Valvular Heart Disease

1. What is the characteristic feature of myxomatous mitral valve ?

• Heaped up calcified masses on the outflow side of the cusps

• Ballooning or hooding of valves

• Commissural fusion

• Masses protrude into the sinus of Valsalva

2. Which one of the following is not included as major criteria in Jones criteria?

• Pancarditis

• Elevated ESR

• Subcutaneous nodule

• Polyarthritis

3. A 19-year-old man has had a low-grade fever for 3 weeks. A tender spleen tip is palpable. There are splinter hemorrhages under the fingernails and tender hemorrhagic nodules on the palms and soles. A heart murmur is heard on auscultation. Which of the following infectious agents is most likely to be cultured from this patient's blood?

• Streptococcus viridans

• Trypanosoma cruzi

• Coxsackievirus B

• Mycobacterium tuberculosis

4. Which of the following is NOT a cause of regurgitation in VHD?

• Primary cuspal abnormality originating from a chronic process

•  Intrinsic disease of the valve cusps

•  Disruption of the supporting structures

• Appear suddenly

5. How many leaflets can be seen in the aortic valve?

• 1

• 2

• 3

• 4

6.  In degenerative valvular heart diseases (VHD) , the extra cellular matrix (ECM) of the valve is affected. Among the mentioned answers, which does not affect the integrity of  degenerative VHD ?

• Calcification

• Alteration in ECM

• Changes in production of matrix metalloproteinases or their inhibitors

• Bacterial infection

7. Which form of infective endocarditis affects those with healthy valves and manifests as a rapidly progressive illness? 

• Acute

• Subacute

8. Which term is known as the primary lesions of IE, consisting of fibrin, leukocytes, platelets, and microbes that stick to the valve surface or endocardium?

• Petechiae

• Embolism

• Vegetations

9. What type of murmur is associated with mitral stenosis ?

• Diastolic murmur

• Mid-systolic murmur which has crescendo-decrescendo character

• Decrescendo blowing diastolic murmur

• Systolic murmur