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INTERNAL MEDICINE > Cardiology > Flashcards

Cardiology Flashcards

1
Q

MC diagnosis of chest discomfort at the ER

A

GI causes

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2
Q

pleuritic, KNIFE-LIKE pain radiation to trapezius

A

pain in acute pericarditis

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3
Q

severe sudden TEARING pain radiating to the INTERSCAPULAR AREA

A

Aortic Dissection

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4
Q

MC presentation of pulmonary embolism

A

dyspnea

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5
Q

clenching of FIST held against the sternum

A

Levine sign

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6
Q

50/M, smoker, HTN, heavy complaining substernal chest pain during exertion lasting 5 minutes and relieve by rest

A

Chronic stable angina pectoris

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7
Q

first line of treatment to reduce angina (Chronic CS)

A

Beta blocker/CCB

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8
Q

Canadian CVS FC of Angina: Emotional stress in cold, few hours from after awakening, slight limitation

A

CCS II

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9
Q

CCS FC of angina: MARKED limitation

A

CCS III

I - ordinary physical activity
IV - inability to carry on any physical activity without discomfort

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10
Q

Definitive test for CAD

A

Coronary angiography

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11
Q

Drugs rescued for patient who cannot stress test

A

Dobutamine
Adenosine
Dipyridamole

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12
Q

Goal LDL for proven CAD:

A

LDL: <100mg/dl
if with DM: <70mg/dl

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13
Q

most important determinant of Pulse pressure

A

Stroke volume

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14
Q

Indications for CABG`

A

Left main coronary artery disease
3 vessels dse + LVEF <50% or DM
2 vessel dse that includes proximal left descending coronary artery

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15
Q

what is MCC of IN-HOSPITAL death among patients suffering from ACS

A

Pump failure

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16
Q

Classification of MI: MI related to percutaneous Coronary Intervention

A

Type 4a

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17
Q

Classification of MI: MI resulting in death when biomarkers are unavailable

A

type 3

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18
Q

Classification of MI: MI related to CABG

A

Type 5

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19
Q

Class of MI: spontaneous MI, Severe CAD but on occasion non obstructive CAD

A

Type 1

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20
Q

Classification of MI: MI secondary to an ischemic balance, coronary artery spasm, arrhythmia, anemia, respiratory failure, hypotension and hypertension with or without left ventricular hypertrophy

A

type 2

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21
Q

Classification of MI: related to Stent thrombosis

A

type 4b

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22
Q

Reflex: Anterior wall involvement, tachycardia, hypertensive

A

James-Reflex

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23
Q

Reflex: inferior wall affected, bradycardia, hypotension

A

Bezold- Jarisch Reflex

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24
Q

first cardiomarker to rise in N-STEMI ACS

A

Myoglobin

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25
Q

best test to detect a REINFARCTION a few days after the initial infarction

A

CK-MB - rise in 3-6hrs, sustain till 1-2 days

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26
Q

cardio marker that rise 3-6 hrs and sustain till 1-2 weeks

A

Troponin

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27
Q

Kilip scoring with Severe heart failure, mid basal rales and pulmonary edema, S3 and S4, Normal BP

A

Class III

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28
Q

Kilip scoring of Mod HF, bibasal rales, Normal BP, S3 gallop, tachypnea

A

Kilip score of 2

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29
Q

MCC of OUT-hospital death from STEMI

A

Vfib

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30
Q

Compromise the first heart sound

A

mitral and tricuspid valve closure

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31
Q

Compromised by the 2nd heart sound

A

Aortic and pulmonic valve closure

32
Q

ECG changes of Hypokalema

A

Flat/inverted T waves
prominent U wave
ST depression
QT prolongation

33
Q

ECG changes of Hyperkalemia

A

Low p waves
Tall T wave

34
Q

ECG changes in HypoCalcemia

A

Prolong QT – associated with long QT syndrome, Torsade de pointes
Hypercalcemica - shortened QT interval

35
Q

Drug that can cause Torsades de pointes (prolong QT)

