ACC SAP Qs

Question 1

PAD: Diagnostic testing

Answer 1

Toe brachial index for ABI >1.4

Question 2

Test to dx chronic venous insufficiency

Answer 2

Uptight position to evaluate for reflux (provoked with Valsalva)

Question 3

Claudication

Answer 3

Tx
Supervised exercise
Cilastazol (contraindicated with HF)
Endovasculartherapy if refractory

Question 4

HF after acute MI

Answer 4

Killip score
HF s/s in s/o MI

Patho:
-↑ sympatehtic - Norepi
-↓parasympathetic - Ach
-↑RASS - renin, ATII

Question 5

RV infarct

Answer 5

Triad:
-hypotension
-JVD
-clear lungs

In s/o inferior infarct
↓RV contractility = ↓LV preload

↑ RV end diastolic pressure displaces septum to L, reduces LV compliance/filling

RV dilation restricts LV filling in noncompliant pericardial sac = equalization of diastolic pressures

Question 6

CAC

Answer 6

40-75 without DM with LDL 70-189.
—-> check CAC for statin guidance

CAC > 400 = high risk future cardiovascular events and silent ischemia

Question 7

V4R

Answer 7

RV infarct in 1/3 patients with inferior STEMI

Question 8

FFR
IFR

cutoffs

Answer 8

FFR </= 0.80

IFR </= 0.89

Question 9

TIMI

Answer 9