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USMLE step 2 cardiology > Cardio 14 > Flashcards

Cardio 14 Flashcards

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USMLE® Step 1 flashcards
1
Q

a common symptom of Chagas disease?

A

Megacolon

Dilated cardiomyopathy

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2
Q

Pathophysiology of DCM?

A

chronic myocarditis

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3
Q

most sensetive PE finding in renovasculer HYTN?

A

abdominal bruit

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4
Q

common age of RVH?

A

> 55

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5
Q

best time for hearing of pericardial cknock?

A

Early diastole

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6
Q

What will be the cause of holosystolic murmur that heard on apex and disapear after duretic therapy with patients In decompensated HF?

A

Secondary MR due to LV dilitation

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7
Q

Mechanism of MR in thise case?

A

LV papilary muscle displacement

Dilation of cusps

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8
Q

Cause of cardiogenic syncop?

A 
AS/HCM
Vtech
sick sinus syndrome
Advanced AV block
Torsades de Pointes
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9
Q

AS/HCM

A

during exercise

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10
Q

Vtach?

A

No preceding symptom

cardiomyopathy or previous MI

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11
Q

sick sinus syndrome?

A

Preceding fatigue or dizziness

Sinus pause on ECG

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12
Q

advanced AV block?

A

bifesicular block
increased PR interval
Dropped QRS complex

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13
Q

Torsades de Pointes?

A

No preceding symptom
Medicmiya
Hypomagnisimiaation
Hypokalemia

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14
Q

CVS sign of AS?

A

Narrow PP
Increase impulse of PMI
Ejection systolic murmure

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15
Q

Niacin S/E

A

Pruritis

Flushing

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16
Q

Mechanism?

A

Increase histamine and prostaglandin release

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17
Q

Management?

A

Low dos Asprin.

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18
Q

Approach for a patient with Chest pain?

A

Low risk–No further testing
Intermediate–stress test
High risk–Coronary angiography

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19
Q

Positive stress test?

A

Coronary angiography

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20
Q

For high risk?

A

Start management

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21
Q

statin mediated myopathy mechanism/

A

inhibit COQ synthesis–affect energy production

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22
Q

other S/E

A

liver toxicity

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23
Q

A common manifestation of atheroembolism?

A

Dermatologic

  • –Blue toe syndrome(blue finger with an intact pulse)
  • —Livedo reticularis
  • —Gangreen
  • —Ulcer
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24
Q

Commonly occur when?

A

vascular procedure like coronary stenting

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25
Q

Which patients are at risk

A 
Aged
Obese
HYN
Smoking
Hypercholesterolemia
DM
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26
Q

Other symptoms?

A 
RF
Pancreatitis
GI bleeding
Mesenteric ischemia
Stroke
Hollenhorst plaque
27
Q

Hollenhorst plaque?

A

Bright, yellow refractile plaque on the retinal artery(indicate proximal source like carotid)

28
Q

Management?

A

suportive
statin
reuce risk
Prevent recurence

29
Q

when to occur?

A

Earley or lately >30 days

30
Q

Amidadrone s/e in tyroid mechanism and treatment?

A

4 mehanism(2 hypotroid and 2 hypertyroidism)

31
Q

1(hypo)

A

Inhibition of pheripherial T3 conversion
Inc T4, Dec T3, normal or decreased TSH
No treatment needed

32
Q

2(Hypo)

A

Decrease synthesis
low T3,T4 but high TSH
Treat with levothyroxine

33
Q

3(AIT type 1)

A

Increase synthesis(pt with nodular goiter or latent grave disease)
HIgh T3, T4 but low TSH
High RAIU and vascularity on U/S
treat with antithyroid drug

34
Q

4(AIT type 2)

A

Destruction
HIgh T3,T4 but low TSH
Low RAIU and vascularity on U/S
treat with steroid

35
Q

Most common cause of AS in young?

A

supravalvular aortic stenosis

36
Q

CM of SVAS?

A

Systolic murmur at right 1st ICS(unlike AS)
Unequal carotid pulse
Unequal upper extremity B/P(due to high flow speed in ascending aorta)
Palpable thril in suprasternal noch
exercise-induced chest pain(due to LV hypertrophy which increases myocardial o2 demand or associated coronary artery congenital stenosis0

37
Q

cause of HF with normal EF?

A

LV diastolic dysfunction
Valvular disease
Pericardial disease
high output HF

38
Q

LV diastolic dysfunction causes?

A

Concentric hypertrophy
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy

39
Q

Valvular disease cause?

A

AS/AR

MS/MR

40
Q

pericardial disease cause?

A

Constrictive pericarditis

cardiac temponade

41
Q

Pathophysiology in pericardial and LV dysfunction?

A

LV stiffness–increase LVEDP–P transmit to atria and pulmonary vein–Left side HF

42
Q

The absence of an S3 gallop excludes what in MR?

A

Sever chronic MR(except in case of pt with HF)

43
Q

What is the cause of Dyspnea in MR with clear lung?

A

decrease CO

44
Q

What causes fixed splitting in AS?

A

Equalization of pressure in left and right atrium

45
Q

common artery for RVI?

A

RCA

46
Q

common artery for PMI?

A

RCA(PMPM)

47
Q

common artery for VSD?

A

RCA(Basal)

LAD(Apical)

48
Q

common artery for FWR?

A

LAD

49
Q

common artery for Anurythm?

A

LAD

50
Q

What does the murmur grade indicate In PMR?

A

mostly soft

the more low grade the more severe

51
Q

What maneuvers can we teach patients with vasovagal syncope?

A

Counter pressure technique

  • -crossing leg with tensing muscle
  • -hand grip
  • -tensing muscle with clenching fist
52
Q

When to do?

A

When prodromal symptom occur

53
Q

mechanism?

A

Increase venous return–abort syncopal episode.

54
Q

Digoxin toxicity treatment?

A

Drug discontinuation
Hydration
If sever Fab AB

55
Q

A most sensitive measure of CHF?

A

BNP>400–High sensitivity

BNP<100 —High NPP

56
Q

ECG fuure of acut pericarditis/

A 
PR depression(atrial myocardium)
ST segment elevation(Ventricular myocardium0
57
Q

Management of acute pericardium?

A

NSAID(If Asprin it should be high dose) with colchicine in case of viral/idiopathic case.
Corticosteroid if the patient fails to take this combination (e.g in case RF)

58
Q

Skin manifestation amyloidosis?

A

Waxy skin thikning

Easy bruzing

59
Q

Beta-blocker toxicity manifestation?

A 
Bradycardia
Heart block
Hypotension
Bronchospasm
Seizure and delirium
60
Q

Management?

A
  • -IV fluid
  • -Atropine
  • -Glucagone
  • -NE/Epinephrin
    • use successively
61
Q

What glucagon can be used?

A

CCB

62
Q

Treatment Dressler syndrome?

A

The same to the idiopathic one

Avoid anticoagulant–the risk of hemorrhagic pericarditis

63
Q

When do we consider rhythm control medication in AF?

A

Unable to adequate HR control
Recurrent symptom(dizziness, palpitation…..)
Heart Failure

64
Q

HR controlling medication?

A

Beta-blocker
CCB
Digoxin

USMLE step 2 cardiology (16 decks)

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