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Challenge Bowl > Cardio > Flashcards

Cardio Flashcards

1
Q

MC initial, noninvasive test ordered in the assessment of a pt w/ caudication:

A

ankle-brachial index (< 0.8 is consistent w/ claudication)

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2
Q

MCly used prophylaxis against DVT in a pt a/b to undergo elective surgery:

A

LMWH - low molecular wt heparin

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3
Q

Initial screening imaging modality performed in the evaluation of a pt suspected of having a PE:

A

spiral CT

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4
Q

location of aortic aneurysm in a pt. w/ Marfan’s syndrome

A

thoracic

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5
Q

Screening modality of choice used in the assessment of a pt suspected of having AAA:

A

Abdominal US

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6
Q

MCC of 2ndary HTN

A

renal dz

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7
Q

electrolytes abnormality for 2ndary HTN that is caused by Conn’s syndrome (hyperaldosteronism):

A

unprovoked hypokalemia

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8
Q

2 classes of recommended BP meds in a pt w/ angina, according to the JNC VII findings:

A

BBs & ACEIs

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9
Q

MC SE if BBs are prescribed to young Caucasian male:

A

ED

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10
Q

MC SE that is seen w/ alpha blockers in the elderly:

A

orthostatic HoTN

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11
Q

MCly ordered blood test used in the pt who is suspected of having occult HF

A

BNP

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12
Q

What is considered to be the earliest sx of HF?

A

DOE

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13
Q

What physical exam sign signifies cardiomegaly in a pt w/ HF?

A

displaced PMI

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14
Q

What is the NY Heart Association (NYHA) HF classification for a pt who has sxs assoc. w/ moderate exertion?

A

Class II

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15
Q

What is the NYHA HF classification for a pt for a pt who has sx assoc. w/ minimal exertion?

A

Class III

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16
Q

What is the NYHA HF classification for a pt who has NO sx on exertion?

A

Class I

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17
Q

What is the NYHA HF classification for a pt who has sx at rest?

A

Class IV

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18
Q

What type of new heart sound may occur in a pt w/ either angina or MI?

A

S4

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19
Q

Name 3 EKG findings that may occur in a pt w/ angina:

A
  1. ST segment depression
  2. T wave inversion
  3. T wave flattening
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20
Q

What is the typically finding on a nuclear stress test for a pt who has angina but NO heart attack?

A

decreased ventricular filling

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21
Q

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?

A

unstable angina

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22
Q

What is the medication class of choice for pts who have Prinzmetal’s angina?

A

CCBs

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23
Q

What is the typical HR in a pt who has SVT?

A

> 150

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24
Q

What is the significance of a lrg biphasic P wave in lead V1 & AvR on the EKG?

A

R & L atrial enlargment

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25
Q

What is the MC sustained cardiac arrhythmia?

A

a-fib

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26
Q

What is the TOC for a pt w/ unstable SVT?

A

immediate cardioversion

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27
Q

What type of SVT is most likely to respond to the lowest amt of electricity for conversion?

A

atrial flutter

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28
Q

What is the TOC for a pt w/ unstable v-tach?

A

immediate defibrillation

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29
Q

Name the main tx for Torsades de pointes.

A

Magnesium sulfate

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30
Q

What type of BBB will make it merely impossible to diagnose an acute MI?

A

Left bundle

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31
Q

If you were going to ts 2nd degree type I heart block, what are the 2 TOC?

A

atropine followed by pacing if pt does not respond

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32
Q

What is the TOC for pts w/ 2nd degree T2HB?

A

immediate transcutaneous pacing followed by permanent pacing

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33
Q

TOC for 3rd degree HB?

A

immediate pacing

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34
Q

What are the 2 lateral precordial heart leads?

A

V5 & V6

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35
Q

What are the 3 heart leads assessed in a pt suspected of having inferior wall damage?

A

II, III, AvF

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36
Q

What heart vessel is MCly involved in a pt having a lateral wall MI?

A

circumflex

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37
Q

What is the MC heart vessel involved in a pt having an inferior wall MI?

A

R coronary artery

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38
Q

What is the MC heart vessel involved in a pt having an anterior wall MI?

