Cardio

Question 1

Mechanism of nitroglycerin to relieve angina

Answer 1

Causes systemic VENOUS vasodilation

Reduce preload

Thus decreasing myocardial O2 demand

(DOES NOT VASODILATE CORONARY ARTERIES)

Question 2

Mediastinal widening on CXR raises suspicion for…

Answer 2

Aortic Dissection

Question 3

Medical treatment for Stanford Type B aortic dissection?

Answer 3

B-blockers

Question 4

Diltiazem

Verapamil

Answer 4

Non-dihydropyridines

Act on heart conducting tissue

Blocks voltage-dependent L-type calcium channels, decrease conduction velocity

Decrease contractility

Rate control in A-fib, SVT prophylaxis

Question 5

Amlodipine
Nifedipine
Felodipine

Answer 5

Dihydropyridines

Acts on vascular smooth muscle

Blocks voltage gatedL-type Ca+ channels

Decreases muscle contractility

*HTN, angina, Raynauds

Question 6

Anti hypertensives ok to use in pregnancy

Answer 6

“Hypertensive Moms Love Nifedipine”

Hydralazine
Methyldopa
Labetalol
Nifedipine

Question 7

Anti-HTN med with potential cyanide toxicity?

Answer 7

Nitroprusside

Question 8

ST segment elevation only during brief episodes of chest pain

Answer 8

Prinzemental Angina

Question 9

Rapid onset sharp chest pain that radiates to the scapula

Answer 9

Aortic Dissection

Question 10

Rapid onset sharp pain in a 20-year old and associated dyspnea

Answer 10

Spontaneous Pneumothorax

Question 11

Sharp pain lasting hours-days and is somewhat relieved by sitting forward

Answer 11

Pericarditis

Question 12

LLA with SE of facial flushing

Answer 12

Niacin

Question 13

LLA with SE of elevated LFTs, myositis

Answer 13

Statins & Fibrates

Question 14

LLA with GI discomfort and bad tast

Answer 14

Bile Acid binding resins

Question 15

LLA with best effect on HDL?

Answer 15

Niacin

Question 16

LLA with best effect on triglycerides/VLDL

Answer 16

Fibrates

Question 17

LLA with best effect on LDL/cholesterol

Answer 17

Statins

Question 18

LLA that binds C. diff toxin

Answer 18

Cholecystiramine

Question 19

Chest pain
Pericardial friction rub
Persistent fever occurring several weeks after an MI

Answer 19

Dressler Syndrome

Question 20

Most common lethal complication after a myocardial infarction

Answer 20

Arrhythmias

Question 21

Coronary artery most commonly occluded in an MI?

Answer 21

Left anterior descending

Question 22

Severe mitral regurg 5 days post MI

Answer 22

Papillary muscle rupture

Question 23

Cardiac tamponade following MI

Answer 23

Rupture of ventricular wall

Question 24

New VSD post MI

Answer 24

Rupture of interventricular septum

Question 25

Stroke following an MI

Answer 25

Mural thrombis - part of it breaks off and becomes an embolis

Question 26

Focal necrotizing vasculitis Necrotizing granulomas in the lung and upper airway Necrotizing glomerulonephritis

Answer 26

Wegener | Granulomatosis with polyangiiits

Question 27

Necrotizing immune complex inflammation of visceral/renal vessels

Answer 27

Polyarteritis Nodosa

Question 28

Vasculitis in young asian women | "Pulseless disease"

Answer 28

Taskayasu arteritis

Question 29

Vasculitis in young asthmatics

Answer 29

Churg strauss = eosinophilic granulomatosis with polyangiits

Question 30

Vasculitis in infants and young children, involved coronary arteries

Answer 30

Kawasaki Disease

Question 31

Most common vasculitis

Answer 31

Giant cell/ Temporal

Question 32

Vasculitis associated with hepatitis B infection | Renal Vessel involvement

Answer 32

Polyarteritis Nodosa

Question 33

Vasculitis c-ANCA +

Answer 33

Wegner's = granulomatosis with polyangiitis

Question 34

Vasculitis p-ANCA +

Answer 34

Microscopic Polyangiitis + Churg-Strauss

Question 35

How do you differentiate wegeners and microscopic polyangiitis?

Answer 35

Microscopic polyangiitis does NOT have nasopharyngeal involvement

Question 36

Palpable purpura Arthralgias Abdominal Pain

Answer 36

HSP = most common childhood systemic vasculitis * often follows URI * Associated with IgA nephropathy (Berger disease)

Question 37

Vasculitis in heavy smokers may lead to intermittent claudication and gangrene, auto amputation of digits

Answer 37

Buerger disease = thromobangiitis obliterans

Question 38

Most important determinant for prognosis in tetralogy of fallot

Answer 38

Pulmonary stenosis

Question 39

Boot-shaped heart on CXR

Answer 39

Right ventricular hypertrophy | Tetrology of Fallot

Question 40

Tetrology of Fallot findings

Answer 40

Early cyanosis R-L shunt Pulmonary Stenosis RVH Overriding Aorta VSD

Question 41

What is the most common cause of death with-in a few hours of having an MI?

Answer 41

Arrhythmia

Question 42

Enlargement of what area in the heart can cause hoarseness?

Answer 42

Enlarged left atrium Left recurrent laryngeal nerve hooks around aorta at the ligamentum arteriosum *Ortner Syndrome

Question 43

Most likely cause of mitral stenosis?

Answer 43

Rheumatic heart disease | Infection with Group A strep

Question 44

Treatment for septic shock?

Answer 44

Norepinephrine

Question 45

What can cause a delta wave?

Answer 45

Wolff-Parkinson White syndrome = | Accessory pathway the bypasses the AV node

Question 46

Dromotrope Ionotrope Chronotrope

Answer 46

``` Dromotrope = increased conduction velocity Inotrope = increased contractiliy Chronotrope = increased heart rate ```

Question 47

Focal myocardial inflammation (interstitial fibrosis with central lymphocytes and macrophages) with multinucleate giant cells

Answer 47

Interstitial myocardial granuloma = Aschoff body Indicates Acute Rheumatic Fever related myocarditis

Question 48

Aschoff body

Answer 48

Indicated acute rheumatic fever related mycarditis