A

Macrolides

36
Q

Associated condition with Opening snap at Diastole

A

Mitral stenosis

37
Q

Associated condition with Tumor Plop at Diastole

A

Atrial Myxoma

38
Q

Associated condition with Pericardial Knock at Diastole

A

Constrictive pericarditis

39
Q

sign where the murmur heard over femoral artery

A

Duroziez sign

40
Q

Sign of jarring of the entire body and bobbing motion of the head, due to AR

A

De musset sign

41
Q

sign: bounding and forceful pulse, rapidly increasing and subsequently collpasing

A

Water-hammer/Corigan pulse - AR

42
Q

capillary pulsation at the root of the nail due AR

A

Quinke’s pulse

43
Q

Booming “pistol shot” sound over femoral arteries due to AR

A

Traube sign

44
Q

Treatment of choice for acute AR:

A

Surgery and usually necessary within 24hrs of diagnosis

45
Q

best initial treatment for symptomatic mitral stenosis

A

Diuretics - relieved of dyspnea from pulmonary congestion

46
Q

most effective treatment for MS

A

Percutaneous mitral balloon valvotomy or valvuloplasty

47
Q

Cardinal sx of HF

A

fatigue and shortness of breath

48
Q

MC systolic HF or HFrEF?

A

HFrEF: depressed <40%
MC: CAD

49
Q

MC diastolic HF or HF with preserved EF?

A

preserved >40-50%
MC: HTN

50
Q

In ACS, time period if NOT re-perfused –> IRREVERSIBLE INJURY

A

20 minutes

51
Q

Medical Management you can give to Chronic HF, but NOT in acute HF?

A

Chronic HF: Beta blockers (Bisoprolol, Carvedilol, Metoprolol)
if given in ACS –> depresses everything

52
Q

MCC of chronic cosntrictive pericardutis in develiping nations

A

TB

53
Q

Becks triad

A

Hypotension
Soft or absent heart sounds
Jugulae venous distention

54
Q

Fluid to consider acute or chronic tamponade?

A

Acute - 200mL
Chronic - >2000mL

55
Q

Decrease in at least 10mmhg os systolic blood pressure

A

Pulsus paradoxus

56
Q

BP ,190/80, taken Enalapril 50mg OD, Creatinine 2.1mg/dL. Consider
Dx if there is detoriation of renal function assoc wit ACEI

A

Renal artery stenosis

57
Q

Differentiate Urgency from emergency

A

Presence of target organ damage

58
Q

Drug that raises the HDL cholesterol

A

Niacin

59
Q

First line tx for severe hypertriglyceridemia

A

Fibrates

60
Q

This prevets pancreatitis in px with severe hypertruglyceredemia

A

Omega 3 FA (fish oils)

61
Q

Decreases LDL, and safe for pregnant and lactating women

A

Bile acid sequestrants

62
Q

MC A/E of statin

A

Liver toxicity

63
Q

How to diagnose Infective Endocarditis

A

2 major
1 major & 3 minor
5 minor

64
Q

Best emperic therapy for IE

A

Vancomycin and Gentamicin

65
Q

What is the caused of Brugada syndrome

A

Loss of function mutation in SCN5a – decrease sodium channel that affect the Phase 0 and Phase 1 of cardiac AP

66
Q

ECG findings in Brugada syndrome

A

Pseudo Right bundle branch block
Persistemt ST segment elevation in leads V1 to V2

67
Q

Medication to avoid in Brugada syndrome

A

Class I antiarrhythmic drugs

68
Q

ABI ratio diagnostic

A

N - 1-1.40
ABI <0.9
Noncompressible arteries due to vasculad calcification >1.40

69
Q

6P’s of Acute Limb ischemia

A

pain
Pallor
Paresthesia
Paralysis
Pulseleness
Poikilothermia

70
Q

First line for symptom improvement for PAD

A

Cilostazol
CI: CHF

71
Q

Most appropriate diagnostic exam in Pulmonary embolism

A

Chest CT with contrast

72
Q

Virchows Triad

A

Endothelial injury
Venous statis
Hypercoagulable stats

73
Q

Gold standard exam for pulmonary embolism

A

Invasive pulmonary angiogram

74
Q

Known as the great masquerader

A

Pulmonary embolism

75
Q

MC ECG abnormality in PE

A

T wave inversion

INTERNAL MEDICINE (5 decks)

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