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CB Internal Medicine > Cardio > Flashcards

Cardio Flashcards

1
Q

What is the classic ECG finding in atrial flutter?

A

“Sawtooth” P waves.

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2
Q

What is the definition of unstable angina?

A

Angina that is new or worsening with no increase in troponin level.

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3
Q

What is the antihypertensive for a diabetic patient with proteinuria?

A

Angiotensin-coverting enzyme inhibitor.

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4
Q

What is “Beck Triad” for cardiac tamponade?

A

Hypotension, distant heart sounds, and jugular venous distention (JVD).

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5
Q

What drugs can be used to slow heart rate?

A

B-blockers, calcium channel blockers (CCB), digoxin, amiodarone.

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6
Q

What is hypercholesterolemia treatment that leads to flushing and pruritus?

A

Niacin

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7
Q

Murmur - hypertrophic obstructive cardiomyopathy

A

A systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (Valsalva maneuver)

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8
Q

Murmur - aortic insufficiency

A

Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increased with increased after load (handgrip maneuver)

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9
Q

Murmur - mitral regurgitation

A

A holosystolic murmur that radiates to the axilla; increase with increased afterload (handgrip maneuver)

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10
Q

Murmur - aortic stenosis

A

A systolic crescendo/ decrescendo murmur that radiates to the neck; increased with increased preload (squatting maneuver)

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11
Q

Murmur - mitral stenosis

A

A diastolic, mid to late, low-pitched murmur preceded by an opening snap

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12
Q

What is the treatment for atrial fibrillation and atrial flutter?

A

If unstable, cardiovert.

If stable or chronic, rate control with CCBs or B-blockers.

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13
Q

What is the treatment for ventricular fibrillation?

A

Immediate cardioversion.

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14
Q

What is Dressler syndrome?

A

An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI.

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15
Q

A patient with a hx of IV drug use, with JVD and a holosystolic murmur at the left sternal border. What is the treatment?

A

Treat existing heart failure, replace tricuspid valve.

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16
Q

What is the diagnostic test for hypertrophic cardiomyopathy?

A

Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

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17
Q

What is pulses paradoxus?

A

A decrease in systolic BP of > 10mm Hg with inspiration; seen in cardiac tamponade.

18
Q

What is the classic ECG finding in pericarditis?

A

Low-voltage, defuse ST-segment elevation.

19
Q

What are eight surgically correctable causes of HTN?

A

1) Renal artery stenosis
2) Coarctation of the aorta
3) Pheochromocytoma
4) Conn syndrome
5) Cushing syndrome
6) Unilateral renal parenchymal disease
7) Hyperthyroidism
8) Hyperparathyroidism

20
Q

How do you evaluate a pulsatile abdominal mass and bruit?

A

Abdominal ultrasound and CT

21
Q

What are the indications for surgical repair of AAA?

A

> 5.5cm, rapidly enlarging, symptomatic, or ruptured

22
Q

What is the treatment for acute coronary syndrome?

A

ASA, heparin, clopidogrel, O2, IV b-blockers (maybe morphine, nitro)

23
Q

What is metabolic syndrome?

A

Abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombotic or pro inflammatory states

24
Q

What is the appropriate diagnostic test for a 50 year old man with stable angina who can exercise to 85% of maximum predicted HR?

A

Exercise stress treadmill with ECG

25
Q

What is the appropriate diagnostic text for a 65 year old woman with a left bundle branch block and severe osteoarthritis who has unstable angina?

A

Pharmacologic stress test (i.e. dobutamine ECHO)

26
Q

What are signs of active schema during stress testing?

A

Angina, ST-segment changes on ECG, or decreased BP

27
Q

What ECH findings suggest MI?

A

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves

28
Q

What are the coronary territories in MI?

A

Anterior wall (LAD/diagonal)
Inferior (PDA - posterior descending artery off RCA)
Posterior (left circumflex/ oblique, RAC/ marginal)
Septum (LAD/diagonal)

29
Q

What is the diagnosis for a young patient with angina at rest and ST-segment elevation with normal cardiac enzymes.

A

Prinzmetal angina

30
Q

What are common symptoms associated with silent MIs?

A

CHF, shock, and altered mental status

31
Q

What is the diagnostic test for PE?

A

Spiral CT with contrast

32
Q

What is protamine used for?

A

Reverses effets of heparin

33
Q

What drug affects prothrombin time?

A

Warfarin

34
Q

What is the diagnosis for a young patient with a family history for sudden death who collapses and dies while exercising?

A

Hypertrophic cardiomyopathy

35
Q

What is the endocarditis regimen?

A

Oral surgery - amoxicillin

GI/GU procedure - not recommended

36
Q

What is “Virchow Triad”?

A

Stasis, hyper coagulability, endothelial damage

37
Q

What is the most common cause of hypertension in young women?

A

OCPs

38
Q

What is the most common cause of hypertension in young men?

A

Excessive EtOH

39
Q

What condition is associated with a “Figure 3 sign”?

A

Aortic coarctation

40
Q

What condition is associated with a “water bottle-shaped heart”?

A

Pericardial effusion (look for pulses paradoxus)

CB Internal Medicine (12 decks)

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