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USMLE step 2 cardiology > cardio 9 > Flashcards

cardio 9 Flashcards

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USMLE® Step 1 flashcards
1
Q

How we treat AF in patients with WPD?

A

Hemodynamically unstable do cardioversion Hemodynamically stable rhythm control with ibutilide or procainamide
Avoid AV blocking drugs–they increase accessory pathway activity—exacerbate the ventricular response

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2
Q

A complication of AF in patients with WPD?

A

The atrial activity bypasses the AV node and uses an accessory pathway–rapid ventricular response–If persist–Risk of V.fib occur

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3
Q

Risk of using drug slow AV activity in WPD?

A

Increases risk of V.Fib

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4
Q

Symptom of sinus bradycardia?

A 
Fatigue
Dizziness
lightheadedness
Hypotension 
Syncope 
Angina
Heart failure
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5
Q

Causes of SB?

A 
SSS
M.Ischemia/Infarction
Hypothyroidism
OSA
ICP
Medication
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6
Q

Management of Sinus bradycardia?

A

1) Monitoring and evaluation
2) Atropine
3) NE/D/Peace maker

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7
Q

In whom do Monitoring and evaluation is considered? what be done in all cases of SB

A
  • -Have no indication for atropine
  • treat underlying cause
  • Iv line, cardiac monitoring
  • 12 lead ECG
  • -Pulse oximetry
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8
Q

What is an indication of atropine?

A

1) Hypotension/Shock
2) Ischemic chest pain
3) Heart failure
4) Acute mental status change

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9
Q

What will be done if they do not respond to atropine?

A

We will give NE/Dopamin or peacemaker

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10
Q

Pulmonary hypertension management?

A

1) Idiopathic9primary)–vasodilators

2) Secondary–treat the underlying cause

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11
Q

What is idiopathic(primary) hypertension?

A

If pulmonary hypertension occurs in
BMPR2 mutation
connective tissue disease(SS)
HIV

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12
Q

What are drugs used for PPH/IPH

A

Bosentan(E-1 blocker)
Alprostadil(PGE2)
Sildinafil(PDE5 inhibitor)

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13
Q

Pulmonic Valve stenosis cause?

A
  • 1-congenital

- 2-acquired–carcinoid,RF

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14
Q

Symptom?

A 
HF in children--- if sever
symptom in adult--- if mild
crescendo - Decreasendo systolic murmur
Systolic ejection clic
Widening of S2 splitting during systole
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15
Q

Diagnosis?

A

Echocardiography

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16
Q

Management?

A 
Percutanous valvutomy(preferd)
Surgery(If indicated)
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17
Q

How to differentiate flow murmur (In ASD and anemia) from that of PS?

A

flow murmurs occur in mid systole and have not wide splitting

18
Q

Common cause and valve involved of IE in IV users?

A
  • -S.Aureus

- -triscupid valve

19
Q

A complication of tricuspid valve Vegetation?

A

septic pulmonary embolism

20
Q

Symptom of septic pulmonary embolism?

A

Cough
Chest pain
Hemoptysis

21
Q

Imaging?

A

Multiple nodule in CXR

22
Q

The major cause of right side HF?

A

Constrictive pericarditis

23
Q

A common cause of constrictive pericarditis?

A

TB
Chest radiation
Surgery

24
Q

Sign, symptom, and imaging future of C.P?

A 
RSHF
Elevated JVP
Hepatojugular Reflex
Kussmaul sign
pericardial knock
           Pericardial calcification in CXR,CT or MRI
25
Q

What is pericardial knock?

A

an ihigh-pitched, early diastolic sound that occurs when unyielding pericardium results in sudden arrest of ventricular filling.

26
Q

what is an ejection click?

A

Ejection clicks are high-pitched sounds that occur at the moment of maximal opening of the aortic or pulmonary valve.
They are heard just after the first heart sound.

27
Q

What are Canon A waves?

A

-Is the enlargement of A waves of jugular vein

28
Q

Mechanism?

A

simultaneous contraction of atria and ventricle

29
Q

Cause?

A

A disease that affects the communication of atria with ventricle–simultaneous atrial and V. contraction–rise Atrial P main let during contraction b/c it push against closed TV
Ventricular tachycardia
Complete heart block (disociation)
Frequant premature VTAC

30
Q

symptom?

A

Haw pain
Headache
The feeling of pulsation at the neck

31
Q

A cardiac complication of sarcoidosis?

A 
Heart block(AV, RBB)
Restrictive cardiomyopathy(early)
Dilated cardiomyopathy(Late)
Valvular dysfunction
HF
SCD(HB or arrhythmia)
32
Q

Diagnosis?

A
  • combine symptom, ECG and CXR

- Endomyocardial biopsy has a low sensitivity

33
Q

Treatment of STEMI?

A 
O2
Antiplatelet
Nitrate
anticoagulation
Beta-blocker 
PCI/Fibrnolytic
Statin
34
Q

o2?

A

If SO2 < 90

35
Q

Antiplatelet?

A

Asprin and p2y12 receptor blocker

36
Q

Nitrate?

A

be cautious in patients with hypotension, RVI, and severe AS

helps for pain also(if not add morphine)

37
Q

anticoagulant?

A

Heparin

38
Q

beta-blocker?

A

conscious in Bradycardia, Cardiogenic shock, and severe HF

39
Q

PCI

A

If the patient present within 12 Hr of symptom

should be given within 90 min of patient arrival

40
Q

Fiibrnolytics?

A

if we have no access to PCI within 12 hr of symptom.

41
Q

Statin

A

as secondary prevention

As soon as possible

USMLE step 2 cardiology (16 decks)

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