Cardio Flashcards
MC initial, noninvasive test ordered in the assessment of a pt w/ caudication:
ankle-brachial index (< 0.8 is consistent w/ claudication)
MCly used prophylaxis against DVT in a pt a/b to undergo elective surgery:
LMWH - low molecular wt heparin
Initial screening imaging modality performed in the evaluation of a pt suspected of having a PE:
spiral CT
location of aortic aneurysm in a pt. w/ Marfan’s syndrome
thoracic
Screening modality of choice used in the assessment of a pt suspected of having AAA:
Abdominal US
MCC of 2ndary HTN
renal dz
electrolytes abnormality for 2ndary HTN that is caused by Conn’s syndrome (hyperaldosteronism):
unprovoked hypokalemia
2 classes of recommended BP meds in a pt w/ angina, according to the JNC VII findings:
BBs & ACEIs
MC SE if BBs are prescribed to young Caucasian male:
ED
MC SE that is seen w/ alpha blockers in the elderly:
orthostatic HoTN
MCly ordered blood test used in the pt who is suspected of having occult HF
BNP
What is considered to be the earliest sx of HF?
DOE
What physical exam sign signifies cardiomegaly in a pt w/ HF?
displaced PMI
What is the NY Heart Association (NYHA) HF classification for a pt who has sxs assoc. w/ moderate exertion?
Class II
What is the NYHA HF classification for a pt for a pt who has sx assoc. w/ minimal exertion?
Class III
What is the NYHA HF classification for a pt who has NO sx on exertion?
Class I
What is the NYHA HF classification for a pt who has sx at rest?
Class IV
What type of new heart sound may occur in a pt w/ either angina or MI?
S4
Name 3 EKG findings that may occur in a pt w/ angina:
- ST segment depression
- T wave inversion
- T wave flattening
What is the typically finding on a nuclear stress test for a pt who has angina but NO heart attack?
decreased ventricular filling
A pt w/ well-controlled angina presents w/ a change in his sx pattern w/ CP. These sx occurs sooner than expected and that lasts longer than usual. The diagnostic work up reveals no EKG findings and cardiac enzymes are negative. What is the dx?
unstable angina
What is the medication class of choice for pts who have Prinzmetal’s angina?
CCBs
What is the typical HR in a pt who has SVT?
> 150
What is the significance of a lrg biphasic P wave in lead V1 & AvR on the EKG?
R & L atrial enlargment
What is the MC sustained cardiac arrhythmia?
a-fib
What is the TOC for a pt w/ unstable SVT?
immediate cardioversion
What type of SVT is most likely to respond to the lowest amt of electricity for conversion?
atrial flutter
What is the TOC for a pt w/ unstable v-tach?
immediate defibrillation
Name the main tx for Torsades de pointes.
Magnesium sulfate
What type of BBB will make it merely impossible to diagnose an acute MI?
Left bundle
If you were going to ts 2nd degree type I heart block, what are the 2 TOC?
atropine followed by pacing if pt does not respond
What is the TOC for pts w/ 2nd degree T2HB?
immediate transcutaneous pacing followed by permanent pacing
TOC for 3rd degree HB?
immediate pacing
What are the 2 lateral precordial heart leads?
V5 & V6
What are the 3 heart leads assessed in a pt suspected of having inferior wall damage?
II, III, AvF
What heart vessel is MCly involved in a pt having a lateral wall MI?
circumflex
What is the MC heart vessel involved in a pt having an inferior wall MI?
R coronary artery
What is the MC heart vessel involved in a pt having an anterior wall MI?
LAD
What is the MC sx of LHF?
dyspnea - initially on exertion, then at rest
What is the MC sx of ischemic HD?
chest pain
What is the most likely sit of occlusion for a pt w/ buttocks claudication?
aortofemoral blockage (Leriche sign)
What is the MC cardiac cause of dependent pitting edema?
R-sided HF
What is the MCC of an awareness of a heartbeat?
anxiety
What heart sound corresponds to the carotid pulse?
S1
What is the MCC of fixed splitting of S2?
