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Panre LA 2025 > cardio > Flashcards

cardio Flashcards

smarty pance flash cards

1
Q

A 13 year old boy passes out while
having an argument with his principal.
His examination findings are normal.
What heart conduction condition do you
suspect?

A

Long QT syndrome

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2
Q

. A 24 year old has a syncopal event.
EKG demonstrates a short PR interval
with an upswept initial QRS. What
underlying condition caused the
syncope?

A

Wolf Parkinson
White

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3
Q

A 30 year old male has a syncopal
event three days after taking an
antibiotic. EKG at the scene reveals
ventricular tachycardia. What disease
condition do you suspect?

A

Acquired long QT
syndrome due to
the antibiotic or
medications

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4
Q

A 75 year old patient passes out while
having an argument with his landlord
over money. What three conditions
should you rule out first?

A

Acute coronary
syndrome -
Ventricular
arrhythmia - Aortic
stenosis

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5
Q
  1. Acute Rheumatic fever occurs after
    what event?
A

Strep throat

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6
Q

adrenal tumor which causes HTN?

A

Pheochromocytoma

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7
Q

. After a stent, in addition to ASA, what
oral antiplatelet agent is used?

A

Clopidogrel

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8
Q

. After running a mile a 16 year old
suffers chest pain and syncope. He is
asymptomatic in the ER. Examination
is normal. What underlying condition do
you suspect?

A

Anomalous
coronary artery

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9
Q

Agent of choice for acute angina
treatment?

A

Nitroglycerine

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10
Q

Angina syncope and heart failure in a
child likely represents ____________.

A

HOCM
(Hypertrophic
Cardiomyopathy)

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11
Q

Angina syncope and heart failure in an
adult likely represents _____________.

A

Aortic stenosis

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12
Q

Aortic stenosis in a 50 year old is
likely due to what abnormality?

A

Bicuspid aortic
valve

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13
Q

Austin Flint murmur is associated with
which murmur?

A

Aortic regurgitation

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14
Q

Best medication for blood pressure
support in cardiogenic shock?

A

Dobutamine

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15
Q

Cancer is an example of what part of
Virchow’s triad?

A

Hypercoagulable
state

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16
Q

Can digoxin be used for HTN?

A

no

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17
Q

Combination therapy with at least 2
agents is recommended for patients
with which stage of HTN?

A

Stage 2 HTN -
Initiate treatment
with 2 or more
agents

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18
Q

Constrictive Cardiomyopathy
occurs by what mechanism?

A

Pericardial sac constricts

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19
Q
  1. Digoxin should never be
    used for which type of heart
    failure?
A

Diastolic

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20
Q
  1. Does pregnancy fit into the
    Virchows triad?
A

Yes - Pregnancy is a
hypercoagulable state

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21
Q
  1. Does renal artery stenosis
    cause primary or secondary
    HTN?
A

Secondary

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22
Q
  1. During pregnancy what
    murmur is commonly first
    discovered?
A

Mitral stenosis

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23
Q

. First line HTN agent for
Diabetic?

A

Ace inhibitor

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24
Q
  1. First medication to give in a
    patient suspected of having
    an AMI?
A

Aspirin

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25
Q
  1. Gallavardin Phenomena is
    associated with what
    valvulopathy?
A

Aortic Stenosis

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26
Q

. Initial procedure to evaluate
for PVD?

A

ABI (Ankle brachial index) -
ABI < 0.8 = PAD

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27
Q

JVD and clear lung fields
describes what type CHF?

A

Right Heart Failure

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28
Q

List 5 causes of systolic
heart failure.

A

CAD (ischemia)
- Tako Tsubo
- Cocaine
- Viral illness
- Chemo/radiation

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29
Q
  1. List 5 side effects of
    amiodarone.
A

Pulmonary HTN
- Elevated
LFTs
- Hypothyroid
- Hyperthyroid
- Iodine allergy

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30
Q

List 6 causes of restrictive
cardiomyopathy.

A

Amyloidosis -
Hemochromatosis -
Sarcoidosis -
Scleroderma -
Fibrosis -
Cancer

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31
Q

List the classifications of
blood pressure as per JNC
VII.

