Cardiovascular

Question 1

What is the best initital test for all forms of chest pain?

Answer 1

ECG

Question 2

Q waves are consistent with what?

Answer 2

a prior MI

Question 3

What is used to confirm the diagnosis of angina?

Answer 3

stress test

Question 4

How is ischemia detected on a stress test?

Answer 4

ST segment depression > 2mm

+/- T wave

Question 5

If a patient has a positive stress test what’s next?

Answer 5

cardiac catheterization

Question 6

What test is more sensitive in detecting ischemia?

Answer 6

exercise stress echocardiography

Question 7

Stress test is C/I in who?

Answer 7

unstable angina , MI, aortic dissection , aortic stenosis, uncontrolled HTN, ventricular arrhythmias

Question 8

How do you diagnosis stable angina pectoris?

Answer 8

positive stress test

perfusion scintigraphy testing

Question 9

What is the txt for stable angina?

Answer 9

beta blockers, ACEI, statins, aspirin, CCB, coronary angioplasty, coronary artery bypass graft surgery

Question 10

How many times can sublingual nitroglycerin be admin?

Answer 10

q 5mins up to 3x

Question 11

What is the definitive procedure for angina?

Answer 11

coronary angiography

Question 12

What medication is used for immediate relief of acute angina?

Answer 12

nitroglycerin

Question 13

What is the 1st line therapy for angina?

Answer 13

b blockers

Question 14

If a pt can’t take a beta blocker for their angina what’s the alternative?

Answer 14

CCB

Question 15

Metabolic Syndrome

Answer 15

abdominal obesity, triglycerides > 150, HDL <40 men, <50 women, fasting glucose >110 and HTN

Question 16

What drug is associated with MI?

Answer 16

cocaine

Question 17

What is the #1 risk factor for MI?

Answer 17

Smoking

Question 18

Angina w/wo ST elevation, but normal artery

Answer 18

Prinzmental variant angina

Question 19

How is prinzmetal’s angina diagnosed?

Answer 19

ECG at time of attack

Question 20

How does prinzmetal’s angina look on ECG?

Answer 20

ST elevation

Question 21

What is the txt for prinzmetal angina?

Answer 21

CCB

Question 22

What is C/I in Prinzmetal angina?

Answer 22

beta blockers

Question 23

What is the best test for diagnosing CHF?

Answer 23

Echocardiogram

Question 24

What is the gold standard for diagnosing right heart failure?

Answer 24

right heart cardiac catherization

Question 25

What lab is elevated in CHF?

Answer 25

BNP

Question 26

What is the treatment of systolic left heart failure?

Answer 26

ACEI + Beta blocker + Loop Diuretic

Question 27

What is the txt for diastolic heart failure?

Answer 27

ACEI + B blocker or CCB

Question 28

What are the 3 beta-1 selective used for CHF?

Answer 28

Bisoprolol Carvedilol Metoprolol succinate

Question 29

What is a feature of systolic heart failure?

Answer 29

S3

Question 30

What does S3 mean?

Answer 30

rapid ventricular filling during early diastole

Question 31

What feature is diastolic heart failure?

Answer 31

S4

Question 32

What drug should NEVER be used for diastolic CHF?

Answer 32

Digoxin

Question 33

What is the most common cause of right heart failure?

Answer 33

left heart failure

Question 34

Left sided heart failure is characterized by?

Answer 34

pulmonary congestion, exertional dyspnea and cough, fatigue, orthopnea, basilar rales, nocturnal dyspnea

Question 35

Right sided heart failure due to chronic lung disease?

Answer 35

Cor pulmonale

Question 36

What is Dressler syndrome?

Answer 36

pericarditis, fever, leukocytosis, and pericardial or pleural effusion occurring 1-2 weeks after MI

Question 37

Two complications of pericarditis?

Answer 37

pericardial effusion and cardiac tamponade

Question 38

Chest pain that is worse when supine and during inspiration and alleviated when leaning forward

Answer 38

pericarditis

Question 39

When is pericardial friction rub best heard?

Answer 39

upright and leaning forward

Question 40

What is Dressler's syndrome?

Answer 40

pericarditis 2-5 days after an acute MI

Question 41

MC viral cause of pericarditis?

Answer 41

Coxsackievirus

Question 42

What does EKG show for pericarditis?

Answer 42

diffuse, ST segment elevations in the precordial leads

Question 43

What is Kussmaul's sign?

Answer 43

an increase rather than normal decrease in CVP during inspiration

Question 44

Txt of pericarditis?

Answer 44

txt the underlying disease | NSAIDs

Question 45

Txt of pericardial effusion?

Answer 45

pericardiocentesis

Question 46

What causes uremic pericarditis?

Answer 46

effect of untreated kidney disease

Question 47

Define primary hypertension?

Answer 47

>130/80 on two readings at two separate visits with NO identifiable cause

Question 48

stage 1 hypertension?

Answer 48

130-139/ 80-89

Question 49

stage 2 hypertension?

Answer 49

>140/90

Question 50

What is seen on fundoscopic exam for a pt with hypertension?

Answer 50

arteriovenous nicking

Question 51

Txt for most hypertension also those w/ diabetes?

Answer 51

Ace or CCB or Thiazide diuretic

Question 52

Txt for stage 2 HTN?

Answer 52

2 hypertensive meds

Question 53

Txt for black adults w/ hypertension?

