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USMLE Step 2 Rapid Review > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Definition of unstable angina

A

Angina that is new, is worsening, or occurs at rest

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2
Q

Antihypertensive for a diabetic px with proteinuria

A

ACEI

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3
Q

Beck’s triad for cardiac tamponade

A

Hypotension, distant heart sounds and JVD

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4
Q

Drugs that slow the heart rate

A

Beta-blockers, CCBs, digoxin, amiodarone

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5
Q

Hypercholesterolemia tx that leads to flushing and pruritus

A

Niacin

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6
Q

Murmur - hypertrophic obstructive cardiomyopathy (HOCM)

A

A systolic ejection murmur heard along the lateral sternal border that increases with a decreasing preload (Valsalva maneuver)

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7
Q

Murmur - aortic insufficiency

A

Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increasing afterload (handgrip)

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8
Q

Murmur - aortic stenosis

A

A systolic crescendo/decrescendo murmur that radiates to the neck; increases with increasing preload (squatting maneuver)

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9
Q

Murmur - mitral regurgitation

A

A holosystolic murmur that radiates to the axilla; increases with increasing afterload (handgrip maneuver)

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10
Q

Murmur - mitral stenosis

A

A diastolic, mid- to late, low-pitched murmur preceded by an opening snap

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11
Q

Tx for atrial fibrillation and atrial flutter

A

If unstabl, cardiovert. If stable or chronic, rate control with CCBs or beta-blockers

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12
Q

Tx for ventricular fibrillation

A

Immediate cardioversion

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13
Q

Dressler ‘s syndrome

A

An autoimmune reaction with fever, pericarditis and increased ESR occurring 2-4 weeks post-MI

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14
Q

IV drug use with JVD and a holosystolic murmur at the left sternal border. Tx?

A

Treat existing heart failure and replace the tricuspid valve

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15
Q

Diagnostic test for hypertrophic cardiomyopathy

A

Echocardiogram (showing a thickened left ventricular wall and outflow obstruction)

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16
Q

Pulsus paradoxus

A

A decrease in systolic BP of >10mmHg with inspiration; seen in cardiac tamponade

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17
Q

Classic ECG findings in pericarditis

A

Low-voltage, diffuse ST-segment elevation

18
Q

Definition of HTN

A

BP >140/90mmHg on 3 separate occasions 2 weeks apart

19
Q

Eight surgically correctable causes of HTN

A

Renal artery stenosis (RAS), coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism

20
Q

Evaluation of a pulsatile abdominal mass and bruit

A

Abdominal US and CT

21
Q

Indications for surgical repair of abdominal aortic aneurysm

A

> 5.5cm, rapidly enlarging, symptomatic or ruptured

22
Q

Tx for acute coronary syndrome

A

ASA, heparin, clopidogrel, morphine, oxygen, sublingual nitroglycerin, IV beta-blockers

23
Q

Metabolic syndrome

A

Abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombic or proinflammatory states

24
Q

Appropriate diagnostic test?

  1. 50 yr old man with stable angina can exercise to 85% of maximum predicted heart rate
  2. A 65 yr old woman with left bundle branch block and severe osteoarthritis has unstable angina
A
  1. Exercise stress treadmill with ECG

2. Pharmacologic stress test (eg dobutamine echo)

25
Q

Target LDL in a px with diabetes

A
26
Q

Signs of active ischemia during stress testing

A

Angina, ST-segment changes on ECG, or decreasing BP

27
Q

ECG findings suggesting MI

A

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves

28
Q

Coronary territories in MI

A

Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal)

29
Q

A young px with angina at rest and ST-segment elevation with normal cardiac enzymes

A

Prinzmetal’s angina

30
Q

Common sx’s associated with silent MIs

A

CHF, shock, and altered mental status

31
Q

Diagnostic test for pulmonary embolism (PE)

A

Spiral CT with contrast

32
Q

Protamine

A

Reverses the effects of heparin

33
Q

Prothrombin time

A

The coagulation parameter affected by warfarin

34
Q

A young px with a family history of sudden cardiac death collapses and dies while exercising

A

Hypertrophic cardiomyopathy

35
Q

Endocarditis prophylaxis regimens

A

Oral surgery: amoxicillin for certain situations

GI or GU procedures: not recommended

36
Q

Virchow’s triad

A

Stasis, hypercoagulability, endothelial damage

37
Q

The most common cause of HTN in young women

A

OCPs

38
Q

The most common cause of HTN in young men

A

Excessive EtOH

39
Q

Figure 3 sign

A

Aortic coarctation

40
Q

Water bottle shaped heart

A

Pericardial effusion; look for pulsus paradoxus

41
Q

Classic ECG findings in atrial flutter

A

“Sawtooth” P waves

USMLE Step 2 Rapid Review (2 decks)

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