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What is the purpose of endomyocardial biopsy specimens in cardiomyopathy patients? A) To measure blood pressure B) To identify histological type and test for mitochondrial or infiltrative diseases C) To assess heart rhythm D) To evaluate coronary artery blockages E) To measure cardiac output
B) To identify histological type and test for mitochondrial or infiltrative diseases Explanation: Endomyocardial biopsy specimens, obtained while the patient is hemodynamically stable, identify histological type and allow tests for mitochondrial or infiltrative diseases.
What is a crucial aspect of managing cardiomyopathy? A) Ignoring the etiology B) Symptomatic therapy with close monitoring and follow-up C) Avoiding diuretics D) Reducing physical activity E) Using only herbal treatments
B) Symptomatic therapy with close monitoring and follow-up Explanation: Symptomatic therapy with close monitoring and follow-up is crucial in managing cardiomyopathy to ensure the patient's condition is managed effectively.
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p.14
Treatment Options for Cardiomyopathy

What is the purpose of endomyocardial biopsy specimens in cardiomyopathy patients?
A) To measure blood pressure
B) To identify histological type and test for mitochondrial or infiltrative diseases
C) To assess heart rhythm
D) To evaluate coronary artery blockages
E) To measure cardiac output

B) To identify histological type and test for mitochondrial or infiltrative diseases
Explanation: Endomyocardial biopsy specimens, obtained while the patient is hemodynamically stable, identify histological type and allow tests for mitochondrial or infiltrative diseases.

p.15
Treatment Options for Cardiomyopathy

What is a crucial aspect of managing cardiomyopathy?
A) Ignoring the etiology
B) Symptomatic therapy with close monitoring and follow-up
C) Avoiding diuretics
D) Reducing physical activity
E) Using only herbal treatments

B) Symptomatic therapy with close monitoring and follow-up
Explanation: Symptomatic therapy with close monitoring and follow-up is crucial in managing cardiomyopathy to ensure the patient's condition is managed effectively.

p.4
Clinical Features of Cardiomyopathies

What is a common clinical feature of hypertrophic cardiomyopathy?
A) S3 gallop
B) Systolic murmur
C) Arrhythmias
D) Right heart failure
E) S4 gallop

E) S4 gallop
Explanation: Hypertrophic cardiomyopathy often presents with an S4 gallop, which is a specific heart sound associated with this condition.

p.1
Definition of Cardiomyopathy

What is a cardiomyopathy?
A) A disease of the heart valves
B) An intrinsic disease of the heart muscle not associated with other forms of heart disease
C) A disease of the blood vessels
D) An infection of the heart lining
E) A congenital heart defect

B) An intrinsic disease of the heart muscle not associated with other forms of heart disease
Explanation: Cardiomyopathy is defined as an intrinsic disease of the heart muscle that is not associated with other forms of heart disease.

p.2
Dilated Cardiomyopathy (DCM) Causes

Dilated cardiomyopathy can be secondary to which of the following?
A) Nutritional deficiencies
B) Systemic disease
C) Physical trauma
D) Genetic mutations
E) Environmental toxins

B) Systemic disease
Explanation: Dilated cardiomyopathy can be secondary to systemic disease or to cardiotoxic drugs.

p.5
Pathogenesis of Dilated Cardiomyopathy

What varies depending on the underlying etiology in the pathogenesis of dilated cardiomyopathy (DCM)?
A) Ventricular dilation and altered contractility
B) Heart rate and blood pressure
C) Oxygen levels and blood sugar
D) Cholesterol levels and triglycerides
E) Red blood cell count and white blood cell count

A) Ventricular dilation and altered contractility
Explanation: The pathogenesis of ventricular dilation and altered contractility seen in DCM varies depending on the underlying etiology.

p.14
Imaging Studies for Cardiomyopathy

What imaging study is useful for recognizing inflammation of the myocardium in acute myocarditis?
A) Echocardiography
B) Cardiac MRI
C) CT scan
D) X-ray
E) PET scan

B) Cardiac MRI
Explanation: Cardiac MRI is useful for patients with concern of acute myocarditis where, in contrast to echocardiography, recognition of inflammation of the myocardium is possible.

