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Internal Medicine Board Exam > Cardiology > Flashcards

Cardiology Flashcards

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1
Q

What is the common Tetralogy of Fallot post-op sequela?

A

Pulmonary Regurgitation

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2
Q

If a patient has HFrEF, what is the best medication to give?

A

Entresto

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3
Q

Bad ABIs 0.62 and 0.44, what is the next best step, for the patient?

A

Invasive Angiography

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4
Q

ABIs that are symptomatic, above 0.68 and 0.98, what are the next best treatment steps?

A

Supervised Exercise Training Program

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5
Q

If a patient has a NSTEMI, EKG looks ok, what is the next best treatment option?

A

Plavix and Aspirin

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6
Q

Left Atrial Myxoma, what is the next best step? Particularly if the patient has a TIA and SOB

A

Surgically Remove Left Atrial Myxoma

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7
Q

A TAVR valve candidate requires what life parameters?

A

80 years old, and less than 10 years of life left, or patient is a poor surgical candidate to live at any point

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8
Q

What is the most common cause of M.I. in young healthy woman?

A

Spontaneous Coronary Artery Dissection

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9
Q

After a STEMI, is there benefit to having another culprit lesion fixed 4-6 weeks after the fact?

A

Yes

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10
Q

AAA screening shows a 6.1cm Aneurysm, what is the next best step?

A

CT angiography

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11
Q

Patient has a bicuspid aortic valve, what is the next test that should be done?

A

CT aortaography

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11
Q

Symptomatic PVCs, Echo is wnl, no CAD, what is the next best step?

A

Propranolol

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12
Q

A patient with end stage restrictive heart disease, RVSP 64, what should be considered next?

A

Cardiac transplant

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13
Q

Patient has a high bleeding risk, had a stent placed 4 months ago. What should be done for the patient’s aspirin and plavix?

A

Hold the Plavix, high risk bleeding, 3 months at a minimum, but 6 months is ideal with the plavix and high GI bleeding risk

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13
Q

Patient has a recurrent peridcarditis, what should be done?

A

Give Colchicine and Ibuprofen, Steroids are only given if NSAIDS are contraindicated

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13
Q

What two statins have a low risk of muscle inflammation and low CK values?

A

Fluvastatin and pravastatin

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14
Q

Osborne Wave is seen in an EKG for what?

A

Hypothermia

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14
Q

Voyager and Compass trail have said that a decreased dose of what can treat PAD (peripheral artery disease)?

A

DOAC, low dose

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15
Q

A patient has an elevated RCRI score, what tests should be done pre-surgery to determine if ok to go?

A

EKG, XR chest, and Echo

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16
Q

What questionarie for functional capacity during preoperative evaluation should be done?

A

Duke Activity Status Index Questionnaire

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17
Q

Patient undergoing surgery, what needs to be evaluated if patient needs an EKG?

A

Type of surgery needed

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18
Q

Aortic Dissection, what is the medication of choice?

A

Esmolol #1
Nitroprusside with beta blocker #2

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19
Q

Cardiac Tamponade has what key JVP waveform?

Constrictive Pericarditis has what key JVP waveform?

A

Cardiac Tamponade: loss of the Y descent, filling ability is impeded

Constrictive Pericarditis: rapid x and y descent, myocardial relaxation is unimpaired

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20
Q

What is the following triad:

