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Flashcards in Cardiology Deck (27):
1

What is the clinical triad that you see that would make you suspect right ventricular infarct in an inferior MI patient?

1. hypotension
2. clear lung fields
3. elevated JVP

2

What should you think about in this clinical scenario? A young man with intermittent claudication of the calf or foot arch with walking - not running.

popliteal artery entrapment

3

What is the clinical history of a patient with Buerger disease?

Thromboangiitis obliterans occurs in men

4

What should you suspect in a patient with unilateral headache associated with either TIAs or a dilated pupil?

spontaneous dissection of the internal carotid artery

5

What is the classic triad that the CXR shows in mitral stenosis?

1. prominent pulmonary artery revascularization
2. an enlarged left atrium
3. normal sized LV

6

What kind of effect can carcinoid cause on the heart valves? If you see carcinoid affecting the valves what does this imply?

Can affect either right sided heart valve
It implies a hepatic tumor

7

If you have mitral regurgitation, is it better to repair or replace the valve?

repair

8

Valsalva ___ (increase/decrease) the murmur of aortic stenosis, ____ the murmur of hypertrophic cardiomyopathy, _____ the murmur of mitral valve prolapse

Decrease, increase, increase

9

In what scenarios do you not shock a patient with an abnormal tachycardia atrial rhythm?

digitalis intoxication and hypokalemia

10

which anti arrhythmic do I definitely not want to prescribe in CHF?

dronaderone

11

What meds do you never give to a WPW patient who also has a-fib?

digoxin, verapamil, beta blockers

12

Never use _______ with any wide complex tachycardia in the emergency setting.

Verapamil - 30% of the time the v tach will rapidly deteriorate

13

If a patient has pericarditis and it doesn't go away after 2 weeks, what should you suspect?

TB

14

What do valsalva and sustained handgrip do to the murmur of HOCM?

Valsalva increases it; handgrip decreases it

15

What's the difference in BNP levels between restrictive cardiomyopathy and constrictive pericarditis?

Restrictive - BNP is elevated
Constrictive - BNP is normal - no actual CHF

16

What does the cardiac cath show in both tamponade and constrictive pericarditis?

the same pressure during diastole in all 4 chambers

17

What congenital syndrome is associated with coarctation of the aorta and a bicuspid aortic valve?

Turner syndrome

18

What do you need to rule out in the pregnant patient presenting with new onset a-fib and pulmonary edema?

mitral stenosis and secundum ASD

19

How do you differentiate acute tamponade from constrictive pericarditis based off of the x and y descents?

tamponade - rapid x but normal y
constrictive pericarditis - rapid x and y descent

20

"Wide fixed split" is a buzzphrase for what cardiac defect?

ASD

21

When do you see canon A waves?

In cases of AV dissociation

22

Large JV pulsations are seen when?

1. right heart failure
2. Tricuspid valve dz
3. pericardial compressive physiology
4. SVC syndrome

23

What does accelerated junctional rhythm (>60) signify?

digitalis toxicity

24

What does the JVP pulse tracing show for constrictive pericarditis? What is the other hallmark of constrictive pericarditis?

Rapid x and y descent
Other hallmark: Kussmaul's sign (paradoxical rise in jugular venous pressure (JVP) on inspiration)

25

What is Kussmaul's sign?

paradoxical rise in jugular venous pressure (JVP) on inspiration

26

Pulsus bisferiens

aortic regurgitation or HCM

27

Pulsus alternans

severely depressed systolic function