AAFP Cardiology

Question 0

Diabetes drug classes that should not be given to patients with heart failure?

Answer 0

Thiazolidiodiones

Metformin

Question 1

Most common cause of hypertension in children under six (work up)?

In older children and adults?

Answer 1

Renal parenchymal disease (UA, urine culture, renal ultrasound)

Essential hypertension

Question 2

Metformin contraindicated with?

Answer 2

Renal insufficiency or heart failure

Question 3

Optimal HF candidate for cardiac resynchronization therapy (pacemaker)?

Answer 3

#LVEF under 35%
#QRS over 120
#Sinus rhythm
#Maximal medical therapy (carvedilol 25 BID., furosemide 40 BID, ACE inhibitor 40 BID)

Question 4

Food shown to decrease risk of sudden cardiac death in patients with cardiovascular disease? (Mech)

Answer 4

Omega-3 fatty acids – (anti-inflammatory, antiplatelet, vasodilator, antiarrhythmics)

Question 6

Management of descending aortic dissection?

Answer 6

#Lower rate below 60 with beta blockers (propanolol or labetalol)
#Lower systolic blood pressure to 100-120 (nitroprusside)

*B-blocker must be given before nitroprusside to prevent reflex tachycardia

Question 7

Who should be screened for abdominal aortic aneurysms?

Answer 7

Male smokers age 65-75

Question 8

Patient presents with supraventricular tachycardia – treatment? If fails? If fails? If fails?

Answer 8

1. Adenosine
2. Verapamil or beta blocker
3. Flecainide or propafenone
4. DC cardioversion

Question 9

Monotherapy for hypertension and African-Americans should include these drugs? (instead of these drugs)

Answer 9

Calcium channel blockers and diuretics (beta blockers or ACE inhibitors)

Question 10

Renal failure will affect the dosing of what anticoagulant?

Answer 10

Lovenox

Question 11

Significance of new onset left bundle branch block in pt with MI?

Indicated treatment?

Answer 11

Occlusion of LAD

Thrombolytics

Question 12

Isolated systolic hypertension in the elderly – responds best to what drug class?

Answer 12

Thiazides

Question 13

Pt with depression – do not use these antihypertensives?

Answer 13

Beta blocker, clonidine

Question 14

Best initial test for peripheral vascular occlusive disease?

Answer 14

ABI

Question 15

Symptoms of congestive heart failure in infants are usually observed when?

Answer 15

Feeding

Question 16

Surgeries with the highest incidence of DVTs?

Answer 16

#neurosurgical procedures
#Orthopedic procedures

Question 17

Patient with aortic stenosis – do not perform this test?

Perferred treatment?

Effect of balloon valvotomy on survival?

Use of medical management?

Answer 17

Exercise stress test

Valve replacement

Does not prolong survival

Not effective

Question 18

Contraindications for beta blockers?

Answer 18

#Hemodynamic instability
#Severe asthma
#Heart block
#Bradycardia

Question 19

Leading cause of death among women?

Answer 19

Cardiovascular disease

Question 20

Who should get a resting EKG for surgery?

Answer 20

#Males over 45, females over 55
#Diabetes
#Chest pain
#Previous history of cardiac disease

Question 21

Perioperative drug to use in patients with prior MI?

Answer 21

Beta-blocker

Question 22

Before treating hyperlipidemia, need to rule out?

Answer 22

# diabetes
#Hypothyroidism
#Liver or renal disease

Question 23

Why should NSAIDs be avoided in patients with heart failure?

Answer 23

#Cause sodium and water retention
#Increases systemic vascular resistance (can cause cardiac decompensation)

Question 24

First-line treatment for a geriatric patient with a systolic blood pressure of at least 160?

Answer 24

Thiazides

Question 25

Treatment for pregnant patients with severe hypertension?