p.6
Clinical Features of Cardiomyopathies

Which of the following is a sign of inadequate cardiac output and heart failure in dilated cardiomyopathy?
A) Bradycardia
B) Hypertension
C) Tachypnea and tachycardia
D) Strong peripheral pulses
E) Increased myocardial contractility

C) Tachypnea and tachycardia
Explanation: Tachypnea (rapid breathing) and tachycardia (rapid heart rate) are signs of inadequate cardiac output and heart failure, which are present on examination in patients with dilated cardiomyopathy.

p.9
Clinical Features of Cardiomyopathies

What percentage of cardiomyopathy cases present with a heart murmur or are diagnosed during screening when another family member has HCM?
A) 10%
B) 25%
C) 50%
D) 75%
E) 90%

C) 50%
Explanation: Many patients with cardiomyopathy are asymptomatic, and 50% of cases present with a heart murmur or are diagnosed during screening when another family member has been diagnosed with HCM.

p.14
Hypertrophic Cardiomyopathy Etiology

What is a characteristic finding in hypertrophic cardiomyopathies?
A) Left atrial dilation
B) Asymmetric septal hypertrophy
C) Right ventricular dilation
D) Normal ventricular size
E) Depressed contractility

B) Asymmetric septal hypertrophy
Explanation: Asymmetric septal hypertrophy and left ventricular outflow tract obstruction are seen in hypertrophic cardiomyopathies.

p.14
Restrictive Cardiomyopathy Characteristics

What is a characteristic finding in restrictive cardiomyopathies?
A) Left ventricular dilation
B) Right ventricular hypertrophy
C) Massive atrial dilation
D) Asymmetric septal hypertrophy
E) Normal atrial size

C) Massive atrial dilation
Explanation: Massive atrial dilation is seen in restrictive cardiomyopathies.

p.6
Clinical Features of Cardiomyopathies

What is often observed in the peripheral pulses of patients with dilated cardiomyopathy?
A) Strong and bounding pulses
B) Weak pulses
C) Irregular pulses
D) Pulses with increased amplitude
E) Pulses with normal strength

B) Weak pulses
Explanation: Peripheral pulses are often weak in patients with dilated cardiomyopathy, indicating poor circulation and inadequate cardiac output.

p.2
Dilated Cardiomyopathy (DCM) Causes

Which virus is associated with causing dilated cardiomyopathy?
A) Influenza virus
B) Echovirus
C) Herpes simplex virus
D) Varicella-zoster virus
E) Epstein-Barr virus

B) Echovirus
Explanation: Infection with echovirus or Coxsackie B virus is associated with causing dilated cardiomyopathy.

p.12
Echocardiography Findings in Cardiomyopathy

Which of the following is a common echocardiographic finding in Hypertrophic Cardiomyopathy?
A) Significantly decreased EF
B) Normal wall thickness
C) Outflow tract obstruction
D) Left or biventricular dilation
E) Normal diastolic function

C) Outflow tract obstruction
Explanation: Hypertrophic Cardiomyopathy is characterized by outflow tract obstruction, often due to interventricular septum hypertrophy and systolic anterior motion (SAM) of the mitral valve.

p.10
Restrictive Cardiomyopathy Characteristics

How common are restrictive cardiomyopathies in pediatrics?
A) Very common
B) Relatively rare
C) Extremely common
D) Equally common as in adults
E) Not found in pediatrics

B) Relatively rare
Explanation: Restrictive cardiomyopathies are relatively rare in pediatric populations, indicating that they are not frequently encountered in children.

p.11
Clinical Features of Cardiomyopathies

Which of the following is NOT a symptom experienced by patients with restrictive cardiomyopathy during activity?
A) Chest pain
B) Shortness of breath
C) Syncope/near-syncope
D) Sudden death
E) Increased appetite

E) Increased appetite
Explanation: During activity, patients with restrictive cardiomyopathy may experience chest pain, shortness of breath, syncope/near-syncope, or even sudden death, but not increased appetite.

p.8
Pathogenesis of Dilated Cardiomyopathy

Which part of the heart is often disproportionately involved in hypertrophic cardiomyopathy?
A) Right atrium
B) Left atrium
C) Inter-ventricular septum
D) Right ventricle
E) Pulmonary artery

C) Inter-ventricular septum
Explanation: In hypertrophic cardiomyopathy, the inter-ventricular septum is often disproportionately involved, leading to increased wall thickness.

