Cardio

Question 1

crushing substernal chest pain, radiating to left arm

ST elevation

dx
mechanism

Answer 1

AMI

plaque rupture w subsequent thrombus formation

Question 2

gradual stenosis of atherosclerotic plaque seen in ___

worse w ____

Answer 2

stable angina

exertion

Question 3

leads v1-v4 STEMI assc artery

leads 1 and avL

leads 2, 3, avF

Answer 3

LAD

LCX (lateral)

inferior (RCA)

Question 4

unequal arm pressures, severe sudden pain, hx of HTN

dx is ___

may be assc w

Answer 4

aotic dissection

aortic regurgitation

Question 5

preceding URI, chest pain better when leaning forward

ecg shows __ elevation and ___ depression

dx is

Answer 5

diffuse ST, PR

pericarditis

Question 6

cardiogenic shock

CO is __, pulm edema w __ PA pressures, __ central venous presures, __ SVR

Answer 6

dec, inc, inc, inc

Question 7

septic shock

svr is ___, CO is ___

Answer 7

dec, inc

Question 8

younger pt, post URI, lung crackles, inc JVP, S3

dx is ____
direct cytotoxicity as a result of ___ into ____

Answer 8

dilated cardiomyopathy

receptor mediated entry of virus, cardiac myocytes

Question 9

Preserved EF, lung crackles, orthopnea, PND, edema

ecg shows hypertrophy

dx is ___, __ dysfxn

mechanism: inability of __ to fill at normal __ pressures

Answer 9

dilated cardiomyopathy, diastolic dysfxn

LV, LA

Question 10

most common cause of HF

EF is ___

this is __ dysfxn

Answer 10

dec contractility of LV

decreased

systolic

Question 11

unequal pulse, HTN, young person

dx is

Answer 11

coarctation of aorta

Question 12

hx of cancer/recent infection/pulsus paradoxus, dec heart sounds, inc JVD

dx is __ or ____

Answer 12

pericardial effusion/tamponade

Question 13

palpitations/syncope, young person, no murmur

dx is ___

look for __ and __ on EKG
may have long ___

Answer 13

WPW
short PR, delta wave
QT

Question 14

vertebrobasilar sx, arm exercise problems, unequal bp/pulse

dx is

Answer 14

subclavian steal syndrome

Question 15

young woman, HTN, abdominal bruit

dx is

Answer 15

fibromuscular dysplasia

Question 16

Post MI

immediate death due to

Answer 16

arrhythmia

Question 17

post mi

3-10 days later, new MR murmur

ruptured

Answer 17

papillary muscle

Question 18

3-10 days post MI, holosystolic murmur at LLSB

ruptured ___

Answer 18

interventricular septim

Question 19

3-10 days post MI, signs of tamponade

ruptured ___

Answer 19

LV free wall

Question 20

several weeks post MI, fever, pleuritic CP, rib

dx is ___

Answer 20

dressler’s syndrome

Question 21

visual sx, NV, ECG changes

med SE is

Answer 21

digoxin

Question 22

angioedema/cough

SE of medicine ___

Answer 22

ace inhibitor

Question 23

lupus like syndrome, antihistone antibodies

med causing sx is

Answer 23

hydralazine

Question 24

high K, gynecomastia

med causing sx

Answer 24

spironolactone

Question 25

crescendo/decrescendo systolic murmur at LLSB inc w valsalva dx is ___

Answer 25

hypertrophic cardiomyopathy

Question 26

apical holosystolic murmur radiation to axilla, LVH, pulmonary congesion murmur is __

Answer 26

mittral regurgitaton

Question 27

pregnant woman, prominen A wave, crackles in lungs, sternal heave, diastolic murmur at apex murmur is

Answer 27

mitral stenosis

Question 28

continuous machinelike murmur, best heard at ___ bounding pulse, LV impulse dx is ___ defect in __ embryology tx w

Answer 28

left infraclavicular site PDA sixth aortic arch nsaids

Question 29

IVDU, fever/chills, SOB, systolic murmur at LLSB, inc w inspiration most common bacterial cause

Answer 29

staph aureus

Question 30

fixed split S2 murmur is

Answer 30

asd

Question 31

systolic murmur at LLSB, inc w inspiration murmur is

Answer 31

TR

Question 32

newborm, CHF, holosystolic murmur at L4ICS, dynamic precordium murmur is

Answer 32

VSD

Question 33

RUSB, SEM, chest pain, syncope, SOB murmur is

Answer 33

as

Question 34

baby w downs, CHF sx defect in __ or ___

Answer 34

av canal/av septum

Question 35

AAA repair, replacing w synthetic graft risk of ischemia to ___

Answer 35

sigmoid colon

Question 36

young asian boy, joint swelling, fissured lips, red tongue, cervical LAN dx is complication w out tx

Answer 36

kawasaki dz coronary artery occlusion

Question 37

post URI, young kid, fever, rash on trunk w sharp borders knees/wrists painful, shin nodules, chorea movements dx is ____ late complication

Answer 37

RF | valvular heart dz

Question 38

post radiation, inc JVP, lower extremity edema, dec EDV and inc EDP in both ventricles dx is __ or ___

Answer 38

constrictive pericarditis/restrictive cardiomyopathy

Question 39

poorly controlled HTN, S4 present, inc BUN/creatinine ratio cause of worsened BP

Answer 39

progressive stenosis of renal arteris

Question 40

dull, frontal HA, elevated BP, high Na, low K cause is

Answer 40

aldosterone overproduction

Question 41

HTN pt, LE swelling med cause is __ such as __ or ___

Answer 41

CCB | amlodipine/nifedipine

Question 42

Doxorubicin/trastuzumab SE is ___, or ____

Answer 42

CHF, dilated cardiomyopathy

Question 43

Amiodarone se (4)

Answer 43

pulm fibrosis, thyroid dysfxn, inc Qt, pt turns blue

Question 44

Hand grip inc ___ inc intensity of __ and __ and ___ dec __ and __ murmurs MVP occurs ____

Answer 44

afterload MR/AR/VSD HCM/AS later

Question 45

valsalva dec ___ dec intensity of ___ inc intensity of ___ MVP occurs ___

Answer 45

prelod most murmurs HCM earlier

Question 46

squatting inc ___ and ___ and ___ dec intenstiy of ___ inc intensity of __, __ and __ murmurs MVP occurs ____

Answer 46

venous return, preload/afterload HCM AS/MR/VSD later

Question 47

systolic heart sounds __/__ stenosis __/__ regurg __/__/__ also

Answer 47

A/P M/T VSD/HCM/MVP

Question 48

diastolic heart sounds __/__ regurg __/__ stenosis

Answer 48

A/P M/T