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Step 3 Final > Aaron: Cardiology > Flashcards

Aaron: Cardiology Flashcards

1
Q

LVEF under 60% is considered normal or abnormal?

A

Abnormal

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2
Q

Intense aortic stenosis has what characteristic?

A

Single second heart sound during inspiration

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3
Q

Asymmetric swelling is code for what disease?

A

DVT most of the time

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4
Q

Acute Decompensated Heart Failure, what drug should be avoided?

A

Metroprolol

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5
Q

If I have a heart attack and a history of an Upper GI bleed 2/2 H. Pylori, does this disqualify me from getting aspirin?

A

No, if it has resolved, all good

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6
Q

85% of open-heart surgery cases can have what un-intended consequence?

A

Constrictive pericarditis, EKG may not show ST elevation in all leads

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7
Q

Sine wave pattern, after receiving chemotherapy can cause what?

A

Arrythmia 2/2 hyperkalemia

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8
Q

Persistent Multifocal Atrial Tachycardia usually occurs why?

How many P wave Morphologies are needed to make this diagnosis?

A

Underlying disease such as Electrolytes and Pulmonary Disease

3 p-wave morphologies

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9
Q

Sudden death upon exercise in young adults, most likely is what underlying problem?

A

Anomalous Coronary Artery

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10
Q

What is the worse risk factor in an aging individual via Coronary Artery Disease?

A

Diabetes Mellitus

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11
Q

Bicuspid Aortic Valve disease in an asymptomatic young adult, what is the next best step?

A

Screen First Degree Relatives

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12
Q

All new unexplained heart failure patients get what test?

A

Treadmill Stress Test

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13
Q

Young male with unexplained foot pain, sudden blood clot in leg, apical diastolic murmur, what is the most likely cause?

A

Left Atrial Myxoma

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14
Q

What age do men have secondary hypertension 2/2 renal stenosis?

A

60-65 years old

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15
Q

What is the underlying cause of secondary hypertension in a 28 year old male?

A

Renal Parenchymal Disease

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16
Q

Can Mechanical Valve patients be switched from warfarin to DOAC instead?

A

No, studies do not show that a DOAC is as safe as Warfarin

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17
Q

Regardless of PAD feelings, what is the first medication addition regardless of the lab status?

A

Cholesterol medication

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18
Q

In the PAD algorithm, where is Cilastozol?

A

After statin/aspirin addition, supervised exercise program

Cannot jump right to this despite what might be thought

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19
Q

Will heart function return after Trastuzumab is removed?

A

Yes

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20
Q

Chest pain, but no ST elevations, some ST inversions, what is the best treatment?

A

Medical Management, no Cath Lab right away

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21
Q

Medication for Heart Failure stage 1 is ACE, Beta Blocker, Diuretics. What is the next drug to add in stage 2?

A

Spironolactone
Help improve mortality

Must be careful with K, dont give with a K over 5 or CKD and elevated K

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22
Q

Post STEMI Pericarditis, what is the first drug to be given?

A

Aspirin, no naproxen and colchicine (other NSAIDs besides Aspirin do not help with heart healing)

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23
Q

With Pericarditis, will ST elevation and PR depression in all leads always be there? Even with a friction rub?

A

NO!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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24
Q

62 year old female with chest pain, negative stress test means what?

A

Less than a 1% chance of CV problems in the next year

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25
Q

A-fib with RVR, what is the DOC?

A

Metoprolol or Verapamil (non-dihydropyridine Calcium channel blocker)

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26
Q

Young female recent cocaine use, left arm pain, negative EKG, negative CT scan, BP 130/80, left arm and leg weakness, what should I think about?

A

Aortic Dissection

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27
Q

If a young male has crazy high BP, no real past medical history, what is the next best step?

A

Start medications, do not go hunting for Conn syndrome or anything

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28
Q

If a young male has crazy high BP, no real past medical history, what is the best drug combination to place him on?

A

Calcium Channel Blocker and ACE inhibitor

P.S. check his lipids

29
Q

Recent car accident and family drama (1 day ago), chest pain, ST elevation, clean coronary Cath, what should I think about?

A

Takasobu Cardiomyopathy, left LV wall hypokinesis

30
Q

What type of pain does an aortic dissection present with?

A

Tearing chest pain versus heart attack is pressure pain

31
Q 
Sudden Cardiac Death family history
Sustained Ventricular Arrythmia
Syncope 2/2 Ventricular Arrythmia
LV Hypertrophy with wall thickness > 30mm
LV EF < 50%

These are all indications of what?

A

A young individual receiving an ICD

32
Q

Do you or do you not shock in PEA or asystole?

A

You DO NOT shock in PEA or asystole

33
Q 
Patient presents with 
Loud S1, Loud P2
Broad and Notched P wave (P-Mitrale)
Mid Diastolic Rumble
Dyspnea
Hemoptysis
A

Rheumatic Heart Disease

Mitral Stenosis

34
Q

Post Coronary Cath, the groin has the following, what could they be?

