less evidence of pulmonary vascular congestion
D	None of the above

Question 12 Explanation:

In combined MS & TS there is absence of ECG evidence of right ventricular hypertrophy (RVH) in a patient with right-sided heart failure. Chest x-ray shows prominence of RA & superior vena cava without much enlargement of PA with less evidence of pulmonary vascular congestion.

Question 13

Thromboembolic complications are most when mechanical valves are used for which valve replacement ?

A	Mitral
B	Tricuspid
C	Aortic
D	Pulmonary

Question 13 Explanation:

Mechanical valves in the tricuspid position are more prone to thromboembolic complications than in other positions.

Question 14

Functional tricuspid regurgitation (TR) may be observed in ?

A	Inferior MI
B	Ischemic cardiomyopathy
C	Idiopathic dilated cardiomyopathy
D	All of the above

Question 15

Severe pulmonary artery hypertension is defined when pulmonary artery systolic pressure is ?

A	> 25 mm Hg
B	> 35 mm Hg
C	> 45 mm Hg
D	> 55 mm Hg

Question 15 Explanation:

Severe pulmonary artery hypertension is defined when pulmonary artery systolic pressure is > 55 mm Hg

Question 16

Carcinoid heart disease predominantly affects which of the following heart valves ?

A	Mitral
B	Tricuspid
C	Aortic
D	Pulmonary

Question 16 Explanation:

Infarction of RV papillary muscles, tricuspid valve prolapse, carcinoid heart disease, endomyocardial fibrosis, radiation, infective endocarditis, and trauma may produce T R .

Question 17

Carcinoid syndrome may cause ?

A	Tricuspid regurgitation
B	Pulmonic stenosis
C	Pulmonic regurgitation
D	All of the above

Question 17 Explanation:

Carcinoid syndrome may cause TR, pulmonic stenosis and/or regurgitation

Question 18

Which of the following is seen in jugular venous pulsations in tricuspid regurgitation ?

A	No x descent
B	Prominent c-v wave
C	Rapid y descent
D	All of the above

Question 18 Explanation:

In severe TR, RA pressure pulse shows no x descent during early systole but a prominent c-v wave with a rapid y descent.

Question 19

In RA pressure pulse, prominent c-v wave with rapid y descent is typical of ?

A	Ebstein’s anomaly
B	Tricuspid regurgitation
C	Constrictive pericarditis
D	All of the above

Question 19 Explanation:

In severe TR, RA pressure pulse may exhibit no x descent during early systole but a prominent c-v wave with a rapid y descent

Question 20

Carvallo’s sign is related to which of the following ?

A	Aortic regurgitation
B	Mitral regurgitation
C	Tricuspid regurgitation
D	Pericarditis

Question 20 Explanation:

A prominent RV pulsation along the left parasternal region and a blowing holosystolic murmur along the lower left sternal margin, which may be intensified during inspiration & reduced during expiration or the strain of the Valsalva maneuver (Carvallo’s sign), are characteristic findings of TR.

Question 21

A positive hepatojugular reflex is seen in ?

A	TS
B	TR
C	PS
D	All of the above

Question 21 Explanation:

In TR, systemic venous congestion causes right-sided heart failure manifesting as marked hepatomegaly, ascites, pleural effusions, edema, systolic pulsations of liver, and a positive hepatojugular reflex.

Question 22

Hepatic vein systolic flow reversal on Doppler echocardiography is a feature of ?

A	TS
B	TR
C	PS
D	All of the above

Question 23

On Doppler examination, “hepatic vein systolic flow reversal” is a feature of ?

A	Constrictive pericarditis
B	Tricuspid regurgitation
C	SVC obstruction
D	All of the above

Question 23 Explanation:

On Doppler examination, severe TR is accompanied by hepatic vein systolic flow reversal.

Question 24

Which of the following heart valves is least affected by infective endocarditis ?

A	Mitral
B	Tricuspid
C	Aortic
D	Pulmonary

Question 24 Explanation:

Pulmonic valve is affected by rheumatic fever far less frequently than are the other valves, and it is uncommonly a nidus for infective endocarditis

Question 25

Which of the following is false about ‘Graham Steell murmur’ ?

A	High-pitched
B	Decrescendo, diastolic
C	Along left sternal border
D	None of the above

Question 25 Explanation:

Graham Steell murmur due to severe pulmonary hypertension is a high-pitched, decrescendo, diastolic blowing murmur along the left sternal border

Question 26

Pulmonic regurgitation occurs universally among patients who have undergone which of the following ?

A	Mustard operation
B	Repair of tetralogy of Fallot
C	Senning operation
D	Ross procedure

Question 26 Explanation:

Pulmonic regurgitation occurs universally among patients who have undergone childhood repair of tetralogy of Fallot with reconstruction of the RV outflow tract

Question 27

Which of the following drug can cause aortic insufficiency ?

A	Methysergide
B	Fenfluramine
C	Penicillin
D	Cisplatin

Question 27 Explanation:

Aortic insufficiency can be caused by serotonin reuptake inhibitors, specifically medications containing fenfluramine or dexfenfluramine isotopes, and dopamine agonists.

Question 28

Which of the following can produce mixed valve lesions ?

A	Mediastinal radiation
B	Carcinoid heart disease
C	Marfan’s syndrome
D	All of the above

Question 29

Bioprosthetic valves are indicated in ?

A	Elderly (> 65 years)
B	Women who expect to become pregnant
C	In whom anticoagulation is contraindicated
D	All of the above

Question 29 Explanation:

Bioprostheses are preferred for patients >65 years, for women who expect to become pregnant & for those who refuse to take anticoagulation or for whom anticoagulation is contraindicated.

