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USMLE step 2 cardiology > cardio 15 > Flashcards

cardio 15 Flashcards

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USMLE® Step 1 flashcards
1
Q

What are symptoms indicate 2ndary HTN secondary to primary hyperparathyroidism?

A

Hypercalcemia
recurrent renal stone
Neuropsychiatric symptoms

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2
Q

Pathophysiology?

A

Increase renin secretion
Sympathetic hyperresponsiveness
Pheripherial vascular constriction

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3
Q

Other CVS complications of PHPT?

A

LV hypertrophy
Arrhythmia
vascular and Valvular calcification

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4
Q

Management of ST elevated MI?

A 
"2ABONS"
O2(O2<90 or dyspnea)
Antiplatlates(asprin and clopidogril)
Beta-blocker(If no CI)
Nitrates(sublingual)
High dose statin
Anticoagulants
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5
Q

Persistent pain, HTN, or HF despite 2ABONS?

A

IV nitrates

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6
Q

Onley persistent pain despite 2ABONS?

A

Morphin

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7
Q

Unstable patient with sinus bradycardia?

A

atrophin

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8
Q

Pulmonary edema?

A

diuretics

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9
Q

The last major treatment?

A

PCI

Thrombolytics if within 120 min PCI not availabele

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10
Q

C/I for beta-blocker?

A 
CHF
Bradycardia
heart block
Hypotension
pulmonary edema 2nd to HF
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11
Q

Why is digoxin C/I in acute MI?

A

increase o2 demand

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12
Q

What indicates if CI is low in septic shock?

A

Late septic shock(grave prognosis)

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13
Q

What CM indicates peripartum cardiomyopathy?

A

Onset in last month of Px and within 5 months of postpartum
LV systolic dysfunction with EF <45%
Ruling out of other cause of HF
No heart disease prior to last month of Px

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14
Q

Associated finding?

A

hollosystoic murmur at cardia apex

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15
Q

Diagnosis?

A

Transthoracic Echocardiography

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16
Q

management?

A

like other

Immediate delivery if have advanced HF/hemodynamic instability

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17
Q

Cause of orthostatic hypotension in aging?

A

loss of baroreceptor responce

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18
Q

Another contributing factor?

A

arterial stiffness
decrease sympathetic neurotransmitter
decrease response to sympathetic stimulation

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19
Q

Definition of orthostatic hypotension?

A

Systolic d/c 20 and diastolic d/c 10

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20
Q

What is the comp of GERD?

A

Esophageal–EE,Barret esophagus,stricture

Extra esophagial–Asthma and laryngitis

21
Q

How we treat if pt has this symptom?

A

8 month of PPI

22
Q

ECG futur of Pericardial temponad?

A

Pulses Alterans

23
Q

Vasospastic angina cause?

A

Hyperactivity of intimal smooth muscle
Due to
Inbalance Autonomic activation

24
Q

clinical manifestation?

A

Age <50
Smoking
Recurrent chest discomfort occurs at rest(sleep) and usually resolves within 15 min.

25
Q

Diagnosis?

A

Ambulatory ECG

C.angiography:absent CAD

26
Q

Treatment?

A

CCB(Preventive)

Nitroglycerin( abortive)

27
Q

Which CCB is preferred?

A

NDP(verapamil and diltiazem)–more coronary vasodilatory effect

28
Q

What is the cause will be patient with AR develop a sudden sign of C pulmonary edema?

A

AR–Rapid rise in LVEDP–PVH–PE

29
Q

Which antiarrhythmic has a use-dependent Effect?

A

Class IC antiarrhythmic(propafenone and flecainide)

30
Q

what is the use-dependent Effect?

A

More pronounced effect(QRS prolongation and QT prolongation) during high HR like during the stress test.

31
Q

Why?

A

They attach to activated NA Chanel and detach during repolarization?–so more effective in high HR.

32
Q

management of cocaine intoxication?

A

BZD
Asprin
Ninroglycerine and CCB

33
Q

BZD benefit?

A

Decrease sympathetic outflow–Reduce anxiety, HR and B/P

34
Q

Asprin?

A

Reduce thrombus formation

35
Q

NG and CCB?

A

Vasodilators—reduce pain

36
Q

Contraindicated management?

A

BB–increase alpha effect–increase vasoconstriction

Fibrinolytic–Increase the risk of ICH

37
Q

Drugs used in MI and unstable angina that exacerbate cough in patients with AS?

A

Asprin
Beta-Blocker(non selective /cardioselective in high dose)
ACE inhibitor

38
Q

Symptom of cor pulmonale?

A

Dyspnea and fatigue on exercise
Exertional angina(Due to low CO)
Syncope(increase cardiac demand)

39
Q

PE finding on cvs?

A

RV heave
Loud P2
Functional TR murmur

40
Q

ECG finding?

A

Incomplete/complete RBB
Right axis deviation
RV hypertrophy
RA enlargement

41
Q

ECHO?

A

RV enlargement
TR
Pulmonary HYTN

42
Q

Catheterization?

A

Elevated pressure
Decrease CO
Pulmonary HYTN

43
Q

AF treatment in old >65 and young treatment d/c?

A

In the young, we may consider rhythm control medication in symptomatic patients but in the old, we should first try improvement with rate controllers to avoid antiarrhythmic s/e.

44
Q

Indiaction to do scraning U/S for AAA?

A

Male
Any smoking history(>100 cigarettes)
age > 65
Family history

45
Q

Hypertryglycerimia managment?

A

If TG 150-500(lifstyl modification)

  • –Wight loss
  • –Increase Exersise
  • –Moderate alcohol intake
46
Q

What if >500-1000?

A

The goal should be decrease pancratitis risk.

  • –Fibrates
  • –Stop alcohol
  • -fish oil
47
Q

Secondary cause of HTG?

A 
Obeity
DM
Hypotyroidism
Nephrotic syndrome
alcohol
48
Q

Drugs cause HTG?

A

Beta blocker
Antiretroviruses
Corticosteroids
Tamoxifine

49
Q

sign of acute pericarditis in ECG?

A

Difuse ST elevation
Difuse PR depresion
Difuse T wave inversion

USMLE step 2 cardiology (16 decks)

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