Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

COMLEX STEP 1 2017 > Cardio > Flashcards

Cardio Flashcards

1
Q

When is the sarcomeric length of left ventricular muscles fibers the greatest?

A

end of diastole - when the LV is filled with blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most serious complication of a patient with a heart transplant?

“man with cardiac transplant suddenly dies 5 years later while working in his garden”

A

Graft vascular disease - from chronic transplant rejection

aka: graft arteriosclerosis - intimal and medial thickening of coronary arteries w/o atheroma formation

NO CHEST PAIN b/c transplanted hearts are denervated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

elevated homocyteine is a risk factor for what type of cardiac event?

A

Thrombotic

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
What is the following disease:
10 year old boy
tachypnea, tacycardia, hypotension
holosystolic murmur
interstitial mycardial granuloma (Aschoff body)
A

Acute rheumatic fever

immune mediated complication of untreated group A streptococcal pharyngeal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the cause of the following Sx:
Smoker
right sided face and arm swelling
engorgement of subcutaneous veings on the same side of neck

A

obstruction of Brachiocephalic vein

thrombosis or lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

holosystolic murmur
flat facial profile
protruding tongue
small ears

A

Trisomy 21 (probably from Meiotic nondisjunction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the disease and organism responsible?
older man
low grade fever, fatigue
diastolic murmur @ LLSB
blood culture: gram + cocci, catalase negative, can grow in hypertonic saline and bile

A 
Enterococcal Endocarditis (possibly from cystoscopy)
enterococcal faecalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the histological appearance of acute graft rejection of a heart transplant (2 weeks after transplant)

A

dense infiltrate of mononuclear cells composed primarily of T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common congenital cardiac malformation in patients with Turner Syndrome?

A

Bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mitral stenosis/Mitral regurg is a/w what type of cardiac disease? what is the mechanism of injury?

A

rheumatic heart disease

M-protein activation of T and B lymphocytes cause immune-mediated damage to the mitral valve, resulting in mitral regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

5 year old, no neonate care
Cyanotic spells improve with squatting
prominent right ventricular impulse
systolic murmur

what is the disease and etiology?

A

Tetralogy of Fallot

abnormal neural crest cell migration = anterior and cephalad deviation of the infundibular septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

a patient with Subacute bacterial endocarditis caused by Strep gallolyticus (bovis) should also be screened for what?

A

colonic neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What kind of cardiomyopathy is found in alcoholics?

A

Dilated Cardiomyopathy (cavitary LV lesion, JVD, S3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dx:
Acute substernal chest pain, sweating, dyspnea
ECG: ST elevation in I, aVL, V1-V3, deep q wave development over several hours

A

transmural infarct of anterolateral left ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What cardiac condition is related to SLE?

A

Acute Pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the mainstay treatment for Von Willebrand disease? What is a side effect of this treatment?

A

Desmopressin (releases vWF/VIII from endothelial stores)

-hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the etiology of infiltrative cardiomyopathy by amyloid protein

A

Transthyretin deposition (protein produced in the liver, mutation in TTR gene cause misfolding = amyloid protein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the diagnosis:

  • heart murmur
  • heart palpitations at night
  • moderate exertion = head pounding + involuntary head bobbing
  • Widening pulse pressure
A

Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which antiarrhythmic drug can cause the side effects:

tachycardia, resting tremor, diarrhea, sweating, anxiety, palpitations (mimics thyroid hormone)

A

Amiodarone - Class III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes Heparin induced thrombocytopenia?

A

formation of autoantibodies against the heparin-platelet factor 4 complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which antiarrhythmic drug can cause pulmonary fibrosis?

A

Amiodarone - Class III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most likely cause:
young child with short stature (3rd percentile)
large hyperpigmented areas on torso and legs
thumb is shorter than normal
pancytopenia
bone marrow aspirate shows scant cellularity

A

Fanconi anemia - caused by a mutation of DNA repair genes

pts present with short stature, repeated infections, and pancytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most appropriate initial management of acute stroke?

