Cardiology

Question 1

Chest pain, worse with movement of left arm. Palpating of chest reproduces pain. Next best step?

Answer 1

Observation. Musculoskeletal in origin. Ischemia doesn’t reproduce pain

Question 2

Chest pain, crushing substernal pain radiating to left arm. Troponin- 0.4. Diagnosis?

Answer 2

MI. Troponin will be above 0.4. Cardiac enzymes not elevated in unstable/ prinzmetal angina

Question 3

Woman on fluconazole and ondansetron develops palpitations. EKG shows TdP. Treatment?

Answer 3

IV Magnesium. If hemodynamically unstable- cardioversion

Question 4

Anterior MI, next best step

Answer 4

Aspirin.

Question 5

Treatment for ventricular fibrillation

Answer 5

Defibrillator.

Question 6

Epigastric burning after playing. No relief with antacids. EKG normal. Next best step?

Answer 6

Exercise ekg. Should be done in those with suspected stable ischemic heart disease

Question 7

Inferior MI, 3 days later develops SOB, hypotension, bibasilar crackles, faint systolic murmur. Cause?

Answer 7

Papillary muscle rupture. Results in MR. Involves RCA.

Question 8

1 hour old baby with respiratory distress. H/o Gest DM in mom, echo shows small LV cavity and increased Iv septum thickness. Next best step?

Answer 8

Beta blocker therapy. Hypertrophic cardiomyopathy of infancy.

Question 9

Becks triad cause

Answer 9

Decreased LV preload in cardiac tamponade

Question 10

Type of syncope confirmed with upright tilt table test

Answer 10

Vasovagal syncope

Question 11

Diagnosis in cerebrovascular disease causing syncope

Answer 11

Do arteriography and carotid USG

Question 12

Diagnosis of Aortic dissection in hypotension patients

Answer 12

Do TEE. Ascending dissection requires urgent surgical repair

Question 13

MCC of acute cardiac arrest post MI ?

Answer 13

V Fib

Question 14

Which woman with cardiac conditions can’t get pregnant?

Answer 14

MAP- MS, AS, PAH.

Question 15

New diastolic murmur after AV replacement. Next step?

Answer 15

Echo. To assess for AR

Question 16

Asymptomatic newborn with 2/6 holosystolic murmur. Best next step?

Answer 16

Do echo. Large defects VSD have soft murmur

Question 17

Congenital long QT syndrome treatment

Answer 17

Propranolol

Question 18

MOA of beta blockers and CCB

Answer 18

Decreases myocardial contractility

Question 19

Use of adenosine

Answer 19

AVNRT

Question 20

Risk factors for Premature atrial complexes

Answer 20

Caffeine, smoking, stress. Please Avoid Caffeine and Smoking- PAC

Question 21

Side effect of niacin given for hyperlipidemia

Answer 21

Cutaneous flushing and itching

Question 22

WPW with Afib. Treatment?

Answer 22

Procainamide. If unstable cardioversion

Question 23

Post catheterisation complication- hypotension, back pain, improves with NS. Next step

Answer 23

CT abd/ pelvis suspicious of retro peritoneal hematoma

Question 24

Management of respiratory failure due to acute decompensated HF

Answer 24

Non invasive positive pressure ventilation

Question 25

Prevention of acute limb ischemia secondary to left atrial thrombus

Answer 25

Apixaban, direct oral anticoagulant must be used

Question 26

Treatment for aortic dissection

Answer 26

Beta blockers then nitroprusside, then surgical correction

Question 27

Cyanotic newborn - ecg shows tall P waves and left axis deviation, decreased pulmonary markings on cxr. Diagnosis?

Answer 27

Tricuspid valve atresia.

Question 28

Blunt thoracic aortic injury diagnosis by ?

Answer 28

CT angiography

Question 29

BNP levels correlate with severity of which chamber?

Answer 29

LV systolic dysfunction.

Question 30

Cardiac complications of sarcoidosis

Answer 30

Restrictive cardiomyopathy, AV block, dilated cardiomyopathy, MVP, AR, ventricular arrhythmias, HF

Question 31

Surveillance method for <80% carotid stenosis with risk factors

Answer 31

Annual carotid duplex

Question 32

Rx of sturge Weber syndrome

Answer 32

Laser therapy, ant epileptic, IOP reduction