p.2
Types of Cardiomyopathy

What is the most common form of cardiomyopathy?
A) Hypertrophic cardiomyopathy
B) Restrictive cardiomyopathy
C) Dilated cardiomyopathy
D) Arrhythmogenic right ventricular cardiomyopathy
E) Ischemic cardiomyopathy

C) Dilated cardiomyopathy
Explanation: Dilated cardiomyopathy (DCM) is identified as the most common form of cardiomyopathy.

p.11
Clinical Features of Cardiomyopathies

What is typically absent in patients with restrictive cardiomyopathy?
A) Gallop rhythm
B) Heart murmurs
C) Pulmonary hypertension
D) Edema
E) Hepatomegaly

B) Heart murmurs
Explanation: Heart murmurs are typically absent in patients with restrictive cardiomyopathy, although a gallop rhythm may be prominent.

p.1
Types of Cardiomyopathy

Which of the following is NOT a type of cardiomyopathy?
A) Dilated
B) Hypertrophic
C) Restrictive
D) Ischemic
E) All of the above are types of cardiomyopathy

D) Ischemic
Explanation: The three types of cardiomyopathy based on anatomical and functional features are Dilated, Hypertrophic, and Restrictive. Ischemic cardiomyopathy is not one of these types.

p.6
Clinical Features of Cardiomyopathies

How is myocardial contractility affected in dilated cardiomyopathy?
A) It is increased
B) It is unchanged
C) It is variably decreased
D) It is consistently decreased
E) It is increased in the right ventricle only

C) It is variably decreased
Explanation: In dilated cardiomyopathy, myocardial contractility is variably decreased, meaning it can vary in degree but is generally reduced.

p.2
Dilated Cardiomyopathy (DCM) Causes

Which of the following is a familial cause of dilated cardiomyopathy?
A) Genetic predisposition
B) Viral infection
C) Alcohol abuse
D) Autoimmune disease
E) Nutritional deficiency

A) Genetic predisposition
Explanation: Familial causes of dilated cardiomyopathy often involve genetic predisposition.

p.7
Clinical Features of Cardiomyopathies

What are neurologic or skeletal muscle deficits associated with in dilated cardiomyopathy?
A) Viral infections
B) Mitochondrial disorders or muscular dystrophies
C) Bacterial infections
D) Autoimmune disorders
E) Allergic reactions

B) Mitochondrial disorders or muscular dystrophies
Explanation: Neurologic or skeletal muscle deficits are associated with mitochondrial disorders or muscular dystrophies in patients with dilated cardiomyopathy.

p.9
Clinical Features of Cardiomyopathies

What type of murmur is associated with mitral insufficiency in HCM?
A) Diastolic murmur in the aortic region
B) Systolic ejection murmur in the pulmonary region
C) Apical murmur
D) Continuous murmur in the tricuspid region
E) Diastolic murmur in the mitral region

C) Apical murmur
Explanation: In HCM, an apical murmur of mitral insufficiency is a characteristic physical examination finding.

p.1
Types of Cardiomyopathy

How are the types of cardiomyopathy classified?
A) By the age of onset
B) By the anatomical and functional features
C) By the severity of symptoms
D) By the genetic mutations involved
E) By the presence of heart murmurs

B) By the anatomical and functional features
Explanation: The types of cardiomyopathy are classified based on anatomical and functional features.

p.14
Echocardiography Findings in Cardiomyopathy

What is a characteristic echocardiography finding in dilated cardiomyopathies?
A) Asymmetric septal hypertrophy
B) Left atrial and ventricular dilation
C) Massive atrial dilation
D) Right ventricular hypertrophy
E) Normal contractility

B) Left atrial and ventricular dilation
Explanation: Dilated cardiomyopathies result in left atrial and ventricular dilation and globally depressed contractility, which are key findings on echocardiography.

p.15
Treatment Options for Cardiomyopathy

When should cardiac transplantation be considered for cardiomyopathy patients?
A) Only in mild cases
B) When the etiology is unknown
C) In all forms of cardiomyopathy due to high mortality rates
D) Only for restrictive cardiomyopathy
E) When the patient is asymptomatic

C) In all forms of cardiomyopathy due to high mortality rates
Explanation: Cardiac transplantation must be considered in all forms of cardiomyopathy because they are associated with high mortality rates.

