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ABIM > Cardio 5 > Flashcards

Cardio 5 Flashcards

1
Q

Treatment for Wide Complex Tachycardia associated with Hemodynamic Instability?

A

Immediate Synchronized Cardioversion

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2
Q

Preferred Antiarrhythmics in patients without CAD or Structural Heart Disease?

A

Flecainide or Propafenone ( favorable in young patients, low side effect profile) , contraindicated in patients with CAD or LVH (structural heart disease)

PF for young

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3
Q

Anti-arrhythmics to be used in patients with Afib and LVH?

A

Amiodarone or Drondarone

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4
Q

Anti-arrhythmics to be used in patients with Afib + Heart Failure

A

Amiodarone or Dofetilide

AFIB= AD

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5
Q

Anti-arrhythmics to be used in patients with Afib and CAD without heart failure?

A

Sotalol or Dronedarone

SoGone

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6
Q

What is a common side effect of donepzil?

A

Syncope and dizziness due to bradycardia or heart blocks.

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7
Q

Faint Diastolic Murmur of Aortic Regurgitation, waxing and waning, neurological deficits like Horner Syndrome, Vocal cord Paralysis?

A

Aortic Dissection

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8
Q
  1. Prolonged PR interval with all P waves conducted?
  2. Progressive Prolong PR interval and non conducted P waves.
  3. Fixed prolonged PR interval with non conducted P waves?
  4. No Pwaves conducting with QRS complex?
  5. What is high-degree AV block?
A
  1. 1st Degree AV Block
    (Second Degree Heart Block- P waves not conducted)
  2. 2nd Degree Type 1 -Long (Wakenbach)
  3. 2nd Degree Type 2 - Fixed
  4. Complete hear block
  5. Multiple successive non-conductive P waves
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9
Q

When can you not tell the difference in heart block types?

A
  1. When there is a 2:1 block present.
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10
Q

Indications for Permanent Pacing in heart block?

A
  1. Symptomatic Without Reversible cause found
  2. Asymptomatic with >3 pauses or heart rate <40 bpm
  3. Alternating Bundle Branch Block
  4. Complete heart block or Mobitz Type 2 (Fixed PR interval, dropped beat has high risk of converting to Complete HEART Block)
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11
Q

Management of a patient with hypertensive urgency (180/120 without end organ damage)?

A

Oral Hypertensive and observe Over a Monitored Setting.

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12
Q
  1. Initial Therapies for PAD?
  2. Which medication to use if the first drug is not tolerable?
  3. Which medication to use if patient is still having persistent symptoms ?
A
  1. Aspirin, along with Smoking Cessation and Graded exercise
  2. Plavix
  3. Cilostazol (usually meet criteria for revascularization at this point)
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13
Q

Common complication of cardiac catherization, it presents with hypotension and a drop in hemoglobin?

A

Retroperitoneal Hemorrhage

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14
Q
  1. Management of Anticoagulation in a patient with Mechanical Bi-leaflet Aortic Valve undergoing a HIGH Bleeding RISK procedure?
  2. Management of Anticoagulation in patient with Mechanical Mitral Valve undergoing a HIGH Bleeding RISK procedure?
A
  1. Stop warfarin 5 days
    Before Procedure until INR < 1.5. No bridging needed.
    Then resume warfarin evening of.
  2. Stop Warfarin 5 days Before Procedure and start Heparin when INR < 2.0. Stop Heparin day of procedure and then resume 1-2 after hemostasis is achieved with warfarin.
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15
Q

Complications Post-MI: Associated with inferior wall MI.
Occurs 3-5 days presenting with Cardiogenic shock and New Holosytolic Murmur due to Acute MR resulting in Pulmonary Edema, associated with the RCA?

A

Papillary Muscle Rupture

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16
Q

Complications Post-MI:
Occurs within 3-5 days presents with new onset chest pain, Holosytolic Murmmur, shock, Left-to- Right Ventricular Shunt (increase in 02 from RA to RV).

A

Interventricular Septum Rupture

17
Q

Complications Post-MI:
Occurs within 5 days to 2 weeks associated with LAD. Presents with Chest Pain, Shock, Distant heart sounds, will see Pericardial Effusion with Tamponade .

A

Free wall rupture

18
Q

Complications Post-MI

Occurs within Several Months, presents with heart failure, stable angina and Dyskinetic Myocardial Wall.

A

Left Ventricular Aneurysm.

19
Q

Complications Post-MI:

  1. Autoimmune phenomenon resulting in fibrinous pericarditis several weeks post MI?
  2. Friction Rub heard 1-3 days post MI?
A
  1. Dresslers Syndrome

2. Post-infarction Fibrinous Pericarditis

20
Q

What is the best study to risk stratify patients with WPW? ( This is to determine there possibility of transforming to AFib or AVRT which can lead to VF and Sudden Cardiac Death)

A

Exercise Testing

21
Q

Difference between athletes heart and HCM?

A

Athletes heart is usually < 12mm and symmetric thickness. HCM is asymmetric, > 15 mm and associated with Q waves and T wave inversions on EKG.

22
Q

What are the 2 common causes of prolonged QTc?

A
  1. Electrolytes ( Hypomag and Hypokalemia)

2. Drugs (Levofloxacin and antipsychotics)

23
Q

Which 2 medications are contraindicated in patients with NSTEMI/Unstable Angina who have ESRD?

A

Lovenox and Eptifibatide (Integrillin) ( they are renal cleared and will cause increase bleeding risk)

24
Q
  1. Rx for symptomatic bradycardia and hemodynamic distress?

2.Next Rx if that is ineffective?

A
  1. Atropine.
  2. Dopamine or Epinephrine infusion until Transcutaneous pacing or Temporary pacing wire can be place.
25
Q
  1. Preferred AC in a patient with eGFR > 30ml/min ?

2. What is the preferred AC when eGFR < 30ml/min?

A
  1. Pradaxa, Eliquis, Xarelto

2. Warfarin

26
Q

Name the 2 indications for Spironolactone in Heart Failure?

A
  1. Symptomatic HF in Class II, III, IV & LVEF < 35%
  2. LVEF < 40% & Symptomatic HF or Diabetes
27
Q

Name the Primary Prevention and Secondary Prevention indications for ICD placement?

A

Primary Prevention:
1. Prior MI & LVEF < 30%,
2. NYHA Class II or III and LVEF < 30%

Secondary Prevention:
1. Prior VF or Unstable VT without Reversible Cause
2. Prior sustained VT with underlying cardiomyopathy

28
Q

Indications for Hydralazine in CHF?

A

Usually given with nitrates when patients dont tolerate ACE or ARBs.

29
Q

Pt presents with 2 week hx of lightheadedness, feeling wooziness and sense of heaviness in head with squatting. Pt has AICD and had lead revision 1 month ago.

Dx?
What is the initial test of choice?

What is the gold standard? Rx?

A

Superior Vena Cava Syndrome.

CT with Contrast

Bilateral Upper Extremity Venography

30
Q

Pt presents with sudden onset of SOB, Chest heaviness, BP 210/100. CXR shows Pulmonary Edema. Pt develops unexplained rise in Cr after starting ACE. Dx?

A

Bilateral Renal Artery Stenosis

31
Q

Medications given in Unstable Angina/NSTEMI?

Which Anticoagulant to give if they have ESRD?

A
  1. Aspirin
  2. Plavix
  3. BB
  4. Heparin

Unfractionated Heparin, not LMWH (Enoxaparin) it is Renal cleared and will lead to further bleeding complications.

ABIM (45 decks)

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