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Cardiology > Alpa-MKSAP > Flashcards

Alpa-MKSAP Flashcards

1
Q

If patient has intermediate risk of cardiovascular disease, which test can be done to further risk stratify in high or low risk?

A

High sensitivity C-reactive protein
(hsCRP)
3.0 mg/L is HIGH risk

OR
Coronary Artery Calcium Scoring
> 400 is HIGH Risk

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2
Q

Which are high intensity statins?

A

Atorvastatin 40-80 mg
Simvastatin 80 mg (Black Box Warning) .
Rosuvastatin 20-40 mg

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3
Q

Biggest modifiable risk factor for acute MI

A

Dyslipidemia

INTERHEART study

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4
Q

What ages (male and female) to give ASA 81 mg as primary prevention?

A

Men 45-79 ys

Women 55-79 yrs

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5
Q

What percentage in 10 year ASCVD scoring is considered HIGH Risk?

A

> 7.5%

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6
Q

How much Left Main Disease is needed for CABG?

A

Symptomatic and 50% stenosis

Asymptomatic and 70% stenosis

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7
Q

How to calculate TIMI score?

A
  1. ASA use in 7 days
  2. Two angina episodes in 24 hours
  3. ST- T wave changes
  4. (+) Biomarkers
  5. Known >50% coronary artery disease
  6. More than 3 Risk Factors (HTN, DLD, DM, Family Hx, Smoking)
  7. Age > 65
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8
Q

Most common arrhythmia after reperfusion?

A

AIVR- Acclerated Idioventricular Rhythm

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9
Q

Most Common Valvular Disease after Tetralogy of Fallot repair?

A

Pulmonary valve regurgitation

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10
Q

50% of patients with Aortic Coarctation will have this aortic valve abnormality

A

Bicuspid Aortic Valve

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11
Q

Which Chemotherapy agents associated with Cardiotoxicity?

Which are reversible?

A

Doxorubicin, daunorubicin, Mitozantrone and Trastuzumab

Anthracyclines are dose dependent and nonreversible
Trastuzumab is reversible

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12
Q

When is anticoagulation indicated for peripartum cardiomyopathy?

A

If LVEF less than 35% with peripartum cardiomyopathy due to risk of VTE

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13
Q

If Pregnant woman having ventricular arrhythmia, what medication?

A

Lidocaine, although Quinidine is preferred

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14
Q

Fetal Arrhythmia, what medication?

A

Procainamide

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15
Q

Antihypertensives in Pregnant Women?

A

Labetalol and Hydralazine

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16
Q

What anticoagulation is given to pregnant women with mechanical valves?

A

Warfarin

Can switch to heparin right before delivery due to warfarin’s AE of fetal intracranial hemorrhage

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17
Q

What ABI value diagnoses Peripheral Arterial Disease?

A

0.90

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18
Q

If ABI > 1.4, what’s the next step?

A

Toe-Brachial Index

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19
Q

Cilostazol is contraindicated in which patients?

A

Heart Failure! or LVEF

20
Q

What is pseudoclaudication?

A

Lumbar Spinal Stenosis

Improves with waist flexion and can be uncomfortable while standing still

21
Q

When to screen for Abdominal Aortic Aneurysm?

A

Men who smoked/still smoke btwn 65-75 yo

22
Q

When to surgically intervene Abdominal Aortic Aneurysm?

A

> 5.5 cm maximal aortic diameter in MEN, more than 0.5 cm growth in 1 year, symptomatic
OR
5.0 cm maximal aortic diameter in WOMEN

23
Q

What is Stanford type A? Type B?

A

Type A: aortic arch and ascending aorta

Type B: descending aorta (distal to left subclavian a.)

24
Q

When do you surgically intervene on type B Acute Aortic Syndrome?

A

Complications:

  1. Occlusion of a major aortic branch leading to end-organ ischemia
  2. Persistent severe hypertension
  3. Persistent pain
  4. Propagation of the dissection (which may be manifested by persistent or recurrent pain
  5. Aneurysmal expansion
  6. Rupture
25
Q

What specific ACE-I will treat Thoracic Aortic Aneurysm?

