IM Plat- Cardiology

Question 1

Defined as a persistently elevated blood pressure of >140/90 mmHg despite taking >3 anti-hypertensive agents including a diuretic.

Answer 1

Resistant hypertension

Question 2

PE finding in patients with cardiac tamponade wherein the systolic BP falls by >10 mmHg with inspiration.

Answer 2

Pulsus paradoxus

Question 3

PE finding in patients with pericardial effusion auscultated as a patch of dullness and increased fremitus below the left scapula.

Answer 3

Ewart’s sign

Question 4

Triads: Virchow’s triad

Answer 4

Stasis
Endothelial injury
Hypercoagulable state

Question 5

A PE finding in patients with AI seen as alternate flushing and paling of the skin at the root of the bail while pressure is applied to the tip of the nail.

Answer 5

Quincke’s pulse

Question 5

Triads: Wolff-Parkinson White syndrome

Answer 5

Widened QRS complex
Short PR interval
Delta wave

Question 6

What is the most common cause of CHF in industrialized countries?

Answer 6

Coronary artery disease

Question 7

What is the accepted and unifying hypothesis in the pathophysiology of Metabolic syndrome?

Answer 7

Insulin resistance

Question 8

What is the loading dose of aspirin in the management of ACS? maintenance dose?

Answer 8

LD: 162-325 mg/day
MD: 72-162 mg/day

Question 9

What is the major site of atherosclerotic disease?

Answer 9

Epicardial arteries (most common: LAD)

Question 10

What is the major site of atherosclerotic disease?

Answer 10

Epicardial arteries (most common: LAD)

Question 11

What is the usual duration of hospitalization for uncomplicated STEMI?

Answer 11

5 days

Question 12

What are the two cardinal symptoms of heart failure?

Answer 12

Shortness of breath and fatigue

Question 13

What is a cost-effective diagnostic test to identify non-cardiac causes of heart failure symptoms?

Answer 13

Chest xray

Question 14

Triads: Dressler’s syndrome

Answer 14

Fever, pleuritic pain, pericardial effusion

Question 15

What are the 2 cornerstone of modern heart failure treatment?

Answer 15

ACE-inhibitors and Beta blockers

Question 16

What is the most common artery involved in focal spasms of Prinzmetal angina?

Answer 16

Right coronary artery

Question 17

This is an increase in the intensity of the holosystolic murmur of tricuspid regurgitation with inspiration seen in patients with cor pulmonale.

Answer 17

Carvallo’s sign

Question 17

What is the most common artery involved in focal spasms of Prinzmetal angina?

Answer 17

Right coronary artery

Question 19

Give the 2 absolute contraindications to nitrate use.

Answer 19

Hypotension

Use of sildenafil or similar drugs in prev. 24-48 hrs

Question 20

Give the 2 absolute contraindications to nitrate use.

Answer 20

Hypotension

Use of sildenafil or similar drugs in prev. 24-48 hrs

Question 21

What are the indications for coronary artery bypass grafting?

Answer 21

1. 3-vessel CAD
2. 2-vessel CAD with involvement of LAD
3. > 50% stenosis of the left main coronary artery

Question 22

When is the best time to measure cardiac troponins in patients with suspected ACS?

Answer 22

12 hours after occurrence of first symptoms

Question 23

What is the alternative drug used to maintain cardiac contractility in patients with contraindications to beta-blockers?

Answer 23

Non-DHP CCB (Verapamil, Diltiazem)

Question 24

What is the most common cause of out-of-hospital deaths in patients with STEMI?

Answer 24

Ventricular fibrillation

Question 25

What are the 2 indications for fibrinolysis?

Answer 25

STEMI and new onset LBBB

Question 25

In the supportive care of patients with STEMI, careful ambulation in the room may start on what day post-MI?

Answer 25

Day 2

Question 27

Most complications of MI have a bimodal peak and occurs within _____.

Answer 27

1-14 days

Question 27

What is the most common cause of cardiogenic shock?

Answer 27

Severe LV dysfunction

Question 29

What vasopressor should you administer to a patient with acute pulmonary edema with SBP

Answer 29

Dobutamine 2-20 mcg/kg/min IV

Question 30

What vasopressor should you administer to a patient with acute pulmonary edema with SBP

Answer 30

NE 0.5-30 mcg/min IV or | Dopamine 5-15 mcg/kg/min

Question 31

What is the hallmark of carditis in patients with rheumatic fever?

Answer 31

Valvular damage

Question 32

Duration of prophylaxis for patients with RF with mild carditis.

Answer 32

10 years after last attack or until 21 years old

Question 33

Duration of prophylaxis for patients with RF with moderate to severe carditis.

Answer 33

10 years after last attack or until 40 years old

Question 33

It is a form of endocarditis resulting from hypercoagulable state.

Answer 33

Marantic endocarditis

Question 34

What is the most specific presentation of rheumatic fever?

Answer 34

Syndenham chorea

Question 35

Blood cultures of a patient with IE showed growth of MSSA. What is the antibiotic of choice and its duration?

Answer 35

Nafcillin or Oxacillin x 4-6 weeks

Question 36

Blood cultures of a patient with IE showed growth of MRSA. What is the antibiotic of choice and its duration?

Answer 36

Vancomycin x 4-6 weeks

Question 37

Blood cultures of a 43-yr old female with prosthetic valve IE showed growth of Staph aureus. What is the antibiotic of choice and its duration?

Answer 37

Vancomycin x 4-6 weeks + Gentamicin x 2 weeks + Rifampin x 6-8 weeks

Question 38

What is the normal ABI?

Answer 38

>1.0

Question 39

What is the most common symptom of peripheral artery disease?

Answer 39

Intermittent claudication

Question 40

Triads: Buerger's disease

Answer 40

Claudication Raynaud's phenomenon Migratory superficial vein thrombophlebitis

Question 41

What is the most common cause of midsystolic murmur in adults?

Answer 41

Aortic stenosis

Question 42

What is the most common cause of midsystolic murmur in adults?

Answer 42

Aortic stenosis

Question 43

What is the most common congenital cardiovascular cause of hypertension?

Answer 43

Coarctation of the aorta

Question 45

What is the most common complication of angioplasty?

Answer 45

Restenosis