A

Tissue plasminogen activator (tPA, alteplase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What role does quinidine therapy play in cardiac dysfunction? What are the side fx of this drug

A

Class I antiarrhythmic (Na channel blocker - slows conduction in heart)

sidefx:
Cinchonism (headache, confusion, dizziness, tinnitus, nausea, flushing, visual disturbances)

Prolong QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does an Inferior STEMI look like on ECG? What artery is involved?

A

ST elevation: II, III, aVF
reciprocal depression: I, aVL
—(distinguishes from pericarditis)

Marginal branch of right main coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most important cause of thrombocytopenia in hospitalized patients?

A

Heparin-induced thrombocytopenia (HIT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the mechanism of action of Hirudin, Lepirudin, Argatroban?

A

Direct thrombin inhibitors - binds to thrombin active site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which hyperlipidemia medication can also cause gouty arthritis? what other side effect can it cause?

A

Niacin - decreased renal excretion of uric acid

facial/upper body flushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Maternal exposure to what medication can cause Ebstein’s anomly in the infant

A

Lithium - to treat bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What metabolic abnormality is associated with torsades de pointes?

A

hypomagnesemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q 
What is the congenital heart defect?
hour old infant evaluated for cyanosis
BP 61/43
HR 143
RR 72
CXR: large ovoid shaped heart and narrow mediastinum
A

Transposition of great vessels

enlarged heart + narrowed mediastinum
Egg of string appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does the truncus arteriosus become in an adult?

A

Ascending aorta and pulmonary trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the Bulbis cordis become in an adult?

A

Smooth parts (outflow tract) of left and right ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does the Left horn of sinus venosus become in an adult?

A

Coronary Sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does the Right horn of sinus venosus become in an adult?

A

Smooth part of right atrium (sinus venarum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does the right common cardinal vein and right anterior cardinal vein become in an adult?

A

Superior Vena Cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which medications:
1. close
2. keep open
the PDA after birth?

A
  1. Indomethacin

2. Prostagland E1 and E2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What part of the heart is the most posterior? what can happen with enlargement?

A

Left Atrium - enlargement can cause:

  1. dysphagia (compression of esophagus)
  2. hoarseness (compression of L recurrent laryngeal N)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the mechanism of Digitalis?

A

blocks Na+/K+ pump = increase intracellular sodium = decrease Na+/Ca2+ exchanger = INCREASe intracellular Ca2+ = increase contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What does the Dicrotic Notch correspond with?

A

Aortic valve closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

In the Jugular Venous Pulse what do the following correspond with:

  1. a wave
  2. c wave
A
  1. atrial contraction - absent in atrial fibrillation

2. RV contraction (closed tricuspid valve bulging into atrium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What does the X descent correspond with in a Jugular Venous Pulse?
what causes this wave to be:
1. Absent
2. Prominent

A

atrial relaXation and downward displacement of closed tricuspid valve during ventricular contraction

  1. absent in tricuspid regurgitation
  2. Prominent in tricuspid insufficiency and right HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the v wave in Jugular venous pulse?

A

increase right atrial pressure due to filling (“villing”) against closed tricuspid valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the y descent in a Jugular venous pulse?
what causes this wave to be:
1. absent
2. prominent

A

RA emptying into RV, prominent in constrictive pericarditis

  1. absent in cardiac tamponade
  2. prominent in constrictive pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What does a fixed S2 split indicate upon auscultation?

A

ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the typical use and mechanism of Milrinone?

A

selective PDE-3 enzyme inhibitor

-causes vasodilation, inotropy in pts with refractory heart failure due to left ventricular systolic dysfunction

47
Q

What cardiac structure and nerve is the third pharyngeal associated with? musculoskeletal?

A

third aortic arch = Common, Proximal Carotid Arteries
glossopharyngeal N
hyoid bone, stylopharyngeus

48
Q

What is Neprilysin?

A

Metalloproteinase that degrades natriuretic peptides, glucagon, oxytocin, bradykinin

meds that inhibit neprilysin can be used in heart failure to encourage:
diuretic
natriuretic
vasodilatory effects (BNP, ANP)

49
Q

Patient is diagnosed with DVT in leg and started in IV heparin
While he is hospitalized he develops a stroke in the MCA
what happened? what auscultation findings should be present?