Has a mass, no bruit?

Bulging, pulsatile mass and systolic Bruit?

No Mass, continuous Bruit?

A

Hematoma

Pseudoaneurysm

AV Fistula

35
Q

A young woman with unexplained pulmonary hypertension, what is a strong lifestyle suggestion?

A

No pregnancy at this time and regular supervised aerobic activity

36
Q

___________ drug inhibits digoxin tubular secretion.

A

Verapamil

37
Q

True or False, isolated V1 T-wave inversions are normal

A

True

38
Q

What age bracket is an S3 normal under?

A

40 years old

39
Q

What is a second DOC in HOCM management after beta blockers?

A

Verapamil

40
Q

Warfarin goal for Aortic Valve Replacement?

Warfarin goal for Mitral Valve Replacement?

A

INR 2.0-3.0

INR 2.5-3.5

41
Q

Most effective way to decrease blood pressure is?

A

Lose weight

42
Q

Best way to control CHF exacerbation blood pressure?

Why not Metoprolol?

A

Nitroglycerin, hit veins, decreases venous preload

If the heart is slow in this CHF episodes, a beta blocker will slow the heart down further, and the pulmonary edema can get worse

43
Q

What is the best drug for an Aortic Dissection?

A

Beta Blocker (Esmolol)

44
Q

S3 heart sound means what?

A

Blood fills an enlarged ventricles

45
Q

S4 heart sound means what?

A

Stiff ventricular wall

46
Q

If I am taking rivaroxaban, and I need surgery, should I stop it?

A

Yes, stop two days before surgery, no need to heparin bridge

47
Q

Quick physical exam feature difference between Marfan’s Syndrome and Ehler’s Danlos Syndrome?

A

Ehler’s Danlos has skin manifestations, Marfan’s does not

48
Q

If a young, 38-year-old male comes in with sudden heart failure, what is something to think about?

A

Autoimmune disease, Marfan’s Disease, Ehler’s Danlos, MVP, collagen problems

49
Q

A young female, hx of Rheumatic fever, comes with SOB, MS, what is the first thing to rule out?

A

Pregnancy, can exacerbate MS/heart problems with extra fluid on board

50
Q

Papillary Muscle ruptures, usually think what?

Chordiae Tendonaie, usually in young people, rupture think what?

A

Recent MI

Collagen problem, Marfan’s or Ehler’s Danlos Syndrome

51
Q

If I have a heart problem and history of bilateral inguinal hernias (16 years old), what is something to think about?

A

Marfan’s or Ehler’s Danlos Syndrome

52
Q

Bicuspid Aortic Valve, what is a commonly associated disease, as well?

A

Thoracic Aortic Aneurysm

53
Q

Young male, crescendo decrescendo murmur at heart’s apex, worse with Valsalva, what am I?

A

HOCM

54
Q

Heart Failure, low EF, but asymptomatic, no medication being taken, what drug should be started?

A

ACE inhibitor and eventually beta blocker

55
Q

Post Heart Attack, how long does a low-risk patient have to wait to resume sexual activity?

A

3-4 weeks

56
Q

When I give diuretics to a patient, besides getting rid of fluid, I am doing what to the heart?

A

Decreasing Pre-load

57
Q

When I have a CHF problem, do I give Beta Blockers?

A

No, the goal is not to slow the heart down, the goal is to relieve fluid the heart has to move, i.e. give diuretics not beta blockers

58
Q

Maybe heart attack, no ST elevations, how long does it take for a troponin to be positive?

When is the peak?

A

2-3 hours

12-48 hours is the peak

59
Q

Heart attack
CK-MB takes how long to elevate?
How long to normalize?

A

4-6 hours

48-72 hours

60
Q

BNP is broken down by neprilysin, what drug can affect this drug value?

A

ACE inhibitor, as a result, the patient has bad BNP clearance, not a reliable marker

61
Q

If there is suspected CHF exacerbation, what are other signs that NEED to be there?

A 
Fluid on lungs
Elevated JVD
Difficulty breathing
Peripheral Swelling
S3
Orthopnea
Orthopnea at night, cannot lay flat

If some combination is not here, look for something else, i.e COPD

62
Q

Does squatting, supine leg raising increase or decrease venous return?

A

Increase venous return

63
Q

Does standing or Valsalva increase or decrease venous return?

A

Decrease venous return

64
Q

Crescendo descrendo murmur in systole is code for what?

A

Aortic Stenosis

65
Q

MVP is an ejection or non ejection murmur?

A

Non-ejection murmur

66
Q

Do MVP/HOCM murmurs increase or decrease with increased venous return?

Do AS/AR/MS/MR murmurs increase or decrease with increased venous return?

A

decrease* (these are the exceptions)

increase

67
Q

Atenolol is cleared by the liver or the kidney?

What disease could cause Beta blocker toxicity?

A

Kidney

CKD can cause problems

68
Q

Calcium gluconate can treat what kind of toxicity?

A

Verapamil toxicity

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