Block 63, 64: cardio

Question 1

define pulseless electrical activity

Answer 1

organized rhythm on cardiac monitoring without a measurable blood pressure or palpable pulse in a cardiac arrest patient

Question 2

clinical symptoms of supravalvlar aortic stenosis

Answer 2

• unequal carotid pulses
• differential blood pressure in upper extremities
• palpable thrill in suprasternal notch

Question 3

systolic anterior motion of mitral valve in patients who have

Answer 3

hypertrophic obstructive cardiomyopathy

Question 4

supravalvular aortic stenosis have angina during exercise, why?

Answer 4

increased myocardial oxygen demand

Question 5

Beck’s triad

Answer 5

hypotension
distended neck veins
muffled heart sound

Question 6

Decreased cardiac contractility is seen in patients who have

Answer 6

systolic heart failure

Question 7

Beck’s triad is diagnostic for what? what causes these symptoms

Answer 7

cardiac tamponade

- shift of interventricular septum toward left ventricular cavity

Question 8

what causes the patient’s dyspnea and weakness in cardiac tamponade

Answer 8

decreased left ventricular preload

Question 9

what are pathologicial causes of exterional syncope

Answer 9

• v tachs

- outflow obstruction

Question 10

when do you see prominent capillary pulsations in the fingertips or nail beds

Answer 10

aortic regurgitation

Question 11

history of recent upper respiratory tract infection followed by sudden onset of cardiac failure in otherwise healthy person suggests

Answer 11

dilated cardiomyopathy, secondary to acute viral myocarditis

Question 12

what is performed in patients with cardiac tamponade for diagnosis and management

Answer 12

echocardiography

Question 13

what is pulmonary capillary wedge pressure in PE

Answer 13

low to normal

Question 14

single photon emission CT scan of heart at rest and during stress shows what? treatment

Answer 14

can show ischemia

- anti platelet

Question 15

treatment for Wolff-Parkinson-White syndrome who develop atrial fibrillation with RVR

Answer 15

cardioversion

Procainamide

Question 16

diagnosis for intermittent coronary artery vasospasm? treatment?

Answer 16

prinzmetal angina

- calcium channel blocker ( diltiazem, amlodipine)

Question 17

PE finding for mesenteric ischemia

Answer 17

severe preumbilical abdominal pain

Question 18

prolonged ‘PR’ interval

Answer 18

first degree heart block

Question 19

‘F’ waves

Answer 19

atrial flutter

Question 20

treatment for first degree AV block

Answer 20

observation

Question 21

captopril radionuclide renal scan can diagnose

Answer 21

renovascular disease or renal artery stenosis

Question 22

irregularly irregular, narrow complex tachycardia, fine fibrillatory waves

Answer 22

a fib.

Question 23

when do you defibrillate a patient

Answer 23

ventricular fibrillation

pulseless ventricular tachycardia

Question 24

treatment for chronic venous insufficiency

Answer 24

leg elevation
exercise
compression threapy

Question 25

PE findings for chronic venous insufficiency

Answer 25

varicose veins skin discoloration medial skin ulceration

Question 26

most dangerous complication of Marfan syndrome

Answer 26

aortic dissection

Question 27

complication of aortic dissection

Answer 27

aortic regurgitation: early diastolic murmur

Question 28

pulsus parvus et tardus ? seen in

Answer 28

arterial pulse with decreased amplitude and delayed peak, | - aortic stenosis

Question 29

treatment for uremic pericarditis

Answer 29

hemodialysis

Question 30

high voltage QRS complexes, lateral St segment depression, lateral T wave diagnosis

Answer 30

left ventricular hypertrophy

Question 31

history of uveitis with mild dyspnea and 2-week history of presyncope episodes likely due to conduction abnormalities. X-ray: bilateral midfield lung opacities

Answer 31

Sarcdoisis involving the heart

Question 32

define cardiac sarcoidosis

Answer 32

noncaseating granuloma infiltration of myocardium | - arrhythmia, cardiomyopathy, HF, sudden cardiac death

