Cardiology Chapter Quiz (Lec 1)

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Questions and Answers

A patient presents with increased venous pressure in the upper extremities and head. Which structure is most likely compromised?

Inferior vena cava

Superior vena cava (correct)

Coronary sinus

Right pulmonary artery

During a cardiac catheterization, the catheter is inadvertently advanced into a vessel carrying deoxygenated blood to the lungs. Which vessel was most likely entered?

Great cardiac vein

Right pulmonary artery (correct)

Aorta

Left pulmonary veins

A surgeon is performing a procedure on the posterior surface of the heart. Which vessel is least likely to be encountered directly during the initial approach?

Right coronary artery

Posterior interventricular artery

Posterior vein of left ventricle

Left pulmonary artery (correct)

A patient experiencing chronic hypoxia due to pulmonary disease develops right atrial enlargement. Which of the following best explains this phenomenon?

Pulmonary hypertension leading to increased afterload on the right ventricle (C) Signup and view all the answers

A thrombus lodged in which of the following vessels would directly impede venous drainage from the myocardium?

Coronary sinus (C) Signup and view all the answers

During an autopsy, significant atherosclerosis is observed in the posterior interventricular artery. Which region of the heart is most likely to exhibit ischemic damage?

Posterior wall of the left ventricle (B) Signup and view all the answers

A patient with severe tricuspid regurgitation experiences backflow of blood into which of the following structures during ventricular systole?

Right atrium (B) Signup and view all the answers

Given a scenario where a patient presents with metabolic acidosis and a PaCO2 of 30 mmHg, and assuming complete respiratory compensation, what would be the expected bicarbonate (HCO3-) concentration according to the Henderson-Hasselbalch equation, considering a normal Pka of 6.1 for the bicarbonate-carbonic acid system and a solubility coefficient of 0.0307 for $CO_2$?

Approximately 15 mEq/L, suggesting appropriate compensation. (C) Signup and view all the answers

Which of the following accurately describes the flow of blood entering the right atrium?

Deoxygenated blood from the superior vena cava, inferior vena cava, and coronary sinus (B) Signup and view all the answers

In a patient with atrial fibrillation, thrombi are most likely to form in which of the following locations due to stasis?

Auricle of the left atrium (D) Signup and view all the answers

In a patient experiencing diabetic ketoacidosis (DKA), severe acidemia ensues. Considering the complex interplay of buffering systems, which of the following buffering mechanisms would provide the most immediate defense against the drastic drop in pH, prior to any renal or respiratory compensation?

Bicarbonate buffering in the extracellular fluid. (A) Signup and view all the answers

A patient is diagnosed with a condition that causes dilation of the great cardiac vein. What is the most likely consequence of this dilation on cardiac function?

Reduced efficiency of myocardial venous drainage (C) Signup and view all the answers

A patient with chronic obstructive pulmonary disease (COPD) presents with compensated respiratory acidosis. Arterial blood gas analysis reveals an elevated PaCO2 of 60 mmHg and a pH within the normal range (7.35-7.45). Which of the following renal adaptations would be MOST critical in achieving this compensation?

Increased excretion of titratable acids like $H_2PO_4^-$. (C) Signup and view all the answers

Consider a scenario where a patient has ingested a significant quantity of methanol, leading to the formation of formic acid and subsequent metabolic acidosis. Which of the following interventions would be the LEAST effective in directly mitigating the acidemia, considering the specific pathophysiology of methanol poisoning?

Administering intravenous sodium bicarbonate to directly buffer excess acid. (B) Signup and view all the answers

In the context of acid-base balance, consider a patient with severe sepsis exhibiting both lactic acidosis (due to anaerobic metabolism) and acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. If the ventilator settings are adjusted to achieve a PaCO2 of 32 mmHg, what potential consequence related to oxygen delivery and cellular metabolism should be MOST carefully monitored?

Increased hemoglobin affinity for oxygen, hindering oxygen release at the tissue level. (D) Signup and view all the answers

A researcher is investigating the effects of a novel drug on acid-base balance in an experimental rat model. The drug is found to inhibit carbonic anhydrase activity specifically in the proximal tubules of the kidney. Predict the MOST likely initial change in arterial blood gases following administration of this drug.

Decreased arterial pH due to reduced bicarbonate reabsorption. (D) Signup and view all the answers

A patient presents with hyperaldosteronism. Considering the known effects of aldosterone on renal tubular function, which combination of arterial blood gas derangements and serum electrolyte abnormalities would be MOST anticipated?

Metabolic alkalosis, hypokalemia, and hypernatremia. (B) Signup and view all the answers

A patient presents with an embolic stroke originating from the heart. Considering the anatomical features, a thrombus dislodging from which location would pose the greatest embolic risk, given the direct circulatory pathway to the cerebral arteries?

Left atrial appendage (D) Signup and view all the answers

A cardiac surgeon is repairing a congenital defect involving the outflow tracts. Damage to which structure would most severely compromise the pulmonary circulation, leading to acute right ventricular hypertension?

The pulmonary valve (B) Signup and view all the answers

In a patient with longstanding uncontrolled hypertension, which of the following structural adaptations of the left ventricle is most likely to be observed, reflecting the heart's response to chronic pressure overload?

Concentric hypertrophy with increased wall thickness (D) Signup and view all the answers

A patient with mitral valve stenosis experiences pulmonary congestion. Which of the following anatomical relationships directly contributes to the pathophysiology of this condition?

Direct connection between the left atrium and the pulmonary veins (A) Signup and view all the answers

During a cardiac catheterization, the catheter is inadvertently passed from the right atrium directly into the left atrium. Which anatomical structure was most likely traversed by the catheter?