p.12
Echocardiography Findings in Cardiomyopathy

What is the characteristic LV cavity size in Dilated Cardiomyopathy (DCM)?
A) Decreased
B) Normal
C) Significantly increased
D) Slightly increased
E) Unchanged

C) Significantly increased
Explanation: In Dilated Cardiomyopathy (DCM), the LV cavity size is significantly increased, which is a key echocardiographic finding.

p.13
Imaging Studies for Cardiomyopathy

What is usually seen on chest radiographs in patients with cardiomyopathy?
A) Cardiomegaly
B) Pulmonary embolism
C) Pleural effusion
D) Pneumothorax
E) Normal heart size

A) Cardiomegaly
Explanation: Cardiomegaly, or an enlarged heart, is typically observed on chest radiographs in patients with cardiomyopathy.

p.10
Restrictive Cardiomyopathy Characteristics

What can restrictive cardiomyopathies be associated with?
A) Only genetic disorders
B) Only infections
C) Systemic disease or idiopathic causes
D) Only environmental factors
E) Only nutritional deficiencies

C) Systemic disease or idiopathic causes
Explanation: Restrictive cardiomyopathies may be idiopathic or associated with systemic diseases, indicating that their causes can be varied.

p.13
Imaging Studies for Cardiomyopathy

What might be observed on an ECG in children with restrictive cardiomyopathy?
A) Ventricular hypertrophy
B) Atrial enlargement with normal QRS voltages
C) Prolonged QT interval
D) Shortened PR interval
E) Normal ECG

B) Atrial enlargement with normal QRS voltages
Explanation: Children with restrictive cardiomyopathies may show atrial enlargement (prominent P waves with normal QRS voltages) on the ECG.

p.8
Pathogenesis of Dilated Cardiomyopathy

What is a common characteristic of the left ventricle in hypertrophic cardiomyopathy?
A) Decreased wall thickness
B) Increased wall thickness
C) Normal wall thickness
D) Thinned walls
E) Dilated walls

B) Increased wall thickness
Explanation: Hypertrophic cardiomyopathy is characterized by the presence of increased left ventricular (LV) wall thickness in the absence of structural heart disease or hypertension.

p.6
Clinical Features of Cardiomyopathies

What is a common result of dilated cardiomyopathies?
A) Enlargement of the right ventricle only
B) Enlargement of the left ventricle only or of both ventricles
C) Decrease in myocardial contractility
D) Enlargement of the atria
E) Increased myocardial contractility

B) Enlargement of the left ventricle only or of both ventricles
Explanation: Dilated cardiomyopathies commonly result in the enlargement of the left ventricle only or of both ventricles, which is a key characteristic of this condition.

p.7
Clinical Features of Cardiomyopathies

What sound may be audible on auscultation in dilated cardiomyopathy?
A) Wheezing
B) Rales
C) Murmurs
D) Crackles
E) Rhonchi

B) Rales
Explanation: Rales may be audible on auscultation in patients with dilated cardiomyopathy, indicating fluid in the lungs.

p.7
Clinical Features of Cardiomyopathies

What can concurrent infectious illness result in for children with dilated cardiomyopathy?
A) Hypertension
B) Circulatory collapse and shock
C) Increased appetite
D) Weight gain
E) Improved cardiac function

B) Circulatory collapse and shock
Explanation: Concurrent infectious illness may result in circulatory collapse and shock in children with dilated cardiomyopathies.

p.15
Treatment Options for Cardiomyopathy

What should be done if the etiology of cardiomyopathy is identified?
A) Ignore it
B) Treat the etiology
C) Only provide symptomatic therapy
D) Avoid any treatment
E) Use only diuretics

B) Treat the etiology
Explanation: If the etiology of cardiomyopathy is identified, it should be treated as part of the management plan.

p.13
Imaging Studies for Cardiomyopathy

What changes might be seen on an ECG in patients with dilated cardiomyopathy?
A) Specific ST-T wave changes
B) Nonspecific ST-T wave changes
C) Normal ECG
D) Prolonged QT interval
E) Shortened PR interval

B) Nonspecific ST-T wave changes
Explanation: The electrocardiogram (ECG) in dilated cardiomyopathy may show nonspecific ST-T wave changes.

