cardio 3

Question 1

What Is AAA?

Answer 1

When the AA size more than 3 cm

Question 2

Risk factor for formation and progression?

Answer 2

Age >60

Smoking (The strongest one)

Male sex

Hypertension

History of atherosclerotic disease

Connective Tissue disease

Question 3

How smoking affects it?

Answer 3

Activate protease activity

Increase chronic inflammation

smooth muscle dysfunction

Cause for initiation and progression of the aneurysm

Question 4

clinical presentation?

Answer 4

Mostly asymptomatic

Rapid expansion–Dull abdominal/back pain and distal embolization

Rapture–shock, back and Abd pain and flank hematoma

Question 5

Indiction to repair

Answer 5

size more than 5.5 cm and rapid expansion >=1 cm per year growth symptomatic patient(as urgent for HS and emergency repair for HUS patients

If asymptomatic jut do lifestyle modification and smoking cessation

Question 6

PAD diagnosis?

Answer 6

intermittent claudication with ABI<0.9

Question 7

Management?

Answer 7

Risk modification

Antiplatelet

statin

Exercise (3/week-30-45 min/12 weeks)–goal is to follow symptom persistency

If the symptom persists–Do revascularization and cilostazol

Question 8

S3 (V.gallop)?

Answer 8

Heard after S2 Normal in children, young adult, and pregnant abnormal-Age>40,HF,RCMP,High output state

Question 9

S4 (A.gallop)?

Answer 9

Heard just before S1 Normal in healthy aged people Abnormal in Young adult, children, acute phase of MI and myocardial hypertrophy

Question 10

What type of splitting can see in MI?

Answer 10

paradoxical

Question 11

Pulses paradoxes?

Answer 11

Decrease SBP >10 during inspiration Can be seen in asthma, COPD, Hypovolemic shock, and constrictive pericarditis.

Question 12

AR finding?

Answer 12

Early Diastolic, Decretiendo, Blowing murmur If due to valvular will be heard in left 3rd and 4th ICS

Question 13

a normal systolic murmur in young adults?

Answer 13

mid systolic and not require further education

Question 14

What is atrial premature beat(PAC)?

Answer 14

Premature atrial activation of atria other than SA node

An atrial premature beat is an extra heartbeat caused by electrical activation of the atria

Criterion. (normal QRS, Different looking P wave, and premature atrial activation(atrial activation before expected time)

Question 15

Precipitating factor?

Answer 15

Smoking, caffeine, alcohol, and stress

Question 16

Diagnosis?

Answer 16

Early P waves in ECG

Question 17

Symptom?

Answer 17

skipped beat and Palpitation sometimes precede AF

Question 18

When echocardiography needed?

Answer 18

Occur in a patient without any precipitating factor?

Question 19

Management?

Answer 19

Beta-Blocker if persistent symptom. stop precipitating factor

Question 20

Cyanide toxicity symptom?

Answer 20

Altered MS, coma, seizure, and lactic acidosis

Question 21

Risk factors?

Answer 21

NP treatment(used for hypertension emergency) Renal insufficiency is a risk

Question 22

How we reduce severe hypertension?

Answer 22

Mean arterial reduction 10-20 % in first 1 hr then 5-10 % in next 23 hour.

Question 23

Stage of alcohol withdrawal?

Answer 23

mild withdrawal symptom, seizure, hallucination, and delirium tremens

Question 24

Mild withdrawal symptom?

Answer 24

6-12 Hr Intact orientation,anxiety,palpitation,GI symptom,insominia,treamer and diaphoresis

Question 25

seizure

Answer 25

12-48

Question 26

hallucination

Answer 26

12-48

Question 27

Delirium Tremens?

Answer 27

48-96hr fever, tachycardia, Hytn, diaphoresis, confusion, agitation, and hallucination.

Question 28

Symptom of cocaine toxicity?

Answer 28

S.H(hypertension, tachycardia, and dilated pupil) chest pain due to coronary vasoconstriction Psychomotor agitation and siezure

Question 29

Complication?

Answer 29

Myocardial Infarction

Intracranial hemorrhage

Aortic Dissection

Pulmonary infarction

Question 30

Mgt?

Answer 30

manage ATP

Benzodiazepine (for B/P and anxiety) Asprin(decrease thrombosis) Nitrogreceline and CCB(for pain)

Question 31

C/I In managment?

Answer 31

Beta-blocker(exacerbate ischemia and fibrinolytic(increase ICH risk).

Question 32

Viral myocarditis symptom?

Answer 32

Relatively young<55 Viral prodrom Chest pain and symptom of heart failure heart failure SCD

Question 33

Diagnosis

Answer 33

Echo(biventricular enlargement) with diffuse hypokinesis MRI-late enhancement of epicardium Biopsy:lymphocyic infiltration ECG–not specific

Question 34

management.

Answer 34

Medication(ACE,BB and diuretic) Temporary assisting device transplant if not help.

Question 35

RV infarction symptom?

Answer 35

Chest pain Autonomic symptom (diaphoresis and vomiting) Raised JVP and Kussmaul sign Clear chest transient Bradycardia AV block due to vagal tone. hypotension

Question 36

ECG finding?

Answer 36

St elevation in II, III, and avf or rt precordial led 4-6 Depression in I and avL

Question 37

Management

Answer 37

Normal saline infusion Avoid nitrate and diuretics

Question 38

Manifestation of heatstroke?

Answer 38

Temperature >40 with CNS dysfunction tachycardia, tachypnea, and hypotension flushing and diaphoresis end-organ dysfunction hemoconcentration

Question 39

Risk factors?

Answer 39

Elderly, obese, and poor physical fitness Alcohol and medication High to, high humidity and lack of ventilation

Question 40

Management

Answer 40

Stabilization(ABC) Cooling(antipyretic is not indicated) management of organ complication