Cardio

Question 1

pulses paradoxus ddx

Answer 1

1. cardiac tamponad
2. asthma
3. COPD

Question 2

fall in systolic pressure > 10 mmHg during inspiration

Answer 2

Pulses paradoxes 
(CT, asthma, COPD)

Question 3

vasospastic angina

Answer 3

hyperactivity of coronary smooth muscle

Clinical:

• < 50 , smoking
• recurrent chest discomfort (at rest/ sleep)
• resolves in 15 minutes

Dx:

• ECG - ST elevation
• Angiogram - NO CAD

Treatment

• CCB
• Sublingual nitrospray

Question 4

ECG shows transient ST segmental elevation in leads 1 , aVL , v4 - V6 during spades of pain , angiogram is normal what is treatment and diagnosis

Answer 4

vasospastic angina

CCB or nitro

Question 5

why non pharm intervention has the greatest impact on high blood pressure

Answer 5

dietary modification to DASH diet

diet high in fruits and vegetables and low in sat fats

Question 6

what does cessation of smoking do with blood pressure

Answer 6

initial: transient rise in BP

- chronic light to moderate smokers have lower BP than nonsmoker

Question 7

patient on warfarin what can interact with it?

Answer 7

ACETAMINOPHEN / NSAIDs

Spanish

Question 8

- pre syncope episodes 
AV block 
LBBB 
bilateral midfield lung opacities 
30 year old

Answer 8

cardiac Sarcoidosis

Question 9

example of cariogenic shock

Answer 9

MI - due to impaired left ventricular contractility - hypotension, poor organ perfusions

Question 10

aortic stenosis clinical features

Answer 10

SAD
delayed and diminished carotid pulse ( pulses parvus et trades)
Single and soft S2
Audible S4
Harsh ejection (Crescendo - decrescendo) systolic murmur in 2nd RICS with radiation to carotids

Question 11

investigation of stable patient who experience syncopy following exercise

Answer 11

exercise stress test ( ECHO needed before EST to make sure there is no organic heart disease

Question 12

what causes acute limb schema

Answer 12

• CARDIAC / arterial EMBOLUS ( AF, LV thrombus, IE)
• arterial thrombosis ( its with pre-exciting PVD) (PVD)
• iatrogenic / blunt trauma

Question 13

suspect acute limb ischemia - on exam right leg - pulses are not palpable distal to popliteal pulse but on the left it is normal

what is the cause

Answer 13

arterial embolism

if pulses were affected on both legs - more likely to be arterial thrombis - PVD hx

Question 14

retrosternal chest pain burning in nature

Answer 14

GERD

Question 15

ECG shows irregularly irregular rhythm - what is the anatomic site most likely origin in patients arrhythmia

Answer 15

PULMONARY VEIN - - most frequent ectopic foci that cause AF

Question 16

what part of the heart is affected in sinus tachycardia

Answer 16

SA node - discharges at a rate from 100-180

Question 17

A flutter most common cause

Answer 17

reentrant circuit around the tricuspid annulus with slowing of the impulse through a region known as cavotricuspid isthmus

Question 18

ECG shows - high voltage QRS , lateral ST segment depression , lateral T wave inversions

Answer 18

left ventricular hypertrophy

Question 19

what cardiac issue does marfan syndrome have

Answer 19

aortic dissection - most dangerous complication

• AR is a complication of aortic dissection - early diastolic murmur

Question 20

inheritance of Marphans

Answer 20

autosomal dominant due to mutations in extracellular metric protein fibrillar 1

Question 21

what is the greatest sensitivity of dx heart failure in a 50 year old male

Answer 21

BNP

Question 22

systolic murmur along lower left sternal boarder that decrease in intensity when moving from standing to squating

Answer 22

Hypertrophic cardiomyopathy

Question 23

S/e of digoxin

Answer 23

anorexia , diarrhea , confusion, visual disturbance , cardiac arrhythmia

Question 24

dofetilide s/e

Answer 24

• class 3 antiarrythmic agent

- tortes de point

Question 25

s/e hydrazine

Answer 25

peripheral edema palpitations orthostatic hypotension drug induced lupus like syndrome

Question 26

metoprolol s/e

Answer 26

``` bradyarrythmia acute worsening of heart failure bronchoconstriction fatigue depression weight gain sexual dysfunction ```

Question 27

verapamil s/e

Answer 27

impairs cardiac contractility and CHF

Question 28

Pericarditis that has non specific Twave abnormalities

Answer 28

Uremic pericarditis - acute or chronic Renal failure - pleuritic chest pain - worse in supine , better sitting up - pericardial friction rub DIFFERENT FROM OTHER CAUSES OF PERICARDITIS THAT CAUSE DIFFUSE ST elevation

Question 29

high urea , pleutic chest pain and friction rub

Answer 29

pericarditis

Question 30

non pleuritic burning chest pain

Answer 30

GERD

Question 31

development of AV block in patients with Infective endocarditis Dx

Answer 31

perivalvular abscess - extends into cardiac conduction tissue

Question 32

tricuspid regurg murmur

Answer 32

holosystolic murmur of tricuspid that comes accentuated during inspiration

Question 33

what is the most common cause of sudden cardiac arrest in the immediate post infraction period in patients with acute myocardial

Answer 33

re-entry ventricular arrhythmia

Question 34

how to determine if LL edema is caused by cardiac or hepatic causes

Answer 34

- Hepatojugular Reflux Cardiac - positive HJR Cirrhosis / hepatic disease - negative HJR

Question 35

presence of ascites, peripheral edema, hapatomegly and or splenomegaly

Answer 35

portal hypertension

Question 36

blue toe syndrome cause

Answer 36

cholesterol embolism - atheroembolism

Question 37

asymptomatic HTN with epistaxis and headache think what Dx

Answer 37

Coarctation of Aorta

Question 38

erosions of the inferior costal surfaces

Answer 38

Coarctation of aorta

Question 39

diffuse vascular calcification

Answer 39

renal disease history

Question 40

prominent right arterial contour

Answer 40

Ebstein congenital abnormality

Question 41

upturning of cardiac apex

Answer 41

- think is a way to describe boot shape heart | - right heart hypertrophy