p.3
Dilated Cardiomyopathy (DCM) Causes

Which infectious disease is associated with dilated cardiomyopathy?
A) Tuberculosis
B) Coxsackie B virus
C) Influenza
D) Hepatitis B
E) Epstein-Barr virus

B) Coxsackie B virus
Explanation: Coxsackie B virus is listed as an infectious disease that can cause dilated cardiomyopathy.

p.3
Dilated Cardiomyopathy (DCM) Causes

Which toxic substance is NOT associated with dilated cardiomyopathy?
A) Cocaine
B) Alcohol
C) Doxorubicin
D) Lead
E) Thiamine deficiency

D) Lead
Explanation: Lead is not listed as a toxic substance associated with dilated cardiomyopathy. Cocaine, alcohol, and doxorubicin are mentioned, and thiamine deficiency is related to wet beriberi.

p.15
Treatment Options for Cardiomyopathy

Which of the following is NOT a component of supportive therapy for cardiomyopathy?
A) Diuretics
B) Inotropic medications
C) Afterload reduction
D) Antiviral medications
E) Symptomatic therapy with close monitoring

D) Antiviral medications
Explanation: Supportive therapy for cardiomyopathy includes diuretics, inotropic medications, afterload reduction, and symptomatic therapy with close monitoring. Antiviral medications are not mentioned as part of the supportive therapy.

p.7
Clinical Features of Cardiomyopathies

Which heart sound is often present in dilated cardiomyopathy?
A) S1
B) S2
C) S3
D) S4
E) S5

C) S3
Explanation: An S3 heart sound is often present in dilated cardiomyopathy, which is indicative of increased ventricular filling pressures.

p.7
Clinical Features of Cardiomyopathies

What does the presence of hypoglycemia, acidosis, hypotonia, or signs of liver dysfunction suggest in dilated cardiomyopathy?
A) Viral infection
B) Inborn error of metabolism
C) Bacterial infection
D) Autoimmune disorder
E) Allergic reaction

B) Inborn error of metabolism
Explanation: The presence of hypoglycemia, acidosis, hypotonia, or signs of liver dysfunction suggests an inborn error of metabolism in patients with dilated cardiomyopathy.

p.4
Clinical Features of Cardiomyopathies

Which of the following is a possible outcome of hypertrophic cardiomyopathy?
A) S3 gallop
B) Sudden death
C) Systolic murmur
D) Right heart failure
E) Frequently asymptomatic

B) Sudden death
Explanation: Hypertrophic cardiomyopathy can lead to sudden death, particularly in young athletes, due to its association with arrhythmias.

p.13
Imaging Studies for Cardiomyopathy

How is the ECG typically described in patients with hypertrophic cardiomyopathy?
A) Normal
B) Universally abnormal with specific changes
C) Universally abnormal with nonspecific changes
D) Showing atrial fibrillation
E) Showing ventricular tachycardia

C) Universally abnormal with nonspecific changes
Explanation: The ECG in hypertrophic cardiomyopathy is universally abnormal, but the changes are nonspecific.

p.11
Clinical Features of Cardiomyopathies

What symptom is associated with the elevation of left-sided filling pressures in restrictive cardiomyopathy?
A) Increased appetite
B) Cough, dyspnea, or pulmonary edema
C) Weight gain
D) Decreased heart rate
E) Increased urination

B) Cough, dyspnea, or pulmonary edema
Explanation: Elevation of left-sided filling pressures in restrictive cardiomyopathy results in symptoms such as cough, dyspnea, or pulmonary edema.

p.2
Dilated Cardiomyopathy (DCM) Causes

Which of the following is NOT a cause of dilated cardiomyopathy?
A) Idiopathic
B) Infection (echovirus or Coxsackie B virus)
C) Familial
D) Hypertension
E) Secondary to systemic disease or cardiotoxic drugs

D) Hypertension
Explanation: The causes of dilated cardiomyopathy include idiopathic, infection (echovirus or Coxsackie B virus), familial, and secondary to systemic disease or cardiotoxic drugs. Hypertension is not listed as a cause.

p.4
Clinical Features of Cardiomyopathies

Which of the following is a clinical feature of dilated cardiomyopathy?
A) S4 gallop
B) Frequently asymptomatic
C) S3 gallop
D) Holosystolic murmur from mitral regurgitation
E) Sudden death

