Cardiology Flashcards by Marian Frac

This congenital heart disease clinically presents as squatting in the toddler after prolonged crying or vigorous playing:

TOF

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On chest radiograph couer-en, sabote configuration is suggestive of this condition:

TOF

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A one-year-old child was referred because of cyanotic spells noted since 4 months of age. The episodes have increased in frequency and duration. The lips and nailbeds appear dusky with mild clubbing of the digits. A systolic ejection murmur Grade 3/6 maximal at the pulmonic area was appreciated. The second heart sound is single.

diagnosis: Tetralogy of fallot

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The cyanotic spells may respond to:

inc. oxygen
propranolol
knee-chest position

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The chest radiograph most probably will show:

Right ventricular enlargement with hypovascular lung field

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Knee-chest position alleviated cyanotic spells. This can be explained by:

Increased systemic vascular resistance thereby pushing venous blood in the lungs for oxygenation

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one of the shunts may palliate symptoms of the above patient:

Modified Blalock

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Balloon atrial septostomy will not benefit one of the ff:

Truncus arteriosus

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In ASD closure, the most frequently reported immediate complication is:

Atrial arrythmia

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A two-year-old child presents with hyperactive precordium and widened pulse pressure. A continuous murmur was appreciated. The most probable diagnosis is:

PDA

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The patient underwent the ff.: separation of pulmonary artery from aorta, closure of aortic defect, placement of valved conduit to reconstruct right ventricular outflow tract, VSD closure. The patient has:

Truncus arteriosus

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The procedure involves systemic venous blood to be directed to the left atrium and the left ventricle and the pulmonary artery into the lungs through the formation of an intra-atrial baffle.

Rastelli

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One of the ff. procedure is done with the aim to improve intracardiac mixing for certain cyanotic heart disease:

balloon atrial septostomy

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Blalock-Taussig shunt is a palliative procedure for cyanotic heart defect. The procedure involves creation of connection between:

A. Subclavian artery and pulmonary vein

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Cardiorespiratory distress in the newborn period may delay closure of the ff. fetal shunt:

A. Ductus arteriosus

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Which of the ff. is the basic problem in large VSD:

A. Fluid over circulation

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A shunting procedure is indicated in patients with:

A. TGA with cyanosis

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7-year-old child was seen by a pediatrician during the physical examination, which of the ff. will warrant referral to a cardiologist:

A. Single second heart sound
B. Widely split and fixed second heart sound
A. Loud P2

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Which of ff. will NOT present fluid over circulation?

A. Coarctation of aorta

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Early closure is indicated in which patient:

A. Large PDA

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Anatomic closure of transposition of great arteries is:

A. Jatene procedure

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A cyanotic TOF will improve by creating any of the ff. shunts EXCEPT:

A. Pulmonary artery banding

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Auscultation of the chest will evaluate the ff. includes:

A. Heart sounds
B. Murmurs
C. Precordial friction

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A 35-year-old male sought consultation for chest pain. History revealed that 10 days prior to consult, he had upper respiratory tract infection relieved by paracetamol and antitussives. The pain is intensified by coughing, inspiration, and lying down but relieved by sitting up and leaning forward. The patient probably has:

A. Acute pericarditis

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On the 4th hospital day, he was complaining of difficulty of breathing. All of the ff. EXCEPT ONE will support the diagnosis of cardiac tamponade:

A. Friction rub

In this patient, one of the ff. is increased:

Jugular venous pulse

A pericardiocentesis was done and the fluid obtained was bloody. To determine that the fluid is from the pericardial cavity and not from the cardiac chambers, one may perform or request which of the ff:

A. Observe formation of clot in the fluid

Which of ff. is true of pulsus paradoxus?