A

Losartan

26
Q

What is the difference between Acute Aortic Dissection and Acute Intramural Hematoma?

A

Dissection has interruption of intima with intimal flap and false lumen within media
Hematoma has crescent shaped hematoma within media but no interruption of intima

27
Q

After diagnosing Marfan Syndrome, how often should you perform Echo to check for aortic root dilation/aneurysm?

A

Echo 6 months after Dx and then annually

28
Q

Which types of Congenital Heart Disease cause Eisemengers Syndrome?
How to manage Eisemengers Syndrome?

A

Severe PAH–> PDA, VSD, ASD

Iron deficiency increases symptoms, so treat it
(Increased Hgb/Hct is physiologic/normal, no phlebotomy)
Avoid dehydration, high altitude, and air emboli in IV lines

29
Q

50% of Bicuspid Aortic Valve patients have this other CHD?

A

Aortic Coarctation

30
Q

What are XRAY findings of Aortic Coarctation?

A

figure 3 sign
OR
rib notching- dilation of intercostal arteries

31
Q

If patient has cryptogenic stroke and patent foramen ovale, how do you manage?

A

Antiplatelet

32
Q

What type of valvular heart disease is a late complication of Tetralogy of Fallot repair?

A

Pulmonary Valve Regurgitation

33
Q

What Congenital Heart Disease is associated with fixed splitting and right ventricular heave?

A

Atrial Septal Defect

34
Q

What Congenital Heart Disease is associated with upper extremity hypertension and radial to femoral artery pulse delay?

A

Aortic Coarctation

35
Q

Noonan syndrome is associated with which congential heart disease?

A

Pulmonary Valve Stenosis

36
Q

For Pulmonary Valve Stenosis, at which peak gradient is considered SEVERE?

A

Peak gradient > 60 mm Hg

37
Q

Target INR for mechanical aortic valve?

Target INR for mechanical mitral valve?

A

Mechanical Aortic Valve INR: 2.5

Mechanical Mitral Valve INR: 3.5

38
Q

How long do you anticoagulate bioprosthetic valve?

A

3 months

39
Q

When to check TTE for valvular heart disease?

first presentation

A

systolic murmur 3/6, diastolic murmur OR symptoms

40
Q

Surgical indication for Aortic Valve Replacement with AS?

A
  1. Symptomatic patients with severe aortic stenosis

2. Asymptomatic patients with severe aortic stenosis LV ejection fraction

41
Q

What Aortic Valve Area (AVA) in Aortic Stenosis is considered SEVERE?

A
42
Q

What type of murmur is associated with Bicuspid Aortic Valve….?

A

Diastolic OR Systolic murmur, with an ejection

43
Q

Surgical Indication for Mitral Regurgitation?

A
  1. Symptomatic acute severe mitral regurgitation
  2. Symptomatic chronic severe mitral regurgitation with LV EF > 30%
  3. Asymptomatic chronic severe mitral regurgitation and mild to moderate LV dysfunction
44
Q

Triad seen with Cardiac Tamponade?

A

JVD
Hypotension
Pulsus Paradoxus
Sinus tachycardia/Electrical Alternans

45
Q

Name 5 causes of Acute Pericarditis?

A

Viral, tuberculosis, HIV, neoplasm, trauma, uremia, radiation, hydralazine penicillin, chemotherapy, autoimmune causes

46
Q

How to treat frequent Premature Ventricular Contractions?

What is considered frequent PVCs?

A

Symptomatic or frequent PVCs (>10,000 PVCs/24 hours or >10% of all beats)
First-line therapy: β-blocker or calcium channel blocker therapy
2nd line therapy: catheter ablation

47
Q

What valvular disease is common after atrial fibrillation ablation?

A

Pulmonary Valve Stenosis

Cardiology (1 decks)

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