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Flash Card Reema > Cardiology > Flashcards

Cardiology Flashcards

1
Q

-same symptoms of angina but SOB instead of pain, what is ur dx?
(-ve troponin )

A

-angina equivalent

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2
Q

-pt with MI, after 2 hours starting ttt, HR 40 pb 80/50 what to give first???

A

IV atropine sulphate , even before IV fluid! repeat until HR corrected up to 3 times

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3
Q

ACS management?

A
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4
Q

Ideal time frame , for tpa in MI and stroke?

-PCI?

A

-MI (best after 30 min and CI after 12 hs)
-stroke (during the first 4 hs and 30 min after symptoms start)

PCI: 90 mins (best) to 120 min

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5
Q

Atrial fibrillation, wanted to stop anticoagulants due to what ever the reason, what is ur next step?

A

Chad score (cha2ds2-vasc)

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6
Q

PCI for MI, anticoagulants should be given, what types of anticoagulants u will give to this pt???

A

Clopidogrel for one year, aspirin for life!!!

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7
Q

In ACS when to use heparin??

A

See the pic

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8
Q

In ACS when to use heparin??

A

See the pic

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9
Q

-What medication in ischemic HD will reduce mortality??

-What medication in CHF will reduce mortality??

A
  • note: all BB here is cardio selective*
    First, IHD :
    ABC,

-Aspirin and ACE inhibitors
-BB
-Stain(c)

حسب الافضلية: عباس ABAS
1- aspirin
2- BB
3-ACEI
4-statin

Second,CHF: effectivety arranged:
1- Acei, ARBs
2-BB
3-SGLT, Spironolactone

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10
Q

Most modifiable risk factor for MI???

A

-HTN (mc)
DM (most serious)
Smocking
BMI

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11
Q

Chad score more than 2 + valvular a fib (mc mitral stenosis) , which anticoagulants is preferred?
-warfarin
-DOAC

A

Warfarin , usually DOAC is preferred over warfarin except in valvular A fib or prosthetic valve!

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12
Q

-CHF presents with AFib , HR 140 bp normal, what to give next??

-stable pt ,hospitalized, u notice A fib on monitor (just developed) what is ur next step?

A

-BB ,best BB given is cardio selective (MBC) best one of them is Bisoprolol

-Cardioversion (see the pic)

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13
Q

HR more than 200 , narrow complex tachycardia , regular,dx??

-best next step in this case if patient is hypotensive?

A

-SVT

-cardioversion

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14
Q

SVT pt , stable, next step???

A

Vagal manoeuvre (carotid massage ,valsalva )

Valsalva better than massage

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15
Q

-CHF pt decompensated( pt has ascites ) on acei and furosemide, best next step??

-CHF pt NOT decompensated( pt has no ascites ) on acei and furosemide, present with hypotension , Labs :high creatinine and FeNa 0.6% best next step??

A

-iv diuretics then if failed therapeutic paracentesis .

-IV fluid carefully

FeNa:
Less than 1 is pre renal cause

More than 1 is renal cause

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16
Q

بيشنت متنفخ
ER, CHF ,SOB,Orthopnea, hepatomegaly, LL edema ,basel crackles , best medication to give?

A

وايد قوي
Furosemide

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17
Q

Best HTN ttt in

1 african:

2 Non african:

3 Old pt:

4 Young pt:

5 DM or CKD : (same medication)

6 CHF or CAD :

7 essential tremors or Hyperthyroidism or migraine +HTN?

A

1 -Thiazide type of diuretic, or CCB

2 -ACEIs and CCB

3 -CCB

4 -ACEi

5- ACEi

6- ACEi

7- BB

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18
Q

-Acei side effect?

-Pt on acei, creatinine increased, when to stop the drug?

A

-see the pic

  • stop if pt basal creatinine increased more than 30%
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19
Q

Thiazide other names??

A

مصر والهند

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20
Q

-Best medication to prevent cardiovascular events???

-PAD initial and diagnostic tests??

A

-Aspirin

-initial > US doppler +ABI (< 0.5 severe ,need emergency intervention ttt)
Diagnostic >conventional angiography

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21
Q

Post MI , severe unilateral leg pain ,dx?

A

Acute arterial emboli, after MI or A fib, can cuz stroke or AKI

If bilateral (atherosclerosis)&raquo_space;acute arterial thrombosis

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22
Q

MC organism in IE in:
1-prosthetic valve?

