Cardio

Question 1

What genetic disorder is MC in Asian males and associated with syncope and sudden cardiac death?

Answer 1

Brugada Syndrome

Question 2

Brugada Syndrome EKG findings

Answer 2

1. ST elevation: V1-V3
2. T wave inversion: V1-V2
3. RBBB

Question 3

Brugada Syndrome treatment

Answer 3

AICD to prevent death from V-fib

Question 4

What are the 3 main components of cariogenic shock?

Answer 4

1. Vasoconstriction: Increased SVR
2. Hypotension: Decreased CO
3. Increased Pulmonary Wedge Pressure= >15mmHg

Question 5

What is the MCC’s of Cariogenic shock

Answer 5

Obstructive:

1. Massive PE
2. Cardiac Tamponade
3. Tension Pneumothorax

Question 6

Cardiogenic shock treatment

Answer 6

1. Oxygen
2. Isotonic fluids: AVOID LARGE AMOUNTS
3. Inotropic drugs: Dobutamine (1st line), Epinephrine

Question 7

what are the 2 MCC of acute pericarditis?

Answer 7

1. Idiopathic

2. Viral: Coxsackie (enteroviruses)

Question 8

What is the MCC of pericardial effusion?

Answer 8

Pericarditis

Question 9

EKG findings in pericardial effusion

Answer 9

1. Low voltage QRS

2. Electrical Alternans

Question 10

What is Beck’s Triad? What condition do we see this in?

Answer 10

Beck’s triad: Muffled heart sounds + Increased JVP + Hypotension
Cardiac tamponade

Question 11

Echo findings in cardiac tamponade

Answer 11

Effusion + Diastolic collapse of cardiac chambers

Question 12

Cardiac tamponade treatment

Answer 12

Pericardiocentesis

Question 13

What size is considered an aortic aneurysm?

Answer 13

> 3.0 cm

Question 14

What is the MC presentation in AAA?

Answer 14

Asymptomatic

Often incidental finding

Question 15

What is the INITIAL study of choice in SUSPECTED AAA?

Answer 15

Abdominal US

Question 16

What is TOC for thoracic aneurysm?

Answer 16

CT scan

Question 17

What is GOLD STANDARD in the diagnosis of AAA?

Answer 17

Angiography

Question 18

What AAA size requires immediate surgical repair regardless of sx’s?

Answer 18

> 5.5 cm OR

>0.5 cm expansion in 6 mos

Question 19

What is the MC risk factor in AAA?

Answer 19

Atherosclerosis

Question 20

What is the most important predisposing factor/RF in Aortic dissection?

Answer 20

HTN

Question 21

What type of aortic dissection has the highest mortality? which is the MC?

Answer 21

Ascending=MC and highest mortality

Question 22

What heart sound would you expect to find in an ascending aortic dissection?

Answer 22

acute new-onset aortic regurgitation

Question 23

What study is considered GOLD STANDARD in aortic dissection?

Answer 23

MRI Angiography

Question 24

What is a classic CXR findings in aortic dissection?

Answer 24

Widening of the mediastinum

Question 25

Which aortic dissection requires surgical management? medical management?

Answer 25

Surgical: Acute Proximal
Medical: Descending

Question 26

What is the medical management in a descending aortic dissection

Answer 26

Esmolol, Labetalol

Question 27

Rate control treatment in A-fib

Answer 27

1. Beta Blocker: Metoprolol
2. Calcium Channel Blocker: Diltiazem
3. Digoxin: if hypotension or CHF

Question 28

Who is cardioversion considered in pt’s with A-fib?

Answer 28

1. Young patients with lone A-fib
2. A-fib <48 hrs OR
3. after 3-4 wks of anticoagulation and TEE shows no atrial thrombi

Question 29

Pharmacologic rhythm control in a-fib

Answer 29

1. Flecainide
2. Sotalol
3. Amiodarone