Cardiology

Question 1

CAD Risk factor
( Family History )
Very important two points

Answer 1

1. First degree Family History ( Mother , Father , siblings )
2. They Presented in young age Men.55 / Women.65.

Question 2

Cardiac Chest pain Features

Answer 2

Dull
Pressure like
Squeezing
Burning 
Tight 
Heaviness 
Aching

Question 3

Cardiac Chest Pain Is not

Answer 3

NOT Tender 
NOT Positional ( means not changing with positions)
NOT Pleuritic 
NOT Sharp 
NOT knife like or pinpoint like 
NOT lasting Few seconds

Question 4

ACS duration of the chest pain is

Answer 4

10-30 Minutes

Question 5

Fever + Chest pain

Answer 5

Pneumonia

PE ( clotting factors gives fever )

Question 6

Unequal BP in both arms

Answer 6

Aortic dissection Diagnosed with CXR which showed widened mediastinum
Confirmed TEE

Question 7

First Diagnostic test for Cardiac chest pain

Answer 7

EKG

Question 8

When To do Cardiac enzymes

Answer 8

ACUTE PAIN ONLY
Not clinic - if he is in the clinic send him to the ER
Not chronic

Question 9

Exercise tolerance test ( ETT ) Indication

Answer 9

When the EKG is not diagnostic comes normal and the patient still have chest pain

Two Things think about them

1. The patient can exercise ( No fracture )
2. You can read the EKG in the Tolerance test “ Like no pathologies that prevent you from reading it Like Digoxin use , Pacemaker , Left bundle branch block .. etc

Question 10

Maximum heart rate

Answer 10

220-Age

Question 11

Chronic Chest pain - Do Exercise tolerance test EKG

You Cannot read EKG ?

Answer 11

1. Nuclear Isotope scan ( Thallium or Sestamibi ).

2. Do Echo for wall motion abnormalities.

Question 12

Chronic Chest pain - Do Excersice tolerance test EKG

Cannot Exercise??

Answer 12

1. Persantine ( Diperidamole ) or adenosine with Isotope scan
2. Dobutamine with Echo

Question 13

When You can’t Use Dipyridamole ?

Answer 13

Asthmatic

caffeine

Question 14

Dobutamine with Echo contraindications :

Answer 14

• severe HTN
• LV outflow obstruction
• Ventricular arrhythmia
  + HOLD B-Blockers before the test

Question 15

ST deprresion on EGK means

Answer 15

Ischemia NOT Infarction

Question 16

TX

1. ST - Elevation
2. ST - Depression

Answer 16

1. Aspirin + Antiplatelets + Angioplasty

2. Aspirin + Antiplatelets + LMWH

Question 17

Holter Monitor For

Answer 17

Rhythm Problems NOT ISCHEMIA

Can be for 1 day - 3 days Max

Question 18

Surgically corrected stenosis after Angiography

Answer 18

If the stenosis 70% and Above

Question 19

The Typical cardiac chest pain

Answer 19

With exertion
Relieved by rest
Location is substernal/ Retrosternal
Associated with nausea

Question 20

Pleuritic chest pain causes

Answer 20

Pneumonia
PE
Pneumothorax

Question 21

Drugs Lower mortality in ACS

The A and B

Answer 21

Aspirin

B-Blocker

Question 22

Cardiac catheterization complications

Answer 22

Hematoma ( Local or retroperitoneal )
Arterial dissection 
Acute thrombosis 
Pseudo aneurysm 
AV Fistula

Question 23

Least complications post cath is with

Answer 23

Radial artery approach

Question 24

Side effect of Both Ace and ARB

Answer 24

Hyper K

Question 25

Statin side effect

Answer 25

Rhabdomyolysis - Myositis - High CPK level | Liver dysfunction - High Transaminases

Question 26

CCB decrease mortality in

Answer 26

HTN only not CAD

Question 27

CCB Side effects Dipines Verapamil

Answer 27

Increase the heart rate Edema Constipation for verapa

Question 28

When you use CCB

Answer 28

Asthmatics where you can’t use B-Blockers Prinzmental angina Cocaine induced chest pain

Question 29

The cardiac marker for Re-infarction

Answer 29

CK-MB

Question 30

Door to Baloon time

Answer 30

90 minutes

Question 31

Erectile dysfunction post MI from Which Med ?

Answer 31

B-Blocker

Question 32

Post MI no pulse . | Causes

Answer 32

Temponade or wall rupture | Ventricular Fibrillation

Question 33

S3 gallop | S4 gallop

Answer 33

Heart failure | Acute Coronary Syndrome

Question 34

Trans thoracic Echo | Trans Esophgeal Echo

Answer 34

EF evaluation | Valve evaluation

Question 35

if you have HF you Must do | EF assessment

Answer 35

``` Initially do Trans-Thoracic Echo Best Test for Ejection fraction : MUGA test ( nuclear ventriculography ) ```

Question 36

Tx of High K with ACE and ARB

Answer 36

Add Patiromer | Switch the ACE with ( Hydralazine/Nitrates ) combined

Question 37

B-blockers for HF

Answer 37

Metoprolol Carvedilol Bisoprolol

Question 38

Tx of The Gynacomastia by spironolactone

Answer 38

Switch to Eplerenone

Question 39

Persistent Dyspnea after all tx of HF is treated with

Answer 39

1. Ivabradine. “ Cause Visual symptoms “ 2. Hydrlazine/ Nitrates . 3. Sacubitril/ Valsartan”ARB” .

Question 40

Which Medication Increasethe obstruction in HCOM

Answer 40

Diuretics

Question 41

Hyperventilation is which Acid-base ?

Answer 41

Respiratory Alkalosis | Co2 is Acid , With Hyperventilating co2 goes out - less co2 means alkalosis

Question 42

All forms of Regurgitations lesion will respond well to

Answer 42

VASODILATORS: ACE , ARB Nifedipine Hydralazine

Question 43

Rate control medications

Answer 43

Digoxin B-Blockers Diltiazem / Verapamil

Question 44

Warfarin Use

Answer 44

Metal Heart Valve | Mitral stenosis with Atrial fibrillation

Question 45

Things increase the venous return | Decrease

Answer 45

``` Squat Leg raise Inhalation - Valsava Standing Exhalation ```