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Samplex Flashcards

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1
Q

Characteristics with decreased likelihood of AMI

A

Inframammary
Sharp
Reproducible
Positional
Pleuritic

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2
Q

Top 5 characteristics with increased likelihood for AMI

A

Radiates to R arm/shoulder
Radiates to both arms
Exertion
Radiates to L arm/shoulder
Diaphoresis
Associated with nausea and vomiting

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3
Q

Qualities of severe MR

A

S3
Short rumbling diastolic murmur

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4
Q

MVP location of murmur if:
-posterior leaflet affected
-anterior leaflet affected

A
  • anterior and medial: base of <3
    -posterior and lateral: Apex
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5
Q

Laplace law states what?

A

Tension = (ventricular pressure X diameter) wall thickness

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6
Q

Cannon A waves signify what?

A

Cannon A waves - simultaneous contraction of atrium and ventricles

AV dissociation
3rd AVB
Pulmonary HTN

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7
Q

Which of the following will cause an atrioventricular
block?

A. Hypokalemia
B. Hypomagnesemia
C. Hyperthyroidism
D.Adrenal insufficiency

A

D. Adrenal insufficiency

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8
Q

Arrhythmia with irregular atrial and ventricular rate

A

AFib and MFAT

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9
Q

Narrow complex tachycardia with VA block V> A

A

Junctional tachycardia

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10
Q

Indication for at least 3 months of Warfarin therapy + full dose anticoagulation post MI

A

-Heart failure
-Severe LV dysfunction
-Afib
-Anterior wall infarct
-History of embolism

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11
Q

Angiographic success
after percutaneous interventions

A

Reduction of stenosis to less than 20%

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12
Q

Operative cut-offs for ASCENDING thoracic aneurysm

A

> /= 5.5 cm
0.5 cm growth/yr
4.5 cm for bicuspid AV for AVR due to severe AS or AR
4-5 cm for Marfan syndrome

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13
Q

Operative and endovascular repair cut offs for DESCENDING thoracic aneurysm

A

> 6cm for OR for degenerative reason
5.5 cm consider for endovascular repair

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14
Q

Drug of choice for thoracic aortic aneurysm

A

Beta blocker

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15
Q

Operative cut off for abdominal aneurysm

A

> 5.5 cm

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16
Q

’

Diastolic murmur heard at the left sternal border

A
  • bicuspid aortic valve
    -endocarditis
    -prolapse
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17
Q

Are most arrhythmias associated with palpitations?

A

No

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18
Q

What phase of systolic cycle and grade of murmur is 2D echo warranted?

A

holosystolic and late systolic; grade III and higher

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19
Q

Anticoagulation indications for Afib

A

-prior stroke
-MS
-hypertrophic CM

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20
Q

Warfarin as anticoagulation of choice in what conditions?

A

-Rheumatic MS
-Mechanical valves

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21
Q

Indications for ICD in post MI

A
  • > 40 days post MI, EF < =30%
    -NYHA II-III, EF < 35%
    -> 5 days post MI with HFrEF, NSVT, inducible VT
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22
Q

ECG findings associated with VT

A

-AV dissociation
- R or Rs in AVR
-No rS or Rs in V1-V6

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23
Q

Lab results with worse outcomes in
patients with acute decompensated heart failure

A

BUN > 43 mg/dL
SBP <115
Elevated Trop I
Crea > 2.75 mg/dL

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24
Q

Acute
mitral regurgitation occurring in the setting of acute myocardial
infarction is due to rupture of which papillary muscle>

