Cardiology Flashcards
Patient PTC with intermittent claudication on lower extremities. on physical examination, you notice diminished pedal pulses and Rubor. what is not true of this condition?
A.patient may have normal physical exam
B. diabetics tend to have more progressive form of this disease
c. more common in men
d. diagnosed with EKG
this is obstructive arterial disease.
it is more common in men
diabetics tend to have more progressive form of this disease
they may a normal physical
this is a peripheral vascular condition so it will not be diagnosed with EKG but rather with doppler US
a 3 year old boy is brought to the pediatriatian by his mother, who says that for 6 months she has noticed that when the child plays at the park his lipss turn blue, then he rests in squatting position because it makes him feel better.A doctor told her one time that the ba
a 10 yr old child had a group A (B hemolytic) streptococcal pharyngitis from which she recovered on penicillin therapy. a month alter she became ill again with fever, joint swelling, involuntary movements and a skin rasj. which of the following is false
a. acute rheumatic fever occurs a few months after initial infection
b. in 75-80 % of cases the tricuspid valve is affected
c. peak incidence is 5-15 y/o
d. the most common sx is migratory polyarthritis
B : its not the tricuspid valve thats defective but the mitral valve
a 25 yr old w was found to have a mid-systolic click and was diagnosed as having floppy valve syndrome. what is false about mitral valve dysfunction
a. mitral stenosis onser:30-40 y/o
b. atrial fibrillation is a complication of mitral stenosis
c. mitral valve prolapse has a mid-diastolic click
d. valsalva maneuver with an MVP will cause an earlier click and longer murmur
C : not a mid diastolic click, its a mid systolic click
a 20 yr old woman was found to have an elevated blood pressure as measured in both arms, but the pressure in her legs was low. what is not a complication if this condition is left untreated?
a. premature CAD
b. ventricular dysfunction by 3th or 4th decade
c. increased risk of pulmonary hypertension
d. aortic aneurysm or dissection
coarctation of the aorta
C??
a 63 yr old causcauson man has started to have episodes of chest pain that awaken im at night. after reviewing the results of the EKG, a stress test is recommended and done. the doctor tells this pt that he has a variant angina. what is not a reason to stop a stress test?
a. chest pain
b. SOB
c. diastolic drop in bp >10MMhG
d. ST depression >2mm
e. Arrhythmias
C : diastolic drop is okay but must stop is theres a systolic drop.
a 45 yr old man PTC with a 6 hour hx of retrosternal chest pain. he describes it as a sharp and episodic. it is relieved by sitting upright and worsened by lying down. he denies any trauma to the chest. ECG reveals diffuse ST elevation in inferior and lateral leads with depression of the pr SEG. Which of the following statements about the ddx of chest pain is false?
a. anxiety tends to have little to no chest pain
b. pulmonary causes will have a sharper pain and can change during respiration
c. MSK causes will be better with movement, reproducible and usually have ahx of trauma, excessive exercise or recent growth spurt
d. Gi causes usually have an association with food, burning type of pain, gas and belching
C: MSK causes will be worse with movement not better
a 45 yr old man presents with a 10 min hx of severe chest pain. he describes it as a tearing pain, it radiates from the from to his back between the shoulder blades. he denies any trauma to the chest. he is known to have HTn who has been noncompliant with his meds. on exam , his Bp is 195/100 mmHg. his is diaphoretic and a diastolic murmur radiating along the right sternal border is auscultated. which of the following is not true?
a. 90% of aortic aneurysms occur n the abdominal aorta
b. malignant HTN is defined as sudden or sustained systolic >140 mmHG with evidence of end organ damage
c. stage II HTN is defined as systolic >140mmHg and diastolic >90mmHg
d. aortic dissection common occurs in ascending aorta
aortic dissection
b. malignant HTN is defined as sudden Diastolic >140mmHg
patient PTC with leg pain. it is warm, tender and edematous over the site of the pain. the pt mentions he just flew in from australia. what is not true of this condition?
a. defined as inflammation of the deep veins
b. positive homans sign is pathognomonic finding
c. there may be mottling or cyanosis
d. anything that causes venous stasis can cause this condition
b: homans sign is not pathognomonic for DVT
C.O formula and normal value
SV x HR
5L/min is normal
EF formula and normal
SV/ EDV x 100%
percentage of blood that is in the ventricle at the end of diastole
normal= 55%
type of pain myocardial ischemia, pericardial and aortic dissection
Myocardial ischemia : squeezing, crushing pressure “like someone is sitting on my chest”
radiates to the left arm, jaw and teeth
does not change with position or breath
pericardial: stabbing.burning pain.
better with leaning forward, worse with inspiration or cough
radiates to the traps
aortic dissection: severe, sudden, excruciating tearing sensation
arteriosclerosis vs atherosclerosis and pathogenesis
arteriosclerosis: arterial wall is thickened and loses elasticity. can incr BP
happens with aging, vasculitis
Atherosclerosis: thickening of the intima due to plaque formation
pathogenesis: first step is endothelial injury
hemodynamic: from uncontrolled HTN
chemical: four histologic stages: fatty streaks, fibroucs cap formation, formation of fibrous plaques, advansed lesions
biologic: viral, bacterial, autoimmune complex, possibly chlamydia
Coronary artery dz risk factors
smoking: 2-4x higher
HTN(<140/90)
low HDL and high LDL
Fhx of premature heart disease: 1st degree male relative younger than 55. or 1st dregree relative younger than 65
diabetes: inc risk 2-4x
obesity/sedentary lifestyle
age: men 45 or older, women 55 or older
