Cardiology

Question 1

What antihypertensive medication is commonly associated with peripheral edema?

Answer 1

Nifedapine is commonly associated with peripheral edema

Question 2

What are the EKG findings characteristic of a pulmonary embolism?

Answer 2

Sinus tachycardia with non-specific ST-T abnormalities

S1Q3T3 is a common finding on the test but doesn’t happen much in real life and is often associated with other pulmonary pathologies

Question 3

Causes of Atrial Fibrilation

Answer 3

“THIRDS”

1. T- thyroid (hyperthyroid)
2. H- hypertension
3. I- ischemia
4. R- rheumatic heart disease
5. D- drugs (cocaine, alcohol)
6. S- something else

Question 4

Describe the murmur of aortic stenosis

Answer 4

The murmur of aortic stenosis is a crescendo-decrescendo murmur that radiates to the carotids.

*severly stenosed aortic valves require replacement. Look for signs of critical aortic stenosis including a late peaking murmur (may occlude S2), pulses parvus et tardus (delayed peripheral pulses) or a displaced left ventrical impulse.

**Valve replacement is indicated if the area of the valve is < 1 cm

Question 5

What are the cutaneous manifestations of familial hyperlipidemia?

Answer 5

Cutaneous manifestations of familial hyperlipidemia include

xanthomas on the skin and tendon sheaths

corneal arcus

xanthalasma

*xanthomas are yellow, non-blanchable, mildly tender nodules

Question 6

What is the diagnostic test of choice for a stable patient with an aortic disection?

Answer 6

hemodynamically stable patients should have a contrast enhanced CT

Patients who are NOT hemodynamically stable should have a TTE performed at bedside

Question 7

What is the recomended medical management for primary pulmonary hypertension?

Answer 7

Treat pHTN with a potent vasodilator like

SILDENIFIL

pulmonary hypertension is defined as a pulmonary arterial pressure > 20mmHg MAP.

Primary pulmonary HTN is often seen in otherwise healthy women between the ages of 20-40

Question 8

What is the initial treatment for suspected temporal arteritis

Answer 8

High dose glucocorticoids

A biopsy is the gold standard for diagnosis, but you don’t want to delay giving steroids while waiting for the results of the biopsy. Delaying the steroids can lead to blindness

Question 9

What is the initial treatment for ventricular fibrilation?

Answer 9

treat ventricricular fibrilation with immediate

DEFIBRILATION

* If the patient does not respond after one round of defibrilation give epinephrine

Question 10

What is the drug of choice to treat an African American with kidney disease and HTN?

Answer 10

in this case you would give an ACEi.

Normally ACEi are not the treatment of choice in AA with HTN alone, but they do demonstrate benefits if there is co-existing kidney disease