A

Posteromedial papillary

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25
What type of exercise treadmill test should be done 1 week post MI?
Heart rate limited TST *as early as 6 days after
26
Indications for coronary arteriography
1. CSAP severely symptomatic despite med tx 2. Questionable diagnosis 3. Survived cardiac arrest 4. Ventricular dysfunction on non invasive testing 5. High risk for coronary events + severe findings on non invasive findings
27
Anti hypertensive with erectile dysfunction side effect
Beta blockers
28
Anti hypertensive contraindicated in HOCM
Nitrates
29
Drugs to give and avoid in Prinzmetal agina
1. Nitrates and CCB first line 2. Avoid Aspirin 3. statin may be of benefit
30
Recommendation for abdominal aneurysm screening
Abdominal ultrasound for 65-75 who ever smoked
31
First line in aortic dissection management and targets
1. Beta blocker (propranolol, esmolol, metoprolol) = target HR 60 2. Nitroprusside = target SBP <=120 3. Verapamil/Diltiazem as alternative **Hydralazine contraindicated
32
Most frequent sites of PAD
Femoral + popliteal > tibia and peroneal > iliac and abdominal aorta
33
Indication for mitral valvuloplasty while pregnant
Severe MS
34
a. Gallavardin effect b. Carvallo’s sign c. Graham Steel murmur d. maladie de Roger
a. Gallavardin effect – aortic stenosis b. Carvallo’s sign – tricuspid regurg c. Graham Steel murmur – pulmonic regurgitation d. maladie de Roger – small ventricular septal defect
35
11. Severe LV systolic dysfunction 12. Hypertrophic obstructive 13. Severe obstructive lung disease
11. Pulsus alterans 12. Bifid pulse 13. Pulsus paradoxus
36
Clinical diagnosis of cardiotoxicity
Symptomatic: >5% EF reduction with EF < 55% Asymptomatic: >10% EF reduction with EF <55%
37
Antiarrhythmic medications have high potency but slowest kinetics
a. flecainide
38
Postural orthostatic tachycardia syndrome diagnosis
> 30 bpm or >120 HR within 10 mins of standing without hypotension
39
Most common form of paroxysmal supraventricular tachycardia
AVNRT
40
Usual atrial rate of atrial flutter
240-300 bpm
41
Most common electrolyte abnormality associated with premature ventricular contractions
Hypokalemia
42
Drugs can be administered in-hospital to augment or unmask ST elevation in affected individuals with Brugada syndrome
Flecainide
43
Inotropic agent retains its effectiveness in the presence of concomitant beta blocker therapy
Milrinone
43
Symptom confers poor prognosis because of the shortest average time to death after the onset of symptoms
HF
44
Traube’s sign
Pistol shot at femoral artery
45
Duroziez's sign
To and fro murmur femoral artery
46
Medications that can retard aortic root dilatation
Beta blockers and ARB
47
CKD stage V presented with symptoms of acute idiopathic pericarditis, which of the following medications should be avoided
Colchicine and anticoagulants
48
Most common cause of large-vessel renal artery occlusive disease
Clonidine
49
First line inotropic agent for treatment of pulmonary embolism related shock
Dobutamine
50
Recommended appropriate treatment goal for patients with statin therapy
30% or greater reduction in LDL-C or LDL-C less than 70mg/dl
51
Diagnosis of HTN in 24 hr BP monitoring
Asleep : >/= 120/75 Awake >/= 135/85
52
Target BP with benefits
<135-140/80-85
53
Definition of malignant hypertension
Syndrome with abrupt increase in BP to those with underlying HTN or sudden onset HTN in a previously normotensive individual
54
Ischemic ST segment response
>0.1 mV flat or downsloping compared to PR segment for more than 0.08 secs
55
Indications to stop TST