A

LAD

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39
Q

What is the MC sx of LHF?

A

dyspnea - initially on exertion, then at rest

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40
Q

What is the MC sx of ischemic HD?

A

chest pain

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41
Q

What is the most likely sit of occlusion for a pt w/ buttocks claudication?

A

aortofemoral blockage (Leriche sign)

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42
Q

What is the MC cardiac cause of dependent pitting edema?

A

R-sided HF

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43
Q

What is the MCC of an awareness of a heartbeat?

A

anxiety

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44
Q

What heart sound corresponds to the carotid pulse?

A

S1

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45
Q

What is the MCC of fixed splitting of S2?

A

ASD

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46
Q

What is the MCC of decreased A2?

A

severe calcific aortic valve stenosis

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47
Q

What is the MCC of an accentuated P2?

A

Pulm HTN

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48
Q

What is the MC heart sound that is initially heard in L ventricular failure?

A

S3

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49
Q

What is the MCC of a normal L-sided S4?

A

athlete w/ physiologic LVH

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50
Q

What is the MCC of a systolic ejection click?

A

Mitral valve prolapse (MVP)

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51
Q

What is the MC reason for an opening snap?

A

Mitral stenosis

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52
Q

What is the MCC of an innocent murmur?

A

Aortic systolic ejection murmur

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53
Q

What is the MCC of a pahtological murmur?

A

structural dz of the valve

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54
Q

What is the MC valvular cause of a NARROW PULSE PRESSURE?

A

Aortic stenosis

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55
Q

What is the MC valvular cause of an increased pulse pressure?

A

Aortic regurgitation

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56
Q

What is the MC valvular cause of a weak pulse?

A

Aortic stenosis

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57
Q

What is the MC NON-valvular cause of a weak pulse?

A

hypovolemic or cardiogenic shock

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58
Q

pulse w/ a double systolic peak, a dicrotic wave is palpable

A

bisferiens (dicrotic pulse)

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59
Q

What sign is known as neck vein distention w/ inspiration?

A

Kussmaul’s sign

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60
Q

a pulse that has a high volume beat accompanied by a low amplitude beat

A

pulsus alternans

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61
Q

MCC of pulsus alternans

A

severe L ventricular failure

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62
Q

What jugular venous wave corresponds to the right atrial contraction?

A

A wave

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63
Q

What jugular neck wave corresponds to S1?

A

C wave

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64
Q

What test best evaluates for left atrial enlargement?

A

TEE (tranesophageal echocardiogram)

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65
Q

What lipid fraction increases after eating a fatty meal?

A

chylomicrons

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66
Q

What lipid fraction contains endogenously synthesized triglycerides?

A

VLDL

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67
Q

What are the 2 lipid tests that are MCly used in the screening for CHD in an asymptomatic pt?

A

total cholesterol & HDL level

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68
Q

What lipd fraction is MCly used to follow in the mgmt of CAD in a pt w/ known heart dz?

A

LDL

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69
Q

What is the primary fxn of lipoprotein (a)?

A

enhances atherosclerosis

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70
Q

Triglyceride levels above 1000 put a pt at risk for what disorder?

A

acute pancreatitis

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71
Q

What classes of antihypertensive medications AE lipids?

A

thiazide diuretics - inc. TG & chol

BB - inc. total cholesteral & dec. HDL

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72
Q

What hyperlipidemia is assoc. w/ tendon xanthomas?

A

Familial hypercholesterolemia

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73
Q

Which is the MC type of familial hypercholesterolemia?

A

Type II hyperlipidemia

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74
Q

Which class of cholesterol medications inhibit HMC-CoA reductase to decrease the ability of the liver to make cholesterol?

A

statins

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75
Q

What are the main SE of statin drugs?

A

Liver toxicity & myopathy

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76
Q

Which class of cholesterol medications inhibits lipolysis in adipose tissue which decreases the release of fatty acids & subsequent synthesis of LDL & VLDL?

A

Nicotinic acid (Niacin)

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77
Q

What is the main SE of nicotinic acid?

A

Flushing

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78
Q

Which class of cholesterol medications binds bile salts & reduce the total bile pool?

