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Loeffler & Hart: Introduction to Human Disease, Sixth Edition Chapter 9 – Test Bank Multiple Choice 1. The right side of the heart receives _____________ blood from the venae cavae and pumps it through the ___________ pressure pulmonary system. A. B. C. D. Oxygenated, high Oxygenated, low Deoxygenated, high Deoxygenated, low Ans: D 2. The electrical pathway followed to produce myocardial contraction follows which path: A. B. C. D. Atrioventricular node, interventricular septum, sinoatrial node Interventricular septum, atrioventricular node, sinoatrial node Sinoatrial node, atrioventricular node, interventricular septum Sinoatrial node, interventricular septum, atrioventricular node Ans: C 3. Which of the following indicates the most damage to the heart? A. B. C. D. Infarction Ischemia Injury Arrhythmias Ans: A 4. A 68-year-old male presents with congestive heart failure. Which of the following assessments would be unlikely? A. B. C. D. E. Crackles heard on auscultation Dull sound when the chest is percussed Shortness of breath Pitting edema of the lower extremities All of the above are likely © 2015 Jones & Bartlett Learning, LLC, an Ascend Learning Company 1 Loeffler & Hart: Introduction to Human Disease, Sixth Edition Chapter 9 – Test Bank Ans: E 5. Atrial fibrillation is an arrhythmia that puts a patient at risk for which of the following? I. Cerebrovascular accident II. Congestive heart failure III. Chest pain IV. Dizziness A. B. C. D. I and II III and IV I, II, and III All of the above Ans: D 6. During a well-baby check, the mother of a 6-month old boy expresses her concern that he is very lethargic, will not cry except when he is extremely uncomfortable, and turns blue immediately upon exertion. What is the most likely explanation? A. The baby is severely anemic. B. The baby has a heart defect which directs blood from the left to the right side of the heart. C. The baby has coarctation of the aorta. D. The baby has a heart defect which directs blood from the right to the left side of the heart. E. The baby has an atrial septal defect. Ans: D 7. Which of the following tests assesses blood flow through the heart? A. Electrocardiogram B. Doppler echocardiogram C. Coronary angiography D. Cardiac catheterization E. Stress test Ans: B © 2015 Jones & Bartlett Learning, LLC, an Ascend Learning Company 2 Loeffler & Hart: Introduction to Human Disease, Sixth Edition Chapter 9 – Test Bank 8. A baby is born with a bicuspid valve. Which of the following is least likely to occur? A. Infective endocarditis B. Aortic stenosis C. Left ventricular hypertrophy D. Cor pulmonale E. Eventual valve replacement Ans: D 9. A 58-year-old man is taken to the hospital following sudden onset of severe, crushing, sub-sternal chest pain. A diagnosis of acute myocardial infarction is made on the basis of his electrocardiogram and serum enzyme elevations. Despite appropriate treatment, he dies 2 hours after entering the hospital. The most likely immediate cause of death is: A. Arrhythmia B. Congestive heart failure C. Rupture of the myocardium D. Stroke E. Extension of the infarct Ans: A 10. Myocardial infarction can present as all of the following except A. Severe, substernal, radiating chest pain B. Fatigue and shortness of breath C. Sudden death D. Congestive heart failure E. Cyanotic heart disease Ans: E 11. How does a myocardial infarct heal? A. Hypertrophy B. Aneurysmal dilatation © 2015 Jones & Bartlett Learning, LLC, an Ascend Learning Company 3 Loeffler & Hart: Introduction to Human Disease, Sixth Edition Chapter 9 – Test Bank C. Scar tissue formation D. Thrombotic plug over damaged tissue. E. Regeneration of myocytes Ans: C 12. A 54-year-old woman carries a diagnosis of mitral regurgitation. She grew up in a remote village in a developing country without access to medical clinics and had several episodes of sore throat as a child. What is the most likely cause of her mitral valve disease? A. Rupture of a necrotic papillary muscle after a myocardial infarction B. Congenital valve defect C. Rheumatic heart disease D. Infective endocarditis E. Pulmonary hypertension Ans: C 13. A 36-year-old previously healthy woman becomes ill over the course of a week with a fever, chest pain, and shortness of breath. Her physician notes that she has an arrhythmia and signs of early congestive heart failure but no heart murmur. Her most likely diagnosis is: A. Myocardial infarct B. Rheumatic heart disease C. Myocarditis D. Infective endocarditis E. Restrictive cardiomyopathy Ans: C 14. The best indicator of congestive heart failure is: A. Elevated arterial systolic pressure B. Elevated arterial diastolic pressure C. Elevated venous pressure D. Elevated troponin enzyme level E. Electrocardiographic changes © 2015 Jones & Bartlett Learning, LLC, an Ascend Learning Company 4 Loeffler & Hart: Introduction to Human Disease, Sixth Edition Chapter 9 – Test Bank Ans. C 15. The most common cause of morbidity and mortality in the United States currently is: A. Diabetes mellitus B. Hypertension C. Atherosclerosis D. Stroke E. Neoplasia Ans: C 16. A 54-year-old obese and diabetic man sustains a myocardial infarction. He is adequately treated and recovering well until 6 days afterwards, when he suddenly collapses as he is going to the bathroom. Which of the following is the autopsy most likely to reveal? A. Massive pulmonary edema and pleural fluid B. Rupture of the myocardium and blood in the pericardial space C. Nothing, as the patient died of ventricular fibrillation, which leaves no morphologic traces D. Re-stenosis of the coronary artery E. Thrombosis over a ventricular aneurysm Ans: B 17. A 19-year-old basketball player collapses as he is running down the court during a semifinal game of the collegiate basketball association tournament. He is attended to immediately but dies en-route to the hospital. The autopsy reveals hypertrophic cardiomyopathy. This is an example of: A. Restrictive heart disease B. Sudden cardiac death C. Congestive heart failure D. Heart disease caused by hypertension E. Dilated heart disease Ans: B © 2015 Jones & Bartlett Learning, LLC, an Ascend Learning Company 5 Loeffler & Hart: Introduction to Human Disease, Sixth Edition Chapter 9 – Test Bank True/False 18. Cor Pulmonale is left heart failure caused by chronic lung disease. Ans: False 19. Congestive heart failure is caused by the inability of the heart to pump the blood returned to it. Ans: True © 2015 Jones & Bartlett Learning, LLC, an Ascend Learning Company 6