MGRADES EXAMS
NURS 5461 Cardiomyopathy UPDATED
ACTUAL Exam Questions and CORRECT
Answers
CARDIOMYOPATHIES - CORRECT ANSWER - A large group of diseases of the
myocardium that result in mechanical and/or electrical pump dysfunction
WHO Classification - CORRECT ANSWER - Dilated • Enlarged • Systolic dysfunction 2.
Hypertrophic • Thickened • Diastolic dysfunction 3. Restrictive • Diastolic dysfunction 4.
Arrhythmogenic RV dysplasia • Fibrofatty replacement 5. Unclassified • Fibroelastosis • LV
noncompaction
DILATED CARDIOMYOPATHY (DCM) - CORRECT ANSWER - Dilation and impaired
contraction of ventricles • Reduced systolic function with or without heart failure • Characterized
by myocyte damage • *Starts in left ventricle then often spreads to right ventricle, then to atria •
Can lead to valvular problems and arrhythmias
DCM - known by many other names - CORRECT ANSWER - Alcoholic cardiomyopathy
Congestive cardiomyopathy Diabetic cardiomyopathy Familial dilated cardiomyopathy
Idiopathic cardiomyopathy Ischemic cardiomyopathy. Peripartum cardiomyopathy Primary
cardiomyopathy
DCM - CORRECT ANSWER - characterized by ventricular enlargement and contractile
dysfunction (Cant squeeze=blood back up) with normal left ventricular (LV) wall thickness. •
The right ventricle may also be dilated and dysfunctional. • Dilated cardiomyopathy is the third
most common cause of heart failure and the most frequent reason for heart transplantation.
Accounts for 10,000 death annually. • 1 in 9 deaths in US, heart failure is mentioned on death
certificate
DCM SIGNS & SXS - CORRECT ANSWER - Indicator of the severity • Fatigue • Dyspnea
on exertion, shortness of breath • Orthopnea, paroxysmal nocturnal dyspnea • Increasing edema,
weight, or abdominal girth
, MGRADES EXAMS
DCM PE FINDINGS - CORRECT ANSWER - • signs of heart failure and volume overload •
Tachypnea • Tachycardia • Hypertension • Signs of hypoxia (eg, cyanosis, clubbing) • Jugular
venous distension (JVD) • Pulmonary edema (crackles and/or wheezes) • S 3 gallop • Enlarged
liver • Peripheral edema
DCM WORKUP - CORRECT ANSWER - • Complete blood count • Metabolic panel •
Thyroid function tests • Cardiac biomarkers • B-type natriuretic peptide assay • Chest
radiography • Echocardiography • Cardiac magnetic resonance imaging (MRI) •
Electrocardiography (ECG) • Endomyocardial Biopsy if cannot find cause
DCM MANAGEMENT - CORRECT ANSWER - • Essentially the same as treatment of
chronic heart failure • Angiotensin-converting enzyme (ACE) inhibitors ('pril)• Angiotensin II
receptor blockers ('tan) (ARBs) • Beta-blockers • Aldosterone antagonists Eplerenone)• Cardiac
glycosides • Diuretics • Vasodilators • Antiarrhythmics • Inotropic agents • Review guideline for
2013 ACCF/AHA Guideline Heart Failure
Surgical options - CORRECT ANSWER - r patients with disease refractory to medical
therapy include the following: • Left ventricular assist devices • Cardiac resynchronization
therapy (biventricular pacing) • Automatic implantable cardioverter-defibrillators • Ventricular
restoration surgery • Heart transplantation
DCM: INFECTIOUS - CORRECT ANSWER - Acute viral myocarditis Coxasackie B or
echovirus Self-limited infection in young people Mechanism?: • Myocyte cell death and fibrosis
• Immune mediated injury • BUT: • No change with immunosuppressive drugs
DCM: TOXIC - CORRECT ANSWER - Alcoholic cardiomyopathy Reversible with
abstinence Mechanism?: • Myocyte cell death and fibrosis
DCM: PERIPARTUM - CORRECT ANSWER - Diagnostic Criteria 1 mo pre, 5 mos post,
Proposed mechanisms: • Inflammatory Cytokines: • TNFa, IL6, Fas/AP01
HYPERTROPHIC
CARDIOMYOPATHY (HCM) - CORRECT ANSWER - Common genetic CV disease
(autosomal dominant mutation 55%). Remainder are spontaneous mutations.