A

bile acid resins

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79
Q

What are the SE of bile acid resins?

A

bloating & constipation

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80
Q

Localized narrowing of the aortic arch that occurs distal to the origin of the L subcalvian artery near the insertion of the ligmentum arteriosum.

A

coarctation of the aorta

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81
Q

2 coexisting physical findings in a pt w/ coarc. of the aorta

A
  1. bicuspid aortic valve

2. rib notching

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82
Q

Pts w/ what underlying condition have the lowest acceptable BP goals?

A

DM (goal = 130/80)

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83
Q

Serious acute SE assoc. w/ the use of ACE inhibitors

A

angioedema

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84
Q

What is considered the gold standard test for the evaluation of renovascular HTN?

A

Renal angiography

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85
Q

This is a high-pitched DIASTOLIC decrescendo murmur that is heard early after A2 at the left sternal border.

A

Aortic insufficiency

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86
Q

An apical diastolic rumbling murmur that is caused by displacement of anterior leaflet of the mitral valve by a pt w/ aortic regurgitation.

A

Austin Flint murmur

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87
Q

Name this physical examination sign: nodding of the head that occurs w/ aortic regurgitation.

A

DeMusset sign

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88
Q

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:

A

Quincke sign

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89
Q

Name this PE sign: Visualization of a rapid rise & rapid fall of a pulse in a pt w/ aortic insufficiency.

A

Corrigan pulse or Water-Hammer pulse

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90
Q

Name this PE sign: Pistol-shot sound that is heard over the femoral artery in a pt w/ aortic regurgitation.

A

Traube sign

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91
Q

Name this PE sign: “to & fro” murmur heard during mild compression of the femoral artery that occurs in a pt w/ aortic regurgitation.

A

Duroziez sign

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92
Q

Classic triad for aortic stenosis

A
  1. external dyspnea
  2. chest pain
  3. syncope
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93
Q

Classic type of pulse assoc. w/ aortic stenosis

A

parvus & tardus (weak & delayed)

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94
Q

Mode of inheritance for HOCM

A

autosomal dominant

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95
Q

Clinical condition assoc. w/ dyspnea & acute pulmonary congestion due to a sudden increase in the L ventricular end-diastolic pressure & L atrial pressure:

A

acute mitral regurgitation

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96
Q

Holosystolic classically radiating to the axilla w/ resultant hyperdyanmic L ventricle & is assoc. w/ pulmonary rales

A

mitral regurgitation

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97
Q

CXR findings for this condition includes straightening of the L heart border, an atrial double density, or elevation of the L mainstem bronchus

A

mitral regurgitation

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98
Q

congested lung tissue w/ fluid in the interstitial spaces & alveoli

A

pulmonary edema

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99
Q

what heart valve abnormality classically is the MCC of cardiogenic pulmonary edema?

A

mitral stenosis

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100
Q

clinical presentation for this condition is chest pain usu located substernally that worsens w/ inspiration & decumbency & lessens w/ sitting up & leaning forward

A

pericarditis

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101
Q

accumulation of air in the pleural space w/ 2ndary lung collapse

A

PTX

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102
Q

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

A

spontaneous PTX

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103
Q

This type of PTX occurs as a result of the pleural pressure being greater than the atmospheric pressure throughout expiration

A

tension PTX

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104
Q

Excruciating, tearing chest pain that radiates into jaw or back that occurs suddenly

A

Aortic dissection

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105
Q

Class of meds for use in the tx of aortic dissection

A

BBs

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106
Q

Drug tx class of choice for pain caused by costochondritis

A

NSAIDs or corticosteroids

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107
Q

This condition presents w/ sharp localized chest pain that may be reproducible w/ palpation & is often confused for acute chest pain syndrome

A

costochondritis (Tietze syndrome)

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108
Q

Retrosternal burning sensation that radiates upward that is typically precipitated by a big meal or recumbency & may be relieved by antacids

A

GERD

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109
Q

Name of the surgical procedure that is performed for pts w/ GERD:

A

Nissan fundoplication

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110
Q

What single medication is proven to be effective in both primary & secondary prevention of MI?