ASD
What is the MCC of decreased A2?
severe calcific aortic valve stenosis
What is the MCC of an accentuated P2?
Pulm HTN
What is the MC heart sound that is initially heard in L ventricular failure?
S3
What is the MCC of a normal L-sided S4?
athlete w/ physiologic LVH
What is the MCC of a systolic ejection click?
Mitral valve prolapse (MVP)
What is the MC reason for an opening snap?
Mitral stenosis
What is the MCC of an innocent murmur?
Aortic systolic ejection murmur
What is the MCC of a pahtological murmur?
structural dz of the valve
What is the MC valvular cause of a NARROW PULSE PRESSURE?
Aortic stenosis
What is the MC valvular cause of an increased pulse pressure?
Aortic regurgitation
What is the MC valvular cause of a weak pulse?
Aortic stenosis
What is the MC NON-valvular cause of a weak pulse?
hypovolemic or cardiogenic shock
pulse w/ a double systolic peak, a dicrotic wave is palpable
bisferiens (dicrotic pulse)
What sign is known as neck vein distention w/ inspiration?
Kussmaul’s sign
a pulse that has a high volume beat accompanied by a low amplitude beat
pulsus alternans
MCC of pulsus alternans
severe L ventricular failure
What jugular venous wave corresponds to the right atrial contraction?
A wave
What jugular neck wave corresponds to S1?
C wave
What test best evaluates for left atrial enlargement?
TEE (tranesophageal echocardiogram)
What lipid fraction increases after eating a fatty meal?
chylomicrons
What lipid fraction contains endogenously synthesized triglycerides?
VLDL
What are the 2 lipid tests that are MCly used in the screening for CHD in an asymptomatic pt?
total cholesterol & HDL level
What lipd fraction is MCly used to follow in the mgmt of CAD in a pt w/ known heart dz?
LDL
What is the primary fxn of lipoprotein (a)?
enhances atherosclerosis
Triglyceride levels above 1000 put a pt at risk for what disorder?
acute pancreatitis
What classes of antihypertensive medications AE lipids?
thiazide diuretics - inc. TG & chol
BB - inc. total cholesteral & dec. HDL
What hyperlipidemia is assoc. w/ tendon xanthomas?
Familial hypercholesterolemia
Which is the MC type of familial hypercholesterolemia?
Type II hyperlipidemia
Which class of cholesterol medications inhibit HMC-CoA reductase to decrease the ability of the liver to make cholesterol?
statins
What are the main SE of statin drugs?
Liver toxicity & myopathy
Which class of cholesterol medications inhibits lipolysis in adipose tissue which decreases the release of fatty acids & subsequent synthesis of LDL & VLDL?
Nicotinic acid (Niacin)
What is the main SE of nicotinic acid?
Flushing
Which class of cholesterol medications binds bile salts & reduce the total bile pool?
bile acid resins
What are the SE of bile acid resins?
bloating & constipation
Localized narrowing of the aortic arch that occurs distal to the origin of the L subcalvian artery near the insertion of the ligmentum arteriosum.
coarctation of the aorta
2 coexisting physical findings in a pt w/ coarc. of the aorta
- bicuspid aortic valve
2. rib notching
Pts w/ what underlying condition have the lowest acceptable BP goals?
DM (goal = 130/80)
Serious acute SE assoc. w/ the use of ACE inhibitors
angioedema
What is considered the gold standard test for the evaluation of renovascular HTN?
Renal angiography
This is a high-pitched DIASTOLIC decrescendo murmur that is heard early after A2 at the left sternal border.
Aortic insufficiency
An apical diastolic rumbling murmur that is caused by displacement of anterior leaflet of the mitral valve by a pt w/ aortic regurgitation.
Austin Flint murmur
Name this physical examination sign: nodding of the head that occurs w/ aortic regurgitation.
DeMusset sign
Name this PE sign: visible pulsations seen in the capillary beds w/ gentle compression of the nailbed or lip in a pt w/ aortic insufficiency:
Quincke sign
Name this PE sign: Visualization of a rapid rise & rapid fall of a pulse in a pt w/ aortic insufficiency.