A

Prehypertension = 120-139/80-
90
- Stage 1 = 140-159/90-99
- Stage 2 = >160/100

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32
Q
  1. List the major systemic
    affects of amiodarone
    therapy?
A

Pulmonary fibrosis
- Infiltrative
liver disease
- Hyper OR
hypothyroid state

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33
Q

List the NYHA classification
of CHF.

A

I asymptomatic
- II symptoms
with moderate exertion
- III symptoms with minimal
exertion
- IV symptoms at rest

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34
Q

List three medications which
may be used both to prevent
arrhythmia and ease
symptoms with HOCM.

A

Diuretics - Beta blockers -
Non-dihydropyridine CCB
(verapamil or diltiazem)

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35
Q

List two types of surgical
procedures to correct
HOCM.

A

Open heart and excision -
Alcohol ablation done through
cardiac cath

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36
Q

Meds for chronic diastolic CHF?

A

Ace inhibitor plus either a
beta blocker or calcium
channel blocker

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37
Q

A military recruit passes out
while standing in formation for a
long period of time. What type of
syncope is this called?

A

Neurocardiogenic syncope
a.k.a. Vasovagal syncope

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38
Q

Most common cause of
cardiogenic shock?

A

Myocardial Infarction

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39
Q

Most common cause of Diastolic
CHF?

A

Hypertension

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40
Q

Most common cause of tricuspid
stenosis?

A

Rheumatic fever

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41
Q

Myocardial damage occurs after
how many minutes of ischemia?

A

30 minutes

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42
Q

. Name the 4 components of
Tetralogy of Fallot.

A

Pulmonary valve stenosis
-VSD (Ventricular Septal
Defect)
- Overriding aorta
- RVH (Right Ventricular
Hypertrophy)

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43
Q

Name the Major Jones criteria.

A

Carditis
- Migratory
polyarthritis
- Subcutaneous nodules
- Erythema marginatum
- Chorea

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44
Q

Non-cardiac hypoxia (e.g.
pneumonia, COPD) commonly
causes what arrhythmia?

A

a fib

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45
Q

Once a patient is diagnosed with
HOCM what family counseling
must be done?

A

Entire family must be
screened for HOCM

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46
Q

Once a patient on a balloon
pump can tolerate a ratio of
___:___ removal may be
considered.

A

3 : 1 - Once patient only
requires assist every third
beat removal may be
considered

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47
Q

Orthostasis is defined as a
change of > __ mmHg systolic
or __ mmHg diastolic BP __
minutes after change from
supine to standing.

A

> 20 mmHg systolic or 10
mmHg diastolic BP 2-5
minutes after change from
supine to standing

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48
Q

. A patient has a cold left arm due
to arterial clot - what is the
most likely valvulopathy?

A

Mitral stenosis

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49
Q

Patient has DVT and unable to
take Coumadin what is next
step?

A

IVC Filter

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50
Q

A patient with pericarditis feels
better in what position?

A

Leaning forward

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51
Q

PVD commonly manifests as
what symptom?

A

Calf pain with exertion that
relieves with rest
(claudication)

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52
Q

Radiologic test of choice in
pregnant woman suspect of
pulmonary embolus?

A

VQ scan

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52
Q

Restrictive Cardiomyopathy occurs by
what mechanism?

A

Deposition into or
between the
myocardial cells

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53
Q

Rheumatic fever affects which valve
first?

A

Mitral valve

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54
Q

. Roth spots in a drug user are most
likely caused by which organism?

A

staph aureus

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55
Q

Should heparin or enoxaparin (Lovenox)
be used for a patient with a CrCl < 15?

A

Heparin (enoxaparin
is contraindicated
for CrCl < 15)

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56
Q

Three meds for acute decompensated
CHF?

A

Nitroglycerin
- ACE inhibitor
- Loop Diuretic

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57
Q

Untreated amaurosis fugax with
temporal arteritis leads to what?

A

Blindness (High
dose steroids most
be started ASAP to
avoid blindness)

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58
Q

Upon auscultation of a patient’s carotid
artery they become bradycardic with a
three second pause. What is the
suspected underlying condition?

A

Carotid sinus
hypersensitivity

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59
Q

Use of which antihypertensive
medications is cautioned after cataract
surgery?