2- native valve

  1. IV drug abuser?
A

1- depend on time
See the pic

2-staph viridans

3 staph aureus

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23
Q

1-Least frequently congenital HD associated with infective endocarditis?

2-Most frequently congenital HD associated with infective endocarditis?

3-Most common congenital anomaly of heart??

A

1- ASD

2- VSD

3- VSD

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24
Q

IE prophylaxis, when to give?

Pt with tonsillectomy, valve prolapse, what antibiotics should be given?

A

1- see the pic

2- no need

Note**
Another indication for for antibiotics prophylaxis is , Cardiac transplant surgery with valve regurgitation!

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25
Q

Decresendo diastolic murmur, what might be the cause?

A

Aortic/Pulmonary regurgitation or Mitral/tricuspid stenosis

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26
Q

Early diastolic murmur,pistol sound in femoral artery , wide pulse pressure dx??

A

Aortic regurgitation

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27
Q

mc murmur with rheumatoc fever?

A

MR

note

MC cause of mitral stenosis is :
Rheumatic fever

MC murmur in rheumatic fever?
Mitral regurgitation

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28
Q

What is the Cardiac murmur that can decrease with valsalva manoeuvre with hand grip ?

A

AS

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29
Q

1-The best next step to confirm a diagnose of all valvular Heart diseases??

2- The most sensitive test for all valvular Heart diseases??

A

1- Transthoracic Echo

2- Transesophageal Echo

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30
Q

What are the indications for aortic valve replacement?

A

See the pic

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31
Q

What the the :
1-Best
2-next
Step in suspected Cardiac tamponade ?

A

1- ECHO

2- x ray

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32
Q

Cardiac tamponade beck triad ?

A
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33
Q

Kussmaul sign, what are the 2 diagnoses come to ur mind???

A
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34
Q

What are the differences between cardiac tamponade and cardiac pericarditis presentations?

A
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35
Q

Highest diagnostic value for constrictive pericarditis ?

A

Cardiac CT, (Ca around the heart)

36
Q

1 -Syncope while coughing or micturition, ECG is normal, what is the next?

2-? Syncope proceeded by nausea , vomiting, and fear , ECG is normal, what is the next?

A

1 and 2 ,Education and reassurance

37
Q

Pt hx of syncope, family hx of sudden cardiac death, pt has murmur ,norma ECG, what is the next step??

A

ECHO

note
If family hx or sudden cardiac death, do ECHO

38
Q

Old age pt, persistent bradycardia with hypotension, what is ur approach?

A

1- atropin ,if not work:»
2- repeat atropin, up to 3 times»
3- transcutaneous pacing»
4- dopamine or epinephrine&raquo_space;
5- transvenuos pacing

39
Q

50 y o, coronary artery ca score is 45%, on atorvaastatin, vit d3 and aspirin, wjat u should stop?

A

-Aspirin, don’t give aspirin in pt less than 70 and ca score less than 100%

40
Q

What is the difference between NSTMI and unstable angina?

A
41
Q

Inferior MI pt suddenly hypotensive , what is the cause?

Next step?

A

-RV infarction, SA node and AV node infarction

Rt sided ECG

42
Q

Hypotension post MI+ bradycardia+increased JVP+ clear lung, dx????

Initial Ttt??

How to confirm dx?

A

Rt ventricular MI

Ttt is IV Fluid +positive inotrops (dopamine, doputaime)
CI is nitrite

Rt sided ECG

43
Q

Ttt used for rhythm control of atrial fib??

A

Amiodarone

44
Q

Dilated cardiomyopathy, now he had A fib, best ttt?

A

BB!

45
Q

Pt on warfarin ,high INR, developed subdural hemoatoma, what to give?

A

Answer: see pic

note normal INR = 0.9 -1
Gaol INR if pt take warfarin = 2-3
Goal of INR if pt have prosthetic valve=3-4

46
Q

Pt , chest pain, diffuse ST elevation, “smily face” , dx and ttt??

A

Pericarditis

NSAID, and consider colchicine .

47
Q

Infective Endocarditis ttt???

A

Native:
Vancomycin +(gentmicine or ceftriaxone)

Prosthetic :

Vancomycin +(gentmicine or rifampin)

48
Q

Give me 2 conditions that will increase the mortality rate associated with Severe symptomatic AS

A

1- development of sympathetic HF

2- pumlonary HTN

49
Q

Most preventable risk factor for:
1 dyslipidemia /MI

2 HTN

3 mostly all other diseases

A

1 smocking (can decrease risk after cessation in 1 year by 50%, decrease risk 100% by 2 years)

2 high BMI > best to control is&raquo_space;weight loss

3 DM control -most serious-

50
Q

Post MI , streptokinase was given, pt developed hemptysis , most appropriate next step??