A

Paradoxical embolism (thrombus from venous system crosses over into arterial circulation from abnormal connection between R and L cardiac chambers - Patent foramen ovale, ASD, VSD)

Ausc: Wide splitting of S2 that does not change with respiration

50
Q

What cardiac effects can doxorubicin (chemotherpy) cause?

A

Dilated cardiomyopathy

51
Q

hypotension
elevated jugular venous pressure
muffled/diminished heart sounds

identify dz and other observed findings?
CXR, lung Auscultation?

A

Beck’s triad = Cardiac tamponade (pericardial effusion)

Pulsus paradoxus = exaggerated drop in systolic blood pressure during inspiration
—-“pulse becomes undetectable to palpation during inspiration”

CXR: Enlarged water-bottle-shaped heart, clear lungs

52
Q

What does valsalva do to heart murmurs?

A

decreases preload
=decreases intensity of most murmurs
increases HOCM murmur

53
Q

What does rapid squatting do to heart murmurs?

A

increases venous return, preload, afterload

decrease intensity of hypertrophic cardiomyopathy murmur

increase intensity of AS murmur

54
Q

What medications should be avoided in patients with Hypertrophic Cardiomyopathy?

A

anything that decrease preload: Vasodilators, diuretics

55
Q

What artery supplies the AV node?

A

AV nodal branch coming off the Posterior descending artery

-this comes off the Right coronary or Left circumflex artery depending on which side heart dominant the patient is (most are Right dominant)

56
Q

What is the mechanism of Ivabradine? what is so unique about it?

A

slows the SA node rate by selective inhibition of funny sodium channels

-this slows rate without affecting inotropy or lusitropy

57
Q

Which drugs can cause Torsades de Pointes?

A 
ABCDE
AntiArrhythmics (Class IA, III)
AntiBiotics (macrolides)
Anti"C"ychotics (haloperidol)
AntiDepressants (TCA's)
AntiEmetics (ondansetron)
58
Q

Congenital long QT syndrome

sensorineural deafness

A

Jervell and Lange-Nielsen syndrome

–autosomal recessive

59
Q

What is the innervation for:

  1. Aortic Arch
  2. Carotid sinus?
A
  1. vagus N to Solitary Nucleus of medulla

2. glossopharyngeal N to Solitary Nucleus of medulla

60
Q

Patient present with history of congestive HF. has an upset stomach, disturbed color perception, anorexia, nausea, vomiting, diarrhea

what is happening and what can occur if not treated?
What lab findings support this?

A

Digoxin toxicity - can develop arrhythmia

GI - anorexia, N/V, abd pain
Neuro - Fatigue, Confusion, Weakness, COLOR VISION abnormality
Cardiac - life threatening arrhythmia (A-fib, CHF)

Lab: ELEVATED EXTRACELLULAR POTASSIUM

61
Q

episodic, transient, attacks of chest discomfort (pressure, squeezing), producing temporary transmural mycardial ischemia with ST elevation (eg in I, aVL, V1-V4)

A

Prinzmetal (variant) angina

62
Q

Pt with Mitral regurg goes into surgery and finds a ruptured postero medial papillary muscle. which artery is blocked?

A

Posterior descending Coronary A.

63
Q

What heart changes usually accompany a S3?

A

increased LV end-systolic volume

64
Q

What lipid lowering medication has a very common adverse effect of facial and upper body flushing? why

also has the side effect of gouty arthritis

A

Niacin - flushing is caused by prostaglandin release

-can take acetylsalicylic acid to inhibit prostaglandin synthesis

65
Q

What are adult derivative sof the 6th aortic arch?

A

proximal pulmonary arteries

on left - ductus arteriosus

66
Q

What heart defects are a/w congenital rubella?

A

PDA, pulmonary artery stenosis, septal defects

67
Q

What heart defect is a/w infant of diabetic mother

A

Transposition of great vessels

68
Q

What heart defect is a/w Williams Syndrome?

