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Uworld Step 2 > Block 59, 60: Cardio > Flashcards

Block 59, 60: Cardio Flashcards

1
Q

what drugs should be withheld for at least 48 hours prior to cardiac testing? when should you not withhold 48 hours prior?

A

beta blockers
calcium channel blockers
nitrates

CAD is present

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2
Q

how do you screen for abdominal aortic aneurysm

A
  • male active or former smokes ages 65-75 with one-time US
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3
Q

what has a high sensitivity for diagnosis for CHF

A

brain natriuretic peptide

BNP

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4
Q

What improves cardiovascular and overall long-term mortality in patients with ST-elevation MI

A

restoration of coronary blood with primary percutaneous intervention or fibrinolysis

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5
Q

Patients with persistent tachyarrythmia ( narrow - or wide-complex) causing hemodynamic instability should be managed how

A

immediate synchronized cardioversion

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6
Q

what is a regular-narrow-complex tachycardia called

A

supraventricular tachycardia

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7
Q

what is cor pulmonale

A

impaired function of the right ventricle due to pulmonary hypertension, usually due to chronic lung disease

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8
Q

long-term tobacco use, chronic cough, barrel-shaped chest, elevated jugular venous pressure, and enlarged liver

A

COPD with cor pulmonale

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9
Q

S4 sound indicates

A

left ventricular hypertrophy from prolonged hypertension

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10
Q

what nonpharmacologic interventions has greatest impact on high blood pressure

A

DASH diet

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11
Q

when do you use an Holter monitor

A

oupatient, identify intermittent arrhythmias in patients with symptoms

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12
Q

how are patients with persistent symptomatic PACS be managed

A

low-dose beta blocker

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13
Q

what is the most common primary cardiac tumor? where is it mostly located

A

Myxomas

left atrium

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14
Q

3 types of clinical features of cardiac myxoma

A
  • constitutional
  • cardiovascular
  • embolization
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15
Q

what electrolyte abnormalities in CHF patients parallels the severity of heart failure

A

Hyponatremia

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16
Q

what heart arrhythmias is specific for digtialis toxcity

A

atrial tachycardia with AV block

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17
Q

clinical features of cyanide toxicity

A
  • altered mental status
  • lactic acidosis
  • seizures
  • coma
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18
Q

when does seizure occur in alcohol withdrawl

A

12-48 hours

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19
Q

what can norepinephrine do to the fingers/toes

A

ischemia of distal fingers and toes secondary to vasospasm

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20
Q

young patient from a developing country, has progressive dyspnea, nocturnal cough, and hemoptysis has

A

rheumatic

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21
Q

abdominal pain and nausea/vomiting are atypical presentations of what

A

acute coronary syndrome

22
Q

who are more likely to have atypical symptoms of acute coronary artery disease

A

women
elderly
diabetics

23
Q

what is the mainstay therapy in patients with alcoholic cardiomyopathy

A

complete cessation of alcohol

24
Q

main reason for orthostatic hypotension in elderly

A

decreasing baroreceptors sensitivity and defects in myocardial response to this reflex

25
Q

patient with muscle weakness, recurrent nephrolithiasis, neuropsychtiatric symptoms, hypercalcemia

A

primary hyperparathyroidism

26
Q

significant hypertension with primary hyperparathyroidism suggests a possbile

A

multiple endocrine neoplasma MEN 2

with pheochromocytoma

27
Q

what are some studies you can do for venous thrombosis

A

D-dimer levels

venous doppler study

28
Q

management of acute limb ischemia after MI with possible arerial embolus from LV thrombus

A
  1. anticoagulation
  2. vascular surgery consultation
  3. TEE
29
Q

Cutaneous flushing and intensive generalized pruritus are well known side effects of what? why? antidote?

A

niacin: prostaglandin-induced peripheral vasodilation

- low dose aspirin

30
Q

why do you do adrenal veins sampling

A

differentiates between adrenal hyperplasia and adenoma , both are causes of primary hyperaldosteronism

31
Q

common cause of secondary hypertension in females

A

fibromuscular dysplasia

32
Q

common causes of cardiac chest pain

A

GERD and esophageal motility

33
Q

3 clinical features of esophageal origin of chest pain

A
  1. prolonged pain lasting more than an hour
  2. postprandial symptoms
  3. heartburn or dysphagia
34
Q

pleuritic chest pain, dyspnea, tachypnea, and tachycardia in long-distance truck driver

A

PE

35
Q

statin medications are recommended for primary prevention in patients with

A

age 40-75

10 year risk of atheroscolertic cardiovasuclar disease equal or greater than 7.5%

36
Q

define exertional heat stroke

A

body temp greater than 104

CNS dysfunction

37
Q

what is a complication that can occur 4 days following an MI

A

Peri-infarction pericarditis

38
Q

what causes Wolff-Parkinson White

A

accessory pathway that bypasses the AV node and directly connects atria to ventricles

39
Q

EKG finding for wolff-parkinson-white

A
  • short PR interval
  • delta wave ( slurred initial upstroke of QRS complex)
  • QRS widening
  • ST/T wave changes
40
Q

most effective intervention in overweight patients with hypertension

A

Loose weight

41
Q

how does nitroglycerin provide pain relief

A

decrease left ventricular wall stress

42
Q

localized pain of the anterior chest that worsens with movement, deep inspiration or coughing. tenderness to palpitation. diagnosis

A

costochondritis

43
Q

treatment for costochondritis

A

reassurance and symptomatic pain management

44
Q

next step in management with suspected acute arterial occlusion of left lower extremity

A

arterial doppler study

45
Q

presents weeks after an MI with chest pain that is improved by leaning forward

A

Dressler’s syndrome

46
Q

treatment for Dressler’s sydnrome

A

NSAID

avoid anticoagulation

47
Q

PE findings for aortic regurgitaiton

A
  • hyperdynamic pulse

- “water hammer” peripheral pulses

48
Q

EKG reading for uremic pericarditis

A

no ST elevation

49
Q

patient with infected sacral decubitus ulcer, hypotension, tachycardia, tachypnea, and mental status changes has

A

septic shock

50
Q

a patient with a drug-eluting stent put in 10 days ago and had another MI? what is the cause

A

not compliant with drug

Uworld Step 2 (30 decks)

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