The fossa ovalis (D) Signup and view all the answers

A patient is diagnosed with hypertrophic cardiomyopathy characterized by asymmetric septal hypertrophy. This condition most directly affects which aspect of cardiac function?

Left ventricular outflow tract obstruction (D) Signup and view all the answers

Following a myocardial infarction affecting the anterior wall of the left ventricle, which complication is most likely to arise due to structural damage in that region?

Ventricular aneurysm formation (C) Signup and view all the answers

A patient undergoes a procedure that damages the chordae tendineae of the mitral valve. What is the most likely immediate consequence of this damage on the heart's function?

Mitral valve regurgitation (D) Signup and view all the answers

Which anatomical feature ensures unidirectional blood flow from the right atrium to the right ventricle, preventing backflow during ventricular contraction?

Tricuspid valve (D) Signup and view all the answers

In a patient with cor pulmonale secondary to chronic obstructive pulmonary disease (COPD), which chamber of the heart is most likely to exhibit significant dilation and hypertrophy?

Right ventricle (D) Signup and view all the answers

Given the intricate role of the cardiac skeleton, what would be the most plausible consequence of its complete absence in a mammalian heart?

Compromised structural integrity leading to disorganized contractions and potential valve incompetence. (B) Signup and view all the answers

Considering the role of the cardiac skeleton in electrical insulation, a targeted ablation of a portion of this structure between the atria and ventricles would most likely result in which of the following?

Atrioventricular re-entrant tachycardia (AVRT) due to aberrant electrical pathways. (A) Signup and view all the answers

A novel pharmaceutical agent is designed to specifically target and degrade collagen fibers within the cardiac skeleton. What is the most probable adverse effect of this agent on cardiac physiology?

Valvular insufficiency due to the compromised structural support of the heart valves. (D) Signup and view all the answers

In the context of cardiac tissue engineering, which component of an artificial cardiac scaffold would be most crucial to replicate the function of the native cardiac skeleton in preventing aberrant electrical conduction?

An anisotropic matrix of non-conductive fibrous proteins. (A) Signup and view all the answers

Considering the arrangement of cardiac chambers, what is the functional significance of the interatrial septum's relative thinness compared to the interventricular septum?

Reflecting the lower pressure gradient between the right and left atria. (C) Signup and view all the answers

A patient presents with paradoxical embolism due to an atrial septal defect (ASD). Considering the anatomical location of this defect, what is the most likely pathway for the embolus to travel from the venous to the arterial circulation?

From the right atrium to the left atrium, bypassing the pulmonary circulation. (D) Signup and view all the answers

If a researcher aims to selectively enhance the contractile force of the atrial myocardium without affecting ventricular function, which of the following targets would be the most specific and effective?

Modulating the activity of phospholamban specifically in atrial sarcoplasmic reticulum. (C) Signup and view all the answers

In a scenario involving complete heart block, where there is no electrical communication between the atria and ventricles, what compensatory mechanism would primarily maintain ventricular contraction, and what would be its typical rate?

Purkinje fibers initiating ventricular contraction at a rate of 20-40 bpm. (A) Signup and view all the answers

Following a myocardial infarction that primarily affects the interventricular septum, which of the following complications is the most life-threatening and requires immediate intervention?

Ventricular septal rupture leading to acute heart failure. (C) Signup and view all the answers

In a scenario involving increased ventricular pressure exceeding atrial pressure, yet paradoxically, blood continues to flow from the atria into the ventricles, which compensatory mechanism is MOST likely facilitating this counter-intuitive phenomenon, considering the interplay of valvular dynamics and myocardial compliance?

Mitral valve prolapse combined with enhanced atrial contractility overcoming the pressure differential via augmented atrial emptying. (A) Signup and view all the answers

Considering a patient presents with acute right ventricular failure secondary to a massive pulmonary embolism, which valvular structure is MOST immediately affected by the resultant pressure overload, and what compensatory mechanism might the heart initially employ to maintain cardiac output, prior to decompensation?

Pulmonary semilunar valve; right ventricular hypertrophy to overcome increased afterload. (C) Signup and view all the answers

If a novel pharmaceutical agent selectively weakens the chordae tendineae without directly affecting the papillary muscles themselves, what is the MOST likely acute consequence on valvular function, and how would this manifest in terms of cardiac auscultation and hemodynamic parameters, assuming no other compensatory mechanisms are immediately activated?

Mitral Regurgitation; a holosystolic murmur radiating to the axilla, with an increase in left atrial pressure. (D) Signup and view all the answers

Suppose a genetic mutation results in the congenital absence of papillary muscles in the left ventricle. Which valvular pathology is MOST likely to arise as a direct consequence, and what long-term structural adaptation would be anticipated in the left atrium to mitigate the immediate hemodynamic stress in a patient surviving to adulthood without surgical intervention, disregarding any other co-morbidities?

Mitral Valve Prolapse; eccentric hypertrophy to accommodate increased blood volume. (A) Signup and view all the answers

In a patient with advanced heart failure and severely reduced ejection fraction (<20%), the aortic and pulmonary semilunar valves are observed to open and close prematurely relative to the typical cardiac cycle. What alteration in ventricular mechanics is MOST likely responsible for this phenomenon, and how would this impact the pressure gradients across the AV valves during diastole, assuming constant atrial function?

Diminished ventricular compliance; reduces the pressure gradients across the AV valves, impairing diastolic filling. (A) Signup and view all the answers

Flashcards

Henderson-Hasselbalch equation

A mathematical formula used to calculate the pH of a buffer solution based on the concentration of acids and their conjugates.

Acidity control

The regulation of hydrogen ion concentration in body fluids to maintain pH balance.