Cardiovascular disorders

Question 1

coronary arteries fill during _____________ (diastole / systole)

Answer 1

diastole

Question 2

What do the numbers represent in the pressure-volume loop?

Answer 2

1. mitral valve opening
2. ventricular filling
3. mitral valve closing
4. isovolumetric contraction
5. aortic valve opening
6. ejection
7. aortic valve closing
8. isovolumetric relaxation

Question 3

what are the criteria for initiating a moderate or high intensity statin?

Answer 3

• clinical ASCVD
• LDL over 190
• DM AND age 40-75
• 10 yr ASCVD risk 7.5% AND age 40-75

Question 4

what is the site of action of fibrates?

Answer 4

blood - stimulate lipoprotein lipase

Question 5

TPA decreases mortality if used within ____ hours post-MI

Answer 5

12

Question 6

what is the treatment for type I heart block?

Answer 6

• adjust doses of medications associated with heart block
• pacemaker ONLY IF SYMPTOMATIC BRADYCARDIA

Question 7

type I heart block is caused by a conduction defect in what part of the heart?

Answer 7

intranodal or His bundle

Question 8

type II heart block is caused by a conduction defect in what part of the heart?

Answer 8

INFRAnodal (His bundle, Purkinje fibers)

Question 9

what is the treatment for type II heart block?

Answer 9

pacemaker

Question 10

paroxysmal SVT is an arrhythmia that arises in which location(s)?

Answer 10

atria or aV junction

Question 11

what is the usual cause of PSVT?

Answer 11

reentry anomaly (AV nodal reentry, AV reentry)

Question 12

what is the difference between AV nodal reentry and AV reentry?

Answer 12

• AV nodal reentry: fast and slow pathways
• AV reentry (WPW): extra pathway

Question 13

what is the pharmacological therapy for nodal reentry tachycardia?

Answer 13

• nodal reentry: BB or CCB
• reentry (WPW): type Ia or Ic, or catheter ablation

Question 14

what is the cutoff for administering cardioversion in a patient with A fib?

Answer 14

two days - if after two days, must confirm that there is no thrombus (if there is a thrombus, anticoag and wait 3-4 weeks before cardioversion)

Question 15

MOA of antiarrhythmics

Answer 15

• Ia: sodium channel blockers (prolong AP)
• Ib: sodium channel blockers (shorten AP)
• Ic: sodium channel blockers (no effect on AP)
• II: BBs
• III: potassium channel blockers
• IV: calcium channel blockers
• Other: potassium channel actviation (decrease in intracellular cAMP)

Question 16

quinidine and procainamide are examples of what class of antiarrhythmic?

Answer 16

Ia (sodium channel blockers - prolong AP)

Question 17

lidocaine and tocainide are examples of what class of antiarrhythmic?

Answer 17

Ib (sodium channel blockers - shorten AP)

Question 18

flecainide and propafenone are examples of what class of antiarrhythmic?

Answer 18

Ic (sodium channel blockers - no effect on AP)

Question 19

what is the equation for EF?

Answer 19

EF = SV / EDV

Question 20

what is the pharmacologic therapy for systolic HF?

Answer 20

• loop diuretic (decrease preload)
• ACE-I or ARB (decrease preload and afterload and increase CO)
• add BB once stable on ACE-I
• add aldosterone blocker (spironolactone or eplerenone) in select patients

Question 21

what is the pharmacologic therapy in diastolic HF?

Answer 21

• CCB, ARB, ACE-I to control BP
• BB to control HR and decrease workload

Question 22

what is the murmur type for aortic stenosis?

Answer 22

systolic ejection (crescendo-decrescendo)

Question 23

what is the murmur type for mitral regurg?

Answer 23

holosystolic

Question 24

what is the murmur type for tricuspid regurg?

Answer 24

holosystolic

Question 25

what is the murmur type for MVP?

Answer 25

late systolic (with click)

Question 26

what is the murmur type for aortic regurg?

Answer 26

early diastolic

Question 27

what is the murmur type for mitral stenosis?

Answer 27

mid/late diastolic

Question 28

what does valsalva do to AS?

Answer 28

decrease

Question 29

what is an austin flint murmur? in which type of valvular disease is it seen?

Answer 29

- late diastolic rumble - aortic regurg

Question 30

what is the quincke sign? in which condition is it seen?

Answer 30

- capillary pulsations in nail bed, more visible when pressure is applied - aortic regurg

Question 31

what is the pharm therapy for hypertrophic cardiomyopathy?

Answer 31

BB, CCB

Question 32

what is the pharm therapy for dilated cardiomyopathy?

Answer 32

diuretics, ACEI, BB, anticoag

Question 33

equal pressure in all chambers on cardiac catheterization = ?

Answer 33

chronic constrictive pericarditis

Question 34

what is the treatment for chronic constrictive pericarditis?

Answer 34

- NSAIDs - colchicine - surgical excision of pericardium

Question 35

acute rheumatic fever is caused by untreated group ___ strep

Answer 35

group A