Cardio

Question 1

pulsus paradoxus

Answer 1

decrease SBP w/ inspiration
pericardial tamponade
COPD
tension pneumo
foreign body

Question 2

pulsus alternans

Answer 2

weak-then strong - poor prognosis

cardiac tamponade

Question 3

pulsus parvus et tardus

Answer 3

weak + delayed

aortic stenosis

Question 4

kussmal sign

Answer 4

increased JVP w/ inspiration
cardiac tamponade
tricuspid regurg
constricitive pericarditis

Question 5

tx brady or symptomatic mobtiz 1

Answer 5

atropine

Question 6

causes of mobitz 1

Answer 6

Digoxine
BB, CCB
increased vagal tone
right ischemia/infarct

Question 7

CHADS2 score

Answer 7

anticoagulate if 2+
CHF
HTN
75y/o = 2
Diabetes
Stroke/tia = 2
vasc dz 
female
65-74

Question 8

multifocal atrial tachy

Answer 8

COPD/hypoxemia

verapamil/Bb for rate ctrl

Question 9

rate ctrl options Afib

Answer 9

BB
CCB
digoxin

Question 10

tx v tach

Answer 10

amiodarone
lidocaine
procainamide

Question 11

MCC:
systolic HF?
diastolic HF?

Answer 11

systolic = CAD
diastolic = HTN

Question 12

tx CHF

Answer 12

BB/ACEI/ARB - prevent remodeling + decrease mortality

spironolactone for types 3-4 decrease mortality

Question 13

BB for CHF

Answer 13

bisoprolol
carvedilol
metoprolol

Question 14

what tx is not usefule in diastolic HF

Answer 14

digoxin
#1 - diuretics

Question 15

PE in HOCM

Answer 15

sustained apical impulse
S4
tx: BB

Question 16

restrictive cardiomyopathy

Answer 16

decreased elasticity
bx = fibrosis/infiltrates
typically see LBBB, low voltage w/ amyloidosis

Question 17

what meds show mortality benefit for tx angina

Answer 17

BB

ASA

Question 18

tx unstable angina

Answer 18

same as stable angina

add clopidogrel, heparin, or enoxaparin

Question 19

when to give heparin + do PCI

Answer 19

TIMI score > 3 out of 7
CP refractory to meds
trop elevated
ST changes > 1mm

Question 20

best predictor survival STEMI

Answer 20

LVEF

Question 21

leads I, AVL, V5-6

Answer 21

LCA

Question 22

leads V1-4

Answer 22

LAD

Question 23

leads II, III, AVF

Answer 23

RCA

Question 24

tx if can’t do PCI w/in 90 min

Answer 24

thrombolysis w/ tPA - reteplase or streptokinase

Question 25

indications to do CABG are "UnLimiTeD"

Answer 25

U - unable to do PCI L - left main disease T - triple vessle D - depressed vent func

Question 26

tx LDL > 130

Answer 26

ezetimibe

Question 27

tx TG > 150

Answer 27

fibrates

Question 28

tx HDL < 40

Answer 28

niacin

Question 29

when to start fasting lipid profile

Answer 29

at 35 at 20 w/ CAD risk factors repeat Q5y

Question 30

hypercholesterolemia vs dyslipidemia

Answer 30

TC > 200 (x2) = hypercholesterolemia | LDL > 130 or HDL < 40 = dyslipidemia (regardless TC)

Question 31

strongest statins

Answer 31

atorvastatin (lipitor) | rosuvastatin (crestor)

Question 32

most effective life style modification for HTN

Answer 32

weight loss

Question 33

cause of 2ndary HTN

Answer 33

``` CHAPS Cushings Hyperaldosteronism (Conn's) Aortic coarcation Pheo Stenosis renal arteries ```

Question 34

HoTN + hypoK + met alkalosis = ?

Answer 34

Conn's syndrome (hyperaldosteronism)

Question 35

tx malignant HTN

Answer 35

IV labetalol, nitropursside, nicardipine

Question 36

PR segment depression + diffuse ST elevation | followed by T wave inversions

Answer 36

pericarditis | tx: ASA if post-MI, ASA/NSAID viral

Question 37

ekg shows electrical alternans

Answer 37

large pedicardial effusion CXR = water bottle shaped heart tx: IV fluid, pericardiocentesis if decompensated do pericardial window

Question 38

blowing diastolic murmur LSB, mid-diastolic rumble (Austin Flint) de Musset's Corrigan's Duroziez

Answer 38

Aortic regurg | Tx: vasodilators (CCB, ACEI)

Question 39

opening snap, mid diastolic murmur at apex | pulm edema

Answer 39

Bblockers | digoxin

Question 40

usually 2nd to rheumatic fever or chordae tendineae rupture | holosystolic murmur radiates to axilla

Answer 40

nitrates/diuretics to reduce preload | antiarrhythmics (AF + LAE common)

Question 41

pulsatile abdominal mass/bruits

Answer 41

aortic aneurysm (assoc w/ atherosclerosis)

Question 42

MC above aortic valve HTN asymmetric pulses and BP

Answer 42

aortic dissection (assoc w/ HTN) CT angiography Stanford system - proximal to left subclavian = type A Tx: BP meds

Question 43

tx DVT

Answer 43

1) IV unfractionated heparin or SQ LMWH | 2) follow w/ PO warfarin x 3-6mon

Question 44

ABI results for PAD

Answer 44

ABI < 0.4 w/ rest pain

Question 45

buttock claudication decreased femoral pulse male impotence

Answer 45

Aortoilliac PAD

Question 46

calf claudication | decreased pulses below femoral artery

Answer 46

femoropopliteal disease