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ABR > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Physiologic S2 split

A

A2 then P2 on inspiration

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2
Q

Paradoxical S2 split

A

AS
HTN
LBBB

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3
Q

Early diastolic S3 sound (aka pericardial knock)

A

Constrictive pericarditis

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4
Q

Pulsus alternans

A

Severe heart failure

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5
Q

Pulsus paradoxus

A

Cardiac Tamponade
SVC obstruction
Pulmonary obstruction

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6
Q

Sustained left parasternal lift (heave)

A

RVH

MS, pHTN, PS

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7
Q

Sustained apex lift/impulse

A

LVH

Bifid or trifid apical impulse with HOCM

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8
Q

Holosystolic murmur

A

MR
TR
VSD
pHTN

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9
Q

Mid-systolic murmur

Crescendo-decrescendo

A

AS (more severe with late peak)
pS
ASD

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10
Q

Late systolic murmur with mid-systolic click

Crescendo

A

MVP

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11
Q

Mid-diastolic murmur

A

MS
TS
ASD

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12
Q

Late diastolic murmur

Plop or diastolic sound

A

Atrial myxoma

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13
Q

Early diastolic murmur

Decrescendo

A

AR

PR

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14
Q 
Murmur
Inc standing
Inc Valsalva
Inc Post-PVC
Dec hand grip
A

HOCM

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15
Q 
Murmur
Inc standing
Inc Valsalva
Inc Post-PVC
Dec hand grip (duration dec, intensity inc)
A

MVP

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16
Q 
Murmur
Dec standing
Dec Valsalva
Dec Post-PVC
Inc hand grip
A

MR

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17
Q 
Murmur
Dec standing
Dec Valsalva
Inc Post-PVC
Dec hand grip
A

AS

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18
Q

Most common murmur in LLSB

A

VSD

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19
Q

Strongest modifiable risk factor for MI

A

Dyslipidemia

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20
Q

Cardiac stress test with baseline ST-T abnormalities or LVH on EKG

A

Exerciser ECHO

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21
Q

Cardiac stress test with LBBB or V-pacing on EKG

A

Vasodilator MPI

SPECT/PET (PET > SPECT if obese or female)

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22
Q

Cardiac stress test is patient unable to exercise and has wheezing

A

Dobutamine stress test

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23
Q

Cardiac stress test if patient unable to exercise and no wheezing

A

Vasodilator or Dobutamine stress test

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24
Q

Indication for MUGA scan

A

Determine LVEF and wall motion abnormalities

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25
Q

Management for chronic angina on ASA and nitrates with increasing frequency

A

Add beta blocker

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26
Q

Decrease frequency if anginal episodes and improved exercise tolerance

A

Ranolazine

Not shown to decrease mortality

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27
Q

Deep T waves in V1 to V4

A

Myocardial ischemia

Wellens syndrome/LAD T-wave inversion syndrome

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28
Q

Chest pain
EKG normal
Stress test with reversible with reversible ischemia
Coronary arteriography negative

Management

A

Microvascular angina/Syndrome X

CCB/Beta blockers and nitrates

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29
Q

Chest pain
Positive ambulatory EKG
Negative angiogram

A

Vasospastic angina

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30
Q

Syncope. Dizzy after dinner

EKG with ST depression in II, III, aVF

A

Postprandial ischemia

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31
Q

Lightheaded after meals + syncope

Management

A

Postprandial hypotension

Small frequent meals

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32
Q

Ticagrelor vs Prasugrel vs Clopidogrel

A

PCI: T and P > C
CABG: C

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33
Q

Indications for thrombolysis

A

CP typical for infarct > 30min w/ LBBB
ST elevation 1mm in 2 cont leads
< 12 hrs post MI
> 2 hrs from PCI center. Not in shock

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34
Q

Absolute contraindications to thrombolytic therapy

A

Previous hemorrhagic stroke
Other CVA events < 1 year
Intracranial neoplasm
Active internal bleed

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35
Q

Relative contraindications to thrombolytic therapy

A 
CVA > 1 year 
Recent internal bleed or major trauma < 2-4 weeks
BP > 180/110
Pregnancy
Active PUD
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36
Q

Indications for PCI

A 
Active STEMI
ST elevation with CP > 12 hrs
MI w/ shock and < 2 hr from PCI center and < 75 yo
tPA contraindicated 
Unstable angina
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37
Q

Management for Vtach or VFib 48 hours after MI

A

ICD

38
Q

Most specific pericarditis finding on EKG

A

PR depression

39
Q

Management for acute pericarditis

A

NSAIDS and colchicine

40
Q

Prophylaxis for pericarditis

A

Colchicine

41
Q

On GDMT + spironolactone

Bilateral breast enlargement

A

D/c spironolactone and start eplerenone

42
Q

Appropriate timing of ICD placement

A

After optimal GDMT for at least 3 months

43
Q

Hypercontractile base and noncontractile apex

Time of recovery

A

Takotsubo cardiomyopathy

Recovery within 2-3 months

44
Q 
Rigid pericardium
Post-cardiotomy, viral, radiation
Mostly normal EKG
BNP < 100
Pericardial calcification 
Thickened pericardium
A

Constrictive pericarditis

45
Q

Rigid ventricle
Amyloid, endomyocardial fibrosis, sarcoidosis
Low voltage EKG, repolarization abnormalities
BNP > 400
Cardiomegaly, ventricular wall thickening

A

Restrictive pericarditis

46
Q

Early systolic murmur at LLSB that increases with decreased flow (standing, Valsalva)