Hypotension
Elevated JVD
Muffeled heart sounds

A

Beck’s Triad -> Cardiac Tamponade

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21
What is Pulsus paradoxus?
Inspiration drops SBP > 10 Can be seen in restrictive pericarditis/cardiac tamponade
22
What is Kussmaul's Sign?
A paradoxical rise in JVP > 10, usually during cardiac restrictive pericarditis/cardiac tamponade Typically, JVP decreases during inspiration -> this sign is indicative of Right Heart Failure, RV has difficulty filling
23
If an athlete has pericarditis, how long should they wait to return to competitive sports?
3 months
24
With regards to tracking pericarditis inflammation, what lab value should be followed?
CRP level
25
Pericarditis round #1? What treatment is recommended?
Round #1) ASA or Ibuprofen Round #2) Colchicine
26
Pericarditis that is refractory to glucocorticoid treatment, what is the next best step?
IL-1 inhibition -> rilonacept
27
The following indications, patients can have what? 1) EF less than 35% or less (NYHA functional class II or III) with GDMT 2) same as above, LBBB and QRS > 150 ms or longer
CRT-D device
28
When can a CRT-D device be considered in patients with the following conditions: 1) Myocardial infarction 2) All other conditions
1) Myocardial infarction is 40 days 2) All other conditions -> 3 months
29
What is number is needed for surgical AAA repair? This is usually found via Abdominal Ultrasound If a AAA gets bigger by how much, should a vascular consult be given?
5.5 cm -> Vascular Surgery follow up 0.5cm in 1 year, vascular consult is needed
30
Looking at a JVP, what is an "a-wave"?
Right Atrium contracts
31
Looking at a JVP, what is an "c-wave"?
Tricuspid Valve Contracts
32
Looking at a JVP, what is an "v-wave"?
filing or right atrium against a closed tricuspid valve
33
Looking at a JVP, what is an "x-descent"?
Relaxation of the right atrium, causes the pressure to drop
34
# What does the triad mean? Claudication Decreased Femoral Pulses Erectile Dysfunction
Leriche's Syndrome | severe aortoiliac occlussive disease (PAD, peripheral artery disease)
35
What valve abnormality has an opening snap followed by middiastolic murmur over the cardiac apex?
Mitral Stenosis
36
What are the mitral balloon valvotomy indications?
Severe Mitral Stenosis, valve area < 1.5 cm Symptomatic and pulmonary artery systolic pressure > 50
37
What medication should be started for prolonged QT interval?
Propanolol
38
End stage heart failure patient is offered a Milirone drip, what is the benefit?
Decrease dyspnea symptoms, does not improve mortality, hypotensive episodes, ischemia events (pallative/hospice treatment plan)
39
If a patient has an elevated ABI, above 1.3, what could this mean?
Calcified and incompressible vessels, can cause claudication symptoms as well
40
Transient Vision loss, unintentional weight loss, diastolic murmur, low baseline cardiac risk factors, what should be considered?
Cardiac Myxoma
41
If a patient has an ASD, what is the most common arrthymia?
Right Bundle Branch Block
42
Are Vitamin E supplements and Beta-carotene supplements recommended for routine cardiac prevention?
No
43
Patients with high risk for pre-eclampsia or possible moderate risk for pre-eclampsia should be given what?
aspirin
44
A patient with elevated triglycerides that is refractory to statin/lipid care wtih elevated ASCVD risk factors, what is a different medication to consider?
Icosapent Ethyl (a highly potent fish oil) | Can do omega-3 fatty acids with NASH/MALD as well
45
If a patient has WPW, what should be evaluated first before ablation?
Exercise EKG
46
Bilateral renal stenosis plus flash pulmonary edema, what disease is this?
Pickering Syndrome
47
What statins are assoicated with low myopathy concerns?
Pravastatin and Rosuvastatin
48
Which three beta blockers are the only beta blockers to improve mortality?
Metoprolol Succinate, Carvedilol, and Bisoprolol
49
HOCM patients with what LV wall thickness have a sudden death risk? HOCM patients with what outflow gradient should have surgery?
LV wall thickness > 30 mm Outflow track gradient > 50 mmHg
50
Cardiomyopathy in preganancy, what three drugs should be avoided 2/2 teratogenicity?
ACE ARB Aldosterone Antagonists
51
Peripartum Cardiomyopathy with an LVEF < 35%, what medication should be given? Acute severe peripartum cardiomyoapthy, what medication improves LVEF and clininical outcomes?
Warfarin Bromocriptine
52
Athlete's heart vs. HOCM, what is two easy distinguish features?
HOCM is > 15mm Athlete's Heart is < 12mm Athlete's heart will not have any diastolic filling problems
53
Pregnant women with a high risk of pre-eclampsia, what should be given?
Aspirin
54
Patient's age 40 to 59 years old that have an ASCVD risk > 10%, what can be considered for primary prevention?
Aspirin
55
Patient's age 60 and older that have an ASCVD risk > 10% what medication is not recommended for primary prevention?
Aspirin
56
Diabetic and increased CV risk what can be given?
Aspirin
57
What size must an aortic or mitral valve vegetation be before surgical intervention?
10mm
58
With infective endocarditis, what is the biggest clinical indicator that can cause acute surgical intervention?
Acute Heart Failure Symptoms
59
A-fib treatment with no CAD or structural heart disease?
Flecanide or Propafenone
60
A-fib treatment with LVH?
Dronedarone or Amiodarone
61
A-fib treatment with CAD without heart failure?
Sotalol or Dronedarone
62
A-fib treatment with heart failure is what?
Amiodarone or Dofetilide

Internal Medicine Board Exam (19 decks)

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