Test Bank For Harrison s principles of internal medicine
self assessment and board review 19 Edition
As a resident on rounds, your attending Dr. X. Pounds who is discussing whether
a patient's mitral regurgitation (MR) is "primary" or "secondary." What is your
attending talking about?
A. In primary MR the leaflets/chordae are responsible for abnormal valve
function, whereas in secondary MR the valve dysfunction is usually caused by
ventricular remodeling.
B. Primary MR occurs early (usually prior to age 18), whereas secondary MR
occurs later in life.
C. Primary MR occurs only in prime number years, whereas secondary MR can
occur in any year.
D. Primary MR is due to a congenital valvular abnormality, whereas secondary
MR is not.
E. Primary MR is caused by infectious endocarditis, whereas secondary MR is
not. - A. In primary MR the leaflets/chordae are responsible for abnormal valve
function, whereas in secondary MR the valve dysfunction is usually caused by
ventricular remodeling.
You are seeing Mr. Garibalt who is a 56-year-old man with severe rheumatic
mitral stenosis. During an exercise test he complains of shortness of breath. All
of the following physiologic parameters will increase during his exercise test
EXCEPT:
A. Diastolic filling time
B. Left atrial pressure
C. Mitral valve pressure gradient
D. Pulmonary arterial pressure
E. Pulmonary vascular resistance - A. Diastolic filling time
,All of the following physical examination findings are seen in aortic regurgitation
EXCEPT:
A. A booming "pistol-shot" sound heard over the femoral arteries
B. A rapidly rising "water-hammer" pulse
C. A systolic crescendo-decrescendo murmur radiating to the carotids
D. A to-and-fro murmur audible over a lightly compressed femoral artery
E. Alternate flushing and paling of the skin at the root of the nails - C. A systolic
crescendo-decrescendo murmur radiating to the carotids
Which of the following physical examination findings are associated with severe
aortic stenosis?
A. A delayed and weak carotid pulse
B. Augmentation of the murmur with Valsalva
C. Bounding femoral pulsation
D. Holosystolic murmur at the apex radiating to the axilla
E. Pan-cycle murmur at the apex - A. a delayed and weak carotid pulse
Which of the following is the most common cause of pulmonic valve stenosis?
A. Calcific degeneration
B. Carcinoid syndrome
C. Noonan syndrome
D. Obstructing tumors
E. Rheumatic fever - C. Noonan syndrome
(Vitalo has this on her slides but has tetralogy of fallot and congenital rubella in
red sooo idk)
Which of the following parameters is typically REDUCED in chronic severe aortic
regurgitation?
A. Diastolic blood pressure
B. Left ventricular afterload
C. Left ventricular diameter
, D. Left ventricular preload
E. Total left ventricular stroke volume - A. diastolic blood pressure
In cases of severe mitral stenosis, which of the following parameters is typically
increased?
A. Cardiac output
B. Left atrial pressure
C. Left ventricular diameter
D. Left ventricular end diastolic pressure
E. Pulmonary vascular compliance - B. left atrial pressure
you are examining Mr. Cooper, a 45-year-old man who has largely avoided
medical care thus far in his life. On examination, you note distended jugular
veins and a soft decrescendo diastolic murmur at the apex. Point of maximal
impulse is small and nondisplaced. You suspect mitral stenosis. Which of the
following is the most common cause of mitral stenosis worldwide?
A. Infectious endocarditis
B. Mitral annular calcification
C. Rheumatic fever
D. Rheumatoid arthritis
E. Systemic lupus erythematosus - C. rheumatic fever
You admit a 19-year-old with acute-onset heart failure and left ventricular
dysfunction. After assessment, you suspect acute viral myocarditis, which is
confirmed on endomyocardial biopsy. Which of the following therapies is
recommended for treatment for acute viral myocarditis?
A. Ibuprofen
B. Lisinopril
C. Oseltamivir
D. Prednisone
E. Thymoglobulin - B. lisinopril
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