C) S3 gallop
Explanation: Dilated cardiomyopathy is characterized by signs of left and right heart failure, and an S3 gallop is a specific clinical feature associated with this condition.

p.15
Treatment Options for Cardiomyopathy

Which of the following treatments is provided for all three types of cardiomyopathy?
A) Antiviral therapy
B) Diuretics, inotropic medications, and afterload reduction
C) Chemotherapy
D) Radiation therapy
E) Antifungal medications

B) Diuretics, inotropic medications, and afterload reduction
Explanation: Diuretics, inotropic medications, and afterload reduction are provided for all three types of cardiomyopathy as part of supportive therapy.

p.4
Clinical Features of Cardiomyopathies

Which clinical feature is associated with restrictive cardiomyopathy?
A) Systolic murmur
B) Frequently asymptomatic
C) Signs of left and right heart failure
D) Sudden death
E) Arrhythmias

C) Signs of left and right heart failure
Explanation: Restrictive cardiomyopathy is characterized by signs of both left and right heart failure, indicating impaired ventricular filling.

p.12
Echocardiography Findings in Cardiomyopathy

What is the typical EF (Ejection Fraction) in Restrictive Cardiomyopathy?
A) Significantly decreased
B) Normal
C) Increased
D) Decreased
E) Variable

B) Normal
Explanation: In Restrictive Cardiomyopathy, the EF is typically normal, distinguishing it from other types of cardiomyopathies where EF may be significantly decreased.

p.5
Pathogenesis of Dilated Cardiomyopathy

Which X-linked cardiomyopathies cause impaired myocardial force generation, myocyte damage/scarring, chamber enlargement, and altered function?
A) Marfan syndrome and Ehlers-Danlos syndrome
B) Duchenne and Becker muscular dystrophies
C) Turner syndrome and Klinefelter syndrome
D) Down syndrome and Patau syndrome
E) Williams syndrome and Noonan syndrome

B) Duchenne and Becker muscular dystrophies
Explanation: Duchenne and Becker muscular dystrophies are X-linked cardiomyopathies causing impaired myocardial force generation, myocyte damage/scarring, chamber enlargement, and altered function.

p.11
Clinical Features of Cardiomyopathies

What condition may develop rapidly in patients with restrictive cardiomyopathy?
A) Pulmonary hypertension and pulmonary vascular disease
B) Increased appetite
C) Weight gain
D) Decreased heart rate
E) Increased urination

A) Pulmonary hypertension and pulmonary vascular disease
Explanation: Pulmonary hypertension and pulmonary vascular disease can develop and may progress rapidly in patients with restrictive cardiomyopathy.

p.8
Pathogenesis of Dilated Cardiomyopathy

What type of dysfunction is typically preserved or even hyperdynamic in hypertrophic cardiomyopathy?
A) Diastolic function
B) Systolic function
C) Atrial function
D) Ventricular function
E) Pulmonary function

B) Systolic function
Explanation: In hypertrophic cardiomyopathy, systolic function is typically preserved or even hyperdynamic, although systolic dysfunction may occur late and is a predictor for death or need for cardiac transplant.

p.9
Clinical Features of Cardiomyopathies

Which of the following is NOT a symptom of Hypertrophic Cardiomyopathy (HCM)?
A) Palpitations
B) Chest pain
C) Easy fatigability
D) Increased appetite
E) Dizziness

D) Increased appetite
Explanation: Symptoms of HCM may include palpitations, chest pain, easy fatigability, dyspnea, dizziness, and syncope. Increased appetite is not listed as a symptom.

p.9
Clinical Features of Cardiomyopathies

What is a well-recognized but uncommon manifestation of HCM that occurs during physical exertion?
A) Chronic cough
B) Sudden death
C) Frequent urination
D) Weight gain
E) Hair loss

B) Sudden death
Explanation: Sudden death is a well-recognized but uncommon manifestation of HCM that occurs during physical exertion.

p.12
Echocardiography Findings in Cardiomyopathy

Which additional finding is associated with Dilated Cardiomyopathy?
A) Outflow tract obstruction
B) Reduced diastolic filling
C) Dilated atria, nondilated ventricles
D) Wall motion abnormalities
E) Normal diastolic function