Corrigan pulse or Water-Hammer pulse
Name this PE sign: Pistol-shot sound that is heard over the femoral artery in a pt w/ aortic regurgitation.
Traube sign
Name this PE sign: “to & fro” murmur heard during mild compression of the femoral artery that occurs in a pt w/ aortic regurgitation.
Duroziez sign
Classic triad for aortic stenosis
- external dyspnea
- chest pain
- syncope
Classic type of pulse assoc. w/ aortic stenosis
parvus & tardus (weak & delayed)
Mode of inheritance for HOCM
autosomal dominant
Clinical condition assoc. w/ dyspnea & acute pulmonary congestion due to a sudden increase in the L ventricular end-diastolic pressure & L atrial pressure:
acute mitral regurgitation
Holosystolic classically radiating to the axilla w/ resultant hyperdyanmic L ventricle & is assoc. w/ pulmonary rales
mitral regurgitation
CXR findings for this condition includes straightening of the L heart border, an atrial double density, or elevation of the L mainstem bronchus
mitral regurgitation
congested lung tissue w/ fluid in the interstitial spaces & alveoli
pulmonary edema
what heart valve abnormality classically is the MCC of cardiogenic pulmonary edema?
mitral stenosis
clinical presentation for this condition is chest pain usu located substernally that worsens w/ inspiration & decumbency & lessens w/ sitting up & leaning forward
pericarditis
accumulation of air in the pleural space w/ 2ndary lung collapse
PTX
acute onset of chest pain that is localized to one side of the chest that is usu pleuritic in nature & is assoc. w/ acute dyspnea
spontaneous PTX
This type of PTX occurs as a result of the pleural pressure being greater than the atmospheric pressure throughout expiration
tension PTX
Excruciating, tearing chest pain that radiates into jaw or back that occurs suddenly
Aortic dissection
Class of meds for use in the tx of aortic dissection
BBs
Drug tx class of choice for pain caused by costochondritis
NSAIDs or corticosteroids
This condition presents w/ sharp localized chest pain that may be reproducible w/ palpation & is often confused for acute chest pain syndrome
costochondritis (Tietze syndrome)
Retrosternal burning sensation that radiates upward that is typically precipitated by a big meal or recumbency & may be relieved by antacids
GERD
Name of the surgical procedure that is performed for pts w/ GERD:
Nissan fundoplication
What single medication is proven to be effective in both primary & secondary prevention of MI?
Aspirin
What is the chief medication class that is used for STEMI?
Thrombolytic therapy
What is the most devastating complication of administering a thrombolytic agent?
bleeding
Chest pain syndrome w/ concurrent ST-segment elevation on EKG that results from spasm of an epicardial coronary artery
Unstable angina or Prinzmetal’s (variant) angina
Medication class of choice for treating pts w/ Prinzmetal’s angina
CCBs
Sx complex of dyspnea, tachypnea, chest pain, cough, syncope, & hemoptysis a few days after surgery
pulmonary embolism
This is a hemodynamic effect of repeated pulmonary emboli
chronic pulm HTN
wide complex polymorphic ventricular tachycardia w/ QRS complexes that progressively change direction or axis that may be seen in the setting of prolonged QT interval
Torsades de pointes
Name the 2 MC presenting s/sx for ventricular fibrillation
- sudden cardiac death
2. syncope
TOC for a pt w/ hemodynamically stable v-tach that is unresponsive to medication
synchronized cardioversion
The most sensitive but least specific enzyme that is used as a cardiac marker is
myoglobin
Which of the cardiac enzymes stays up for the longest timeframe following an acute MI?
Troponin
MIs that are a direct result of acute coronary artery vasospasm are MCly caused by the ingestion of what illegal substance?
cocaine
What is the MCC of death related to MI?
dysrhythmia
Medication class TOC for pts following MI who also have poor L ventricular ejection (<40%)
ACE Inhibitors
Which of the papillary muscles is MCly affected following acute MI?
posterior papillary muscle of the mitral valve
Med class TOC for pts w/ pericarditis 7-10 days following AMI?
NSAIDs
Septal wall MI leads to what complication w/in the heart?
