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INSTRUCTIONS Hypertrophic cardiomyopathy: New hope for an old disease



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Hypertrophic cardiomyopathy: New hope for an old disease


GENERAL PURPOSE: To review and update information about HCM. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Explain the pathophysiology of HCM. 2. List the clinical manifestations of HCM. 3. Plan appropriate nursing interventions for patients with HCM.


1. The primary structural abnormality in HCM is thickening of the wall of the


a. right atrium.


b. left ventricle.


c. right ventricle.


2. A common pathophysiologic characteristic of HCM is


a. tricuspid valve regurgitation.


b. infective endocarditis.


c. diastolic dysfunction.


3. SAM of the mitral valve leaflet is generally the direct cause of


a. LVOT obstruction.


b. ventricular septal hypertrophy.


c. myocyte disarray.


4. The treatment of choice for patients who have HCM with symptomatic AF is


a. surgical septal myectomy.


b. pharmacologic cardioversion.


c. synchronized electrical cardioversion.


5. Which statement about the angina that accompanies HCM is correct?


a. It is often atypical.


b. It always involves epicardial arterial stenosis.


c. It does not occur at rest.


6. A clinical manifestation of HCM that usually occurs in later stages of the disease is


a. bradycardia.


b. fluid retention.


c. peripheral neuropathy.


7. Which of the following ECG abnormalities is common with HCM?


a. prolonged PR interval


b. T wave inversion


c. tall R waves


8. Which test is performed routinely to determine HCM's severity?


a. contrast-enhanced CMR


b. continuous ambulatory ECG monitoring


c. transthoracic echocardiography


9. A risk factor for SCD in patients who have HCM is


a. unexplained syncope.


b. a history of atrial tachycardia.


c. LV hypertrophy of at least 15 mm.


10. Which of the following is indicated for patients with HCM who are at highest risk for SCD?


a. biventricular pacemaker


b. implantable loop recorder


c. ICD


11. Which of the following can help minimize dysrhythmias and allow better ventricular filling in patients with HCM?


a. atenolol


b. captopril


c. indomethacin


12. What percentage of patients with HCM progress to the burn-out stage of the disease?


a. 2% to 3%


b. 12% to 13%


c. 20% to 30%


13. Which of the following is a Class Ia agent that depresses sodium-dependent depolarization?


a. adenosine


b. dronedarone


c. disopyramide


14. Which of the following interventions for HCM remodels the affected area by creating a localized myocardial infarction?


a. mitral valvuloplasty


b. ASA


c. surgical septal myectomy


15. Which term refers to a person's individual sequence of genes?


a. phenotype


b. allele


c. genotype


16. For patients with HCM, which of the following drugs is contraindicated?


a. nifedipine


b. lorazepam


c. gabapentin


17. Patients who have HCM should avoid taking which type of drugs?


a. statins


b. diuretics


c. antihistamines


18. Nurses should inform patients who have HCM to do all of the following except


a. take nitroglycerine for angina.


b. stay hydrated.


c. monitor for sudden weight gain.