ESTUDYR
OMSA STUDY GUIDE MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
Which of the following is NOT one of the four heart valves?
A. Tricuspid
B. Mitral
C. Pulmonary vein valve
D. Aortic
Rationale: The four valves are tricuspid, mitral (bicuspid), pulmonic (pulmonary), and aortic;
there is no pulmonary vein valve.
Where is the tricuspid valve located?
A. Between the left atrium and left ventricle
B. Between the right atrium and right ventricle
C. Between the aorta and left ventricle
D. Between the pulmonary vein and left atrium
Rationale: The tricuspid valve separates right atrium and right ventricle.
Where is the mitral valve located?
A. Between the right atrium and right ventricle
B. Between the left atrium and left ventricle
C. Between the left ventricle and aorta
D. Between the pulmonary artery and right ventricle
Rationale: The mitral valve (bicuspid) sits between left atrium and left ventricle.
Where is the aortic valve located?
A. Between the right ventricle and pulmonary artery
B. Between the left atrium and left ventricle
C. Between the left ventricle and the aorta
D. Between the right atrium and vena cava
Rationale: The aortic valve opens from the left ventricle into the aorta.
Where is the pulmonic valve located?
A. Between the left ventricle and aorta
B. Between the left atrium and left ventricle
C. Between the right ventricle and pulmonary artery
D. Between the right atrium and superior vena cava
Rationale: The pulmonic valve controls flow from right ventricle into pulmonary artery.
,ESTUDYR
What is the primary function of heart valves?
A. Produce electrical impulses
B. Generate cardiac muscle contraction
C. Initiate blood clotting
D. Prevent backflow of blood
Rationale: Valves ensure unidirectional blood flow by closing to prevent regurgitation.
When you hear a normal heartbeat “lub-dub,” which is true about the sounds?
A. Only the tricuspid valve makes sound
B. “Lub-dub” results from valve closures (S1 S2); aortic and pulmonic closures are involved
C. Sounds come from pericardial friction only
D. “Lub” is mitral opening and “dub” is aortic opening
Rationale: Heart sounds arise from valve closures—S1 (AV valves) and S2 (semilunar valves).
Angina pectoris is best described as:
A. A form of valve disease
B. Chest pain of cardiac origin
C. Inflammation of pericardium
D. An arrhythmia
Rationale: Angina is ischemic chest pain from reduced coronary blood flow.
What typically causes angina pectoris?
A. Infection of the cardiac valves
B. Hypertrophic cardiomyopathy
C. Myocardial ischemia (insufficient oxygen to heart muscle)
D. Electrical conduction block
Rationale: Ischemia from atherosclerotic coronary disease commonly causes angina.
How does nitroglycerin relieve angina?
A. By increasing heart contractility
B. By blocking calcium channels centrally
C. By dilating coronary arteries and improving myocardial blood flow
D. By decreasing blood oxygen demand via sedation
Rationale: Nitroglycerin is a vasodilator that increases coronary perfusion and reduces preload.
Angina turns into myocardial infarction (MI) when:
A. Pain is treated with aspirin promptly
B. Heart rate increases only
C. Myocardial ischemia persists long enough to cause cell death (necrosis)
,ESTUDYR
D. Only arrhythmias occur without ischemia
Rationale: MI is myocardial necrosis resulting from prolonged ischemia.
The term for death of heart muscle is:
A. Infarctosis
B. Cardiomyolysis
C. Necrosis
D. Hypoxia
Rationale: Necrosis denotes irreversible cell death including myocardial tissue.
Which is NOT a common risk factor for cardiovascular disease?
A. Family history
B. Smoking
C. Hypertension
D. Frequent exercise
Rationale: Exercise is protective; the other options are established risk factors.
A classic sign of myocardial infarction (MI) is:
A. Chest pain that is relieved by nitroglycerin
B. Chest pain not relieved by nitrates, possible radiating pain and hypotension
C. Rash and itching
D. Sudden improved exercise tolerance
Rationale: MI chest pain often persists despite nitrates and can radiate with systemic signs.
If you suspect a patient is having an MI, immediate initial steps include:
A. Administer B12 and start antibiotics
B. MONA: Morphine, Oxygen, Nitrates, Aspirin; place on monitor and start IV
C. Send home with rest instructions
D. Start insulin infusion
Rationale: MONA + monitoring/IV are classic immediate measures in suspected MI (per
ACLS/prehospital protocols).