A

Alpha blockers

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60
Q

Use of which antihypertensive
medications is cautioned after recent
MI?

A

Minoxidil - Clonidine

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61
Q

Venous insufficiency is differentiated
from right heart CHF in a patient with
lower extremity edema by what exam
finding?

A

A patient in CHF will
have JVD and
hepatojugular reflux

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62
Q

A venous ulcer most often forms
where?

A

on the inside of the leg, above the ankle and below the calf

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63
Q

Vitamin deficiency that causes high
output cardiac failure?

A

Thiamine - Beriber

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64
Q

What are painful lesions on the hands
which occur with endocarditis?

A

Osler’s nodes =
“Ouch”

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65
Q

What are painless lesions on the hands
which occur with endocarditis?

A

Janeway lesions

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66
Q

What are the 2 recommended statins
for treatment in acute MI?

A

Atorvastatin 80 mg
or rosuvastatin 40
mg

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67
Q

What are the 3 “D” findings of
pericardial tamponade?

A

Distant heart
sounds
- Distended
jugular veins
- Decreased arterial
pressure

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68
Q

What are the 3 main causes of
mitral and tricuspid regurgitation?

A

Dilatation (Aneurysm) -
Degeneration of leaflets
- Chordae tendineae
rupture

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69
Q

What are the big three meds for
chronic systolic heart failure?

A

Beta blocker - ACE
inhibitor - Loop diuretic

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70
Q

What are the mainstay meds for
chronic diastolic heart failure?

A

ACE inhibitor - Beta
blocker or calcium
channel blocker
(diltiazem or verapamil)

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71
Q
  1. What are the mainstay meds of
    acute decompensated heart
    failure?
A

NTG - ACE inhibitor -
Loop diuretic

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72
Q

What are the modifiable cardiac
risk factors?

A

Smoking - DM -
Cholesterol - Blood
pressure - Obesity

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73
Q

What are the most common side
effects of dihydropyridine calcium
channel blockers (amlodipine
felodipine)?

A

Lower extremity edema
and headache

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74
Q

What are the signs of HOCM on
exam?

A

Apical lift - S4 gallop -
Ejection murmur medial
to apex

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75
Q

What are the three main symptoms
of Aortic stenosis?

A

ASH (Angina - Syncope
- Heart Failure)

76
Q

What are the three main symptoms
of Mitral stenosis?

A

PHD (Palpitations -
Heart Failure - Dyspnea
on exertion)

77
Q

What are the two main causes of
aortic and pulmonic regurgitation?

A

Dilatation (Aneurysm) -
Degeneration of leaflets

78
Q

What are two CXR findings in
pulmonary embolus?

A

Hamptons hump -
Westermark sign

79
Q

What arm does anginal pain tend to
radiate toward?

A

left

80
Q

What arrhythmia can occur with
structural changes such as
hypertrophy or dilatation of the
ventricle?

A

Ventricular tachycardia

81
Q

What arrhythmia is associated
with arterial embolism?

A

Atrial fibrillation

82
Q

What balloon pump setting would
be best for initial treatment of the
acute patient in cardiogenic
shock?

A

1 : 1 Balloon pump
assists with every beat

83
Q

What blood pressure medication
can make peripheral artery
disease symptoms worse?

A

Beta blockers

84
Q

What blood pressure medicine is
commonly associated with
impotence in men?

A

Beta blockers

85
Q

What cardiac abnormality is
associated with a bicuspid aortic
valve?

A

Coarctation of aorta

86
Q

What cardiac drug can cause hypo
or hyperthyroidism?

A

Amiodarone

87
Q

What cardiac drug can produce
yellow vision?

A

Digoxin

88
Q

What causes the sudden cardiac
death in a HOCM patient?

A

Ventricular tachycardia
that degenerates into
ventricular fibrillation

89
Q

What characteristic will be seen in
blood which is drawn from with in
the pericardial sac during
pericardial centesis?

A

Blood does not clot
when put into tray (+
clotting = not in the
pericardial space)

90
Q

What class of medication should
you think of when you see the
suffix “azosin”?