A. There is a drop of more than 10 mmHg in systolic blood pressure

Chronic constrictive pericarditis is mostly due to:

A. M. tuberculosis

Mechanical valve is preferred in which of the ff: patients:

A. Patients with peptic ulcer disease B. 28-year-old female who desires to have a child C. 8-year-old child with congenital hypertrophic subaortic stenosis D. NOTA-answer

Indications for surgery in patients with aortic stenosis include all EXCEPT:

A. Aortic valve area of 3.5 cm2

Compared to angioplasty, CABG:

A. Offers complete revascularization

Indications for CABG are patients with:

A. 3-vessel disease with reduced LV ejection fraction B. Significant left main coronary disease C. 2-vessel disease involving LAD with reduced LF function

Which of the ff. statements is true of blood pressure determination:

A. Cuff used should cover approximately 2/3 of the upper arm

Equalization of pressure in all cardiac chambers is supportive of:

Constrictive pericarditis

The triad of syncope, angina, and congestive heart failure is present in:

A. Aortic stenosis

Physical finding of LA myxoma may mimic mitral stenosis. What maneuver would you perform to determine whether the difficulty of breathing is from LA myxoma or mitral stenosis:

Ask the patient to lie down

Giant left atrium is present in patient with:

A. Mitral valve insufficiency

The most common cause of ventricular outflow obstruction is:

Aortic stenosis

A 42-year-old female sought consultation for dyspnea which occurs on sitting position and relieved by lying down. At one time she had syncope when she tied her shoelace. This is most probably due to:

A. Atrial myxoma

Which of the ff. is true of percutaneous pericardiocentesis:

A. Can be done in the absence of cardiac tamponade B. Management of recurrent idiopathic effusion C. Immediate treatment of hemodynamically significant chronic effusion

Revascularization procedure in ischemic heart can be done through any of the ff. EXCEPT:

A. Thallium scintigraphy

Intracardiac pressures increased in:

A. Cardiac tamponade B. Tricuspid disease C. Constrictive pericarditis

A 65-year-old man was seen at the emergency room with a recent onset of high blood pressure. On examination his blood pressure was 190/100. A bruit was heard at the epigastric area, she was given Captopril and the systolic blood pressure dropped to 100. This patient is most likely having:

Renal artery stenosis

All of the ff. are signs of aortic insufficiency EXCEPT:

A. Homan

A 43-year-old female was seen at the emergency room with cardiac findings of the ff: accentuated first heart sound. Components of second heart sound are closely split, opening snap audible at expiration. This is consistent with:

A. Mitral stenosis

On echocardiography, a thrombus was seen at the left atrium. Which of the ff. is the best option for this patient:

A. Open mitral commissurotomy

To demonstrate aortic arch anomaly, the preferred diagnostic procedure is:

A. MRA

The most common pathologic condition associated with aortic aneurysm:

A. Atherosclerosis

The most common site of aortic rupture is:

A. Distal to subclavian artery

Abdominal aortic aneurysm may present as constipation and this can be explained by:

A. Obstruction of inferior mesenteric artery

Which of the ff. will not support the diagnosis of aneurysm:

Intermittent claudication

Aortic dissection is type I when:

A. Intimal tear involves the ascending and descending aorta

Aortic dissection can be suspected when there is abrupt development of:

A. Chest pain B. Aortic insufficiency C. Diminished or absent pulse

The purpose of administrating beta-blockers to patient with aortic dissection is to decrease:

A. Force of cardiac contraction

A patient was diagnosed to have aortic dissection. Rupture with aortic insufficiency was suspected because of:

A. Heart murmurs

For aortic aneurysm, the ff. is an indication for operation EXCEPT:

A. Ascending aortic aneurysm of 5.0 cm

Differential diagnosis of pulseless disease include:

A. Buerger’s B. Takayasus arteritis C. Giant cell arteritis

Peripheral artery disease may present as any of the ff. EXCEPT:

A. Paraplegia

Which of the ff. best describes intermittent claudication:

A. The pain is aggravated by activity

Severe occlusive disease manifested as pain at rest with multi-segment involvement is found in ABI of:

A. Less than 0.5

Which is not part of the trifurcation of the arteries in the leg:

A. Anterior tibial

This type of vasculitis is strongly associated with smoking:

A. Buerger’s

In Buerger’s disease, angiographic finding of “tree root” is explained by:

A. Development of collateral circulation

A patient sought consultation for palpitations. He gives a history of transient loss of consciousness without neurologic deficits. Pertinent findings include rapid heart rate with irregular rhythm. This is consistent with:

