Cardiology

Question 1

S4 description

Answer 1

TENnessee

Extra heart sound before S1

Question 2

Peri-infarction pericarditis vs. Dressler syndrome

Answer 2

<4 days vs 4 weeks

NSAIDs and steroids are avoided because they inhibit collagen deposition (rupture risk)

Question 3

Cardiac tamponade signs

Answer 3

1) Distant heart sounds
2) Elevated JVP
3) Hypotension
4) Pulsus paradoxus (>10mmHg drop in BP w/ inspiration)

Question 4

Cor pulmonale causes

Answer 4

1) COPD
2) Interstitial lung disease
3) Pulmonary vascular disease (thromboembolic)
4) OSA

Question 5

Torsades des pointes treatment

Answer 5

Magnesium sulfate for stable

Defibrillation for unstable

Question 6

Ventricular aneurysm EKG

Answer 6

Persistent ST-segment elevation

Deep Q waves

Question 7

Most common site of A-fib initiation

Answer 7

Myocytes at the pulmonary veins

Can disrupt with catheter based radiofrequency ablation

Question 8

Thiazide diuretics association

Answer 8

Hyperglycemia

Can cause decreased insulin release and glucose utilization in peripheral tissues

Question 9

Anatomic abnormalities in HCM

Answer 9

Basal anterior septum thickening

Systolic anterior motion of the mitral valve

Question 10

Hypertensive urgency vs emergency

Answer 10

Emergency has signs of end-organ damage (papilledema, encephalopathy, retinal hemorrhage)

Question 11

Management of pulseless electrical activity

Answer 11

CPR and epinephrine with identification of reversible causes (no cardioversion or defibrillation)

Question 12

Effectiveness of interventions for HTN

Answer 12

1) Weight loss
2) DASH diet
3) Exercise

Question 13

Ventricular wall aneurysm EKG

Answer 13

Q waves

Persistent ST-elevations

Question 14

Treatment for polycythemia vera

Answer 14

Serial phlebotomy

If thrombosis risk then hydroxyurea

Question 15

Kussmaul sign

Answer 15

increase or lack of decrease in JVP with inspiration

positive in constrictive pericarditis

Question 16

Causes of constrictive pericarditis

Answer 16

1) surgery
2) radiation
3) TB
4) uremia
5) repeated viral

Question 17

PCI intervention guidelines

Answer 17

within 12 hours of symptomatic onset
90 min first contact to balloon
120 min if outside transfer

Question 18

STEMI interventions

Answer 18

ASA
P2Y12
Heparin
Nitrates
B-blockers
Statins

Question 19

WPW SVT

Answer 19

Delta waves are often not visible during re-entrant SVT

Question 20

cold limb after MI?

Answer 20

Echo for LA or LV thrombus due to decreased wall motion

Question 21

treatment of cocaine induced MI

Answer 21

give benzos first to alleviate agitation

same treatment as regular MI but NO BETA BLOCKER

Question 22

D-dimer sensitivity/specificity

Answer 22

Use in LOW pretest probability

High sensitivity and thus NPV

Question 23

treatment for HOCM

Answer 23

beta blockers (second line verapamil)
slows HR, improves filling and thereby decreases obstruction