A

Aspirin

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111
Q

What is the chief medication class that is used for STEMI?

A

Thrombolytic therapy

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112
Q

What is the most devastating complication of administering a thrombolytic agent?

A

bleeding

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113
Q

Chest pain syndrome w/ concurrent ST-segment elevation on EKG that results from spasm of an epicardial coronary artery

A

Unstable angina or Prinzmetal’s (variant) angina

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114
Q

Medication class of choice for treating pts w/ Prinzmetal’s angina

A

CCBs

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115
Q

Sx complex of dyspnea, tachypnea, chest pain, cough, syncope, & hemoptysis a few days after surgery

A

pulmonary embolism

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116
Q

This is a hemodynamic effect of repeated pulmonary emboli

A

chronic pulm HTN

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117
Q

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

A

Torsades de pointes

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118
Q

Name the 2 MC presenting s/sx for ventricular fibrillation

A
  1. sudden cardiac death

2. syncope

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119
Q

TOC for a pt w/ hemodynamically stable v-tach that is unresponsive to medication

A

synchronized cardioversion

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120
Q

The most sensitive but least specific enzyme that is used as a cardiac marker is

A

myoglobin

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121
Q

Which of the cardiac enzymes stays up for the longest timeframe following an acute MI?

A

Troponin

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122
Q

MIs that are a direct result of acute coronary artery vasospasm are MCly caused by the ingestion of what illegal substance?

A

cocaine

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123
Q

What is the MCC of death related to MI?

A

dysrhythmia

124
Q

Medication class TOC for pts following MI who also have poor L ventricular ejection (<40%)

A

ACE Inhibitors

125
Q

Which of the papillary muscles is MCly affected following acute MI?

A

posterior papillary muscle of the mitral valve

126
Q

Med class TOC for pts w/ pericarditis 7-10 days following AMI?

A

NSAIDs

127
Q

Septal wall MI leads to what complication w/in the heart?

A

VSD

128
Q

Earliest sx of L-sided HF

A

DOE

129
Q

Name the condition associated w/ Peripheral edema, increased JVD, RUQ pain from liver engorgement, & pulsatile, tender liver

A

R-sided CHF

130
Q

MCC of R-sided CHF

A

L-sided CHF

131
Q

TOC for pts w/ CHF that acts as a vasodilator & impairs cardiac remodeling

A

ACEIs

132
Q

MC valve that is involved w/ infective endocarditis

A

mitral

133
Q

these are NONTENDER scaly plaques located on the palms & soles of the feet & are seen in pts w/ infective endocarditis

A

Janeway lesions

134
Q

Retinal hemorrhages w/ central clearing that are seen in pts w/ infective endocarditis are known as:

A

Roth spots

135
Q

These are TENDER nodules seen on the tips of the fingers & toes in pts who have infective endocarditis

A

Osler nodes

136
Q

What medication is considered to be the best alternative to use for endocarditis prophylaxis in a pt who is allergic to PCN?

A

Clindamycin or Cephalexin (Keflex)

137
Q

HTN w/ signs of end-organ damage is known as:

A

Malignant HTN

138
Q

Which class of antihypertensive is assoc. w/ severe orthostatic HoTN as a 1st dose phenomena?

A

alpha blackers

139
Q

Classification for the antihypertensive agent Hydralazine (Apresoline)

A

direct vasodilator

140
Q

known SE w/ long-term use of hydralazine

A

Lupus-like syndrome

141
Q

MCly used antihyeprtensive agent during pregnancy:

A

methyldopa (aldomet)

142
Q

Antihyeprtensive class that is strictly CI during pregnancy due to its potential to cause renal agenesis

A

ACEIs

143
Q

The XR finding for this disorder is a widened mediastinum w/ intimal calcium separation & L-sided pleural effusion

A

aortic dissection

144
Q

initial medication class used in the medical tx of acute aortic dissection

A

BBs

145
Q

location for the majority of AAA

A

infrarenal

146
Q

pulsatile abdominal mass w/ abdominal or renal bruits & decreased femoral pulses

A

AAA

147
Q

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)