D) Wall motion abnormalities
Explanation: Dilated Cardiomyopathy often presents with wall motion abnormalities and systolic dysfunction, along with left or biventricular dilation.

p.5
Pathogenesis of Dilated Cardiomyopathy

Which components of the cardiac muscle are involved in autosomal dominant and X-linked inherited disorders causing DCM?
A) Mitochondria and ribosomes
B) Sarcomere proteins, the cytoskeleton, and bridging proteins
C) Endoplasmic reticulum and Golgi apparatus
D) Nucleus and lysosomes
E) Cell membrane and cytoplasm

B) Sarcomere proteins, the cytoskeleton, and bridging proteins
Explanation: Several components of the cardiac muscle, including sarcomere proteins, the cytoskeleton, and the proteins that bridge the contractile apparatus to the cytoskeleton, have been identified in autosomal dominant and X-linked inherited disorders.

p.5
Pathogenesis of Dilated Cardiomyopathy

What exacerbates the risk of toxicity in drug cardiotoxicity (doxorubicin) resulting in DCM?
A) High cholesterol levels
B) Concomitant radiation therapy
C) Low blood pressure
D) High blood sugar
E) Increased oxygen levels

B) Concomitant radiation therapy
Explanation: Drug cardiotoxicity (doxorubicin) results in DCM, and the risk of toxicity appears to be exacerbated by concomitant radiation therapy.

p.3
Dilated Cardiomyopathy (DCM) Causes

Which gene mutation is associated with a genetic predisposition to dilated cardiomyopathy?
A) MYH7
B) TTN
C) MYBPC3
D) LMNA
E) ACTC1

B) TTN
Explanation: The TTN gene mutation is specifically mentioned as a genetic predisposition for dilated cardiomyopathy.

p.3
Hypertrophic Cardiomyopathy Etiology

Which of the following is NOT a cause of hypertrophic cardiomyopathy?
A) Myosin binding protein C mutation
B) β-Myosin heavy chain mutation
C) Amyloidosis
D) Autosomal dominant inheritance
E) Genetic mutation

C) Amyloidosis
Explanation: Amyloidosis is a cause of restrictive cardiomyopathy, not hypertrophic cardiomyopathy.

p.8
Hypertrophic Cardiomyopathy Etiology

What is the most common inheritance pattern for hypertrophic cardiomyopathy?
A) Autosomal recessive
B) X-linked recessive
C) Autosomal dominant
D) Mitochondrial
E) Y-linked

C) Autosomal dominant
Explanation: Hypertrophic cardiomyopathy is usually familial with an autosomal dominant inheritance pattern, meaning that only one copy of the mutated gene is needed for the condition to be passed on.

p.9
Clinical Features of Cardiomyopathies

Which of the following is a characteristic physical examination finding in HCM?
A) Overactive precordial impulse with a lift or heave
B) Diastolic murmur in the mitral region
C) Systolic ejection murmur with an ejection click
D) Continuous murmur in the pulmonary region
E) Diastolic murmur in the tricuspid region

A) Overactive precordial impulse with a lift or heave
Explanation: Characteristic physical examination findings in HCM include an overactive precordial impulse with a lift or heave, a systolic ejection murmur in the aortic region not associated with an ejection click, and an apical murmur of mitral insufficiency.

p.12
Echocardiography Findings in Cardiomyopathy

What is a common additional finding in Restrictive Cardiomyopathy?
A) Left or biventricular dilation
B) Outflow tract obstruction
C) Dilated atria, nondilated ventricles
D) Wall motion abnormalities
E) Normal diastolic function

C) Dilated atria, nondilated ventricles
Explanation: Restrictive Cardiomyopathy is characterized by dilated atria and nondilated ventricles, along with reduced diastolic filling.

p.8
Pathogenesis of Dilated Cardiomyopathy

What can the mitral valve demonstrate in hypertrophic cardiomyopathy?
A) Diastolic anterior motion
B) Systolic anterior motion
C) Posterior motion
D) No motion
E) Lateral motion

B) Systolic anterior motion
Explanation: The mitral valve can demonstrate systolic anterior motion and mitral insufficiency in hypertrophic cardiomyopathy.

