INSTRUCTIONS Hypertrophic cardiomyopathy: A clinical and genetic update
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Hypertrophic cardiomyopathy: A clinical and genetic update
General Purpose: To provide information on HCM. Learning Objectives: After reading the article and taking this test, the reader should be able to: 1. Discuss the pathophysiology and criteria for diagnosis of HCM. 2. Recognize the clinical presentation and recommended treatment of a patient with HCM.
- A recognizable trait of HCM is LVH usually greater than or equal to
- 5 mm.
- 7 mm.
- 12 mm.
- 15 mm.
- Which statement about HCM is true?
- HCM is the second most common inherited heart condition.
- Most individuals with HCM reach a normal life expectancy.
- The ethnic group most commonly affected by HCM is Blacks.
- HCM is a major cause of SCH in children under the age of 15.
- The most commonly reported symptom of HCM in otherwise young, healthy adults without any underlying cardiac conditions is
- chest pressure.
- A drop in BP in HCM patients may cause
- atrial dysrhythmias.
- chest pain.
- VT in HCM patients may result from
- diastolic dysfunction.
- right atrial hypertrophy.
- mitral regurgitation.
- septal hypertrophy.
- Physical exam on a patient with HCM reveals a
- cardiac murmur that decreases during Valsalva.
- point of maximal impulse that is forceful and sustained.
- palpable S3 gallop.
- decrescendo diastolic murmur.
- The murmur that is most prominent above the left sternal border is from
- subvalvular aortic stenosis.
- rheumatic valvulitis.
- valvular aortic stenosis.
- supravalvular aortic stenosis.
- An ECHO can be used for all of the following except to
- measure the shape of the heart.
- visualize valve function.
- measure the partial pressure of oxygen in the heart.
- visualize blood flow.
- Which ECHO finding is consistent with the major diagnostic criteria for HCM?
- posterior wall thickness of 10 mm
- anterior septum thickness of 8 mm
- free wall thickness of 12 mm
- The genetic basis of HCM may be confirmed via
- cardiac catheterization.
- cardiac exercise stress test.
- An electrophysiology study will provide specific details on
- the presence of inducible dysrhythmias.
- structural changes within the heart.
- underlying myocardial ischemia.
- the heart's degree of functionality.
- Diastolic dysfunction may cause
- shortness of breath.
- loss of consciousness.
- ventricular dysrhythmias.
- The abnormal BP response during exercise stress testing for an HCM patient is defined by a
- fall in the systolic BP.
- fall in the diastolic BP.
- rise in the systolic BP.
- rise in the diastolic BP.
- Which dysrhythmia is very common in HCM patients?
- junctional tachycardia
- premature atrial contractions
- atrial fibrillation
- wandering atrial pacemaker
- Which class of drugs has traditionally been used to treat HCM symptoms?
- angiotensin-converting enzyme inhibitors
- Verapamil helps HCM symptoms by
- increasing left ventricular contractility.
- causing ventricular relaxation.
- augmenting outflow obstruction.
- causing a positive chronotropic effect.
- What procedure has significantly eased symptoms in more than 90% of HCM patients?
- alcohol septal ablation
- heart transplantation
- an ICD
- septal myectomy
- Which statement about the genetics of HCM is true?
- It is inherited in an autosomal recessive manner.
- The MYBPC3 is the gene most frequently associated with HCM.
- The current methods of genetic testing can detect all types of mutations.
- There is a 25% risk of transmitting HCM to offspring in those with positive cardiogenetic test results.