Answer 53

Thiazide and CCB

Question 54

SDE of acei

Answer 54

cough, hyperkalemia, C/I preggo

Question 55

Sde of spironolactone?

Answer 55

hyperkalemia

Question 56

Beta blockers are C/I in?

Answer 56

Asthma

Question 57

What does alpha blockers txt?

Answer 57

HTN and BPH

Question 58

sde of CCB?

Answer 58

leg edema

Question 59

sde of hydralazine?

Answer 59

lupus like syndrome and pericarditis

Question 60

Acute rebound hypertensive episode have been reported to occur with the sudden withdrawal of?

Answer 60

Clonidine

Question 61

sde of thiazide?

Answer 61

hypokalemia

Question 62

MC cause of secondary hypertension?

Answer 62

Primary aldosteronism

Question 63

In a hypertensive emergency, blood pressure must be reduced in ?

Answer 63

1 hr

Question 64

Bp of a hypertensive emergency?

Answer 64

>180/ > 120

Question 65

What is a hypertensive emergency

Answer 65

bp >180/>120 with end-stage organ damage

Question 66

What is a hypertensive urgency?

Answer 66

bp >180/>120 WITHOUT target end organ damage

Question 67

What is malignant HTN?

Answer 67

diastolic > 120 associated w/ papilledema and either encephalopathy or nephropathy

Question 68

Consequence of untreated malignant HTN?

Answer 68

progressive renal failure

Question 69

What drug can cause malignant htn?

Answer 69

MAOI

Question 70

DOC for hypertensive emergency?

Answer 70

sodium nitroprusside

Question 71

DOC for hypertensive urgency?

Answer 71

Clonidine

Question 72

DOC for malignant htn?

Answer 72

hydralazine

Question 73

Sde of sodium nitroprusside?

Answer 73

cyanide toxicity

Question 74

antidote for cyanide toxicity caused by sodium nitroprusside?

Answer 74

sodium thiosulfate

Question 75

Which hyperlipidemia medication cause flushing?

Answer 75

Niacin

Question 76

Severe hypertriglyceridemia >500 causes?

Answer 76

pancreatitis eruptive xanthomas lipemia retinalis

Question 77

Xanthomas are seen in?

Answer 77

hyperlipidemia

Question 78

Guidelines for fasting lipid panel on asymptomatic pts?

Answer 78

q 5 yrs

Question 79

Txt for hyperlipidemia?

Answer 79

statins, fibrates, niacin, fish oil

Question 80

Sde of statin?

Answer 80

myopathy, rhabdomyolysis

Question 81

What drug is used for the txt of isolated hypertriglyceridemia

Answer 81

gemfibrozil

Question 82

What is is endocarditis?

Answer 82

infection of the endocardium

Question 83

What causes acute bacterial endocarditis?

Answer 83

S. aureus

Question 84

What causes subacute bacteral endocarditis?

Answer 84

Strep viridans

Question 85

What causes endocarditis in IV drug users?

Answer 85

Staph aureus

Question 86

What causes prosthetic valve endocarditis?

Answer 86

Staph epidermidis

Question 87

Large vegetations in endocarditis is caused by?

Answer 87

Candida

Question 88

What is the txt for large vegetations in endocarditis?

Answer 88

Amp B

Question 89

MC cause of endocarditis?

Answer 89

Strep viridans

Question 90

What pathonogemics are seen in endocarditis?

Answer 90

Splinter hemorrhages Osler nodes- painful lesions Roth spots Janeway lesions

Question 91

Dx of endocarditis?

Answer 91

Blood cultures- before abx 3sets- 1hr apart | Transesophageal echocardiogram

Question 92

What is the gold standard for dx endocarditis?

Answer 92

Transesophageal echocardiogram

Question 93

Whom should receive prophylactic for endocarditis prior to dental procedure?

Answer 93

``` prosthetic heart valves hx of endocarditis unrepaired cyanosis heart disease congenital heart disease repaired w/ prosthetic device heart valve dx after heart transplant ```

Question 94

Txt for native valve endocarditis?

Answer 94

IV ampicillin plus nafcillin + gentamicin

Question 95

Txt for prosthetic valve endocarditis?

Answer 95

vancomycin + gentamicin + raifampin

Question 96

Txt for IV drug user endocarditis?

Answer 96

IV nafcillin

Question 97

Txt for pcn allergic pts with endocarditis?

Answer 97

vancomycin, clindamycin, cephalexin, azithromycin

Question 98

What is the abx prophylaxis for endocarditis?

Answer 98

2g of Amoxicillin 30-60 before procedure

Question 99

Which valve is affected with IV drug users w/ endocarditis?

Answer 99

Tricuspid

Question 100

What are Osler nodes?

Answer 100

PAINFUL, violaceous raised lesions of the fingers, toes, or feet

Question 101

What are Janeway lesoins?

Answer 101

PAINLESS, red lesions of the palms or soles

Question 102

What are Roth spots?

Answer 102

exudative lesions in the retina

Question 103

What criteria is used to establish endocarditis?

Answer 103

Duke

Question 104

Initial txt for pt with suspected endocarditis?

Answer 104

Vancomycin + cefepime

Question 105

What should be routinely check with statins?

Answer 105

CMK and LFTs

Question 106

1S Line thx for triglycerides?

Answer 106

Fibrates gemfibrozil

Question 107

What is the 2nd line txt for triglycerides?

Answer 107

Niacin

Question 108

High levels of triglycerides increase the chance of?

Answer 108

acute pancreatitis