Diagnostics In Cardiology

Question 1

With a Holter monitor, patients keep a symptom diary and it is compared to their data. How often do these match up?

Answer 1

Very rare. Patients are mostly asymptomatic during recording peroid.

Question 2

Which test is described as subcutaneous monitoring device

Answer 2

Implantable loop recorder

Question 5

I want to evaluate my patient for septal defect or a patent foramen ovale. What test should I order?

Answer 5

Transesophageal Echocardiogram TEE

Question 6

My patient might have myocarditis. What test should I order?

Answer 6

YOU shouldn’t order anything. The cardiologist will order an MRI

Question 8

What are the cardiac enzymes that can be tested. which one is used the most often

Answer 8

CK (creatine kinase)
CK-MB
Troponin (used most often)

Question 9

Which diagnostic exam is continuous ECG monitoring on a video screen

Answer 9

Telemetry

Question 10

Why is a CT scan not that useful in cardiac diagnostic

Answer 10

Motion of the heart

Question 12

What test should be done post-resuscitation from a cardiac arrest

Answer 12

Catheterization/angioplasty

Question 13

You want to give your patient Dobutamine for a stress test, but they have ___________ so you cannot.

Answer 13

AFib

LBBB

Question 15

My patient has unstable angina, what test should I order

Answer 15

Catheterization/Angioplasty

Question 17

What are the risks associated with catheterization/angioplasty

Answer 17

Bleeding
Arrhythmia
Vessel injury
Post-procedure bleeding

Question 20

I want to determine the chamber size of my patient. What test should I order?

Answer 20

Transthoracic Echocardiogram TTE

Question 22

I want to evaluate my patient for ascending aortic atherosclerosis. What test should I order?

Answer 22

Transesophageal Echocardiogram TEE

Question 23

Which test is an ultrasound directed AT the heart

Answer 23

Transthoracic Echocardiogram

Question 26

What device is used to detect the tracer in a nuclear medicine imaging stress test

Answer 26

Gamma ray detection camera

Question 27

Which diagnostic test is the gold standard for CAD

Answer 27

Cardiac catheterization/ angiogram

Question 28

Which test should I order to monitor ST segment abnormalities

Answer 28

Holter Monitor

Question 30

With an event recorder, the patient must activate themselves when they are symptomatic. What time frame does the recorder capture

Answer 30

Previous 2-5 min + next few min

Question 31

Does my patient have endocarditis? Not sure, so I’ll order this test:

Answer 31

Transesophageal echocardiogram TEE

Question 33

I want to evaluate my patient for myocardial motion. What test should I order?

Answer 33

Transesophageal Echocardiogram TEE

Question 34

When is the peak of cardiac enzymes

Answer 34

18-24 hours

Question 35

What type of patient would get an implantable loop recorder

Answer 35

Infrequent symptoms

Syspected arrhythmia + non-invasive tests were negative

Question 36

In catherterization/Angiogram, dye is injected into the groin arm or neck, and patetncy is viewed via

Answer 36

Fluoroscopy

Question 38

What is the difference in deteching ischemia between an exercise ECG stress test and nuclear medicine imaging stress test

Answer 38

Nuclear medicine imaging can detect the specific areas of ischemia, location/size of the injured muscle, and narrowing arteries whereas exercise ECG cannot

Question 39

I suspect valvular pathologies on my patient. Which tests could confirm this

Answer 39

Transesophageal Echocardiogram TEE | Transthoracic Echocardiogram TTE

Question 40

What type of ischemia would you be testing for if you ordered an echocardiogram stress test

Answer 40

Ischemia related to development of wall motion abnormality with stress

Question 42

I had my patient do a stress test, and they experienced angina. What do I do now?

Answer 42

Catheterization/Angioplasty

Question 43

Which diagnostic test is described as ambulatory ECG

Answer 43

Holter monitor

Question 44

I’m thinking my patient has an aortic dissection. What tests could confirm this?

Answer 44

Transesophageal Echocardiogram TEE CT scan MRI

Question 47

How does a stress test work

Answer 47

Increase myocardial oxygen demand to reveal hypoperfusion in diseased coronary arteries. Compare to resting

Question 48

What is a CT scan useful for

Answer 48

Thoracic aorta Pericardium Aortic dissection Coronary artery calcium deposits

Question 49

What is the difference between a Holter monitor and Event Recorder

Answer 49

Holter monitor = continuous 24-48 hours | Event recorder = needs activation from patient, 30-60 days

Question 50

What can be used for pharmacologic stress if exercise is not possible

Answer 50

Adenosine Dipyridamole Dobutamine

Question 52

An MRI can evaluate myocardial perfusion with a __________ contrast during ___________ stress

Answer 52

Gadolinium | Adenosine

Question 53

What test should be done before valve surgery if they have chest pain or ECG changes

Answer 53

Catheterization/Angioplasty

Question 55

I want to evaluate the valve function and structure of my patient. What test should I order?

Answer 55

Transthoracic Echocardiogram TTE

Question 58

Which is the least expensive cardiac diagnostic test

Answer 58

ECG

Question 59

My patient has a history of MI and current ECG changes. What do I do now?

Answer 59

Catheterization/Angioplasty

Question 60

Holter monitor is best at detecting:

Answer 60

Syncope Palpatations Heart rate variability ST segment

Question 63

I want to calculate my patients ejection fraction. What test should I order?

Answer 63

Transthoracic Echocardiogram TTE

Question 64

I want to evaluate the diastolic function of my patient. What test should I order?

Answer 64

Transthoracic Echocardiogram TTE

Question 65

How long can creatine kinase (CK) and CK=-MB be detectable in the blood after a cardiac event

Answer 65

36-48 hours

Question 69

I want to evaluate my patients wall motion after they had an MI. What test should I order?

Answer 69

Transthoracic Echocardiogram TTE

Question 72

Which diagnostic test is a smaller ultrasound probe down the esophagus behind the heart

Answer 72

Transesophageal echocardiogram

Question 74

How long can troponin be detected in the blood after a cardiac event

Answer 74

Up to 10 days

Question 77

Which test is usually done FIRST

Answer 77

ECG

Question 80

High sensitivity troponin can detect levels as low as

Answer 80

5 ng/dL

Question 82

What is injected for a nuclear medicine imaging stress test

Answer 82

Thalium 201 or Technetium-99m

Question 83

When performing an exercise stress test, what are you looking for?

Answer 83

ECG changes Increased heart rate Symptom development

Question 88

When is ECG done as a solitary assessment

Answer 88

Almost NEVER

Question 94

When is the onset of cardiac enzymes

Answer 94

3-12 hours