Cardio

Question 1

Classic ECG finding in atrial flutter

Answer 1

Sawtooth P waves

Question 2

Definition of unstable angina

Answer 2

Angina that is new or worsening with no increase in troponin level

Question 3

Antihypertensive for a diabetic patient with proteinuria

Answer 3

ACE inhibitor

Question 4

Beck triad for cardiac tamponade

Answer 4

Hypotension, distant heart sounds, raised JVP

Question 5

Drugs that slow heart rate

Answer 5

b-blockers, CCB, digoxin, amiodarone

Question 6

Hypercholesterolaemia treatment that leads to flushing and pruritus

Answer 6

Niacin

Question 7

Murmur for HOCM

Answer 7

Systolic ejection murmur heard along the lateral sternal border that increases with a decreased preload (Valsalca manoeuvre)

Question 8

Murmur for aortic insufficiency

Answer 8

Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur best heard sitting up

More prominent with increased afterload (handgrip manoeuvre)

Question 9

Murmur for aortic stenosis

Answer 9

Systolic crescendo/decrescendo murmur radiating to neck

More prominent with increased preload (squatting manoeuvre)

Question 10

Murmur for mitral regurgitation

Answer 10

Pansystolic murmur radiating to axilla

Increases with increasing afterload (handgrip manoeuvre)

Question 11

Murmur mitral stenosis

Answer 11

Mid to late diastolic, low pitched preceded by opening snap

Question 12

Treatment for atrial fibrillation & atrial flutter

Answer 12

Unstable —> cardiovert

Stable/chronic —> rate control with CCBs or b-blockers

Question 13

Treatment for VF

Answer 13

Immediate cardioversion

Question 14

IV drug use with increased JVP and a holosystolic murmur at the left sternal border. Treatment?

Answer 14

Tear existing heart failure, tricuspid valve replacement

Question 15

Diagnostic test for HOCM

Answer 15

Echo: LV wall thickening & LVOTO

Question 16

Pulsus paradoxus

Answer 16

Decrease in systolic bp > 10mmHg on inspiration

Seen in cardiac tamponade

Question 17

Classic ECG findings in pericarditis

Answer 17

Low voltage, diffuse ST-segment elevation

Question 18

8 surgically correctable causes of HTN

Answer 18

Renal artery stenosis
CoA
Phaeo 
Conn syndrome 
Cushing syndrome
Unilateral renal parenchymal disease
Hyperthyroidism
Hyperparathyroidism

Question 19

Evaluation of a pulsator abdominal mass and bruit

Answer 19

Abdominal USS and CT

Question 20

Indications for surgical repair of AAA

Answer 20

> 5.5cm, rapidly enlarging, symptomatic or ruptured

Question 21

Treatment for ACS

Answer 21

Aspirin, heparin, clopidogrel, morphine, O2, sublingual nitroglycerin, IV b-blockers

Question 22

Metabolic syndrome features

Answer 22

Abdo obesity, high TGs, low HDL, HTN, insulin resistance, prothrombotic or pro inflammatory states

Question 23

50 year old man with stable angina can exercise to 85% of max predicted heart rate. Diagnostic test?

Answer 23

Exercise stress treadmill ECG test

Question 24

65 year old woman with LBBB and severe osteoarthritis has unstable angina

Answer 24

Pharmacological stress test (e.g dobutamine echo)

Question 25

Signs of active ischaemia during stress echo testing

Answer 25

Angina, ST elevation, hypotension

Question 26

ECG findings in MI

Answer 26

ST elevation (ST depression = ischaemia), flattened T waves & Q waves

Question 27

Coronary territories

Answer 27

Anterior wall = LAD/diagonal Inferior = PDA Posterior = LCx/oblique; RCA/marginal Septum= LAD/diagonal

Question 28

A young patient with angina at rest and ST elevation with normal cardiac enzymes

Answer 28

Prinzmetal angina

Question 29

Common symptoms associated with silent MIs

Answer 29

CHF, shock and altered mental status

Question 30

Diagnostic test for PE

Answer 30

Spiral CT with contrast

Question 31

Effects of protamine

Answer 31

Reverses the effects of heparin

Question 32

Prothrombin time

Answer 32

The coagulation parameter affected by warfarin

Question 33

A young patient with a family history of sudden cardiac death collapse and dies while exercising

Answer 33

HOCM

Question 34

Endocarditis prophylaxis regimens

Answer 34

Oral surgery- amoxicillin for certain situations GI/GU procedures - not recommended

Question 35

Virchows triad

Answer 35

Stasis, hypercoagulability, endothelial damage

Question 36

Most common cause of HTN in young women

Answer 36

OCPs

Question 37

Most common cause of HTN in young men

Answer 37

Excessive EtOH

Question 38

Figure 3 sign

Answer 38

CoA

Question 39

Water bottle shaped heart

Answer 39

Pericardial effusion Look for pulsus paradoxus