A

Supravalvular aortic stenosis

69
Q

Where is the infarct location and artery involved if there is ST elevations or pathologic Q waves in:
V1-V2?

A

Anteroseptal (LAD)

70
Q

Where is the infarct location and artery involved if there is ST elevations or pathologic Q waves in:
v3-v4

A

Anteroapical (distal LAD)

71
Q

Where is the infarct location and artery involved if there is ST elevations or pathologic Q waves in:
V5-V6

A

Anterolateral (LAD or LCX)

72
Q

Where is the infarct location and artery involved if there is ST elevations or pathologic Q waves in:
I, aVL

A

Lateral (Left circumflex)

73
Q

Where is the infarct location and artery involved if there is ST elevations or pathologic Q waves in:
II, III, aVF

A

inferior (Right coronary artery)

74
Q

Where is the infarct location and artery involved if there is ST elevations or pathologic Q waves in:
V7-V9, ST depression in V1-V3 with tall R waves

A

Posterior (Posterior descending artery)

75
Q

10 year old immigrant shows up with dyspnea, fatigability
dx’d with congenital heart defect as infant, not treated
has toe cyanosis, clubbing with no finger abnormalities
all extremity pulses are full and equal

identify?

A

Patent ductus arteriosus

  • -cyanosis from eisenmenger syndrome
  • -differential clubbing/cyanosis WITHOUT BP or pulse discrepancy = pathognomonic for PDA
76
Q

Which drug should be taken for stable angina if the pt is allergic to aspirin?

A

Clopidogrel (irreversibly binds to ADP receptor of platelets, inhibiting aggregation) - as effective as aspirin

77
Q

What artery does the Middle Meningeal A. branch off of?

what foramen does it enter?

A

Maxillary A.

enters the cranium through the foramen spinosum

78
Q

A patient treated with an anti-arrhythmic shows a slowing of phase 0 depolarization, and prolongation of phase 3 of the ventricular action potential.

what class of drug is this and what are 3 examples?

A

Class IA antiarrythmic

Quinidine
Procainamide
Disopyramide

79
Q

several weeks after MI, autoimmune cause of fibrinous pericarditis

A

Dressler Syndrome

80
Q

presence of hemosiderin-laden macrophages in lungs

identify the cause?

A

Left heart failure

  • -increase pulmonary venous pressure = venous distention and transudation of fluid
  • -microhemorrhage in pulmonary vessels = RBC’s phagocytosed by Macrophages = “HF CELLS”
81
Q

What are signs of bacterial Endocarditis?

A

FROM JANE

Fever
Roth Spots
Osler nodes
Murmur

Janeway lesions
Anemia
Nail-bed hemorrhage (splinter)
Emboli

82
Q

What are symptoms of Rheumatic Fever?

A

J(heart)NES

Joint (migratory polyarthritis)
(heart) - carditis
Nodules in skin (subcutaneous)
Erythema marginatum - pink rings on torso, inner limbs
Sydenham chorea - rapid, irregular movement of arms, legs, trunk, face

83
Q

What type of vasculitis is Temporal arteritis? What demographic? what is a bad complication this can lead to?

A

Giant Cell arteritis = Large vessel-vasculitis
Elderly females
may lead to irreversible blindness due to ophthalmic artery occlusion

84
Q

What type of vasculitis is Takayasu arteritis?
Demographic?
Symptoms, Physical exam findings?
Biopsy findings? - where does this affect the most?

A

Asian females < 40 years old
“Pulseless disease” - weak upper extremity pulses, fever, night sweats, arthritis, myalgias, skin nodules, ocular disturbances
Bx: Granulomatous thickening and narrowing of AORTIC ARCH and proximal great vessels

85
Q 
Asian 4 years old
Conjunctival Injection
Rash
Cervical Adenopathy
Red Tongue
Edema, erythema of hands and feet
Fever

Identify dz and dz type, demographic.

What is another name for this dz?