A

Hypertrophic cardiomyopathy

47
Q

LV wall thickness > 15mm

LV wall thickness < 15mm

A

HOCM

Athletes heart

48
Q

1st line Management for HOCM

A

Beta blocker

49
Q

Severe Aortic stenosis

A

Gradient > 40
Valve < 1 sq cm
Late peaking murmur

50
Q

Differentiate severe AS from not severe AS

A

Dobutamine ECHO

51
Q 
Surveillance:
Asx mild AS
ASx moderate AS
ASx severe AS. LVEF > 50%
ASx severe AS. LVEF < 50%
A

ECHO q 3-5 years
ECHO q 1-2 years
ECHO q 6-12 mo
AV replacement t

52
Q

Management for AR
ESD < 40. EDD < 60
ESD > 50. EDD > 65

A

ECHO in 6-12 mo

Surgery

53
Q

Opening snap
Mid diastolic rumble at apex
Straightening of L heart border

A

Mitral stenosis

54
Q

Management for MS if valve < 1.5 sq cm

A

Valvuloplasty

55
Q

Management for MR if LVEF < 60% and LVESD > 40

A

Transcatheter MV repair

56
Q

Incomplete fusion of septum primum

A

PFO

57
Q

Incomplete covering of foremen ovale by septum primum

A

Secundum ASD

58
Q

Septum primum does not connect to endocardia cushion

A

Primum ASD

59
Q

Management for VSD if L to R shunt > 1.7:1

A

Surgery

60
Q

Wide pulse pressure

A

PDA

61
Q

Management for Marfan

A

Early ECHOs
Beta blockers and Losartan
If aorta dilation > 4.5 cm - Repair

62
Q

Surgical indications for TAA and AAA

A

ASx TAA > 6cm
ASx AAA > 5.5cm

Symptomatic any size

63
Q

AAA screening

A

And US for males 65-75 with any h/o smoking

64
Q

Frequency of AAA screening

A

3-3.9cm&raquo_space; 3 years
4-4.9cm&raquo_space; 1 year
5-5.4 cm&raquo_space; 6 mo

65
Q

INR goal for mechanical AV and mechanical MV

A

AV 2-3 (ASA + Warfarin)

MV 2.5-3.5 (ASA + Warfarin)

66
Q

Rhythm control for Afib without structural heart disease

A

Flecainide

Propafenone

67
Q

Rhythm control for Afib without CAD or CHF

A

Sotalol

Amiodarone

68
Q

Rhythm control for Afib with CHF but without CAD

A

Amiodarone

Dofetilide

69
Q

CHADS-VASc

A 
CHF - 1
HTN - 1
Age > 75 - 2
DM - 1
Stroke/TIA/DVT - 2
Vascular Dz - 1
Age 65-74 - 1
Female - 1
70
Q

Peri-op warfarin management with Afib

A

CHADSVASc < 4 — d/c warfarin 5 days prior to surgery w/o bridging

CHADSVASc > 6 — d/c warfarin 5 days prior and bridge with LMWH

71
Q

Goal INR to clear for surgery

A

1.5

72
Q

Peri-op DOAC management

A

Hold 2 days prior and restart 2 days after. No bridge

73
Q

Rate control and AC in Afib compared to cardioversion

A

Decreased stroke

Decreased hospitalizations

74
Q

Management for persistent Afib refractory to 2 meds

A

Ablation of pulmonary vein

75
Q

Drug that will bring Afib into NSR

A

Ibutilide

76
Q

Intra-atrial macroreentrant tachycardia
250-350/min

Management

A

Atrial flutter

Slow AV conduction with beta blockers or diltiazem

77
Q

Management for AVNRT

A

carotid massage
Then Adenosine 6mg
Then Adenosine 12mg

78
Q

Management for WPW

A

Exercise EKG if asymptomatic

EPS + radioablation if with any arrhythmia or unexplained syncope

79
Q

Management for inappropriate sinus tachycardia

A

Beta blocker

Ivabradine

80
Q

> 3 distinct morphological types of p wave

Management

A

Multifocal atrial tachycardia
(Seen in COPD, theophylline use, CHF)

Oxygen

81
Q

Management for PVC

A

No heart disease, Asx: no treatment
No heart disease, Sx: beta blocker
Heart disease; low LVEF: ICD

82
Q

QT interval formula

A

QTc = QT / sq rt (RR)

83
Q

Indications for ICD

A

Sudden cardiac death: Vtach or VFib
NICM (LVEF < 35%) + 3 mo GDMT
ICM (LVEF < 35%) + 40 days p MI
HOCM w/ NSVT + FHx of sudden death

84
Q

Asian
Cardiac arrest
FHx of young death

Management

A

Brigades syndrome

ICD

85
Q

Management for 2 deg Type II AV block

A

If secondary to IW or RV MI — no PPM

If secondary to AWMI — PPM

86
Q

Anorexia
Blurry vision
Yellow appearing objects
Decreased red and green color vision

A

Digoxin toxicity

87
Q

Best test for familial combined hyperlipedemia

A

Apoprotein B

88
Q 
Intensity of statin therapy
ASCVD > 75 yo
ASCVD < 75 yo
LDL > 190
DM 80-189
10 yr ASCVD risk 7.5-20%. >20 %
A 
Moderate 
High
High
Moderate 
Moderate. High.
89
Q

Muscle biopsy with necrotizing muscle fibers
no inflammation
no vacuoles

A

Statin induced myopathy

90
Q

Etiology of flushing associated with niacin

A

PGDE2

ABR (12 decks)

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