cardiology

Question 1

reversible causes of asystole or pulseless electrical activity

Answer 1

hypotension, hypo, and hyperkalemia, hypothermia, hypoxia, hydrogen ions acidosis,.

tension pneumothorax, tamponade, cardiac, toxins, thrombosis pulmonary or coronary, trauma

Question 2

common malformations in Down syndrome

Answer 2

1. duodenal atresia
2. hischsprung’s disease,
3. hypothyroidism
4. atlantoaxial instability
5. endocardial cushion defects

Question 3

conditions in Down syndrome

Answer 3

ADHD, Acute leukemias, MDD, seizure, autism, Alzheimer’s dementia

Question 4

bosentan

Answer 4

endothelin receptor antagonist

Question 4

cha2ds2vacs

Answer 4

stroke risk;
congestive heart failure, hypertension, age<75 2, diabetes, stroke2, vascular disease, age 60-75, sex category (female)

Question 4

Bivaliirudin

Answer 4

anticoagulation

Question 5

sacubitril valsartan

Answer 5

neprilysin inhibitor+ angiotansin receptorblockers

Question 6

kussmaul sign and pulsus paraduxus

Answer 6

pulsus paradoxus; in tamponade,

Kussmaul sign: an increase of JVP ( instead of a decrease ) in INSPIRATION.

Question 7

drugs that can cuase elevated digoxin level

Answer 7

amiodarone, verapamil, spironolactone, quinine, quinidine, erythromycin and tetracycline

Question 8

drugs can cause long QT syndrome

Answer 8

diuretics (due to electrolyte imbalance)
antiemetics ( ondansetrone)
antipsychotics( Haloprodiole, quetiapine risperidone)
TCA
SSRI
antiarrhythmics( amiodarone, sotalol, flecainide)
antianginal drugs( ranolazine)
antiinfective drugs(macrolides, fluroquinolones, antifungal)

Question 9

class 3 antiarrhythmics drugs

Answer 9

Amiodarone, sotalol, dofetilide, and ibutilide , dronedarone

Question 10

preferred antiarrhythmic drugs for AF

Answer 10

no CAD or structrural heart disease:flecainide propafenone both 1C
LVH; dronedarone or amiodarone
CAD without heart frilure; sotalol,
heart failure; amiodarone dofetilide
recurrent symtomes refractory to medication; radiofrequency ablation

Question 11

heart failure classses

Answer 11

classs one ; no symptome or limitation
class 2 ; slight limitation of physical activity
class3 ; marked limitation of physical activity
class4; inability of perform physical activity without significant discomfort

Question 12

cardiac resynchronization therapy?

Answer 12

LV ejection fracture<35
presents of symptoms
LVBB with QRS duration>150

Question 13

ICD implatable cardioverter- defibrilator ?

Answer 13

MI with LV EF< 30 or symptoms with <35
VF or VT with reversible cause or cardiomyopathy

Question 14

what does precordial T inversion suggestive of

Answer 14

arrhythmogenic right ventricular cardiomyopathy

Question 15

metonazole

Answer 15

thiazide

Question 16

cyp2c9 inhibi

Answer 16

metronidazole, quinolones, azoles, amiodarone, acetaminophen,

Question 17

CYP2c9 induction

Answer 17

oral contraceptive, green leafy vegtables,

Question 18

INR independent interactions

Answer 18

NSAIDS, clopidogrel, ginko biloba

Question 19

v tach pharmacologic cardioversion

Answer 19

amioodarone, procainamide, lidocaine, sotalol

Question 20

cyanide poisoning

Answer 20

hydroxocobalamin, sodium thiosulfate, sodium nitrate

Question 20

sever AS

Answer 20

soft single-second heart sound
a delayed and diminished carotid puls parvus et tardus
loud and late peaking systolic murmur

Question 21

HCM implantable cardiovascular defiblirato

Answer 21

family history of death from HCM
syncope
VT non sustained
hypotensive blood pressure response to exercise
extreme LVH more than 3 cm
survivor of cardiac arrest
sustained VT

Question 21

revised cardiac risk index (cardiovascular ris of noncardiac surgery)

Answer 21

high risk surgery(vascular)
ischemic heart disease
history of congestive heart failure
history of cerebrovascular disease
diabetes mellitus treated with insulin
preoperative creatinine of more than 2 mg
0 or 1 => surgery
2 or more=> Can go one flight of stairs? or equivalent if not pharmacologically based testing

Question 22

symptoms of impending respiratory failure

Answer 22

ph 7.23 or paco2 >45
clinical sign of respiratory failure resp rate >25 for 2 hours
hypoxia

Question 23

risk factores for extubation failure

Answer 23

weak cough
frewuent suctioning
poor mental status
positive fluid balance 24 hours prior to extubation
pneumonia as initial cause
age >65
comorbid conditions