A

runaway pacemaker

148
Q

volume of blood in the ventricle at the end of diastole which is primarily a reflection of venous return

A

preload

149
Q

The amt of blood being pumped out of the L ventricle during contraction

A

ejection fraction

150
Q

Blood that gets pumped out during systole

A

preload

151
Q

force against which the ventricles must contract to eject blood - this is determined by arterial PRESSURE & size of the ventricular cavity:

A

afterload

152
Q

Amt of blood that is filling the L ventricle by the end of diastole

A

end diastolic volume (EDV)

153
Q

blood remaining in the L ventricle at the end of systole

A

end systolic volume (ESV)

154
Q

EDV - ESV =

A

strove volume (SV)

155
Q

SV x HR

A

Cardiac Output (CO)

156
Q

The relationship b/w SV & EDV

A

ejection fraction

157
Q

What percentage is considered the normal ejection fraction?

A

60-80%

158
Q

This cardiac enzyme rises w/in 4-6 h, peaks in 12-20 hrs, & remains elevated for 2-3 days:

A

CK-MB

159
Q

Amount of time that troponin may stay elevated following an MI:

A

7-14 days

160
Q

MC pathogen causing endocarditis in the DRUG-USING population:

A

Staph aureus

161
Q

MCC of prosthetic valve endocarditis:

A

Staph epidermidis

162
Q

Name the condition associated with muffled heart sounds, increased JVP pressure, pulsus paradoxus:

A

Cardiac tamponade

163
Q

Classical PE finding for a pt w/ pericarditis

A

pericardial friction rub

164
Q

Classic EKG finding for pt w/ pericarditis

A

ST-segment elevation in all leads along w/ low voltage

165
Q

Pericardial fluid collection causes obstruction of flow into the heart:

A

cardiac tamponade

166
Q

This cardiac condition has a classic EKG presentation of peaked P waves, right axis deviation, RBBB, & RVH

A

Cor pulmonale

167
Q

Most common category of CM

A

dilated

168
Q

What vitamin deficiency is assoc. w/ the development of dilated CM?

A

Thiamine (beriberi)

169
Q

What hematologic condition is assoc. w/ the development of dilated CM?

A

hemochromatosis

170
Q

MC infectious process causing dilated CM & acute myocarditis:

A

Coxsackie B

171
Q

MC type of hypertrophic CM

A

HOCM

172
Q

MCC of restrictive CM:

A

amyloidosis

173
Q

Marfan’s syndrome is most likely to cause what type of heart valve abnormality?

A

Aortic regurgitation

174
Q

What heart valve is MCly involved by rheumatic fever?

A

mitral

175
Q

Diagnostic evaluation of choice for a pt suspected of having aortic stenosis:

A

echocardiogram

176
Q

Syphilitic aortitis is most likely to cause what type of heart valve abnormalitiy?

A

aortic regurgitation

177
Q

Boot-shaped L ventricle on CXR is most likely due to what heart valve abnormality?

A

aortic regurgitation

178
Q

What valve abnormality is most likely to lead to dyspnea, orthopnea, & attacks of frank pulmonary edema w/ exercise & also produces a-fib:

A

mitral stenosis

179
Q

New heart murmur which is caused by an MI w/ resultant rupture of the papillary muscle:

A

mitral regurgitation

180
Q

MC cardiac abnormality that is found in the adult yrs is:

A

bicuspid aortic valve

181
Q

Malignant heart tumors are MCly due to:

A

sarcomas

182
Q

Highest BNP levels are seen in what NYHA classification:

A

Class IV

183
Q

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?

A

Aspirin & statins

184
Q

What group of pts undergoing PTCA have the highest risk of complications from their procedures?

A

diabetics

185
Q

Leading cause of death for women older than 50:

A

CAD

186
Q

A heart sound that makes a sound like the work “Kentucky” is mostly likely due to what?

A

S3

187
Q

MCC of a continuous machinery type murmur

A

Patent ductus arteriosus (PDA)

188
Q

2 cardinal features of mitral stenosis:

A

opening snap & diastolic rumbling murmur

189
Q

Best position of a pt in order to identify mitral stenosis:

A

left lateral decubitus

190
Q

What type of MI is most likely assoc. w/ 2nd degree heart block?