A

Alpha blockers -
example doxAZOSIN

91
Q

What class of medication should
you think of when you see the
suffix “dipine”?

A

Dihydropyridine
calcium channel
blockers - example
amloDIPINE

92
Q

What condition is right ventricular
collapse on echocardiogram
pathognomonic for?

A

Pericardial tamponade

93
Q

What condition occurs when
congenital cyanotic heart murmurs
cause right heart failure?

A

Eisenmenger
syndrome

94
Q

What congenital abnormality should
be considered with a child who
frequently squats?

A

Tetralogy of Fallot

95
Q

What disorder is most likely in a
patient with calf pain with walking
that improves with rest?

A

Peripheral Artery
Disease

96
Q

What diuretic can be used if
furosemide is not available?
What diuretic can be used if
furosemide is not available?

A

Bumetanide

97
Q

What does a Beta blocker do for a
post AMI patient?

A

Prevents arrhythmia
and reduces cardiac
work load

98
Q

what does a BP> 180/120 with end
organ dysfunction define?

A

Hypertensive
emergency

99
Q

What does an ACE
inhibitor/ARB do for a post
AMI patient?

A

Decreases afterload to rest
myocardium and
prevents/decreases remodeling

100
Q

What do low ejection
fraction and hypertrophic
(HOCM) heart have in
common?

A

Sudden death due to VT

101
Q

what drug can produce
blue vision?

A

Sildenafil

102
Q

What EKG changes are
seen in a patient during a
Prinzmetal attack?

A

ST elevations which resolve
after attack (Persistent
elevations suggest MI)

103
Q

What EKG changes are
seen with a ring abscess
of the mitral valve?

A

Variable heart block

104
Q

What finding is
pathognomonic for
Rheumatic fever?

A

Aschoff bodies (Subcutaneous
nodules)

105
Q

What happens to renal
function during cardiogenic
shock?

A

Reduced cardiac flow =
reduced kidney perfusion this
leads to pre-renal failure then
ATN if not corrected

106
Q

What heart sound will
likely be present with
HOCM?

A

S4

107
Q

What heart valve murmur
rarely causes a
symptomatic problem?

A

Pulmonary regurgitation

108
Q

What HTN med classes can
cause bradycardia?

A

Beta Blockers - Central agents
(clonidine) - Verapamil and
Cardizem

109
Q

What hypertension agent is
commonly associated with
edema in the lower
extremities?

A

Calcium channel blockers

110
Q

What is a complication of
cardiac cath that causes
Grey-Turner’s sign?

A

Retroperitoneal hematoma

111
Q

What is calf pain with walking
that improves with rest called?

A

Claudication

112
Q

What is first-line treatment for
varicose veins?

A

Compression stockings

113
Q

What is most common cause of
right heart failure?

A

Left heart failure

114
Q

What is most common genetic
hypercoagulable state?

A

Factor V deficiency

115
Q
  1. What is most common
    pathogen causing of subacute
    endocarditis?
A

Strep. viridans

116
Q

What is the diameter of an
aortic aneurysm at which
surgical intervention is
recommended?

A

> 5.4 cm

117
Q

What is the first medication to
be given to a patient with an
acute arterial emboli?

A

Heparin

118
Q

What is the first step and
evaluation of a patient with calf
pain when he walks that is
relieved with rest?

A

Ankle brachial index

119
Q

What is the gold standard to
evaluate peripheral artery
disease?

A

Angiography

120
Q

What is the initial dose of
clopidogrel (Plavix) in acute
MI?

A

300 mg

121
Q

What is the INR goal for a
patient on warfarin for a
mechanical heart valve?

A

2.5 - 3.5

122
Q

What is the likely cause of HTN
in a 30 year old female who is
still poorly controlled after 3
medications?

A

Renal Artery Stenosis

123
Q

. What is the medical treatment
of patent ductus arteriosus
(PDA)?

A

Indomethacin

124
Q
  1. What is the medication
    suggested by JNC VII for a
    patient who has no compelling
    indications?
A

Diuretic
(Hydrochlorothiazide is the
most common)

125
Q

What is the most common
cause of constrictive
cardiomyopathy?

A

Radiation therapy

126
Q

. What is the most common skin
manifestation seen in
endocarditis?