Question 33

Apixaban MOA

Answer 33

factor Xa inhibitor

Question 34

MOA of Carvedilol

Answer 34

non-selective beta and alpha-adrenergic blocker

Question 35

Dofetilide? side efffect

Answer 35

``` class III antiarrhythmic drug - prolong QT ```

Question 36

exertional dyspnea, pounding heart sensation, widened pulse pressure, valve problem?

Answer 36

aortic regurgitation

Question 37

common cause of aortic regurgitation in developing countries

Answer 37

rheumatic heart disease

Question 38

most common cause of aortic regurgitation in developed countries

Answer 38

aortic root dilation | congenital bicuspid valve

Question 39

"water hammer" or Corrigan pulse

Answer 39

wide pulse pressure ( systolic-diastolic) | Aortic regurgitation

Question 40

characterise aortic stenosis

Answer 40

- pulse with delayed upstroke | - delayed peak

Question 41

when can you hear a pounding sensation and increased awareness of heartbeat in aortic regurgitation

Answer 41

left lateral decubitus position | - brings LV close to chest wall

Question 42

A-fib finding on EKD

Answer 42

no P waves narrow-complex tachycardia irregularly irregular rhythm

Question 43

3 main risk factors for aneurysm expansion and rupture

Answer 43

large diameter rate of expansion cigarette smoking

Question 44

when do you perform surgery on abdominal aortic aneurysm

Answer 44

size greater than 5.5 cm

Question 45

what other drugs may potentiate the anticoagulant effects of Warfarin

Answer 45

Acetaminophen NSAIDS amiodarone

Question 46

what are drugs that decrease the anticoagulant effects of Warfarin

Answer 46

Ginseng, St. John's wort | Rifampin

Question 47

3 major mechanical complications of MI include

Answer 47

1. MI due to papillary muscle rupture 2. left ventricle free wall rupture 3. inter ventricular septum rupture

Question 48

inferior wall MI with delayed presentation, sudden onset of hypotension, dyspnea and tachypnea, pulmonary edema, and soft sysolic murmur

Answer 48

acute MR due to papillary muscle rupture

Question 49

when does MR due to papillary muscle rupture occur after an MI

Answer 49

3-5 days

Question 50

use dependence of drugs?

Answer 50

- faster heart rates, Flecanide has less time to dissociate from sodium channels - decrease in impulse conduction and widening of QRS Class IC antiarrythmic agents and IV calcium channel blcokers

Question 51

initial management of drugs for cocaine users in Er

Answer 51

Benzodiazepines aspirin nitroglycerin calcium channel blockers

Question 52

a thickened and often calcified pericardium that limits diastolic filling can result in

Answer 52

constrictive pericarditis

Question 53

constrictive pericarditis is an important cause of what? and what are symptoms

Answer 53

right heart failure - peripheral edema - ascites - elevated jugular venous pressure - pericardial knock ( middiastolic sound) - pericardial calcification on chest radiograph

Question 54

what is a complication of MI that occurs weeks to months after MI? treatment?

Answer 54

ventricular remodeling - dilation of ventricles - use ACE inhibitors

Question 55

what mitral abnormality is seen in hypertrophic cardiomyopathy

Answer 55

abnormal leaflet motion | - b/c basal anterior septum is thickened. and thinner near valve

Question 56

patients with unexplained congestive heart failure, proteinuria, and left ventricular hypertrophy in absence of history of hypertension

Answer 56

amyloid cardiomyopathy

Question 57

how does arteriovenous fistula impact the heart

Answer 57

high-output cardiac failure increase cardiac preload get heart failure with good cardiac output

Question 58

PE findings for severe aortic stenosis

Answer 58

- pulses parvus and tardus: diminished and delayed carotid pulse 2. mid- to -late peaking systolic murmur at second right intercostal space 3. soft and single second heart sound