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FP board review > Cardio > Flashcards

Cardio Flashcards

0
Q

What is better for a diabetic patient CABG or stenting?

A

CABG. Diabetic patients actually have a higher risk of restenosis with stenting. Indications for coronary artery bypass grafting include three vessel disease with LV dysfunction and left main stem disease with 50% occlusion.

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1
Q

Which is more specific stress echocardiogram or stress thallium test?

A

Stress echocardiogram is more specific and the stress Thallium test is more sensitive.

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2
Q

What is the ECG pattern/s associated with pericarditis?

A

Normal ECG and/or diffuse ST elevation; small QRS complexes; electrical alternans

ECG changes present in only 80% of pericarditis

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3
Q

What is the best initial treatment for CHF secondary to cardiac tamponade?

A

IV saline.

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4
Q

In a patient presenting in stable condition with SVT what is the treatment of choice?

A

Amiodarone, sotalol or procainamide

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5
Q

What is the first line treatment of torsades?

A

Magnesium. Usually goes away on its on, but if mag doesn’t work then isoprotranol.

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6
Q

What is the diagnosis from finding a new LBBB?

A

Indicates a STEMI. If within first 90 minutes get the to cath lab for angioplasty. If beyond 120 minutes, the fibrinolytics.

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7
Q

Treatment for narrow complex SVT that is not associated with hemodynamic collapse?

A

Adenosine

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8
Q

A pulsus paradoxicus occurs in which conditions?

A

Cardiac Tamponade, “constrictive pericarditis, severe asthma, or anything else that reduces right heart filling (e.g., tension pneumothorax”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

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9
Q

What is holiday heart?

A

Atrial fibrillation caused by alcohol intake.

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10
Q

A patient presents with the symptoms of syncope or angina with exercise and has a murmur indicates:

A

Aortic obstruction most likely die to ventricular hypertrophy

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11
Q

What is the time period and treatments for atrial fibrillation?

A

Prior to 48 hours after onset, cardioversion is indicated. After 48 hours after the onset, then mgmt with rate control.

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12
Q

All of the following can be used for cardioversion

A

“Ibutilide, Electrical cardioversion, Quinidine, Procainamide.”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

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13
Q

Is there a benefit to cardioverting a patient with a CHADS score of 1?

A

“A CHAD2 score of “1” is considered “lone atrial fibrillation.” It is reasonable to allow the patient to remain in atrial fibrillation, as long as they are rate controlled.
“Outcomes of patients who stay in atrial fibrillation and are given appropriate therapy are the same as in patients in whom one tries to maintain sinus rhythm with drugs such as amiodarone, etc.”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

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14
Q

What is the proper way to handle a patient on warfarin who needs surgery?

A

Stop the warfarin for up to a week. It is okay to have a patient with intro for relation off of their anticoagulant for up to a week before starting warfarin

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15
Q

What is the danger in aged cheese consumption with an MAOI?

A

“Aged cheese can cause problems in combination with monoamine oxidase inhibitors (MAOIs). In combination with an MAOI, aged cheese and other sources of tyramine can cause a hypertensive emergency”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

16
Q

Does mitral valve prolapse or mitral stenosis cause PACs?

A

“Anything that can cause an increase in left atrial pressures (and therefore atrial wall stretching) is associated with an increase in the number of PACs. Mitral stenosis causes increased pressures in the left atrium, wall stretching, and enlargement and thus predisposes to PACs”

“hypertrophic cardiomyopathy, other causes of CHF, drugs (e.g., theophylline and digoxin), and neurologic diseases can be associated with PACs.”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389
Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

17
Q

What is the procedure of choice to diagnose congestive heart failure?

A

“Echocardiography is the procedure of choice for the diagnosis of CHF. This is for two reasons. First, you can assess left ventricular systolic function as well as look for diastolic dysfunction to determine if this is systolic or diastolic heart failure. Second, you can evaluate the potential causes of heart failure including valvular heart disease, ischemic heart disease, and pericardial disease.”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

18
Q

What is the significance of BNP in diagnosing CHF?