A

Petechiae are not specific
for infective endocarditis
but are its most common
skin manifestation

127
Q

What is the most likely cause
of orthostatic hypotension in
which there is no reflex
increase in heart rate?

A

Autonomic dysfunction
(examples: age diabetes)

128
Q

What is the most likely cause of
syncope in an older adult which
occurs during an argument?

A

Myocardial ischemia

129
Q

What is the most likely cause of
syncope which occurs after a
period of prolonged motionless
standing?

A

Neurocardiogenic
(vasovagal)

130
Q

What is the most likely cause of
syncope which occurs while
shaving and has an associated
bradycardia?

A

Carotid sinus
hypersensitivity

131
Q

What is the most likely disorder in
a patient with apical ballooning on
echo and a presentation similar to
MI?

A

Tako Tsubo

132
Q

What is the pathognomonic
echocardiogram finding in
pericardial tamponade?

A

Collapse of the right
ventricle

133
Q

What is the recommended initial
treatment for a Stanford type A
aortic dissection?

A

Surgical management

134
Q

What is the recommended initial
treatment for a Stanford type B
aortic dissection?

A

Medical treatment

135
Q

What is the rise in jugular pressure
which occurs with inspiration in a
patient with pericardial tamponade
called?

A

Kussmaul sign

136
Q

What is the Stanford classification
of an aortic dissection of the
descending aorta?

A

Type B

137
Q

What is the term for a hoarse voice
caused by mitral stenosis?

A

Ortner’s syndrome

138
Q

What is the treatment for angina in
a patient who is allergic to
nitrates?

A

Calcium channel
blockers

139
Q

What is the treatment for a nonsurgical cyanotic heart disease
causing polycythemia?

A

Phlebotomy

140
Q

What is the treatment for
constrictive cardiomyopathy?

A

Pericardial stripping

141
Q

What is the treatment for dilated
cardiomyopathy?

A

Same as systolic heart
failure - (Beta blocker -
Loop Diuretic - ACE
inhibitor)

142
Q

What is the treatment for mitral
valve prolapse?

A

Reassurance and beta
blockers

143
Q

What is the treatment for
phlebitis due to an IV?

A

Elevation - Warm
compress - NSAIDs

144
Q

What is the treatment for
Prinzmetal angina?

A

Calcium channel blockers

145
Q

What is the treatment for
thrombophlebitis?

A

One month of low
molecular weight heparin

146
Q

What is Virchows triad?

A

Stasis
- Hypercoagulable
state
- Trauma (= risk of venous thrombus)

147
Q

What lab most sensitive for
AMI?

A

Troponin

148
Q

What leads represent anterior
wall?

A

V3 V4

149
Q

What leads represent lateral
wall?

A

V5 V6 I AVL

150
Q

What maneuver makes the
HOCM murmur louder?

A

Valsalva or standing

151
Q

What mechanical intervention
can improve coronary perfusion
and work load of heart?

A

Aortic Balloon Pump

152
Q

What medication can assist in
closing an open PDA (Patent
Ductus Arteriosus)?

A

Indomethacin

153
Q

What medications are
recommended for a patient with
CAD?

A

Beta blocker and ACE
inhibitor

154
Q

What murmur has a continuous
machinery quality?

A

PDA (Patent Ductus
Arteriosus)

155
Q

What murmur has a Left
parasternal lift pulmonic area
ejection murmur and fixed
splitting of S2?

A

ASD (Atrial Septal Defect)

156
Q

What murmur is heard with MVP
(Mitral Valve Prolapse)?

A

Midsystolic click

157
Q

What murmur is pansystolic and
is best heard mid sternal
border?

A

vSD (Ventricular Septal
Defect)

158
Q

What must be ruled
out in a Marfan patient
with chest pain
radiating to the back?

A

Aortic dissection

159
Q

What physical sign is
easily seen with
tricuspid stenosis?

A

JVD (Jugular Venous Distension)

160
Q

What secondary cause
of HTN will present
with abdominal
bruits? What is the
first diagnostic test?

A

Renal artery stenosis - Renal artery
doppler is the initial test

161
Q

What sign
distinguishes mitral
regurgitation from
tricuspid
regurgitation?