Congestive heart failure (CHF) is best defined as:
A. Infection of the heart valves
B. Heart’s inability to pump adequate forward blood flow
C. Sudden arrhythmia only
D. Elevated cholesterol without symptoms
Rationale: CHF denotes failure of cardiac pumping leading to congestion/organ hypoperfusion.
Right-sided CHF leads to:
A. Pulmonary edema primarily
, ESTUDYR
B. Systemic venous congestion—peripheral edema, ascites, JVD
C. Improved renal perfusion
D. Cerebral hemorrhage
Rationale: Right heart failure causes systemic venous backflow and peripheral edema.
Symptoms of right-sided CHF typically include:
A. Pulmonary crackles and cough
B. Peripheral edema (ankles), ascites, and jugular venous distension
C. Bradycardia and syncope only
D. Chest pain radiating to jaw
Rationale: Systemic fluid accumulation presents as peripheral swelling and ascites.
Left-sided CHF most directly causes:
A. Lower limb ischemia
B. Pulmonary congestion and edema (e.g., pink frothy sputum)
C. Abdominal pain and ascites only
D. Peripheral cyanosis without lung symptoms
Rationale: Left heart failure causes increased pulmonary venous pressure and fluid leakage into
lungs.
Common symptoms of left-sided CHF are:
A. Swollen ankles predominately
B. Jaundice and pruritus
C. Dyspnea, orthopnea, and paroxysmal nocturnal dyspnea
D. Visual disturbances only
Rationale: Pulmonary fluid accumulation yields shortness of breath and nocturnal breathing
difficulty.
Standard treatment for CHF often includes:
A. Antibiotics long-term
B. Diuretics to remove excess fluid
C. High-salt diet to increase volume
D. Diaphragmatic pacing
Rationale: Diuretics reduce preload and relieve congestive symptoms.
How is cardiovascular status typically monitored in the perioperative setting?
A. Kidney biopsy only
B. Serial CT scans only
C. Pulse, blood pressure, and EKG monitoring
OMSA STUDY GUIDE MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
Which of the following is NOT one of the four heart valves?
A. Tricuspid
B. Mitral
C. Pulmonary vein valve
D. Aortic
Rationale: The four valves are tricuspid, mitral (bicuspid), pulmonic (pulmonary), and aortic;
there is no pulmonary vein valve.
Where is the tricuspid valve located?
A. Between the left atrium and left ventricle
B. Between the right atrium and right ventricle
C. Between the aorta and left ventricle
D. Between the pulmonary vein and left atrium
Rationale: The tricuspid valve separates right atrium and right ventricle.
Where is the mitral valve located?
A. Between the right atrium and right ventricle
B. Between the left atrium and left ventricle
C. Between the left ventricle and aorta
D. Between the pulmonary artery and right ventricle
Rationale: The mitral valve (bicuspid) sits between left atrium and left ventricle.
Where is the aortic valve located?
A. Between the right ventricle and pulmonary artery
B. Between the left atrium and left ventricle
C. Between the left ventricle and the aorta
D. Between the right atrium and vena cava
Rationale: The aortic valve opens from the left ventricle into the aorta.
Where is the pulmonic valve located?
A. Between the left ventricle and aorta
B. Between the left atrium and left ventricle
C. Between the right ventricle and pulmonary artery
D. Between the right atrium and superior vena cava
Rationale: The pulmonic valve controls flow from right ventricle into pulmonary artery.
,ESTUDYR
What is the primary function of heart valves?
A. Produce electrical impulses
B. Generate cardiac muscle contraction
C. Initiate blood clotting
D. Prevent backflow of blood
Rationale: Valves ensure unidirectional blood flow by closing to prevent regurgitation.
When you hear a normal heartbeat “lub-dub,” which is true about the sounds?
A. Only the tricuspid valve makes sound
B. “Lub-dub” results from valve closures (S1 S2); aortic and pulmonic closures are involved
C. Sounds come from pericardial friction only
D. “Lub” is mitral opening and “dub” is aortic opening
Rationale: Heart sounds arise from valve closures—S1 (AV valves) and S2 (semilunar valves).
