Valvular Heart Disease

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Questions and Answers

Which of the following is a risk factor for infective endocarditis?

  • Valve damage (correct)
  • Right ventricular hypertrophy
  • Pulmonary hypertension
  • Mitral incompetence

Which organism is NOT commonly associated with the composition of a vegetation in infective endocarditis?

  • Group D Streptococcus
  • Candida (correct)
  • Skin Strep
  • Gut commensals

What is the most common causative organism for acute native valve endocarditis?

  • Staphylococcus aureus (correct)
  • Alpha-haemolytic streptococci
  • Enterococci
  • Group B streptococci

Which type of endocarditis is characterized by indolent but potentially deteriorating disease?

<p>Subacute native valve endocarditis (D)</p> Signup and view all the answers

Which valve is more susceptible to early-onset prosthetic valve endocarditis?

<p>Mitral valve (D)</p> Signup and view all the answers

What percentage of cases of prosthetic valve endocarditis involve mechanical and bio-prosthetic valves?

<p>10% (D)</p> Signup and view all the answers

Which valve is most commonly involved in infective endocarditis in IV drug abusers?

<p>Tricuspid valve (B)</p> Signup and view all the answers

What is the main principle of treatment for infective endocarditis?

<p>Antibiotic therapy (C)</p> Signup and view all the answers

Which diagnostic imaging technique is especially useful in the diagnosis of infective endocarditis?

<p>Echocardiography (B)</p> Signup and view all the answers

What is the most common route of entry for organisms causing infective endocarditis?

<p>Bloodstream (C)</p> Signup and view all the answers

Which term describes the narrowing of the valve outlet caused by thickening of valve cusps, or increased rigidity or scarring?

<p>Stenosis (D)</p> Signup and view all the answers

What is the term for incomplete seal when valves close, allowing blood to flow backwards?

<p>Incompetence (A)</p> Signup and view all the answers

Which of the following is NOT a common cause of cardiac valve stenosis and incompetence?

<p>Bicuspid valve (C)</p> Signup and view all the answers

Which valves are associated with systole?

<p>Mitral and tricuspid (B)</p> Signup and view all the answers

Which valves are associated with diastole?

<p>Aorta and pulmonary (D)</p> Signup and view all the answers

Which of the following is NOT a sign of aortic stenosis?

<p>Mitral stenosis (C)</p> Signup and view all the answers

What percentage of heart failure involves valve disease?

<p>10% (A)</p> Signup and view all the answers

Which of the following is NOT a risk factor for infective endocarditis?

<p>Myocardial infarction (C)</p> Signup and view all the answers

What is the term for the composition of a vegetation in infective endocarditis?

<p>Regurgitation (D)</p> Signup and view all the answers

Which of the following is NOT a probable causative organism of infective endocarditis?

<p>Pseudomonas aeruginosa (C)</p> Signup and view all the answers

Which type of block can generate circus re-entry movements?

<p>Unidirectional block (D)</p> Signup and view all the answers

What is the main characteristic of Wolf-Parkinson-White Syndrome?

<p>Short PR interval (A)</p> Signup and view all the answers

Which class of anti-dysrhythmic drugs blocks fast sodium channels?

<p>Class Ia (B)</p> Signup and view all the answers

Which class of anti-dysrhythmic drugs prolongs the duration of action potential repolarization?

<p>Class III (A)</p> Signup and view all the answers

Which class of anti-dysrhythmic drugs blocks Ca2+ channels?

<p>Class IV (A)</p> Signup and view all the answers

Which of the following drugs does NOT fit into the Vaughn-Williams Classification?

<p>Digoxin (D)</p> Signup and view all the answers

What is the frequency of impulses generated in circus re-entry movements?

<p>High (B)</p> Signup and view all the answers

What is the main characteristic of the grey area in the text?

<p>Area of damage with no conduction (B)</p> Signup and view all the answers

What is the term for the early upstroke of the QRS complex in Wolf-Parkinson-White Syndrome?

<p>Delta wave (D)</p> Signup and view all the answers

What is the term for the movement of a sinus impulse through a unidirectional block?

<p>Sinus impulse extinguished (A)</p> Signup and view all the answers

Which category of event is responsible for the origin of dysrhythmias?

<p>Circus re-entry (C)</p> Signup and view all the answers

Which type of dysrhythmia is associated with the AV node?

<p>Junctional (D)</p> Signup and view all the answers

Which type of dysrhythmia has the fastest inherent rate?

<p>Atrial fibrillation (B)</p> Signup and view all the answers

Which category of event is responsible for changes in the heart cells?

<p>Heart block (D)</p> Signup and view all the answers

Which type of dysrhythmia is more serious?

<p>Sustained ventricular arrhythmias (B)</p> Signup and view all the answers

Which type of dysrhythmia is associated with the origin at the sinoatrial node (SAN)?

<p>Atrial fibrillation (A)</p> Signup and view all the answers

Which category of event is responsible for changes in the conduction of the impulse through the heart?

<p>Ectopic pacemaker activity (A)</p> Signup and view all the answers

Which type of dysrhythmia is associated with the origin at the atrioventricular node (AVN)?

