PCM

Question 1

Pre HTN?

Answer 1

120-139/80-89

Question 2

stage 1 HTN?

Answer 2

140-159/90-99

Question 3

stage 2 HTN?

Answer 3

> 160/>100

Question 4

s3 due to? heard where? when? with what?

Answer 4

blood flow from atria to vents
apex
early diastole
bell

Question 5

S4 due to? heard where? when? with what?

Answer 5

atrial contraction
ICS2
late diastole
diaphragm

Question 6

loud crescendo-decrescendo systolic murmur? where is it heard best?

Answer 6

aortic stenosis

Right ICS2

Question 7

risk factors for calcific AS?

Answer 7

hypercholesterolemia
DM
HTN
smoking
rheumatic fever

Question 8

what is the most common valvular disease in the developed world?

Answer 8

AS

Question 9

When is AS referred for aortic valve replacement?

Answer 9

once symptomatic

Question 10

in AS, w/o surgical tx, avg overall survival in symptomatic patients is ___ years

Answer 10

2-3 years

Question 11

when AS is severe, systolic murmur may become ____, ___ is absent, ___ is present, see ___ carotid upstroke

Answer 11

inaudible
S2
S4
delayed

Question 12

Murmurs in mitral regurg: describe it, heard best? loud ___, quiet ___, louder with ___

Answer 12

holosystolic
apex
loud S3
quiet S1
Valsalva

Question 13

Diastolic blowing murmur? heard where?

Answer 13

aortic regurg

L sternal border

Question 14

when does aortic regurg murmur increase?

Answer 14

handgrip or squatting

Question 15

rumbling diastolic murmur? heard best where? loud ___?

Answer 15

mitral stenosis
apex
S1 is loud

Question 16

machine like murmur? heard best where?

Answer 16

PDA

L ICS2

Question 17

most common cardiac (structural) palpitation? most common noncardiac cause?

Answer 17

MVP

panic disorder

Question 18

Can normal resting ECG rule out arrhythmia?

Answer 18

no, ECG is just a snapshot

Question 19

what reduces the likelihood that palpitations are caused by arrhythmias?

Answer 19

family Hx of panic disorder

palpitations lasting <5 minutes

Question 20

mid systolic click? what kind of murmur?

Answer 20

MVP

late systolic or pan-systolic

Question 21

inheritance of MVP?

Answer 21

AD with variable penetrance

Question 22

most common arrhythmia in clinical practice

Answer 22

atrial fib

Question 23

what arrhythmia has an increased risk of stroke?

Answer 23

a fib

Question 24

what are the CHADs criteria and how many points for each?

Answer 24

previous stroke or TIA (2)
>75 (1)
HTN (1)
DM (1)
HF (1)

Question 25

tx for CHAD score 2-6? 1? 0?

Answer 25

warfarin warfarin or aspirin aspirin

Question 26

most common cause of systolic HF?

Answer 26

CAD (60-70% of cases)

Question 27

most common cause of diastolic HF?

Answer 27

HTN

Question 28

common causes of HF?

Answer 28

CAD HTN idopathic cardiomyopathy valvular heart disease

Question 29

pulmonary edema is only seen in ___ failure

Answer 29

LV

Question 30

what can rule in HF?

Answer 30

``` displaced cardiac apex (major) S3 (major) edema PND JVD orthopnea crackles murmur ```

Question 31

what can rule out HF?

Answer 31

absence of dyspnea on exertion | reduced BNP

Question 32

NYHA HF class 1: limitations? sx?

Answer 32

none, none

Question 33

NYHA HF class 2: limitations? sx?

Answer 33

mild limitations of physical activity | symptoms on exertion, comfortable at rest or with mild activity

Question 34

NYHA HF class 3: limitations? sx?

Answer 34

marked limitation of physical activity | HF symptoms with mild exertion, only comfy at rest

Question 35

NYHA HF class 4: limitations? sx?

Answer 35

any activity | symptoms at rest

Question 36

what is the most common cause of death in women?

Answer 36

CVD

Question 37

Chest pain in women features...

Answer 37

delayed dx fewer interventions dx tests less accurate lower pretest probability

Question 38

what is the initial care of a suspected acute MI?

Answer 38

``` MONA Morphine Oxygen Nitroglycerine Aspirin ```

Question 39

What improves survival post MI?

Answer 39

beta blocker

Question 40

clinical triad with pericarditis?

Answer 40

chest pain friction rub diffuse ST (and PR depression without flipped T waves)

Question 41

presentation with costochondritis?

Answer 41

sick a few weeks ago with cold/flu | sharp stabbing pain

Question 42

what are causes of aortic dissection?

Answer 42

HTN, cocaine, tertiary syphilis (marfans, Ehrlos danlos)

Question 43

What is motivational interviewing?

Answer 43

uses pt insignt as means for exploring attitude/behavioral changes that would benefit their health

Question 44

who controls the interaction in motivational interviewing?

Answer 44

patient