VSD
Earliest sx of L-sided HF
DOE
Name the condition associated w/ Peripheral edema, increased JVD, RUQ pain from liver engorgement, & pulsatile, tender liver
R-sided CHF
MCC of R-sided CHF
L-sided CHF
TOC for pts w/ CHF that acts as a vasodilator & impairs cardiac remodeling
ACEIs
MC valve that is involved w/ infective endocarditis
mitral
these are NONTENDER scaly plaques located on the palms & soles of the feet & are seen in pts w/ infective endocarditis
Janeway lesions
Retinal hemorrhages w/ central clearing that are seen in pts w/ infective endocarditis are known as:
Roth spots
These are TENDER nodules seen on the tips of the fingers & toes in pts who have infective endocarditis
Osler nodes
What medication is considered to be the best alternative to use for endocarditis prophylaxis in a pt who is allergic to PCN?
Clindamycin or Cephalexin (Keflex)
HTN w/ signs of end-organ damage is known as:
Malignant HTN
Which class of antihypertensive is assoc. w/ severe orthostatic HoTN as a 1st dose phenomena?
alpha blackers
Classification for the antihypertensive agent Hydralazine (Apresoline)
direct vasodilator
known SE w/ long-term use of hydralazine
Lupus-like syndrome
MCly used antihyeprtensive agent during pregnancy:
methyldopa (aldomet)
Antihyeprtensive class that is strictly CI during pregnancy due to its potential to cause renal agenesis
ACEIs
The XR finding for this disorder is a widened mediastinum w/ intimal calcium separation & L-sided pleural effusion
aortic dissection
initial medication class used in the medical tx of acute aortic dissection
BBs
location for the majority of AAA
infrarenal
pulsatile abdominal mass w/ abdominal or renal bruits & decreased femoral pulses
AAA
type of pacemaker malfxn in which the pacemaker generates many more frequent impulses than indicated (can have a rate over 400 w/ assoc. heart block)
runaway pacemaker
volume of blood in the ventricle at the end of diastole which is primarily a reflection of venous return
preload
The amt of blood being pumped out of the L ventricle during contraction
ejection fraction
Blood that gets pumped out during systole
preload
force against which the ventricles must contract to eject blood - this is determined by arterial PRESSURE & size of the ventricular cavity:
afterload
Amt of blood that is filling the L ventricle by the end of diastole
end diastolic volume (EDV)
blood remaining in the L ventricle at the end of systole
end systolic volume (ESV)
EDV - ESV =
strove volume (SV)
SV x HR
Cardiac Output (CO)
The relationship b/w SV & EDV
ejection fraction
What percentage is considered the normal ejection fraction?
60-80%
This cardiac enzyme rises w/in 4-6 h, peaks in 12-20 hrs, & remains elevated for 2-3 days:
CK-MB
Amount of time that troponin may stay elevated following an MI:
7-14 days
MC pathogen causing endocarditis in the DRUG-USING population:
Staph aureus
MCC of prosthetic valve endocarditis:
Staph epidermidis
Name the condition associated with muffled heart sounds, increased JVP pressure, pulsus paradoxus:
Cardiac tamponade
Classical PE finding for a pt w/ pericarditis
pericardial friction rub
Classic EKG finding for pt w/ pericarditis
ST-segment elevation in all leads along w/ low voltage
Pericardial fluid collection causes obstruction of flow into the heart:
cardiac tamponade
This cardiac condition has a classic EKG presentation of peaked P waves, right axis deviation, RBBB, & RVH
Cor pulmonale
Most common category of CM
dilated
What vitamin deficiency is assoc. w/ the development of dilated CM?
Thiamine (beriberi)
What hematologic condition is assoc. w/ the development of dilated CM?
hemochromatosis
MC infectious process causing dilated CM & acute myocarditis:
Coxsackie B
MC type of hypertrophic CM
HOCM
MCC of restrictive CM:
amyloidosis
Marfan’s syndrome is most likely to cause what type of heart valve abnormality?