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

There are 29 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
26	27	28	29	End

Return

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

1. On Echocardiogram, which of the following can be found in a patient of AR ?
A. Increased systolic excursion of posterior LV wall
B. High-frequency diastolic fluttering of anterior mitral leaflet
C. Dilatation of aortic annulus
D. All of the above

2. Which of the following findings in color flow Doppler imaging suggest severe AR ?
A. Central jet width > 65 % of left ventricular outflow tract
B. Regurgitant volume > 60 mL/beat
C. Regurgitant fraction > 50%
D. All of the above

3. Which of the following is contraindicated in the treatment of acute aortic regurgitation ?
A. Intravenous diuretics
B. Vasodilators (sodium nitroprusside)
C. Intraaortic balloon counterpulsation
D. Surgery

4. In AR, which of the following drugs can delay the need for surgery ?
A. Digitalis glycosides
B. Diuretics
C. Nondihydropyridine calcium channel blockers
D. Long-acting nifedipine
5. In AR, operation should be carried out in ?
A. LVEF < 50%
B. LV end-systolic volume > 55 mL/m2
C. Acute, severe AR
D. All of the above

6. Which of the following about tricuspid stenosis is false ?
A. Generally congenital in origin
B. More common in women than men
C. Does not occur as an isolated lesion
D. Rheumatic TS commonly associated with TR

7. Systemic venous congestion sets in when mean RA – RV diastolic pressure gradient is ?
A. 1 mm Hg
B. 2 mm Hg
C. 3 mm Hg
D. 4 mm Hg

8. In Tricuspid stenosis (TS), jugular veins may show ?
A. Giant ‘a’ wave
B. Less conspicuous ‘v’ wave
C. Slow ‘y’ descent
D. All of the above

9. Which of the following statements is false ?
A. Development of MS precedes that of TS
B. Presence of TS can mask clinical features of MS
C. TS is almost always accompanied by significant TR
D. None of the above

10. Murmur of which of the following valvular heart disease is heard best over the xiphoid process ?
A. TS
B. TR
C. VSD
D. All of the above

11. In sinus rhythm, murmur of TS is most prominent during ?
A. Early diastole
B. Mid systole
C. Presystole
D. All of the above

12. Which of the following is false about combined MS & TS ?
A. Absence of ECG evidence of RVH
B. Prominence of RA & SVC without enlarged PA on CxR
C. Less evidence of pulmonary vascular congestion
D. None of the above

13. Thromboembolic complications are most when mechanical valves are used for which valve replacement ?
A. Mitral
B. Tricuspid
C. Aortic
D. Pulmonary

14. Functional tricuspid regurgitation (TR) may be observed in ?
A. Inferior MI
B. Ischemic cardiomyopathy
C. Idiopathic dilated cardiomyopathy
D. All of the above
15. Severe pulmonary artery hypertension is defined when pulmonary artery systolic pressure is ?
A. > 25 mm Hg
B. > 35 mm Hg
C. > 45 mm Hg
D. > 55 mm Hg

16. Carcinoid heart disease predominantly affects which of the following heart valves ?
A. Mitral
B. Tricuspid
C. Aortic
D. Pulmonary

17. Carcinoid syndrome may cause ?
A. Tricuspid regurgitation
B. Pulmonic stenosis
C. Pulmonic regurgitation
D. All of the above

18. Which of the following is seen in jugular venous pulsations in tricuspid regurgitation ?
A. No x descent
B. Prominent c-v wave
C. Rapid y descent
D. All of the above

19. In RA pressure pulse, prominent c-v wave with rapid y descent is typical of ?
A. Ebstein’s anomaly
B. Tricuspid regurgitation
C. Constrictive pericarditis
D. All of the above

20. Carvallo’s sign is related to which of the following ?
A. Aortic regurgitation
B. Mitral regurgitation
C. Tricuspid regurgitation
D. Pericarditis

21. A positive hepatojugular reflex is seen in ?
A. TS
B. TR
C. PS
D. All of the above

22. Hepatic vein systolic flow reversal on Doppler echocardiography is a feature of ?
A. TS
B. TR
C. PS
D. All of the above
23. On Doppler examination, “hepatic vein systolic flow reversal” is a feature of ?
A. Constrictive pericarditis
B. Tricuspid regurgitation
C. SVC obstruction
D. All of the above

24. Which of the following heart valves is least affected by infective endocarditis ?
A. Mitral
B. Tricuspid
C. Aortic
D. Pulmonary

25. Which of the following is false about ‘Graham Steell murmur’ ?
A. High-pitched
B. Decrescendo, diastolic
C. Along left sternal border
D. None of the above

26. Pulmonic regurgitation occurs universally among patients who have undergone which of the following ?
A. Mustard operation
B. Repair of tetralogy of Fallot
C. Senning operation
D. Ross procedure

27. Which of the following drug can cause aortic insufficiency ?
A. Methysergide
B. Fenfluramine
C. Penicillin
D. Cisplatin

28. Which of the following can produce mixed valve lesions ?
A. Mediastinal radiation
B. Carcinoid heart disease
C. Marfan’s syndrome
D. All of the above
29. Bioprosthetic valves are indicated in ?
A. Elderly (> 65 years)
B. Women who expect to become pregnant
C. In whom anticoagulation is contraindicated
D. All of the above

Valvular Heart Disease

[MCQ] Valvular Heart Disease- Part 6

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

Valvular Heart Disease- Part 6

Share this:

Related

[MCQ] Valvular Heart Disease- Part 5

[MCQ] Cardiomyopathy and Myocarditis

You may also like

Leave a Comment Cancel Reply