A

In an asymptomatic patient a BNP less than 100 essentially rules out CHF. A BNP from 100 to 500 is indeterminate for chf. A BNP greater than 500 essentially means that the patient has congestive heart failure.

“Non-CHF causes of an elevated BNP include renal failure, ACS, sepsis/SIRS, pulmonary hypertension (PHTN), and COPD. Obesity causes a falsely low BNP”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

19
Q

Which NYHA CHF classification is Spironalactone indicated?

A

“Spironolactone has been shown to reduce mortality in patients with New York Heart Association (NYHA) Class III and Class IV CHF. It has not been studied in Class I and Class II failure. Serum potassium needs to be monitored closely after initiation of spironolactone, especially since it will generally be used with an ACE inhibitor or ARB, both of which can increase the serum potassium. This drug should be avoided in patients with renal insufficiency or patients with serum potassium >5 mEq/L”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

20
Q

Which drugs are associated with causing a CHF exacerbation?

A

Beta blockers and some calcium channel blockers

21
Q

What percentage of CHF patients have diastolic dysfunction?

A

Approximately 50% because it’s somewhere between 40 and 60%.

22
Q

Atropine AND Procainamide are no longer in the ACLS guidelines. T or F

A

True

23
Q

A mildly hypertensive patient that has a hypokalemia is most likely due to hypoaldosteronism. T or F

A

False. “Hyperaldosteronism can cause hypokalemia and hypertension. Aldosterone increases the secretion of potassium, which leads to hypokalemia”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

24
Q

What is the most likely cause of hyperaldosteronism?

A

Adrenal adenoma.

25
Q

What EKG findings are associated with pericardial effusion?

A

Electrical alternans exemplified by diminished QRS amplitude.

26
Q

What EKG findings are indicative of pericarditis?

A

“sinus tachycardia, diffuse ST elevations, and PR depression”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

27
Q

What are the treatments for PSVT?

A

Diltiazam 0.25 mg per kilogram IV, Verapamil 5 mg to 2.5 mg per kilogram IV and a Adenosine 6 mg IV initially followed by 12 mg IV.

Cardioversion is also an option but medications should be tried first.

28
Q

What does Wolf Parkinson White syndrome look like and how is it treated?

A

EKG shows a shortened PR interval, widened QRS with delta waves.

“The drug of choice is procainamide in patients with WPW that presents with PSVT, including atrial fibrillation/flutter. The other alternative is ibutilide. The reason is that the AV node is protective since it helps block most reentrant conductions. If you block the AV node with beta-blockers or calcium channel blockers, the reentrant loop is allowed to go “wild”

The clues to look for are a young patient with previous episodes of palpitations, rapid heart rate, or syncope”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

29
Q

How does one find a left anterior fascicular block on EKG?

A

“any patient with a net negative force in lead II (i.e., left axis deviation) will have a LAFB. Also, look for net negative deflection in leads III and aVF.”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

30
Q

What does a LBBB look like on EKG?

A

“Criteria include QRS width ≥0.12 ms, upright (monophasic) QRS in leads I and V6, and a mostly negative QRS in V1.

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

31
Q

How is a right bundle branch block defined on an EKG?

A

“The RBBB is defined by a QRS width of >0.12 ms (>3 small blocks) and an rsR᾿ (“rabbit ears”) in chest leads V1–V3”

Excerpt From: Mark Graber & Jason Wilbur. “Family Practice Examination and Board Review, Third Edition.” McGraw-Hill Medical, 2013. iBooks.
This material may be protected by copyright.

Check out this book on the iBooks Store: https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewBook?id=582642389

32
Q

Which electrolyte abnormality is associated with high Peaked T waves and EKG?

A

Hyperkalemia

33
Q

What percentage of CHF patients have diastolic dysfunction?

A

Approximately 50% because it’s somewhere between 40 and 60%.

34
Q

Atropine AND Procainamide are no longer in the ACLS guidelines. T or F

A

True

FP board review (15 decks)

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