A

Carvallo s sign (The murmur of
tricuspid regurgitation increases in
intensity during held deep
inspiration)

162
Q

What test can be
performed to evaluate
neurocardiogenic
syncope?

A

Tilt table test

163
Q
  1. What test should be
    ordered for a patient
    with suspected
    pheochromocytoma?
A

Urine for VMA (Vanillylmandelic acid)

164
Q

What three criteria
define a heart attack?

A

EKG changes - Chest pain -
Elevated cardiac enzymes

165
Q

What three tests are
recommended before
starting amiodarone?

A

Thyroid panel - Pulmonary function
testing - Liver function test

166
Q

What two murmurs
are most associated
with atrial
fibrillation?

A

Mitral stenosis - Mitral regurgitation

167
Q

What two populations
more commonly have
diastolic heart
failure?

A

Elderly women and black patients

168
Q
  1. What type of heart
    failure may
    pericardial tamponade
    initially present like?
A

Right heart failure: Tamponade looks
like right heart failure because the
right ventricle is the weakest of the
two and collapses first due to the
fluid around the heart

169
Q

What underlying disease state is
likely in a patient with a malar
rash and recurrent DVT?

A

Systemic Lupus
Erythematosus(SLE) with
antiphospholipid
syndrome

170
Q

What valvular abnormality is
most commonly associated with
a peripheral arterial emboli?

A

Mitral stenosis

171
Q

What valvulopathy increases
afterload?

A

Aortic stenosis

172
Q

What will most likely happen to
the INR of a patient on warfarin
when they are given
amiodarone?

A

INR increases

173
Q
  1. When treating a patient with
    hypertensive urgency the goal is
    not to reduce the BP more than
    __% in __ hours?
A

Goal is to reduce blood
pressure no more than
25% every 1-2 hours

174
Q

Which antihypertensive
medications are contraindicated
with asthma and isolated PAD?

A

Beta blockers

175
Q

Which antihypertensive
medications are contraindicated
with bradycardia or heart block?

A

Beta blockers - Nondihydropyridine CCB -
Central agents (clonidine)

176
Q

. Which antihypertensive
medications are contraindicated
with pregnancy?

A

ACE inhibitors -
Angiotensin II receptor
blockers - Thiazide
diuretics - Direct renin
inhibitors

177
Q

Which antihypertensive
medications are contraindicated
with renal artery stenosis?

A

ACE inhibitors and
Angiotensin II receptor
blockers (Note: caution
with direct renin inhibitors)

178
Q

Which antihypertensive
medications can cause
angioedema?

A

ACE inhibitors -
Angiotensin II receptor
blockers (ARBs) - Direct
renin inhibitors

179
Q

Which antihypertensive
medications can cause AV
block?

A

Non-dihydropyridine CCB -
Central agents (clonidine)

180
Q
  1. Which antihypertensive
    medications can cause
    bradycardia?
A

Beta blockers - Nondihydropyridine CCB -
Central agents (clonidine)

181
Q
  1. Which antihypertensive
    medications can cause
    constipation?

diarrhea?

A

Verapamil - Central
agents (clonidine)

Direct renin inhibitors

182
Q

. Which antihypertensive
medications can cause
depression?

edema

A

Beta blockers - Central
agents (clonidine)

Dihydropyridine CCB (e.g. amlodipine nifedipine) - Benzothiazepine CCB
(diltiazem) - Minoxidil

183
Q

Which antihypertensive medications can cause
hyperkalemia?

hyperuricemia

hypokalemia

A

ACE inhibitors - Angiotensin II receptor blockers (ARBs) - Direct renin
inhibitors - Aldosterone antagonists (spironolactone)

Thiazide

Thiazide

184
Q

Which electrolyte disorder can increase the chance of
digoxin toxicity?

A

Hypokalemia

185
Q

. Which lab value must be obtained before initiating ACE
inhibitor therapy

A

Potassium

186
Q

Why are post menopausal women more prone to heart
disease?

A

Estrogen is cardio protective

187
Q

You have performed pericardial centesis. How do you
ensure you are in the pericardial space?

A

Blood evacuated from the pericardial space does not clot

Panre LA 2025 (2 decks)

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