Rapid Review

Question 1

Classic ECG finding in atrial flutter

Answer 1

Sawtooth P waves

Question 2

Definition of unstable angina

Answer 2

Angina that is new, is worsening, or occurs at rest

Question 3

Antihypertensive for a diabetic patient with proteinuria

Answer 3

ACEi

Question 4

Beck’s triad for cardiac tamponade

Answer 4

Hypotension

Distant heart sounds

JVD

Question 5

Drugs that slow HR

Answer 5

B-blockers

CCBs

Digoxin

Amiodarone

Question 6

Hypercholesterolemia tx that leads to flushing and pruritus

Answer 6

Niacin

Question 7

Murmur - HOCM

Answer 7

Systolic ejection heard along lateral sternal border that increases with lower preload (Valsalva)

Question 8

Murmur - AR

Answer 8

Austin Flint murmur

Diastolic, decrescendo low-pitched blowing murmur that is best heard sitting up.

Increases with increased afterload (handgrip maneuver)

Question 9

Murmur - AS

Answer 9

Systolic crescendo/decrescendo murmur that radiates to the neck

Increases with increased preload (squatting maneuver)

Question 10

Murmur - MR

Answer 10

Holosystolic murmur that radiates to the axilla

Increases with increased afterload (handgrip)

Question 11

Murmur - MS

Answer 11

Diastolic, mid-to-late low pitched murmur preceded by an opening snap

Question 12

Treatment for AFib and AFlutter

Answer 12

If unstable, cardiovert

If stable or chronic, rate control with CCBs or B-blockers

Question 13

Tx for VFib

Answer 13

Immediate cardioversion

Question 14

Dressler’s Syndrome

Answer 14

An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4w post MI

Question 15

IV drug use with JVD and a holosytolic murmur at the L sternal border. Tx?

Answer 15

Treat existing heart failure and replace the tricuspid valve.

Question 16

Diagnostic test for hypertrophic cardiomyopathy

Answer 16

Echo (showing thickened LV wall and outflow obstruction)

Question 17

Pulsus paradoxus

Answer 17

A decrease in systolic BP of more than 10 mmHg with inspiration

Seen in cardiac tamponade

Question 18

Classic ECG findings in pericarditis

Answer 18

Low-voltage, diffuse ST segment elevation

Question 19

Definition of HTN

Answer 19

BP above 140/90 on 3 separate occasions 2 weeks apart

Question 20

8 surgically correctable causes of HTN

Answer 20

1) Renal artery stenosis
2) Coarctation of the aorta
3) Pheochromocytoma
4) Conn’s Syndrome
5) Cushing’s Syndrome
6) Unilateral renal parenchymal disease
7) Hyperthyroidism
8) Hyperparathyroidism

Question 21

Evaluation of a pulsatile abdominal mass and bruit

Answer 21

Abdominal US and CT

Question 22

Indications for surgical repair of AAA

Answer 22

Greater than 5.5 cm

Rapidly enlarging

Symptomatic

Ruptured

Question 23

Tx for ACS

Answer 23

ASA
Heparin
Clopidogrel
Morphine
O2
Sublingual Nitro
IV B-blockers

Question 24

Metabolic syndrome

Answer 24

Abdominal obesity

High TGs

Low HDL

HTN

Insulin resistance

Prothrombic or proinflammatory states

Question 25

Appropriate diagnostic test? 1) 50 yo M with stable angina can exercise to 85% of maximum predicted HR 2) 65 yo F with LBBB and severe osteoarthritis has unstable angina

Answer 25

1) Exercise stress treadmill with ECG | 2) Pharm stress test (dobutamine echo)

Question 26

Target LDL in patient with diabetes

Answer 26

Less than 70

Question 27

Signs of active ischemia during stress testing

Answer 27

Angina ST segment changes on ECG Lower BP

Question 28

ECG findings suggesting MI

Answer 28

ST segment elevation (depression means ischemia) Flattened T waves and Q waves

Question 29

Coronary territories in MI

Answer 29

Anterior wall (LAD/Diagonal) Inferior (PDA) Posterior (L circumflex/oblique, RCA/marginal) Septum (LAD/diagonal)

Question 30

Young patient with angina at rest and ST segment elevation with normal cardiac enzymes

Answer 30

Prinzmetal's angina

Question 31

Common symptoms associated with silent MIs

Answer 31

CHF Shock AMS

Question 32

Diagnostic test for pulmonary embolism

Answer 32

Spiral CT with contrast

Question 33

Protamine

Answer 33

reverses effects of heparin

Question 34

Prothrombin time

Answer 34

Coagulation parameter affected by warfarin

Question 35

Young patient with FHx of sudden death collapses and dies while exercising

Answer 35

Hypertrophic cardiomyopathy

Question 36

Endocarditis ppx regimens

Answer 36

Oral surgery - amoxicillin for certain situations GI or GU procedures - not recommended

Question 37

Virchow's triad

Answer 37

Stasis Hypercoagulability Endothelial damage

Question 38

Most common cause of HTN in young women

Answer 38

OCPs

Question 39

Most common cause of HTN in young men

Answer 39

Excessive EtOH

Question 40

Figure 3 sign

Answer 40

aortic coarctation

Question 41

Water-bottle shaped heart

Answer 41

Pericardial effusion. Look for pulsus paradoxus