Atrial fibrillation

Four hours after admission, he complained of pain in his right leg. The right leg is cold to touch compared to the left leg with absent popliteal artery pulsation. Which of the ff. should be considered:

A. Acute femoral thromboembolism

The management of choice for the above patient is:

A. Embolectomy

All of the ff. are danger signs of peripheral arterial disease EXCEPT:

A. Absent dorsalis pedis

Symptomatic carotid artery disease may present as:

A. TIA B. Amaurasis fugax C. Acunar infarct

Marfan’s syndrome is associated with:

A. Aortic insufficiency

All of the ff. characterizes threatened limb EXCEPT:

Intact capillary refill

Fontaine’s classification of chronic limb ischemia in the presence of rest and nocturnal pain is:

A. Stage III

Carotid endarterectomy is indicated within 6 months of symptomatic carotid artery disease if the degree of occlusion is:

A. 70%

Which of the ff. diagnostic procedure is advised in peripheral arterial disease when one plan to do revascularization:

A. Angiography

In most of the patients, peripheral artery disease will present as:

A. Asymptomatic

Pain of ischemic origin may present as any of the ff. EXCEPT:

A. Aggravated by inspiration

A patient was referred for cyanosis of the leg. Duplex ultrasound demonstrated obstruction of the common femoral artery. What pulse cannot be appreciated:

A. Popliteal B. Dorsalis pedis C. Superficial femoral

The artery which is the reference during pulse evaluation of a patient with peripheral artery disease is:

A. Brachial

In aortic dissection, drugs are given to maintain which of the ff.:

A. CR = 80-100 B. Mean arterial pressure = 90 C. Systolic blood pressure = 120

In aortic dissection, delayed closure is indicated for:

A. Elderly with substantial contractility B. Patient who underwent cardiac operation recently C. Stable condition

Homan’s sign is present in patient with:

A. Deep vein thrombosis

Treatment option for patients with acute deep vein thrombosis include all EXCEPT:

A. Aspirin

The most sensitive non-invasive tool to diagnose deep vein thrombosis is:

A. Duplex ultrasound

Arterial hypoperfusion due to compartment syndrome in massive deep vein thrombosis is:

A. Phlegmasia cerulen dolens

Which of the ff. patients are at increase risk for deep vein thrombosis:

A. Pregnant women B. Normotensive housewife taking oral contraceptive pills C. Elderly men diagnosed to have squamous cell CA of the lung

Which of the ff. is not a factor in the development of varicose veins:

D. Oncogenic virus

The goal in the management of deep vein thrombosis is to:

A. Lessen propagation of the clot B. Reduce potential for pulmonary embolism C. Limit damage to venous valve

Venous valve is present in:

A. Saphenous vein

Which is not a component of venous pump:

A. Cardiac muscle

Pulmonary embolism is considered a very important consequence of this venous disorder:

A. Deep vein thrombosis

Venous insufficiency is detected by duplex ultrasound as:

A. Reflux

All of the ff. is true of chronic venous insufficiency:

A. Patients complaints include leg fatigue, discomfort, and heaviness B. In the majority of patients with CVI, most important factor appears to be venous reflux C. The most frequent complication of CVI is DVT

All of the ff. is true of varicose veins:

A. Important component of treatment is use of elastic compression stockings B. Sclerotherapy acts by destroying veins C. Saphenous vein ligation may be preferred for patients with large varicose veins

Which of the ff. is true of ulcers due to venous insufficiency:

A. Characterized by a clear base and hyperpigmented borders

Which of the ff. is/are true of lymphedema:

A. It is a chronic condition caused by ineffective lymphatic transport

Scimitar sign

PAPVR

Water bottle

Pericardial effusion

booming diastolic and systolic sounds heard over the femoral artery

Traube’s

to and from motion of the head synchronous with cardiac cycle

De Musset’s

to and from murmurs audible if the femoral artery is lightly compressed

Duroziez’s

water hammer pulse

Corrigan

Alternate paling and flushing of lightly compressed skin (

Quincke’s

Taking the blood pressure in either leg may help the physician in the diagnosis of this condition:

A. Coarctation of aorta

A shunting procedure is indicated in patients with:

A. TGA with cyanosis

Snowman

TAPVR