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Uworld Step 2 > Block 63, 64: cardio > Flashcards

Block 63, 64: cardio Flashcards

1
Q

define pulseless electrical activity

A

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

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2
Q

clinical symptoms of supravalvlar aortic stenosis

A
  • unequal carotid pulses
  • differential blood pressure in upper extremities
  • palpable thrill in suprasternal notch
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3
Q

systolic anterior motion of mitral valve in patients who have

A

hypertrophic obstructive cardiomyopathy

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4
Q

supravalvular aortic stenosis have angina during exercise, why?

A

increased myocardial oxygen demand

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5
Q

Beck’s triad

A

hypotension
distended neck veins
muffled heart sound

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6
Q

Decreased cardiac contractility is seen in patients who have

A

systolic heart failure

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7
Q

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

A

cardiac tamponade

- shift of interventricular septum toward left ventricular cavity

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8
Q

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

A

decreased left ventricular preload

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9
Q

what are pathologicial causes of exterional syncope

A
  • v tachs

- outflow obstruction

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10
Q

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

A

aortic regurgitation

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11
Q

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

A

dilated cardiomyopathy, secondary to acute viral myocarditis

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12
Q

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

A

echocardiography

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13
Q

what is pulmonary capillary wedge pressure in PE

A

low to normal

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14
Q

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

A

can show ischemia

- anti platelet

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15
Q

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

A

cardioversion

Procainamide

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16
Q

diagnosis for intermittent coronary artery vasospasm? treatment?

A

prinzmetal angina

- calcium channel blocker ( diltiazem, amlodipine)

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17
Q

PE finding for mesenteric ischemia

A

severe preumbilical abdominal pain

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18
Q

prolonged ‘PR’ interval

A

first degree heart block

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19
Q

‘F’ waves

A

atrial flutter

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20
Q

treatment for first degree AV block

A

observation

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21
Q

captopril radionuclide renal scan can diagnose

A

renovascular disease or renal artery stenosis

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22
Q

irregularly irregular, narrow complex tachycardia, fine fibrillatory waves

A

a fib.

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23
Q

when do you defibrillate a patient

A

ventricular fibrillation

pulseless ventricular tachycardia

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24
Q

treatment for chronic venous insufficiency

A

leg elevation
exercise
compression threapy

25
Q

PE findings for chronic venous insufficiency

A

varicose veins
skin discoloration
medial skin ulceration

26
Q

most dangerous complication of Marfan syndrome

A

aortic dissection

27
Q

complication of aortic dissection

A

aortic regurgitation: early diastolic murmur

28
Q

pulsus parvus et tardus ? seen in

A

arterial pulse with decreased amplitude and delayed peak,

- aortic stenosis

29
Q

treatment for uremic pericarditis

A

hemodialysis

30
Q

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

A

left ventricular hypertrophy

31
Q

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

A

Sarcdoisis involving the heart

32
Q

define cardiac sarcoidosis

A

noncaseating granuloma infiltration of myocardium

- arrhythmia, cardiomyopathy, HF, sudden cardiac death

33
Q

Apixaban MOA

A

factor Xa inhibitor

34
Q

MOA of Carvedilol

A

non-selective beta and alpha-adrenergic blocker

35
Q

Dofetilide? side efffect

A 
class III antiarrhythmic drug 
- prolong QT
36
Q

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

A

aortic regurgitation

37
Q

common cause of aortic regurgitation in developing countries

A

rheumatic heart disease

38
Q

most common cause of aortic regurgitation in developed countries

A

aortic root dilation

congenital bicuspid valve

39
Q

“water hammer” or Corrigan pulse

A

wide pulse pressure ( systolic-diastolic)

Aortic regurgitation

40
Q

characterise aortic stenosis

A
  • pulse with delayed upstroke

- delayed peak

41
Q

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

A

left lateral decubitus position

- brings LV close to chest wall

42
Q

A-fib finding on EKD

A

no P waves
narrow-complex tachycardia
irregularly irregular rhythm

43
Q

3 main risk factors for aneurysm expansion and rupture

A

large diameter
rate of expansion
cigarette smoking

44
Q

when do you perform surgery on abdominal aortic aneurysm

A

size greater than 5.5 cm

45
Q

what other drugs may potentiate the anticoagulant effects of Warfarin

A

Acetaminophen
NSAIDS
amiodarone

46
Q

what are drugs that decrease the anticoagulant effects of Warfarin

A

Ginseng, St. John’s wort

Rifampin

47
Q

3 major mechanical complications of MI include

A
  1. MI due to papillary muscle rupture
  2. left ventricle free wall rupture
  3. inter ventricular septum rupture
48
Q

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

A

acute MR due to papillary muscle rupture

49
Q

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

A

3-5 days

50
Q

use dependence of drugs?

A
  • 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

51
Q

initial management of drugs for cocaine users in Er

A

Benzodiazepines
aspirin
nitroglycerin
calcium channel blockers

52
Q

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

A

constrictive pericarditis

53
Q

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

A

right heart failure

  • peripheral edema
  • ascites
  • elevated jugular venous pressure
  • pericardial knock ( middiastolic sound)
  • pericardial calcification on chest radiograph
54
Q

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

A

ventricular remodeling

  • dilation of ventricles
  • use ACE inhibitors
55
Q

what mitral abnormality is seen in hypertrophic cardiomyopathy

A

abnormal leaflet motion

- b/c basal anterior septum is thickened. and thinner near valve

56
Q

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

A

amyloid cardiomyopathy

57
Q

how does arteriovenous fistula impact the heart

A

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

58
Q

PE findings for severe aortic stenosis

A
  • 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

Uworld Step 2 (30 decks)

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