<p>Supraventricular tachycardia (B)</p> Signup and view all the answers

Which type of dysrhythmia is associated with ventricular origin?

<p>Ectopic beats (C)</p> Signup and view all the answers

Which type of dysrhythmia is associated with atrial origin?

<p>Atrial fibrillation (D)</p> Signup and view all the answers

Which of the following is the correct order of the phases of cardiac action potential?

<p>Phase 0: rapid depolarization, Phase 1: partial repolarization, Phase 2: plateau, Phase 3: repolarization, Phase 4: stable (A)</p> Signup and view all the answers

Which of the following is NOT a possible cause of ectopic pacemakers?

<p>Decreased K+ outflow (C)</p> Signup and view all the answers

Which of the following is a characteristic of second degree heart block type 2 (Mobitz type 2)?

<p>There is progressive lengthening of the P-R interval until a P wave fails to produce a QRS complex (C)</p> Signup and view all the answers

Which of the following is a characteristic of third degree heart block?

<p>The AV node is completely blocked and no electrical activity from the atria progresses to the ventricles (A)</p> Signup and view all the answers

Which of the following is a characteristic of Wenckebach heart block?

<p>There is progressive lengthening of the P-R interval until a P wave fails to produce a QRS complex (C)</p> Signup and view all the answers

What is the most likely cause of heart block?

<p>Damage to the conducting system due to ischemia (A)</p> Signup and view all the answers

What is the primary path for electrical conduction between the atria and ventricles?

<p>AV node (C)</p> Signup and view all the answers

What is the term for the phenomenon when an electrical impulse re-stimulates a region of the heart after its refractory period has passed?

<p>Circus re-entry movements (A)</p> Signup and view all the answers

What is the term for the condition where the AV node is only slightly affected and conduction is slowed, resulting in an abnormally long P-R interval?

<p>First degree heart block (D)</p> Signup and view all the answers

Which of the following is NOT a subtype of second degree heart block?

<p>2:1 or 3:1 (C)</p> Signup and view all the answers

Flashcards

Infective Endocarditis Risk Factor

Damage to heart valves increases the risk of bacteria adhering and causing infection.

Uncommon IE Organism

Candida is a fungus; bacterial species are more commonly associated with infective endocarditis.

Common Acute IE Organism

A common cause of acute native valve endocarditis.

Subacute Endocarditis

Subacute native valve endocarditis is characterized by a slow but potentially deteriorating disease course.

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Early-Onset Prosthetic Valve Risk

Mitral valves are more prone to early-onset prosthetic valve endocarditis.

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Prosthetic Valve Endocarditis Cases

10% of prosthetic valve endocarditis cases involve mechanical and bio-prosthetic valves.

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Tricuspid Valve & IV Drug Use

The tricuspid valve is most commonly affected in IV drug abusers due to the route of entry.

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IE Treatment Principle

Antibiotic therapy is the foundation of treatment for infective endocarditis.

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IE Diagnostic Imaging

Echocardiography is very useful for visualizing vegetations and assessing valve function.

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IE Entry Route

The bloodstream is the most common route of entry for organisms causing infective endocarditis.

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Valve Stenosis

Stenosis is the narrowing of a valve outlet due to thickening, rigidity, or scarring.

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Valve Incompetence

Incomplete valve closure that allows backward blood flow.

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Valves in Systole

During systole, the mitral and tricuspid valves are closed to prevent backflow into the atria.

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Valves in Diastole

During diastole, the aortic and pulmonary valves are closed to prevent backflow into the ventricles.

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Sign of Aortic Stenosis?

Aortic stenosis leads to chest pain, shortness of breath and fainting spells.

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Unidirectional Block

Unidirectional block enables circus re-entry movements by only allowing impulse travel in one direction.

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WPW Syndrome

Short PR interval is the main characteristic of Wolf-Parkinson-White Syndrome.

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Class Ia Action

Class Ia anti-dysrhythmic drugs block fast sodium channels, slowing down phase 0 depolarization.

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Class III Action

Class III anti-dysrhythmic drugs prolong the duration of action potential repolarization.

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Class IV Action

Class IV anti-dysrhythmic drugs block Ca2+ channels, slowing conduction in the AV node.

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Circus Re-entry Frequency

High frequency impulses are generated in circus re-entry movements because the impulse is continuously re-circulating.

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Grey Area

The grey area is an area of damage with no conduction, essential for circus re-entry.

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Delta Wave

Delta wave is responsible for the early upstroke of the QRS complex.

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Event Category - Heart Block

Heart block changes the conduction of the impulse through the heart.

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Serious Dysrhythmia?

Sustained ventricular arrhythmias are more serious due to their immediate impact on cardiac output and risk of sudden cardiac death.

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Event Category - Ectopic Pacemakers

Ectopic pacemaker activity involves changes in the heart cells, that lead to dysrhythmias.

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Cardiac Action Potential Phases

Sequence: Rapid depolarization, partial repolarization, plateau, repolarization, stable.

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Cause of Heart Block

Damage to the conducting system due to ischemia is the most likely cause of heart block.

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Primary Conduction Path

The AV node is primarily involved in electrical conduction between the atria and ventricles.

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First Degree Heart Block

The AV node slows conduction, resulting in an abnormally long P-R interval.

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