A

Kawasaki disease - Medium Vessel-vasculitis AKA “Mucocutaneous Lymph Node Syndrome”

Asian Children < 4 years old
Sx: CRASH and BURN 
Conjunctival injection
Rash (polymorpheus - desquamating)
Adenopathy (cervical)
Strawberry tongue (oral mucositis)
Hand-foot changes (edema, erythema)
Burn = Fever

may develop CORONARY ARTERY ANEURSYMS
Tx = ASPIRIN, IVIG

86
Q 
Heavy smoker, male < 40 years old
Intermittent claudication - gangrene, autoamputation
superficial nodular phlebitis
Raynauds
SEGMENTAL thrombosing vasculitis

what type of disease is this? what is treatment?

A

Buerger disease (thromboangiitis obliterans) - medium vessel vasculitis

Tx: smoking cessation

87
Q 
Young adults (males)
Hepatitis B seropositivity in 30% of patients
Fever, weight loss, malaise, headache
Abdominal pain, Melena
Hypertension, neuro dysfunction
cutaneous eruptions, renal damage

Identify dz and etiology, location of involvement

A

Polyarteritis nodosa

  • renal and visceral vessels, NOT pulmonary arteries
  • Immune complex mediated (type III)
  • Transmural inflammation of the arterial wall w fibrinoid necrosis
88
Q

Perforation of nasal septum
chronic sinusitis, otitis media, mastoiditis
Hemoptysis, cough, dyspnea
Hematuria, red cell casts

identify dz, related markers, CXR findings

A

Granulomatosis with polyangiitis (Wegener)
–small vessel vasculitis
Triad:
1. FOCAL necrotizing vasculitis
2. Necrotizing granulomas in the lung and upper airway
3. Necrotizing glomerulonephritis

a/w PR3-ANCA, c-ANCA (anti-proteinase 3)
CXR: large nodular densities
Tx: cyclophosphamide, corticosteroids

89
Q

Necrotizing vasculitis commonly involving lung, kidneys, skin with pauci-immune glomerulonephritis and palpable purpura
No granulomas

identify dz and related markers

A

Microscopic polyangiitis - small vessel vasculitis
–presents similar to Wegener (Granulmatosis w polyangiitis)

MPO-ANCA/p-ANCA (anti-myeloperoxidase)
Tx: cyclophosphamide, corticosteroids

90
Q

asthma, sinusitis, skin nodules/purpura, peripheral neuropathy (wrist/foot drop)
can involve heart, GI, kidneys

identify dz, related markers and lab findings

A

Churg-Strauss (Eosinophilic granulomatosis with polyangiitis)

-MPO-ANCA, p-ANCA
Increased IgE

91
Q

Where do atherosclerotic plaque shows a predominance for developing?
What is the descending order of commonality of atherosclerotic plaque formation

A

large elastic arteries (Aorta, carotid, iliac arteries)

abdominal aorta > coronary arteries > popliteal, internal carotic > circle of willis

92
Q

What is the most common cause of valvular Aortic Stenosis in developed nations?

A

Calcific degeneration of the trileaflet aortic valve

93
Q

What is the most appropriate management for acute pericarditis?

A

NSAIDs - inhibit production of prostaglandins

94
Q

What are ECG findings, Sx of

  1. hypokalemia
  2. hyperkalemia
A
  1. U waves, flattened T waves, arrhythmias, muscle cramps, muscle cramps, spasm, weakness
  2. Wide QRS, peaked T waves, arrhythmias, muscle weakness
95
Q

What is the mechanism and possible use of Cilostazol?

A

Phosphodiesterase III inhibitor - increases cAMP in platelets = inhibits platelet aggregation + vasodilation

–can be used for angina prophylaxis
, intermittent claudication, coronary vasodilation

96
Q

What are causes of high output heart failure?

