Block 61: Cardio

Question 1

Exaggerated fall in systemic blood pressure greater than 10 mm Hg during inspiration

Answer 1

Pulsus Paradoxus

Question 2

when does pulsus paradoxus occur

Answer 2

cardiac tamponade
severe asthma
COPD

Question 3

when does fat embolism occur following an injury

Answer 3

12-24 hours

Question 4

how does patient present with anaphylaxis shock

Answer 4

hypotension
tachycardia
urticarial rash 
wheezing 
maybe upper airway edema

Question 5

most common cause of dilated cardiomyopathy in relatively young adults

Answer 5

viral myocarditis

Question 6

what are PE findings that indicated cardiac tamponade

Answer 6

hypotension
tachycardia
distended jugular veins
pulsus paradoxus

Question 7

Mobitz type I AV block

Answer 7

progressive prolongation of PR interval and drop QRS

Question 8

first-degree AV block is

Answer 8

prolonged PR interval

Question 9

initial management of pulmonary hypertension

Answer 9

loop diuretics

ACE inhibitors

Question 10

when is carotid endarterectomy indicated

Answer 10

• symptomatic carotid artery stenosis 70-99%

- men with asymptomatic carotid artery stenosis of 60-99%

Question 11

transient loss of consciousness along with loss of postural or motor tone during urination ? what triggers this

Answer 11

situational (postmicturition) syncope

- alteration in autonomic response, lead to cardioinhibitory, vasodepressor or mixed response

Question 12

how do nitrates help the heart

Answer 12

• lower preload
• lower left ventricular end-diastolic vasodilation
• reduce wall stress
• reduce oxygen demand

Question 13

who automatically gets put on statin

Answer 13

diabetic patients age 40-75 years

Question 14

role of fish oil

Answer 14

reduce serum triglycerides

Question 15

initial medical management of patients with acute aortic dissecion

Answer 15

IV beta blockers

Question 16

pulsatile abdominal mall

Answer 16

abdominal aortic aneurysm

Question 17

study of choice for diagnosis and follow-up of abdominal aortic aneurysms

Answer 17

Ultrasound

Question 18

patient has systolic-diastolic abdominal bruit, has high specificity for what

Answer 18

reno-vascular hypertension

Question 19

patient with epigastric burning provoked by exertion ( heavy lifting) and relieved over several minutes by rest

Answer 19

atypical angina

Question 20

initial test for suspected stable ischemic heart disease

Answer 20

exercise stress test.

Question 21

what should be obtained in all patients with syncope due to structural heart defect

Answer 21

echocardiogram

Question 22

upright tilt table testing, tests for

Answer 22

vasovagal syncope

Question 23

Dobutamine MOA? effects on heart

Answer 23

strong beta-1 receptor
weak beta-2 and alpha-1

• increase myocardial contractility, better EF
• reduced left ventricular end-sysolic volume
• symptomatic improvement of decompensated CHF

Question 24

electrical alternans (varying amplitude of QRS complexes) with sinus tachycardia is ? treatment?

Answer 24

large pericardial effusion

- pericardiocentesis

Question 25

when is primary percutaneous coronary intervention PCI recommended

Answer 25

within 90 mins.

but can be done 12 hours within onset

Question 26

treatment for acute pericarditis

Answer 26

NSAID

Question 27

renovascular hypertension should be suspected in all patients with resistant hypertension and

Answer 27

1. diffuse atherosclerosis
2. asymmetric kidney size
3. recurrent flash pulmonary edema
4. increase in creatinine great than 30%

Question 28

aortic regurgitation murmur

Answer 28

• high-pitched, blowing
• decrescendo diastolic murmur, begins after A2
• left sternal border between 3rd and 4th intercostal space

Question 29

what type of murmurs are usually due to underlying pathologic cuases

Answer 29

diastolic and continuous

Question 30

treatment for heart block

Answer 30

pacemaker

Question 31

side effects of amiodorone

Answer 31

hypo/hyperthyroidism 
hepatotoxicity 
bradycardia
heart block
pneumonitis
neurologic symptoms 
visual disturbances

Question 32

progressive dyspnea, decreased exercise tolerance, atrial fibrillation with RVR, and LV systolic function, diagnosis? treatment?

Answer 32

tachycardia-mediated cardiomyopathy

• aggressive rate control
• restoration of normal sinus rhythm

Question 33

basic work up for patients are who initially diagnosed with hypertension

Answer 33

1. urinalysis
2. chem panal
3. lipid profile
4. baseline electrocardiogram