Answer 25

``` #Hydralazine #Labetalol #Oral nifedipine ```

Question 26

Drug associated with lower mortality in CHF patients?

Answer 26

ACE inhibitor

Question 27

Major risk factors for perioperative cardiovascular risk in the elderly?

Answer 27

``` #Unstable coronary syndrome #CHF #arrhythmias (AV block, ventricular arrhythmia, uncontrolled ventricular rate) #Severe valvular disease ```

Question 28

Intermediate risk factors for perioperative cardiovascular events in elderly?

Answer 28

``` #Mild angina #Previous MRI #Compensated CHF #Diabetes #Efficiency ```

Question 29

Two signs of peripheral vascular disease after exercise?

Answer 29

``` #Decrease in ABI #20 mm or Greater decrease in ankle systolic blood pressure ```

Question 30

Criteria for severe preeclampsia?

Answer 30

``` # blood pressure of 160/110 #Proteinuria over 5 g per day #Thrombocytopenia under 100,00 #LFT abnormalities #Epigastric/right upper quadrant pain #altered Mental status ```

Question 31

Renal failure will affect the dosing of what anticoagulant?

Answer 31

Lovenox

Question 32

Significance of new onset left bundle branch block in pt with MI? Indicated treatment?

Answer 32

Occlusion of LAD Thrombolytics

Question 33

Isolated systolic hypertension in the elderly – responds best to what drug class?

Answer 33

Thiazides

Question 34

Pt with depression – do not use these antihypertensives?

Answer 34

Beta blocker, clonidine

Question 35

Best initial test for peripheral vascular occlusive disease?

Answer 35

ABI

Question 36

Symptoms of congestive heart failure in infants are usually observed when?

Answer 36

Feeding

Question 37

Surgeries with the highest incidence of DVTs?

Answer 37

``` #neurosurgical procedures #Orthopedic procedures ```

Question 38

Patient with aortic stenosis – do not perform this test? Perferred treatment? Effect of balloon valvotomy on survival? Use of medical management?

Answer 38

Exercise stress test Valve replacement Does not prolong survival Not effective

Question 39

Contraindications for beta blockers?

Answer 39

``` #Hemodynamic instability #Severe asthma #Heart block #Bradycardia ```

Question 40

Leading cause of death among women?

Answer 40

Cardiovascular disease

Question 41

Who should get a resting EKG for surgery?

Answer 41

``` #Males over 45, females over 55 #Diabetes #Chest pain #Previous history of cardiac disease ```

Question 42

Perioperative drug to use in patients with prior MI?

Answer 42

Beta-blocker

Question 43

Before treating hyperlipidemia, need to rule out?

Answer 43

``` # diabetes #Hypothyroidism #Liver or renal disease ```

Question 44

Why should NSAIDs be avoided in patients with heart failure?

Answer 44

``` #Cause sodium and water retention #Increases systemic vascular resistance (can cause cardiac decompensation) ```

Question 45

First-line treatment for a geriatric patient with a systolic blood pressure of at least 160?

Answer 45

Thiazides

Question 46

Treatment for pregnant patients with severe hypertension?

Answer 46

``` #Hydralazine #Labetalol #Oral nifedipine ```

Question 47

Drug associated with lower mortality in CHF patients?

Answer 47

ACE inhibitor

Question 48

Major risk factors for perioperative cardiovascular risk in the elderly?

Answer 48

``` #Unstable coronary syndrome #CHF #arrhythmias (AV block, ventricular arrhythmia, uncontrolled ventricular rate) #Severe valvular disease ```

Question 49

Intermediate risk factors for perioperative cardiovascular events in elderly?

Answer 49

``` #Mild angina #Previous MRI #Compensated CHF #Diabetes #Efficiency ```

Question 50

Two signs of peripheral vascular disease after exercise?

Answer 50

``` #Decrease in ABI #20 mm or Greater decrease in ankle systolic blood pressure ```

Question 51

Criteria for severe preeclampsia?

Answer 51

``` # blood pressure of 160/110 #Proteinuria over 5 g per day #Thrombocytopenia under 100,00 #LFT abnormalities #Epigastric/right upper quadrant pain #altered Mental status ```