A

PAGET

Pagets
Anemia, AV fistula
Graves dz
Endotoxic shock
Thiamine deficiency
97
Q

What do the following do to Preload/Afterload:

  1. Mueller Maneuver
  2. Squatting
  3. Handgrip
  4. Valsalva maneuver
  5. Standing
A
  1. Increases preload
  2. Increases preload
  3. Increases Afterload
  4. Decreases Preload
  5. Decreases Preload
98
Q

55 year old pt presents to the ED with stabbing chest pain which radiates down his left arm. pain started when he was moving furniture w his son and this is the fourth time this has happened in similar situations. Sublingual Nitroglycerin quickly relieves his sx.

what would be seen on ECG? what is the Nitro for?

A

Stable Angina
–ST depressions = myocardial ischemia that is NOT TRANSMURAL

(ST elevatiosn are for acute TRANSMURAL ischemia)
`
Nitroglycerin - decreases preload (Venous dilation)

99
Q

What is the most likely complication in the first several hours during or after an MI?

A

cardiac arrhythmia

100
Q

A 55 yr old male w acute MI 2 days ago suddenly develop palpitations and anxiety. ECG shows multifocal premature ventricular contractions

what is most appropriate initial step in managment? what is the mechanism?

A

cardiac arrhythmias are classic complication of acute MI

LIDOCAINE (Class Ib) = first choice therapy for ventricular arrhythmias a/w MI

mechanism = small reduction in phase 0 slope; shorten action potential; shorten repolarization

101
Q

Identify abnormality, and mechanism of therapy:

92 year old presents with peaked T-waves and widened QRS on ECG. calcium gluconate is administered.

A

Hyperkalemai

–Calcium gluconate stabilizes the cardiac cell membrane = prevent fatal arrhythmias

102
Q

What are the first to meds prescribed with stable angina?

A

Nitrates and B-blockers

103
Q

What is the cardiac biomarker used to tell if a reinfarction has occured after an MI four days prior?

A

CK-MB - first appears 4-6 hrs after symptom onset
–levels peak 24 hours and returns to normal within 3 days.

(troponins also appear 4-6 hours after sx, but stay elevated for up to 10 days)

104
Q

What are ECG findings of apical hypertrophic cardiomyopathy?

A

Giant T-wave inversions in precordial leads (V1-V6)

105
Q

What are two most appropriate initial therapies for Acute aortic regurgitation?

A

Afterload reduces:
hydralazine
ACE inhibitors

if signs of HF: inotropes too

106
Q

What is the initial management of Atrial Flutter?

A

Diltiazem, Verapamil

nondihydropyridine Ca channel blocker

107
Q

Pt was minor Pulm embolism shows up. What is MOST LIKELY to be seen on EKG?

A
  1. Sinus Tachycardia - most likely to be seen

- -S1,Q3,T3 = seen in MASSIVE Embolisms, not minor ones

108
Q

What symptoms should a patient be monitored for when administered macrolides?

A

Prolonged QTc interval

109
Q

A pt prescribed erectile dysfunction meds is noticing a slight blue tint to his visual field. what is happening?

A

Sildenafil inhibits PDE-5
but also weakly inhibits PDE-6
——PDE-6 is required for transformation of light into electrical signals = cyanopsia or blue vision

110
Q

Identify dz and etiology:
4 yr old w palpitations, syncope, one seizure episode. has not be verbally communicating despite making eye contact. There is a chance that child is deaf.

A

Long QT syndromes

  • -palpitations syncope, seizures
  • -Jervell and Lange-Nielsen
  • —-autosomal receccive disorder (mutation in outward-rectifying potassium current)
  • -Hearing impairment

*other long QT: Romano-Ward - similar, but NO hearing impairment

111
Q

What is the treatment of Kawasaki dz (medium vasculitis) ?

A

Intravenous immunoglobulin

112
Q

What is the mechanism of fibrates?

A

enhances activity of LPL - hydrolyzes fatty acids from VLDL

=promotes fatty acid uptake into adipose tissue and less circulating the bloodstream

113
Q

Identify most likely cause:

3 year old w mild mid-systolic murmur on the mid precordium. No hx of cyanosis of respiratory distress

A

Still’s murmur

–benign systolic murmurs

114
Q

what is the normal percentage of oxygen saturation in blood found circulating through the foramen ovale of a fetus?

A

approximately 65%

COMLEX STEP 1 2017 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions