2nd BLOCK Flashcards

1
Q

The procedure of choice for reduction in transvalvular gradients in symptomatic infants and children with Aortic Stenosis.

A

Aortic Valvotomy with CBP

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2
Q

A drug used in acute HF that enhances myocardial contraction by increasing cAMP, resulting in activation of protein kinase, and phosphorylation of slow calcium channels.

A

Dobutamine

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3
Q

The decrease in blood pressure to indicate pulsus paradoxus should be:

A

At least 10 mmHg

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4
Q

During ward rounds, a resident physician encounters a dyspneic patient with ascites and bipedal edema. Two years ago, the patient was diagnosed with heart failure and has been in and out of the hospital since then. During endorsement, the resident physician shared some information regarding heart failure. Which of his statement below is incorrect?

• Heart failure is a progressive disorder in which the heart is unable to pump sufficient blood to meet the needs of the body
• The cardinal symptoms of HF are dyspnea, fatigue, and fluid retention
• Three-fourths of HF cases are due to hypertension, making it the predominant cause of heart failure
• Chronic activation of the SNS and the RAAS is associated with remodeling of cardiac tissue, loss of
myocytes, hypertrophy, and fibrosis
• 60-75% of HF patients die within 5 years

A

Heart failure is a progressive disorder in which the heart is unable to pump sufficient blood to meet the needs of the body

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5
Q

A patient is to undergo a partial pericardiectomy. This procedure is best described as:

A

A surgical procedure where the visceral pericardium is removed.

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6
Q

A “seal bark” or “brassy” cough is usually appreciated in a patient with:

A

Vascular Rings

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7
Q

Mr. Basco has a pericardial effusion with tamponade. He is most likely to describe chest pain that

A

Decreases when he is leaning forward

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8
Q

Genetic mutations of any of the four genes that encode proteins of the cardiac contractile elements such as sarcomeric proteins are more likely seen in which type of cardiomyopathy?

A

Hypertrophic Cardiomyopathy

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9
Q

Which of the following vegetative endocarditidis is likely to present with small vegetation on either sides of
leaflets?

  • Non-thrombotic Bacterial Endocarditis
  • Subacute Bacterial Endocarditis
  • Rheumatic Heart Disease
  • Libman-Sacks Endocarditis
A

Libman-Sacks Endocarditis

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10
Q

Which of the following types of Cardiomyopathy is associated with dystrophin gene mutation?

  • Restricted Cardiomyopathy
  • Dilated Cardiomyopathy
  • Hypertrophic Cardiomyopathy
  • None of the above
A

Dilated Cardiomyopathy

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11
Q

A common sequelae of large ventricular septal defect, requiring early surgical repair

A

intractable congestive heart failure

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12
Q

The signs and symptoms of chylomicron retention disease appear in the first few months of life and they include the following EXCEPT:

  • Hypercholesterolemia
  • none of the above
  • Failure of weight-gain and growth
  • Diarrhoea & Vomiting
  • Steatorrhea
A

None of the above

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13
Q

Class 1C Antiarrhythmic

  • Hydralazine
  • Flecainide
  • Verapamil
  • Dobutamine
  • Lidocaine
A

Flecainide

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14
Q

A 60-year-old alcoholic man was admitted to the hospital with a 2-day history of epigastric pain associated with nausea, vomiting, and diarrhea. The man was diagnosed with heart failure a year ago, and his symptoms have improved with captopril, furosemide, and digoxin. On admission, hypokalemia, increased creatinine, and premature ventricular contractions were noted. Which of the following adjustments would be appropriate for the patient?

  • Reduce digoxin dose and increase furosemide dose
  • Discontinue digoxin and start losartan
  • Reduce digoxin dose and give potassium supplements
  • Discontinue digoxin and start milrinone
A

Discontinue digoxin and start milrinone

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15
Q

Ms. Jimenez has a cardiac tamponade and will require medical treatment. The medical intervention that would first be used is:

A

Removing the fluid from the pericardial space.

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16
Q

A 4th year medical student took the blood pressure of patients. Which of the following results that he documented needs to be corrected?

  • Mr. L has stage 2 HPN, with BP of 140/100
  • Mrs. B has stage 1 HPN, with BP of 130/90
  • Mr. D has a blood pressure of 110/70, which is within normal range
  • Ms. S is prehypertensive, with BP of 130/90
A

Ms. S is prehypertensive, with BP of 130/90

17
Q

In a patient with Transposition of Great Vessels (TGA), in order to achieve and maintain adequate saturations, the following procedure should be done.

  • provide constant oxygen via face mask
  • infuse prostaglandin E1
  • provide intermittent oxygen via nasal cannula
  • infuse indomethacin
A

infuse indomethacin

18
Q

Which is incorrectly paired?

  • All of the above
  • none of the above
  • Atrial Septal Defect: Chest Radiograph may show evidence of increased pulmonary vascularity w/ prominent hilar markings and cardiomegaly
  • TAPVC: Chest Radiograph will show normal sized heart with generalized pulmonary edema
  • Truncus Arteriosus: Chest Radiograph consistent with pulmonary over-circulation and a right aortic arch can be appreciated 90% of the time
  • Aortic Coarctation: Chest Radiograph may show “rib notching”
A

TAPVC: Chest Radiograph will show normal sized heart with generalized pulmonary edema

19
Q

ACE inhibitors are contraindicated during the 2nd and 3rd trimesters of pregnancy because of the following risks, except:

  • Fetal anuria and renal failure
  • Fetal hypotension
  • Fetal malformation
  • Premature contractions and labor
A

Premature contractions and labor

20
Q

Which side effect is associated with amlodipine?

  • Edema
  • Cough
  • QT prolongation
  • Bradycardia
A

Edema

21
Q

What is the classical term for angina caused by coronary vasospasm?

A

Prinzmetal angina

22
Q

What are absolute contraindications for pericardiocentesis?

  • Post infarction myocardial rupture
  • Aortic dissecting aneurysm
  • Trauma
  • None
A

None

23
Q

A 34-year old woman sought consultation at the emergency room due to palpitations, fatigue and worsening chest pain which she claimed to have been recurring over the last 2 years. She was afebrile on physical examination. Her pulse rate is 75/minute, respiratory rate of 15/ minute and blood pressures of 110/70 mmHg. A midystolic click with late holosystolic murmur is noted on chest auscultation. The patient admitted to having one or two anxiety attach each month. What is the likely condition the patient is suffering from?

A

Mitral valve prolapse

24
Q

The preferred method of treating cyanide poisoning:

A

Sodium nitrite

25
Q

REFERENCE VALUES: AST

A

5-30 U/L at 37 ⁰C

26
Q

A patient with a stage III breast cancer of her left breast is considered at risk for developing cardiac tamponade primarily because of her

A

Treatment with radiation therapy of 3000 cGy.

27
Q

Functional regurgitation is likely seen in which of the following conditions?

  • Narrowing of the valve
  • Thickening of the mural endocardium
  • Dilatation of the annular ring of the tricuspid valve
  • Pulling of papillary muscle downward and upward
A

Pulling of papillary muscle downward and upward

28
Q

While advising a patient with Stage A heart failure, she asks regarding specific foods high in sodium. What will be your response?

  • Pizza
  • Apple
  • Fish in ginger broth
  • Oatmeal
A

Pizza