A

It’s a complication of thrompolytic , give transexamic acid and aminocaprioc acid

51
Q

HTN ttt in less than 55 what?

A

ACEi

52
Q

Black people HTN ttt?

A

Thiazide CCB

53
Q

What are the acute complications of MI (within 24 h) ?

A
54
Q

Complication of MI after 24 h??

A
55
Q
A

ECG!!!

56
Q

Types of heart block difference between each other?

A

Al has PR interval prolongation!

57
Q

Nyha classification of HF??

A
58
Q

Pt with TIA , admission decision will be based on what???

A

More than 3 , admit .

59
Q

Ischemic stroke , high blood pressure, , what is the target for bp control?

A

180/105

60
Q

What is the goal of hypertension ttt in patient with

Ischemic stroke with no TPA ttt
Ischemic stroke with TPA
hemorrhagic stroke

بكون سعيده جدا واموت بسلام لو جاوبتوها كلها صم

A

schemic stroke with no TPA
(Permissive HTN> 220/110(

Ischemic stroke with TPA
(<180/ 105)

hemorrhagic stroke
Systolic 160-140

61
Q

Angina pain, decrease pain after nitroglycerin, what contributed to pain relief???

A

Decrease afterload

62
Q

Young woman , transient angina symptoms,dx?

Ttt?

A

Variant angina

CCB

63
Q

LDL goal in DM pt with IHD??

A

Less than 70

64
Q

Criteria to diagnose Rheumatic heart disease?

A
65
Q

V5,v6 , l
Have ST elevation, which cardiac wall had infarcted ?

A

Lateral wall

66
Q

Difference between early and late MI induced pericarditis?

Management??

A
67
Q

Difference between SA ,UA,NSTEMI,STEMI??

A
68
Q

Difference between SA ,UA,NSTEMI,STEMI??

A
69
Q

HF , asymptomatic,A fib on ECG, what to give?

HF , acute , symptomatic , A fib, what to give?

A

1- BB

2- BB is contra indicated! Give digoxin.

70
Q

-Early diastolic murmur?

-Mid diastolic murmur?

-Both together in the same pt?

A

-Aortic/polu regurgitation

-Tricuspid or mitral stenosis

-aortic regurgitation

71
Q

Type of valvular disease that have the worst prognosis in pregnancy due to high complications ?

A. AS
B. MS
C. AR
D. AS

A

Mitral stenosis

72
Q

Q
Mention 2 high intensity statin
And 1 low intensity

A
73
Q

Q: what class of statin you will give for
- diabetic alone

  • diabetic + LDL 170
  • anyone with LDL 200
  • TIA patient
A
74
Q

Q
TPA (alteplase )
Indication
Mention 4

A

STEMI
massive PE
Stroke in first 4.5 hr
PAD

75
Q

Q: The 2 indication of using defibrillation ?

A

A:
Pulseless VT
VF

76
Q
A
77
Q

Q: what is the antiplatelet of choice in patient
Going to PCI
glinting to fibrinolytic ?

A

A:
Patient treated by PCI, or not treated by any reperfusion therapy > Ticagrelol

Patient treated by fibrinolytics > clopidogrel

78
Q

Q: what is the anticoagulant of choice in patient
Going to PCI
glinting to fibrinolytic ?

A

A:
Patient treated by PCI > UFH

Patient treated by fibrinolytics > LMWH (enoxaprin)

79
Q

Q: complete the blank
In patient with chest discomfort
Ideally 12 lead ECG should be done within ……. and if not diagnostic with high clinical suspicion should be repeated every …….

A

A:
In patient with chest discomfort
Ideally 12 lead ECG should be done within ….10 min… and if not diagnostic with high clinical suspicion should be repeated every …15 min….

80
Q
A

To dx u need 2 out of 3: (acute stemi)

Typical hx
ECG finding
Cardiac enz

Answer is :C

81
Q
A

To dx u need 2 out of 3: (acute stemi)

Typical hx
ECG finding
Cardiac enz

Answer is :C

82
Q

When discharging patient after MI what to give medication?

A
83
Q

The combination of fever and new murmur
Suggest ?

A

IE

84
Q
A
85
Q

Systolic ejection murmur ddx???

A

Aortic stenosis

Hypertrophic cardiomyopathy > (increase with standing and valsalva)

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