Aortic regurgitation
What heart valve is MCly involved by rheumatic fever?
mitral
Diagnostic evaluation of choice for a pt suspected of having aortic stenosis:
echocardiogram
Syphilitic aortitis is most likely to cause what type of heart valve abnormalitiy?
aortic regurgitation
Boot-shaped L ventricle on CXR is most likely due to what heart valve abnormality?
aortic regurgitation
What valve abnormality is most likely to lead to dyspnea, orthopnea, & attacks of frank pulmonary edema w/ exercise & also produces a-fib:
mitral stenosis
New heart murmur which is caused by an MI w/ resultant rupture of the papillary muscle:
mitral regurgitation
MC cardiac abnormality that is found in the adult yrs is:
bicuspid aortic valve
Malignant heart tumors are MCly due to:
sarcomas
Highest BNP levels are seen in what NYHA classification:
Class IV
What are the 2 medications that are currently recommended if a pt is found to have an elevation in the high sensitivity C reactive protein?
Aspirin & statins
What group of pts undergoing PTCA have the highest risk of complications from their procedures?
diabetics
Leading cause of death for women older than 50:
CAD
A heart sound that makes a sound like the work “Kentucky” is mostly likely due to what?
S3
MCC of a continuous machinery type murmur
Patent ductus arteriosus (PDA)
2 cardinal features of mitral stenosis:
opening snap & diastolic rumbling murmur
Best position of a pt in order to identify mitral stenosis:
left lateral decubitus
What type of MI is most likely assoc. w/ 2nd degree heart block?
inferior wall
Gradual prolongation of the PR interval w/ a dropped QRS complex:
2nd degree Wenkebach (Mobitz) Type I
Dz in which the Jones criteria is used to make the dz:
Rheumatic fever
What endocrine abnormality should be assessed in a pt w/ new onset a-fib?
hyperthyroidism
R waves > than 11 mm in lead AVL defines what condition?
LVH
Multifocal atrial tachycardia usu is 2ndary to what clinical condition?
Underlying pulmonary dz
In add’n to diffuse ST segment elevation, what else is seen on the EKG in a pt who has acute pericarditis?
PR segment depression
Brain naturetic peptide is used in the evaluation of what clinical condition?
chronic heart failure
What PE finding has a 98% positive predictive value for chronic heart failure?
S3 gallop
Low voltage seen throughout the EKG most likely suggests:
Pericarditis
R wave larger than the S wave in lead AVR suggests posterior wall MI & what other condition?
RBBB
P waves greater than 3 mm in width in lead II w/o any peaked P waves suggests what atrial abnormality?
left atriale enlargement (P mitrale)
A crescendo-descrescendo systolic flow murmur that occurs after S1 w/ a rapid rise & fall of the carotid pulse is MCly due to:
HOCM
MC chest location for hearing HOCM:
Lower left sternal border
MC location for hearing aortic stenosis:
Right upper sternal border
What clinical condition does rib notching on CXR be the classic finding?
coarctation of the aorta
CXR shows cephalization of the vessels - this is classic for:
pulmonary edema
CXR reveals pulmonary edema w/ HORIZONTAL LINES in the basal periphery due to leakage of interstitial fluid, this finding is known as;
Kerley B lines
CXR reveals a finding known as a “BAT WING” or “BUTTERFLY” appearance - this is due to:
alveolar edema (pleural effusions, pulm edema)
MC initial EKG abnormality for a pt having a “positive” stress test?
ST-segment depression
Blockage of this vessel is assoc. w/ the highest coronary artery mortality:
left main
Medication that is strictly CI in a pt w/ WPW
Verapamil
2 physiologic reasons that S3 gallops occur:
Dilated ventricle (CHF) & rapid filling
When in the cardiac cycle does S3 occur?
Early diastole (S4 occurs in late diastole)
At what intensity of heart murmur will a thrill be palpable?