A

inferior wall

191
Q

Gradual prolongation of the PR interval w/ a dropped QRS complex:

A

2nd degree Wenkebach (Mobitz) Type I

192
Q

Dz in which the Jones criteria is used to make the dz:

A

Rheumatic fever

193
Q

What endocrine abnormality should be assessed in a pt w/ new onset a-fib?

A

hyperthyroidism

194
Q

R waves > than 11 mm in lead AVL defines what condition?

A

LVH

195
Q

Multifocal atrial tachycardia usu is 2ndary to what clinical condition?

A

Underlying pulmonary dz

196
Q

In add’n to diffuse ST segment elevation, what else is seen on the EKG in a pt who has acute pericarditis?

A

PR segment depression

197
Q

Brain naturetic peptide is used in the evaluation of what clinical condition?

A

chronic heart failure

198
Q

What PE finding has a 98% positive predictive value for chronic heart failure?

A

S3 gallop

199
Q

Low voltage seen throughout the EKG most likely suggests:

A

Pericarditis

200
Q

R wave larger than the S wave in lead AVR suggests posterior wall MI & what other condition?

A

RBBB

201
Q

P waves greater than 3 mm in width in lead II w/o any peaked P waves suggests what atrial abnormality?

A

left atriale enlargement (P mitrale)

202
Q

A crescendo-descrescendo systolic flow murmur that occurs after S1 w/ a rapid rise & fall of the carotid pulse is MCly due to:

A

HOCM

203
Q

MC chest location for hearing HOCM:

A

Lower left sternal border

204
Q

MC location for hearing aortic stenosis:

A

Right upper sternal border

205
Q

What clinical condition does rib notching on CXR be the classic finding?

A

coarctation of the aorta

206
Q

CXR shows cephalization of the vessels - this is classic for:

A

pulmonary edema

207
Q

CXR reveals pulmonary edema w/ HORIZONTAL LINES in the basal periphery due to leakage of interstitial fluid, this finding is known as;

A

Kerley B lines

208
Q

CXR reveals a finding known as a “BAT WING” or “BUTTERFLY” appearance - this is due to:

A

alveolar edema (pleural effusions, pulm edema)

209
Q

MC initial EKG abnormality for a pt having a “positive” stress test?

A

ST-segment depression

210
Q

Blockage of this vessel is assoc. w/ the highest coronary artery mortality:

A

left main

211
Q

Medication that is strictly CI in a pt w/ WPW

A

Verapamil

212
Q

2 physiologic reasons that S3 gallops occur:

A

Dilated ventricle (CHF) & rapid filling

213
Q

When in the cardiac cycle does S3 occur?

A

Early diastole (S4 occurs in late diastole)

214
Q

At what intensity of heart murmur will a thrill be palpable?

A

IV, V, VI

215
Q

Description of heart murmur for aortic stenosis

A

crescendo-decrescendo systolic murmur

216
Q

What is the underlying cause of a pt having a water-hammer pulse?

A

aortic regurgitation

217
Q

What is the TOC for a pt w/ symptomatic aortic stenosis?

A

surgical replacement of the aortic valve (versus commisurotomy)

218
Q

Classic description of the murmur caused by aortic regurgitation?

A

decrescendo diastolic murmur

219
Q

What is the initial effect on the left ventricle in a pt w/ aortic regurg.

A

left ventricular dilation

220
Q

A pt w/ Ortner’s syndrome has hemoptysis, hoarseness, & diastolic murmur - what is the most likely underlying cause?

A

mitral stenosis

221
Q

of all of the valvular heart lesions, which is the best tolerated by the pt?

A

mitral regurgitation

222
Q

80% of mitral regurgitant murmurs are due to what underlying condition?

A

Mitral valve prolapse (MVP)

223
Q

Pt w/ MVP and chest pain, palpitations, & dyspnea have what syndrome?

A

Barlow’s syndrome

224
Q

What murmur MCly radiates from the apex into the axilla?

