New perls from AMBOSS

Question 1

what is the rate control target on AFib?

Answer 1

The target resting heart rate for patients with Afib is < 110/minute for asymptomatic patients and < 80/minute for symptomatic patients

Question 2

Tx for asthmatic patient that presents with a SVT or an AVnRT

Answer 2

1st line valsalva
2nd line is adenosine BUT this can cause bronchosmasm.
that’s why you’ll better give:
3°.-BBlockers /CCB.

Question 3

chronic nitrate therapy Side effect and how to avoid it

Answer 3

tolerance . The most effective strategy to prevent this is intermittent therapy with nitrate-free intervals of at least 8 hours, which would be accomplished by avoiding isosorbide dinitrate at night.

Question 4

beta blocker intoxication. Clinical features

Answer 4

Bradycardia, hypotension, wheezing, confusion, hypoglycemia, and prolonged PR intervals

Question 5

beta blocker intoxication Treatment

Answer 5

1st IV fluids and atropine.. and dextrose?

2°line: glucagon

Question 6

pulmonary embolism (PE) + hemodynamic instability (e.g., SBP < 90 mm Hg) Treatment

Answer 6

thrombolysis with alteplase or other recombinant tissue plasminogen activators (tPA) is indicated.

Question 7

ARBs effects over:
urinary sodium excretion
Vessel tone
Renin activity
Angiotensin II level
Aldosterone Level

Answer 7

urinary sodium excretion ↑
Vessel tone ↓
Renin activity ↑
Angiotensin II level ↑
Aldosterone Level ↓

Question 8

what does an Echo reveals at pericardial effusion.

Answer 8

anechoic space between the pericardium and epicardium,

Question 9

pulmonary hypertension Dx

Answer 9

Right heart catheterization

Question 10

Amiodarone SE

Answer 10

pulmonary fibrosis, treated by stoping amd >glucocorticoid
Blue-gray skin discoloration
elevation in AST and ALT =stop amd

Question 11

Sick sinus syndrome synonym ?

Answer 11

Sinus bradycardia with sinus pause and junctional escape rhythm

Question 12

S4 gallop. is a common sign of

Answer 12

Decreased compliance of the left ventricle

Question 13

hyperviscosity syndrome

Answer 13

triad of mucosal bleeding, neurological symptoms, and visual changes

Question 14

polycythemia vera (PV) Patho

Answer 14

mutation in the Janus kinase 2

Question 15

mutation in the Janus kinase 2 is also seen in

Answer 15

polycythemia vera (PV)
 essential thrombocythemia (ET) and primary myelofibrosis (PMF).

Question 16

PV Dx Cx

Answer 16

all 3 major criteria
or
1 minor + 2 major

Question 17

PV major criteria

Answer 17

1 evidence of increased RBCs (↑ Hb, ↑ Hct)
2 bone marrow biopsy showing hypercellularity with trilineage growth
3 evidence of a mutation in the JAK2 gene.

Question 18

PV minor criteria

Answer 18

decreased EPO levels.

Question 19

primary Raynaud phenomenon Tx

Answer 19

Calcium channel blockers

Question 20

Small Kidney + hypertension =

Answer 20

should raise concern for renal artery stenosis

Question 21

should raise concern for renal artery stenosis Important sign

Answer 21

Abdominal bruit

Question 22

Scarlet fever signs

Answer 22

Sore throat and fever followed by a diffuse maculopapular rash, an erythematous tongue (strawberry tongue), and perioral pallor

Question 23

Abciximab main use

Answer 23

Glycoprotein IIb/IIIa antagonists such as abciximab are mainly used in high-risk patients with myocardial infarction undergoing percutaneous coronary intervention (PCI).

Question 24

wide pulse pressure with elevated systolic blood pressure and normal diastolic pressure. common finding of

Answer 24

A decrease in arterial compliance secondary to reduced arterial elasticity and increased stiffness is a common occurrence in the elderly population (> 60 years). It results in isolated systolic hypertension,

Question 25

most common cause of unexpected mortality after diagnostic or interventional cardiac catheterization.

Answer 25

retroperitoneal hemorrhage

Question 26

most common cause of mitral valve degeneration and subsequent mitral valve prolapse.
in developed countries

Answer 26

Myxomatous valve degeneration

Question 27

most common cause of mitral valve degeneration and subsequent mitral valve prolapse.
in undeveloped countries

Answer 27

Inflammatory valve degeneration, due to rheumatic fever

Question 28

The accumulation of fluid and protein in the lungs from ARDS disrupts alveolar surfactant and increases the force needed to maintain open alveoli. An increase in the pressure required to inflate the lungs is the result of a ________ in lung compliance,

Answer 28

decrease

Question 29

most important factor for cyanosis at Fallot T

Answer 29

Degree of right ventricular outflow obstruction.
When there is a high degree of RV outflow obstruction, blood will flow through the VSD instead of through the pulmonary artery for oxygenation in the lungs.

Question 30

Renal artery stenosis Cx Fx

Answer 30

Hypertension that is difficult to control, hypokalemia, and a significant increase in creatinine after adding an ACE inhibitor

Question 31

HOCM Echo findings

Answer 31

systolic anterior motion of the anterior mitral valve leaflet, asymmetrical septal hypertrophy, and septal wall thickness of >15 mm

Not exactly Reduced left ventricular ejection fraction. that’s why young guys can have this with no hypotension

Question 32

Idiopathic APBs 1st L treatment

Answer 32

avoid triggers,(caffeine +- alcohol consumption, stress, and smoking)

Question 33

Idiopathic APBs unstable treatment

Answer 33

electrophysiological evaluation with concurrent ablation or medical therapy with beta blockers can be considered