Symptoms (dizziness, dyspnea, chest discomfort) ST depression >0.2 mV SBP fall > 10 Ventricular tachyarrhythmia
56
Mainstay anticoagulation in ACS
UFH
57
Different types of MI
1 - atherosclerotic 2- Ischemic imbalance 3- Death but biomarkers are unavailable 4- PCI related: >5x elevation if initial is normal; >20% if baseline is elevated + new symptoms/new ECG findings/LBBB 5-CABG: >10x elevation
58
Criteria for ST elevation
Female: V2-V3: >1.5mm Male > 40: > 2mm Male < 40: > 2.5mm *All other leads >1mm
59
NTproBNP or BNP can elevated in what circumstances
WARR Women Age Renal dysfunction R sided HF
60
Cardinal symptoms of HF
Fatigue and shortness of breath
61
Main mechanism of dyspnea in HF
Pulmonary congestion: Increase in intraalveolar fluid
62
Pathophysiology of long QT syndromes
LQTS 1 and 2: K LQTS 3: Na
63
Settings of long QT occurrence
LQT1: Swimming LQT2: Auditory stimuli/emotional stimuli LQT3: Sleep
64
Increased risk of long QT
QTc > 0.5 s Female History of syncope/cardiac arrest
65
Treatment for prolonged QTc
Non selective beta blocker (nadolol and propranolol)
66
Decade when idiopathic fibrosis of the AV node starts
40 years old
67
Part that is involved in acute anterior MI
distal AV node complex resulting in wide unstable escape rhythms
68
Alcohol consumption that leads to chronic alcoholic CM
5-6 drinks daily for 10 years
69
Cardiac function can recover after how many months of abstinence
3-6 months of abstinence
70
When does PPCM occur?
Last trimester until 6 months
71
Risk factors for PPCM
-increased maternal age -increased parity -mutations in TTN
72
Potential therapy for PPCM
Bromocriptine
73
How many years post anthracycline exposure is systolic dysfunction evident?
1 yr
74
Therapy for PPCM
BB and ACE-i
75
TSAT threshold for hemochromatosis
> 60% men > 45-50% female
76
Treatment for Takotsubo CM?
Nitrates
77
In which infection is cardiac the MC cause of death?
Diptheria - 1/2 of cases
78
MC cause of infective cause of CM?
Chagas' Disease - conduction and rhythm problems; thrombogenic LV Tx: -HF meds -Anticoagulation
79
Therapy for all kinds of amyloid?
Loop diuretics
80
Medical treatment for HOCM
Beta blockade Non dihydropyridine CCB Disopyramide
81
Medication that reduce rate of aortic dilatation by blocking TGF B signaling?
Angiotensin antagonist
82
Target monitoring parameters for aortic dissection
HR ~60 SBP <= 120
83
Treatment for aortic dissection
1) IV beta blocker: esmolol/propranolol 2) IV nitroprossuide 3) If Stanford A: emergent surgical correction
84
Debakey and Stanford Classification for Aortic Diseases
Debakey 1- Ascending + descending aorta 2. Ascending only 3. Descending only Stanford A- Ascending B- Arch of aorta and/or Descending
85
MC clinical sign of IE?
Fever then Heart murmur
86
MC lab finding in IE?
Anemia
87
Abx regimen for prosthetic valves IE MSSA and MRSA
Gentamicin (2 weeks) and Rif (6-8) weeks for both MSSA: Nafcillin/oxacillin 6-8 wks MRSAL Vancomycin 6-8 wks
88
Abx regimen for MSSA and MRSA native valve IE
Cefazoloin/Oxacillin +/- Vancomycin if MRSA
89
Emergent/same day OR for IE indications
Cardiogenic shock/pulmonary edema Acute AR with preclosure of MV Ruptured sinus of valsava in R heart Rupture into pericardial sac
90
ABI cutoffs and interpretation
<0.9 abnormal 0.91-0.99 Borderline 1-1.4 Normal >1.4 Noncompressove
91
C of CEAP
C0 no signs of venous disease C1 Telangiectasia C2 Varicose veins C3 edema C4 skin changes (hyperpig, eczema) C5 Healed ulcer C6 active venous ulcer (C6r recurrent)
92
Indications for surgery for MVP with severe primary MR
Symptomatic LV dysfunction Recent onset AF PAH

CVS Recall (2 decks)

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