A

mitral regurgitation

225
Q

This murmur has a diastolic rumble & loud S2 assoc. w/ it:

A

mitral stenosis

226
Q

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:

A

Still’s murmur

227
Q

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:

A

venous hum

228
Q

deep inspiration will dramatically increase which valvular heart murmur?

A

tricuspid regurgitation

229
Q

Machine-like heart murmur that has a continuous diastolic-systolic component:

A

PDA

230
Q

Pt w/ Rheumatic fever who has focal, interstitial myocardial inflammation is said to have what abnormality?

A

Aschoff body

231
Q

MC valvular heart abnormality assoc. w/ rheumatic fever

A

mitral regurgitation (60-80%)

232
Q

skin finding in rheumatic fever that is assoc. w/ progressively enlarging red spots

A

erythema marginatum

233
Q

What EKG finding is part of the minor criteria for Rheumatic fever?

A

increased PR interval

234
Q

MCly affected valve in a pt w/ IV drug abuse

A

Tricuspid

235
Q

Classic oral organism resulting in infective endocarditis:

A

Strep viridans

236
Q

What class of cardiac drugs may result in clinical depression?

A

BBs

237
Q

What class of antihypertensive medications may result in stress incontinence when prescribed for women?

A

alpha blockers (ex terazosin [Minipress])

238
Q

2 common SE seen in pt given a dihydropyridine CCB:

A

constipation & peripheral edema

239
Q

What antihypertensive class worsens gout?

A

thiazide diuretics

240
Q

Dressler’s syndrome following MI most likely occurs how soon after MI?

A

1-6 wks

241
Q

EKG finding in a pt w/ Variant or Prinzmetal’s angina:

A

ST segment elevation

242
Q

3 components constituting acute coronary syndrome

A
  1. unstable angina
  2. NSTEMI
  3. STEMI
243
Q

In a pt w/ acute pulmonary embolism, this XR finding shows elevation of hemidiaphragm on the same side of the PE:

A

Hamptom’s hump

244
Q

Tearing or ripping pain located b/w the scapula:

A

aortic dissection

245
Q

Beck’s triad is assoc. w/ what clinical condition?

A

cardiac tamponade

246
Q

Name Beck’s triad:

A
  1. muffled heart sounds
  2. jugular venous distension
  3. HoTN
247
Q

Gold standard for making the dx of aortic dissection

A

aortogram

248
Q

Portion of the blood vessels that results in aortic dissection:

A

Tear in the intima

249
Q

Abnormal heart sound that is assoc. w/ AMI

A

S4

250
Q

What med class is recommended for pts w/ NSTEMI & during angioplasty w/ stenting?

A

Glycoprotein IIb/IIIa inhibitors

251
Q

Drop in BP more than 10 mm systolic when pt takes a deep breath:

A

pulsus paradoxus

252
Q

What agent used in the mgmt of HF decreases sx & hospitalizations, but has NO effect on the mortality:

A

digoxin

253
Q

What vitamin deficiency is seen w/ the long term use of diuretics?

A

folate deficiency

254
Q

overdose w/ what class of agents causes hyperemia, dry skin, dilated pupils, delirium, & tachycardia?

A

anticholinergics

255
Q

Overdose w/ this med leads to miosis, bradycardia, HoTN, hypoventilation, & reduced level of consciousness:

A

opiates (narcotics)

256
Q

Overdose w/ this agent leads to salivation, lacrimation, urination, defecation, GI distress, & vomiting:

A

cholinergics such as organophosphates

257
Q

describe the numbers for pre-HTN

A

120-139/80-89

258
Q

Type of psychiatric med that may be linked w/ hypertensive crisis

A

MAOIs

259
Q

What med may precipitate a hypertensive crisis in a pt taking MAOIs?

A

demerol

260
Q

Initial med class that is recognized for the tx of HTN:

A

thiazide diuretics

261
Q

Pt has HTN & pre-existing heart dz. What is the recommended agent class to use to tx this pt?

A

BBs

262
Q

2 classes of meds that are recommended for pts w/ HTN & stable angina:

A

BBs & CCBs

263
Q

2 med classes that are recommended in treating African Americans w/ HTN:

A

Thiazide diuretics & CCBs

264
Q

What SE of HTN meds are the elderly pts at highest risk of having?