p.4
Clinical Features of Cardiomyopathies

Which clinical feature is NOT associated with dilated cardiomyopathy?
A) S3 gallop
B) Systolic murmur
C) Signs of left heart failure
D) Arrhythmias
E) Signs of right heart failure

D) Arrhythmias
Explanation: While arrhythmias are more commonly associated with hypertrophic cardiomyopathy, dilated cardiomyopathy is characterized by signs of left and right heart failure, an S3 gallop, and a systolic murmur.

p.10
Restrictive Cardiomyopathy Characteristics

Which of the following is a characteristic of restrictive cardiomyopathy (RCM)?
A) Enlarged ventricular chamber dimensions
B) Increased myocardial wall thickness
C) Preserved systolic function
D) Reduced atrial size
E) Decreased ventricular diastolic pressure

C) Preserved systolic function
Explanation: RCM is characterized by normal ventricular chamber dimensions, normal myocardial wall thickness, and preserved systolic function.

p.11
Echocardiography Findings in Cardiomyopathy

What echocardiographic finding is characteristic of restrictive cardiomyopathy?
A) Normal atrial size
B) Moderate right and severe left atrial enlargement
C) Decreased ventricular size
D) Increased ventricular thickness
E) Normal ventricular size and thickness

B) Moderate right and severe left atrial enlargement
Explanation: Echocardiography of restrictive cardiomyopathy demonstrates moderate right and severe left atrial enlargement relative to normal bi-ventricular size and thickness.

p.3
Restrictive Cardiomyopathy Characteristics

Which heart disease is associated with restrictive cardiomyopathy?
A) Ischemic heart disease
B) Loffler endocarditis
C) Chagas disease
D) Peripartum cardiomyopathy
E) Coxsackie B virus

B) Loffler endocarditis
Explanation: Loffler endocarditis is listed as a heart disease that can cause restrictive cardiomyopathy.

p.10
Restrictive Cardiomyopathy Characteristics

What can result from abnormal ventricular myocardial compliance and high ventricular diastolic pressure in RCM?
A) Ventricular dilation
B) Atrial dilation
C) Decreased cardiac output
D) Increased myocardial wall thickness
E) Reduced systolic function

B) Atrial dilation
Explanation: Dramatic atrial dilation can result from the abnormal ventricular myocardial compliance and high ventricular diastolic pressure in restrictive cardiomyopathy.

p.8
Pathogenesis of Dilated Cardiomyopathy

What type of dysfunction is associated with impaired LV filling in hypertrophic cardiomyopathy?
A) Systolic dysfunction
B) Diastolic dysfunction
C) Atrial dysfunction
D) Ventricular dysfunction
E) Pulmonary dysfunction

B) Diastolic dysfunction
Explanation: In hypertrophic cardiomyopathy, LV filling is impaired, leading to diastolic dysfunction.

p.5
Pathogenesis of Dilated Cardiomyopathy

What can cause DCM following viral myocarditis?
A) Direct myocardial injury or viral-induced inflammatory injury
B) Increased cholesterol levels
C) High blood pressure
D) Low oxygen levels
E) High blood sugar

A) Direct myocardial injury or viral-induced inflammatory injury
Explanation: DCM can occur following viral myocarditis due to direct myocardial injury or viral-induced inflammatory injury.

p.11
Clinical Features of Cardiomyopathies

What is a common manifestation of abnormal ventricular filling in restrictive cardiomyopathy?
A) Increased heart rate
B) Systemic venous circulation with edema, hepatomegaly, or ascites
C) Decreased blood pressure
D) Increased appetite
E) Weight loss

B) Systemic venous circulation with edema, hepatomegaly, or ascites
Explanation: Abnormal ventricular filling in restrictive cardiomyopathy is often referred to as diastolic heart failure and is manifested in the systemic venous circulation with symptoms such as edema, hepatomegaly, or ascites.

p.3
Dilated Cardiomyopathy (DCM) Causes

Which systemic disorder is a common cause of both dilated and restrictive cardiomyopathy?
A) Amyloidosis
B) Sarcoidosis
C) Systemic sclerosis
D) Hemochromatosis
E) Loffler endocarditis

B) Sarcoidosis
Explanation: Sarcoidosis is mentioned as a systemic disorder that can cause both dilated and restrictive cardiomyopathy.

Study Smarter, Not Harder
Study Smarter, Not Harder