Cardio

Question 1

nitrates exert their effect by…

Answer 1

systemic venodilation

Question 2

AV fistulas CV findings

Answer 2

there is shunting of large amounts of blood, lowers SVR, increases preload to the heart, and increases CO; widening of PP and ECG shows LV hypertrophy

Question 3

hypertrophic cardiomyopathy mode of inheritance

Answer 3

autosomal dominant

Question 4

constrictive pericarditis clinical presentation

Answer 4

fatigue and dyspnea on exertion, peripheral edema, JVD and ascites (venous overload), pulsus paradoxes, Kussmaul’s sign

Question 5

Kussmaul sign

Answer 5

increase in JVD with inspiration

Question 6

infective endocarditis major and minor criteria

Answer 6

major:
- positive blood culture from typical organism
- echo shows vegetations
minor:
- previous cardiac lesion
- IV drug use
- temperature
- embolic phenomena
- immunologic phenomena
- positive blood culture from atypical organism

definitive IE: 2 major OR 1 major + 3 minor

possible IE: 1 major + 1 minor OR 3 minor

Question 7

tx of congenital long QT

Answer 7

refrain from vigorous exercise, avoid meds that lengthen QT, keep electrolyte balance

beta blockers and (if symptomatic) add pacemaker

Question 8

acute tx of hyperkalemia

Answer 8

if there are ECG changes, K+ >/=, or rapidly rising K+ d/t tissue breakdown –> give calcium gluconate or insulin+glucose

Question 9

cardiac exam finding on acute phase of myocardial infarction

Answer 9

new fourth heart sound; d/t left ventricular stiffening and dysfunction induced by myocardial ischemia