A

orthostatic HoTN

265
Q

What med taken in females increases the risk for the development of HTN?

A

OCPs

266
Q

What HTN med class is assoc. w/ hyperkalemia?

A

ACEIs

267
Q

3 classes of meds approved to control HTN during pregnany

A
  1. Methyldopa
  2. BBs (labetalol)
  3. Hydralazine
268
Q

Pt w/ 2ndary HTN who has a higher BP reading in the arms than the legs:

A

Coarctation of the aorta

269
Q

What HTN med class is preferable to use in those w/ migraine HAs, thyrotoxicosis, or essential tremor?

A

BBs

270
Q

What HTN med is indicated for use in those w/ a hx of Raynaud’s phenomena?

A

CCBs

271
Q

2 IV meds that are used to tx HTN emergency

A

IV nitroprusside & Labetolol

272
Q

What med class does Ezetimibe (Zetia) belong?

A

cholesterol absorption inhibitor

273
Q

Test that should be ordered if a pt on a statin complains of myalgias:

A

CPK (also aldolase)

274
Q

What med has the most potency at raising an HDL level?

A

Niacin

275
Q

What is the MC bile acid sequestrant agent used in the US?

A

Cholestryamine

276
Q

What test should be done in a pt taking the cholesterol absorption inhibitors?

A

LFTs

277
Q

Name 2 meds that are common causes for dilated CM:

A
  1. cocaine

2. adriamycin

278
Q

What infectious agent is a cause of dilated CM?

A

Coxsackie B

279
Q

What is the MC heart valvular abnormalitiy that occurs w/ dilated CM?

A

mitral regurgitation

280
Q

Name the type of abnormal respiration that occurs w/ restrictive CM:

A

Kussmaul

281
Q

What is the definitive tx for restrictive CM?

A

heart transplant

282
Q

What is the definitive way to make the dx of restrictive CM?

A

cardiac bx

283
Q

What is the MC type of defect leading to ASD?

A

ostium secundum

284
Q

What kind of heart murmur is seen w/ ASD?

A

systolic heart murmur

285
Q

What congenital dz is assoc. w/ coarctation of the aorta?

A

Turner’s syndrome

286
Q

What valvular abnormality is typically seen in a pt w/ coarctation of the aorta?

A

bicuspid aortic valve

287
Q

Name the type of murmur that occurs w/ VSD:

A

systolic murmur

288
Q

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?

A

Eisenmenger’s syndrome

289
Q

What congenital exposure is known to cause patent ductus arteriosus?

A

Rubella

290
Q

What is the MC tx for PDA?

A

surgical ligation

291
Q

What is the MC type of cyanotic heart dz (congenital)?

A

Tetralogy of Fallot

292
Q

type of murmur that occurs w/ Tetralogy of Fallot:

A

holosystolic

293
Q

What abnormal blood pattern occurs in a pt w/ cyanotic heart dz?

A

polycythemia

294
Q

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:

A

aortic stenosis

295
Q

What diagnostic modality is MCly performed prior to valve replacement/valve repair in the elderly population?

A

Coronary angiogram

296
Q

Where does the aortic stenotic murmur radiate?

A

into the carotids

297
Q

What 2 maneuvers lead to the murmur of aortic insufficiency becoming worse?

A

leaning fwd & holding breath

298
Q

What med intake is the cause of Epstein’s anomaly?

A

Lithium during pregnancy

299
Q

What valvular abnormality is MCly assoc. w/ a R ventricular heave?

A

pulmonary stenosis

300
Q

Name the MC med used in prophylaxis against bacterial endocarditis?

A

Amoxicillin

301
Q

Surgical tx of constrictive pericarditis:

A

pericardial window

302
Q

Name the MC cancer that metastasizes to the heart:

A

melanoma

303
Q

What is the typical CXR finding for a pt w/ constrictive pericarditis?

A

pericardial calcifications

304
Q

What is the EKG finding for pericardial effusion?

A

Low voltage & electrica alternans

305
Q

What is the immediate tx for pericardial effusion?

A

pericardiocentesis

Challenge Bowl (9 decks)

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