IV, V, VI
Description of heart murmur for aortic stenosis
crescendo-decrescendo systolic murmur
What is the underlying cause of a pt having a water-hammer pulse?
aortic regurgitation
What is the TOC for a pt w/ symptomatic aortic stenosis?
surgical replacement of the aortic valve (versus commisurotomy)
Classic description of the murmur caused by aortic regurgitation?
decrescendo diastolic murmur
What is the initial effect on the left ventricle in a pt w/ aortic regurg.
left ventricular dilation
A pt w/ Ortner’s syndrome has hemoptysis, hoarseness, & diastolic murmur - what is the most likely underlying cause?
mitral stenosis
of all of the valvular heart lesions, which is the best tolerated by the pt?
mitral regurgitation
80% of mitral regurgitant murmurs are due to what underlying condition?
Mitral valve prolapse (MVP)
Pt w/ MVP and chest pain, palpitations, & dyspnea have what syndrome?
Barlow’s syndrome
What murmur MCly radiates from the apex into the axilla?
mitral regurgitation
This murmur has a diastolic rumble & loud S2 assoc. w/ it:
mitral stenosis
This murmur is caused by turbulent flow in the L ventricle outflow, is loudest in the supine position, & is low-pitched w/ a musical quality & commonly a grade II-III/VI. Seen most frequently in children:
Still’s murmur
This is a continuous murmur described as a soft, blowing murmur located in the infraclavicular region radiating into the neck which disappears when the pt lays supine or thurn his head:
venous hum
deep inspiration will dramatically increase which valvular heart murmur?
tricuspid regurgitation
Machine-like heart murmur that has a continuous diastolic-systolic component:
PDA
Pt w/ Rheumatic fever who has focal, interstitial myocardial inflammation is said to have what abnormality?
Aschoff body
MC valvular heart abnormality assoc. w/ rheumatic fever
mitral regurgitation (60-80%)
skin finding in rheumatic fever that is assoc. w/ progressively enlarging red spots
erythema marginatum
What EKG finding is part of the minor criteria for Rheumatic fever?
increased PR interval
MCly affected valve in a pt w/ IV drug abuse
Tricuspid
Classic oral organism resulting in infective endocarditis:
Strep viridans
What class of cardiac drugs may result in clinical depression?
BBs
What class of antihypertensive medications may result in stress incontinence when prescribed for women?
alpha blockers (ex terazosin [Minipress])
2 common SE seen in pt given a dihydropyridine CCB:
constipation & peripheral edema
What antihypertensive class worsens gout?
thiazide diuretics
Dressler’s syndrome following MI most likely occurs how soon after MI?
1-6 wks
EKG finding in a pt w/ Variant or Prinzmetal’s angina:
ST segment elevation
3 components constituting acute coronary syndrome
- unstable angina
- NSTEMI
- STEMI
In a pt w/ acute pulmonary embolism, this XR finding shows elevation of hemidiaphragm on the same side of the PE:
Hamptom’s hump
Tearing or ripping pain located b/w the scapula:
aortic dissection
Beck’s triad is assoc. w/ what clinical condition?
cardiac tamponade
Name Beck’s triad:
- muffled heart sounds
- jugular venous distension
- HoTN
Gold standard for making the dx of aortic dissection
aortogram
Portion of the blood vessels that results in aortic dissection:
Tear in the intima
Abnormal heart sound that is assoc. w/ AMI
S4
What med class is recommended for pts w/ NSTEMI & during angioplasty w/ stenting?
Glycoprotein IIb/IIIa inhibitors
Drop in BP more than 10 mm systolic when pt takes a deep breath:
pulsus paradoxus
What agent used in the mgmt of HF decreases sx & hospitalizations, but has NO effect on the mortality:
digoxin
What vitamin deficiency is seen w/ the long term use of diuretics?
folate deficiency
overdose w/ what class of agents causes hyperemia, dry skin, dilated pupils, delirium, & tachycardia?
anticholinergics
Overdose w/ this med leads to miosis, bradycardia, HoTN, hypoventilation, & reduced level of consciousness:
opiates (narcotics)
Overdose w/ this agent leads to salivation, lacrimation, urination, defecation, GI distress, & vomiting:
cholinergics such as organophosphates
describe the numbers for pre-HTN
120-139/80-89
Type of psychiatric med that may be linked w/ hypertensive crisis
MAOIs
What med may precipitate a hypertensive crisis in a pt taking MAOIs?
demerol
Initial med class that is recognized for the tx of HTN:
thiazide diuretics
Pt has HTN & pre-existing heart dz. What is the recommended agent class to use to tx this pt?
