Cardio

Question 1

Kussmaul sign

Answer 1

⬆️ JVP in inspiration

Question 2

Atrial fibrillation

Answer 2

cardioversion only if 🔽48 h and ETT NEG for intracardiac clot

Question 3

RESTRICTIVE CARDIOMYOPATHY CAUSES?

Answer 3

sarcoidosis, amyloid, hemochrombtosis, endomyocardial fibrosis, scleroderma
CLASSIC CARDIAC FAILURE FEATURES !

Question 4

AMYLOIDOSIS:

Answer 4

increased ventricular wall thickness with a non dilated left ventricular cavity &raquo_space; ALSO proteinuria, peripheral neuropathy, hepatomegaly, enlarged tongue, periorbital purport, thickening of the skin, anaemia,

Question 5

Hypertrophic cardiomyopathy

Answer 5

> > Autosomal dominant disease&raquo_space;> Exertional dyspnea, chest pain, palpitations, syncope&raquo_space; HARSH CRES-DECRES SYSTOLIC MURMUR HEARD BEST AT THE APEX AND LOWER LEFT EXTERNAL BORDER&raquo_space;> ⬆️ AFTERLOAD AND PRELOAD: MURMUR⬇️
⬇️PRELOAD: ⬆️MURMUR

bblockers

Question 6

When is carotid endarderectomy indicated?

Answer 6

MEN
ASYMPTOMATIC IF >60%
SYMPTOMATIC > GRADE IIA 50% > GRADE IA 70%

WOMEN ONLY IF >70%

Question 7

Pericarditis EKG

Answer 7

ST elevation in all leads ! > PR segment depression: most specific

Question 8

Rheumatic fever

Answer 8

most common mitral stenosis (pregnant immigrant) Dysphagia, hoarseness, AF, hemoptysis > DIASTOLIC MURMUR > squatting and leg raising ⬆️

Question 9

Digoxin toxicity

Answer 9

fatal arrhythmias / fatigue, weakness, color disturbances/ nausea, abdominal pain
Amiodarone&raquo_space;> increases risk of digoxin toxicity !

Question 10

MITRAL regurgitation

Answer 10

Pansystolic radiating to the axilla

Question 11

Aortic regurgitation

Answer 11

Wide pulse pressure
• Water-hammer (wide, bounding) pulse
• Quincke pulse (pulsations in the nail bed)
• Hill sign (BP in legs as much as 40 mm Hg above arm BP)
• Head bobbing (de Musset sign)
⬆️ Afterload &raquo_space; WORSE
Valsalva ( ⬇️ preload)&raquo_space; Better

Question 12

Aortic stenosis

Answer 12

Valsalva, hangrip > ⬇️
WEAK AND SLOW RISING CAROTID PULSE
Surgery works better

Question 13

Constrictive pericarditis

Answer 13

right heart failure + calcifications around the heart in X ray

Question 14

TAMPONADE:

Answer 14

hypotension, tachycardia, distended neck veins, clear lungs, EKG electrical alternate

Question 15

Mitral regurgitation 3 days after MI

Answer 15

Sudden onset of shock, dyspnea, pulmonary edema. Mid-late systolic murmur.

—–> Papillary muscle rupture

Most common in inferior wall infarction

Question 16

Aortic dissection

Answer 16

Suspicion ! > HTN, Marfan > Tearing pain > Pulse deficit, >20 mm hg between arms

Renal function OK? > Yes&raquo_space; Chest CT
Renal failure&iodine allergy> TEE

Question 17

Urge urinary incontinence pathogenesis

Answer 17

Urethral hypermobility

Question 18

Homocystinuria

Answer 18

Marfanoid body habitus
Fair hair and eyes
Developmental delay
CVA

Question 19

Most common cause of neonatal sepsis

Answer 19

Group B streptococcus

Question 20

Zenker diverticulum is due to:

Answer 20

Esophageal dysmotility

Question 21

predispose to intussusception

Answer 21

Hypertrophied peyer patches (due to viral gastroenteritis)

Zenker diverticulum

Question 22

first degree AV block treatment

Answer 22

No observation

possible electrophysiology testing

Question 23

Bath salts intoxication

Answer 23

Like PCP but longer duration

Might present with seizures

Question 24

Peritoneal irritation in bladder trauma

Answer 24

must be dome rupture

neck and anterior wall are extra peritoneal

Question 25

Every case of leukocoria is consider....

Answer 25

Retinoblastoma until proven otherwise

Question 26

Transudate pH

Answer 26

``` near serum (7,45) exudates tend to be more acidic ```

Question 27

Chronic pancreatitis

Answer 27

Chronic epigastralgia Malabsorption DM II CT: pancreatic calcifications

Question 28

Antipsychotics block D2 causing...

Answer 28

Hyperprolactinemia: galactorrhea, menstrual irregularities, infertility Common atypical antipsy: risperidone and paliperidone

Question 29

Zollinger ellison syndrome with steatorrhea....

Answer 29

inactivation of pancreatic enzymes due to acidic duodenum pH

Question 30

acid-base status in aldosterone deficiency

Answer 30

Kidney loses Na and spares H+ / K+ leading to... | Normal anion gap acidosis

Question 31

If slowly return to baseline mental status after loss of consciousness suspect...

Answer 31

Seizure | Syncope> immediate return to baseline

Question 32

Small for gestational age dx:

Answer 32

Weight under p 10th > complications: hypoxia, hypothermia, POLYCYTHEMIA, hypocalcemia

Question 33

Vomiting causes:

Answer 33

Hypochloremia hypokalemia ↑ HCO3 ↓ H+

Question 34

Hypomagnesemia might cause ....

Answer 34

hypokalemia

Question 35

Renal colic might produce ileus due to

Answer 35

vagal reaction

Question 36

if maternal grave's disease...

Answer 36

Neonatal thyrotoxicosis | due to TSH receptor antibody crosses placenta

Question 37

Oxygen in COPD indicated when :

Answer 37

Resting PaO2 <55 mmhg or SaO2<88% | PaO2 <59 mmhg or SaO2 <89% if cor pulmonale

Question 38

Medulloblastoma

Answer 38

2nd most common posterior fossa tumor | majority in cerebellar vermis > ataxia

Question 39

Nitroprusside might cause:

Answer 39

Cyanide toxicity

Question 40

kidney stones are more commonly composed by...

Answer 40

calcium oxalate

Question 41

Nephrotic syndrome in Hodgkin lymphoma ...

Answer 41

most likely minimal change disease

Question 42

Solid malignancy and nephrotic syndrome due to:

Answer 42

Membranous glomerolopathy

Question 43

Fat embolism usually after a long bone fracture, signs:

Answer 43

Dyspnea neurological impairments Petechial rash

Question 44

Causes of digital clubbing

Answer 44

Lung malignancies cystic fibrosis Right to left cardiac shunts

Question 45

Most common cause of megaloblastic anemia in alcoholics

Answer 45

Folate deficiency

Question 46

First line therapy for myasthenia gravis

Answer 46

Pyridostigmine (long acting ach inhibitor) Second line: immunotherapy / thymectomy

Question 47

Rivaroxaban not recommended in:

Answer 47

Renal impaired patients

Question 48

Acute lymphadenitis most likely due to:

Answer 48

S pyogenes and S aureus