Angina pectoris is best described as:
A. A form of valve disease
B. Chest pain of cardiac origin
C. Inflammation of pericardium
D. An arrhythmia
Rationale: Angina is ischemic chest pain from reduced coronary blood flow.
What typically causes angina pectoris?
A. Infection of the cardiac valves
B. Hypertrophic cardiomyopathy
C. Myocardial ischemia (insufficient oxygen to heart muscle)
D. Electrical conduction block
Rationale: Ischemia from atherosclerotic coronary disease commonly causes angina.
How does nitroglycerin relieve angina?
A. By increasing heart contractility
B. By blocking calcium channels centrally
C. By dilating coronary arteries and improving myocardial blood flow
D. By decreasing blood oxygen demand via sedation
Rationale: Nitroglycerin is a vasodilator that increases coronary perfusion and reduces preload.
Angina turns into myocardial infarction (MI) when:
A. Pain is treated with aspirin promptly
B. Heart rate increases only
C. Myocardial ischemia persists long enough to cause cell death (necrosis)
,ESTUDYR
D. Only arrhythmias occur without ischemia
Rationale: MI is myocardial necrosis resulting from prolonged ischemia.
The term for death of heart muscle is:
A. Infarctosis
B. Cardiomyolysis
C. Necrosis
D. Hypoxia
Rationale: Necrosis denotes irreversible cell death including myocardial tissue.
Which is NOT a common risk factor for cardiovascular disease?
A. Family history
B. Smoking
C. Hypertension
D. Frequent exercise
Rationale: Exercise is protective; the other options are established risk factors.
A classic sign of myocardial infarction (MI) is:
A. Chest pain that is relieved by nitroglycerin
B. Chest pain not relieved by nitrates, possible radiating pain and hypotension
C. Rash and itching
D. Sudden improved exercise tolerance
Rationale: MI chest pain often persists despite nitrates and can radiate with systemic signs.
If you suspect a patient is having an MI, immediate initial steps include:
A. Administer B12 and start antibiotics
B. MONA: Morphine, Oxygen, Nitrates, Aspirin; place on monitor and start IV
C. Send home with rest instructions
D. Start insulin infusion
Rationale: MONA + monitoring/IV are classic immediate measures in suspected MI (per
ACLS/prehospital protocols).
Congestive heart failure (CHF) is best defined as:
A. Infection of the heart valves
B. Heart’s inability to pump adequate forward blood flow
C. Sudden arrhythmia only
D. Elevated cholesterol without symptoms
Rationale: CHF denotes failure of cardiac pumping leading to congestion/organ hypoperfusion.
Right-sided CHF leads to:
A. Pulmonary edema primarily
, ESTUDYR
B. Systemic venous congestion—peripheral edema, ascites, JVD
C. Improved renal perfusion
D. Cerebral hemorrhage
Rationale: Right heart failure causes systemic venous backflow and peripheral edema.
Symptoms of right-sided CHF typically include:
A. Pulmonary crackles and cough
B. Peripheral edema (ankles), ascites, and jugular venous distension
C. Bradycardia and syncope only
D. Chest pain radiating to jaw
Rationale: Systemic fluid accumulation presents as peripheral swelling and ascites.
Left-sided CHF most directly causes:
A. Lower limb ischemia
B. Pulmonary congestion and edema (e.g., pink frothy sputum)
C. Abdominal pain and ascites only
D. Peripheral cyanosis without lung symptoms
Rationale: Left heart failure causes increased pulmonary venous pressure and fluid leakage into
lungs.
Common symptoms of left-sided CHF are:
A. Swollen ankles predominately
B. Jaundice and pruritus
C. Dyspnea, orthopnea, and paroxysmal nocturnal dyspnea
D. Visual disturbances only
Rationale: Pulmonary fluid accumulation yields shortness of breath and nocturnal breathing
difficulty.
Standard treatment for CHF often includes:
A. Antibiotics long-term
B. Diuretics to remove excess fluid
C. High-salt diet to increase volume
D. Diaphragmatic pacing
Rationale: Diuretics reduce preload and relieve congestive symptoms.
How is cardiovascular status typically monitored in the perioperative setting?
A. Kidney biopsy only
B. Serial CT scans only
C. Pulse, blood pressure, and EKG monitoring