BBs
2 classes of meds that are recommended for pts w/ HTN & stable angina:
BBs & CCBs
2 med classes that are recommended in treating African Americans w/ HTN:
Thiazide diuretics & CCBs
What SE of HTN meds are the elderly pts at highest risk of having?
orthostatic HoTN
What med taken in females increases the risk for the development of HTN?
OCPs
What HTN med class is assoc. w/ hyperkalemia?
ACEIs
3 classes of meds approved to control HTN during pregnany
- Methyldopa
- BBs (labetalol)
- Hydralazine
Pt w/ 2ndary HTN who has a higher BP reading in the arms than the legs:
Coarctation of the aorta
What HTN med class is preferable to use in those w/ migraine HAs, thyrotoxicosis, or essential tremor?
BBs
What HTN med is indicated for use in those w/ a hx of Raynaud’s phenomena?
CCBs
2 IV meds that are used to tx HTN emergency
IV nitroprusside & Labetolol
What med class does Ezetimibe (Zetia) belong?
cholesterol absorption inhibitor
Test that should be ordered if a pt on a statin complains of myalgias:
CPK (also aldolase)
What med has the most potency at raising an HDL level?
Niacin
What is the MC bile acid sequestrant agent used in the US?
Cholestryamine
What test should be done in a pt taking the cholesterol absorption inhibitors?
LFTs
Name 2 meds that are common causes for dilated CM:
- cocaine
2. adriamycin
What infectious agent is a cause of dilated CM?
Coxsackie B
What is the MC heart valvular abnormalitiy that occurs w/ dilated CM?
mitral regurgitation
Name the type of abnormal respiration that occurs w/ restrictive CM:
Kussmaul
What is the definitive tx for restrictive CM?
heart transplant
What is the definitive way to make the dx of restrictive CM?
cardiac bx
What is the MC type of defect leading to ASD?
ostium secundum
What kind of heart murmur is seen w/ ASD?
systolic heart murmur
What congenital dz is assoc. w/ coarctation of the aorta?
Turner’s syndrome
What valvular abnormality is typically seen in a pt w/ coarctation of the aorta?
bicuspid aortic valve
Name the type of murmur that occurs w/ VSD:
systolic murmur
What is the name of the syndrome that occurs in a pt w/ VSD when the shunt is reversed & the pt develops the soon to be fatal condition of R-to-L shunting?
Eisenmenger’s syndrome
What congenital exposure is known to cause patent ductus arteriosus?
Rubella
What is the MC tx for PDA?
surgical ligation
What is the MC type of cyanotic heart dz (congenital)?
Tetralogy of Fallot
type of murmur that occurs w/ Tetralogy of Fallot:
holosystolic
What abnormal blood pattern occurs in a pt w/ cyanotic heart dz?
polycythemia
This valvular problem has a mid -to late systolic murmur that may disappear as the murmur progresses, has a single S2 or paradoxically split S2 w/ delay in the carotid upstroke:
aortic stenosis
What diagnostic modality is MCly performed prior to valve replacement/valve repair in the elderly population?
Coronary angiogram
Where does the aortic stenotic murmur radiate?
into the carotids
What 2 maneuvers lead to the murmur of aortic insufficiency becoming worse?
leaning fwd & holding breath
What med intake is the cause of Epstein’s anomaly?
Lithium during pregnancy
What valvular abnormality is MCly assoc. w/ a R ventricular heave?
pulmonary stenosis
Name the MC med used in prophylaxis against bacterial endocarditis?
Amoxicillin
Surgical tx of constrictive pericarditis:
pericardial window
Name the MC cancer that metastasizes to the heart:
melanoma
What is the typical CXR finding for a pt w/ constrictive pericarditis?
pericardial calcifications
What is the EKG finding for pericardial effusion?
Low voltage & electrica alternans
What is the immediate tx for pericardial effusion?
pericardiocentesis
