Cardiology

Question 0

what medication lower mortality in systolic dysfunction

Answer 0

ACE inhibitors/ARBs
Beta blockers
spironolactone/eplerenone

Question 1

sytolic dysfunction treatment

Answer 1

ACE inhibitors/ ARBS
beta blockers
spironolactone
diuretics
Digoxin

Question 2

What medications can be used instead of ACE - and ARBS that lowers mortality in patients with systolic dysfunction

Answer 2

Hydralazine/nitrates

Question 3

Device for CHF that lowers mortality in systolic dysfunction

Answer 3

implantable defibrillator

Question 4

Medications used in treatment of diastolic heart failure

Answer 4

Beta blocker

Diuretics

Question 5

treatment of stable angina

Answer 5

Aspirin
bet blockers
nitrates

Question 6

treatment for unstable angina/ non-ST elevation MI

Answer 6

aspirin
beta blockers
nitrates
heparin
GP IIb/IIIa inhibitors

Question 7

Treatment for STEMI

Answer 7

aspirin
beta blockers
nitrates
Thrombolytics
heparin (only after thrombolytics)

Question 8

Indiacations for using thrombolytics

Answer 8

STEMI or new LBBB

Start within 12 hours of onset of chest pain and within 30 minutes after arriving to the ER

Question 9

indications for using clopidogrel or prasugrel

Answer 9

1. Aspirin allergy

2. Acute MI

Question 10

positive ionotropic agents used in patients with CHF

Answer 10

Dobutamine
Amrinone
Milrinone

Question 11

indications for using implantable defibrillator

Answer 11

used in patients whose EF <35%

Question 12

indications for biventricular pacemaker

Answer 12

Used when EF< 35% and QRS above 120msec.

Question 13

maneuvers that work on preload (venous return)

Answer 13

Squatting & leg raise- increases venous return, therefore increases the intensity of murmur

Valsalva and standing up- decreases venous return therefore decreases intensity of the murmurs

Question 14

maneuvers that work on Afterload

Answer 14

Handgrip

Amyl Nitrate

Question 15

Effect of handgrip on afterload

Answer 15

Afterload functions as the opposite of ACE inhibitor (used to treat AR and MR)
-Handgrip increases afterload making AR and MR murmurs worse by pushing blood backward into the heart (increases intensity)

Question 16

what murmurs increase in intensity with handgrip

Answer 16

AR, MR and VSD

Question 17

effect on amyl nitrate on afterload

Answer 17

amyl nitrate causes vasodilation therefore decreases the intensity of AR, MR and VSD

had opposite affect of handgrip

Question 18

Maneuvers that increase/ decrease HOCM and MVP

Answer 18

increased intensity with valsalva, standing and Amyl nitrate

decreased intensity with squatting, leg raise, handgrip

Question 19

effect of handgrip on AS mumur

Answer 19

softens the murmur of aortic stenosis

Handgrip increases afterload therefore the ventricle cannot empty out. If the ventricle cannot empty, there wont be a murmur

Question 20

effect of amyl nitrate on AS

Answer 20

increases intensity of AS

-amyl nitrate decreases afterload and decreases the pressure in the aorta, thus increasing blood flow from the ventricle to the aorta cause an increase in intensity

Question 21

Treatment for regurgitant murmurs

Answer 21

ACE-, ARBs, nifedipine

Diuretics can also be used

Question 22

Management of stenotic murmurs

Answer 22

Best initial: Diuretics

anatomic defect therefore balloon valvuloplasty or valve replacement should be performed eventually

Question 23

when is surgery indicated in asymptomatic patients with AR

Answer 23

EF 55mm

Question 24

when is surgery indicated in patients with MR

Answer 24

EF 40mm

Question 25

best therapy for ASD

Answer 25

percutaneous or cath devices

Question 26

murmur associated with pregnancy and immigrants (rheumatic fever)

Answer 26

Mitral stenosis

Question 27

Therapy for PAD

Answer 27

Aspirin Ace inhibitors CILOSTAZOL