NURS 5461 Cardiomyopathy UPDATED
ACTUAL Exam Questions and CORRECT
Answers
CARDIOMYOPATHIES - CORRECT ANSWER - A large group of diseases of the
myocardium that result in mechanical and/or electrical pump dysfunction
WHO Classification - CORRECT ANSWER - Dilated • Enlarged • Systolic dysfunction 2.
Hypertrophic • Thickened • Diastolic dysfunction 3. Restrictive • Diastolic dysfunction 4.
Arrhythmogenic RV dysplasia • Fibrofatty replacement 5. Unclassified • Fibroelastosis • LV
noncompaction
DILATED CARDIOMYOPATHY (DCM) - CORRECT ANSWER - Dilation and impaired
contraction of ventricles • Reduced systolic function with or without heart failure • Characterized
by myocyte damage • *Starts in left ventricle then often spreads to right ventricle, then to atria •
Can lead to valvular problems and arrhythmias
DCM - known by many other names - CORRECT ANSWER - Alcoholic cardiomyopathy
Congestive cardiomyopathy Diabetic cardiomyopathy Familial dilated cardiomyopathy
Idiopathic cardiomyopathy Ischemic cardiomyopathy. Peripartum cardiomyopathy Primary
cardiomyopathy
DCM - CORRECT ANSWER - characterized by ventricular enlargement and contractile
dysfunction (Cant squeeze=blood back up) with normal left ventricular (LV) wall thickness. •
The right ventricle may also be dilated and dysfunctional. • Dilated cardiomyopathy is the third
most common cause of heart failure and the most frequent reason for heart transplantation.
Accounts for 10,000 death annually. • 1 in 9 deaths in US, heart failure is mentioned on death
certificate
DCM SIGNS & SXS - CORRECT ANSWER - Indicator of the severity • Fatigue • Dyspnea
on exertion, shortness of breath • Orthopnea, paroxysmal nocturnal dyspnea • Increasing edema,
weight, or abdominal girth
, MGRADES EXAMS
DCM PE FINDINGS - CORRECT ANSWER - • signs of heart failure and volume overload •
Tachypnea • Tachycardia • Hypertension • Signs of hypoxia (eg, cyanosis, clubbing) • Jugular
venous distension (JVD) • Pulmonary edema (crackles and/or wheezes) • S 3 gallop • Enlarged
liver • Peripheral edema
DCM WORKUP - CORRECT ANSWER - • Complete blood count • Metabolic panel •
Thyroid function tests • Cardiac biomarkers • B-type natriuretic peptide assay • Chest
radiography • Echocardiography • Cardiac magnetic resonance imaging (MRI) •
Electrocardiography (ECG) • Endomyocardial Biopsy if cannot find cause
DCM MANAGEMENT - CORRECT ANSWER - • Essentially the same as treatment of
chronic heart failure • Angiotensin-converting enzyme (ACE) inhibitors ('pril)• Angiotensin II
receptor blockers ('tan) (ARBs) • Beta-blockers • Aldosterone antagonists Eplerenone)• Cardiac
glycosides • Diuretics • Vasodilators • Antiarrhythmics • Inotropic agents • Review guideline for
2013 ACCF/AHA Guideline Heart Failure
Surgical options - CORRECT ANSWER - r patients with disease refractory to medical
therapy include the following: • Left ventricular assist devices • Cardiac resynchronization
therapy (biventricular pacing) • Automatic implantable cardioverter-defibrillators • Ventricular
restoration surgery • Heart transplantation
DCM: INFECTIOUS - CORRECT ANSWER - Acute viral myocarditis Coxasackie B or
echovirus Self-limited infection in young people Mechanism?: • Myocyte cell death and fibrosis
• Immune mediated injury • BUT: • No change with immunosuppressive drugs
DCM: TOXIC - CORRECT ANSWER - Alcoholic cardiomyopathy Reversible with
abstinence Mechanism?: • Myocyte cell death and fibrosis
DCM: PERIPARTUM - CORRECT ANSWER - Diagnostic Criteria 1 mo pre, 5 mos post,
Proposed mechanisms: • Inflammatory Cytokines: • TNFa, IL6, Fas/AP01
HYPERTROPHIC
CARDIOMYOPATHY (HCM) - CORRECT ANSWER - Common genetic CV disease
(autosomal dominant mutation 55%). Remainder are spontaneous mutations.
