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USMLE step 2 cardiology > Cardio 7 > Flashcards

Cardio 7 Flashcards

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USMLE® Step 1 flashcards
1
Q

Anterior MI blocked vessel and ECG pattern?

A

LAD ST-elevation V1-V6

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2
Q

Inferior MI?

A

RCA or LCX ST elevation in II, III and aVF

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3
Q

Posterior MI?

A

LCX or RCA ST depression in V1-V3 ST-elevation I and aVL—LCA ST-depression in I and aVL—RCA

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4
Q

LCA and diagonal?

A

ST elevation in I,aVL, V5 and V6 ST depression in II, III and aVF

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5
Q

Right ventricle MI?

A

Occur in 1/2 of inferior MI RCA ST elevation in lead 4-6

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6
Q

Type of ventricular arrhythmia?

A

Ventricular premature beat Ventricular tachycardia(sus..and non-sus.) Ventricular fibrillation

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7
Q

The common cause of SCA in acute MI?

A

Ventricular fibrillation

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8
Q

Common time of Ventricular FIB

A

In the first 1 hour (50%)

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9
Q

Cause of Ventricular arrhythmia in post-MI?

A

In the first 10 min post-MI–Reentry(due to delay conductin in the infarcted area) the predominant mechanism

IN 10-60 MIn post-MI-Abnormal automaticity

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10
Q

Rare arrhythmia in post-MI?

A

Supraventricular tacyaretemia other than AFIB and fluter

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11
Q

All patients with persistent narow or wide complex arrhythmia with hemodynamic instability management?

A

Immediate synchronized direct current cardioversion

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12
Q

why we do not use amiodarone in hypotensive patients?

A

It will exacerbate the Hypotension

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13
Q

Cause of syncope in HCM?

A

Mainly due to outflow obstruction Rarely may be due to ischemia, arrhythmia, and inappropriate baroreceptor response that result in vasodilatin.

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14
Q

Management of carotid artery stenosis depends on?

A

Presence of symptom (TIA and Stroke) Severity of stenosis

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15
Q

Asymptomatic with low-grade stenosis(<80 % occlusion)?

A

Antiplatelet Statin Risk factor managment

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16
Q

Symptomatic (Having TIA or Stroke in last 6 months)?

A

Carotid endarterectomy

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17
Q

Asymptomatic with high-grade (80-99%) stenosis?

A

Carotid endarterectomy

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18
Q

Why carotid endarterectomy is preferred over stent?

A

low periprocedural mortality and stroke risk

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19
Q

Treatment of mild HTN?

A

Lifestyle modification

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20
Q

component of Lifestyle modification

A

Weight loss DASH diet Exercise Reduce dietary salt Limit alcohol intak

21
Q

Wight loss mechanism and effect on SBP?

A

Reduction of BMI<25 5-20 per 10 KG loss

22
Q

DASH diet mechanism and effect on SBP?

A

High fruit and vegetable and low saturated and total FAT 8-14

23
Q

Exercise mechanism and effect on SBP?

A

30 min/day for 5-6 day/week 4-9

24
Q

Low sodium diet mechanism and effect on SBP?

A

<3gm/day 2-8

25
Q

Low alcohol intake mechanism and effect on SBP?

A

<2/day for men and <1/day for women 2-4

26
Q

Smoking session in HTN.

A

Decrease CV complication

27
Q

Clu of renovascular disease?

A

Sever HTN(>180/120 after age 55 Malignant HTN(end-organ damage) Resistant HTN(Not respond to 3 drugs) Defuse atherosclerosis Recurrent flash pulmonary edema

28
Q

Physical examination?

A

Asymmetric renal size >1.5 Abdominal bruit (systolic-diastolic)-Highley specific

29
Q

Laboratory?

A

an unexplained rise in creatinine(>30%) after ACE inhibitor/ARB

30
Q

Imaging

A

Unexplained atrophic kidney

31
Q

Diagnosis confirmation?

A

Renal Dopler sonography CT/MRI angiography

32
Q

When we suspect UE atherosclerosis

A

Mild B/P discrepancy

33
Q

symptom of aortoenteric fistula?

A

Abdominal pain GI bleeding Hypotension

34
Q

Torsades de Pointes?

A

Polymorphic ventricular tachycardia

35
Q

treatment?

A

IV magnesium sulfate: hemodynamically stable Defibrillation;: hemodynamically Unstable

36
Q

Cause of TdS other than drugs?

A

Decrease serum Mg, K, and Ca

Starvation and Hypothermia

Hypothyroidism

Sinus node dysfunction and AV block

MI

Intracranial disease

HIV

37
Q

B blocker effect in DM patients?

A

Block B-1 receptor –decrease lipolysis(B1) mediated–insulin resistance and weight gain

-decrease B/F to Skeletal M–reduce glucose uptake increase unopposed alpha effect–decrease B/F to muscle–decrease glucose uptake decrease insulin secretion

38
Q

Pulmonary endolism symptom?

A

Pluritic chest pain Dyspnes Tachypnea Tachycardia

39
Q

CXR?

A

low sensitivity(usually normal)

Atelectasis

Infiltration and pleural effusion

Pheripherial hypo lucency due to oligimia (westmark sign)

Wage shaped lung opacity(Hampton’s hump)

Enlarged pulmonary artery(filcher sign)

40
Q

Acute managment of aortic dissection?

A

Pain control(morphine)

Reduction of systolic blood pressure to 100—120 (sodium nitroprusside if B/P more than 120 despite beta-blocker

Decrease left ventricular contractility by beta-blocker –reduce stress on aorta (labetalol, esmolol, and propranolol are the preferred ones.

If ascending–emergency surgery b/c 1-2 % mortality per hour

41
Q

Treatment of any arrhythmia with hemodynamic instability?

A

Direct cardioversion

42
Q

Typical ECG future of cardiac tamponade?

A

Pulses alterans with sinus tachycardia

If have large effusion –Low QRS voltage

43
Q

Cardiovascular risk managment in DM patients?

A

General measure

Blood pressure and cholesterol

44
Q

G.mesure?

A

Healthy wight

Exercise

smoking cessation

45
Q

Blood pressure?

A

Medication and lifestyle modification

Target <140/90

Continiu measure ,120/80

46
Q

colestrol?

A

High intensity statin–establish CVD or 10 year risk of CVD .=20 Moderate intesisty statine–all other patient age > 40

47
Q

What are Premature ventricular contractions (PVCs)?

A

are extra heartbeats that begin in one of your heart’s two lower pumping chambers (ventricles).

These extra beats disrupt your regular heart rhythm, sometimes causing you to feel a fluttering or a skipped beat in your chest

48
Q

Ventricular tachycardia (VT)?

A

is a fast, abnormal heart rate.

It starts in your heart’s lower chambers, called the ventricles.

VT is defined as 3 or more heartbeats in a row, at a rate of more than 100 beats a minute.

If VT lasts for more than a few seconds at a time, it can become life-threatening.

USMLE step 2 cardiology (16 decks)

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