Cardiology 2

Question 1

Chest pain at rest, especially midnight to early morning.. Usually not exertional and not relieved wit rest.
ECG shows transient ST elevations that resolve with symptom resolution.
What is the treatment for this condition?

Answer 1

Vasospastic Prinzmetal Angina
Tx with Calcum channel blockers.

Avoid BB as they may lead to unopposed vasospasm.

Question 2

Which HF has preserved EF, thick ventricular walls, small LV chamber, and an S4?

Answer 2

Diastolic HF

Question 3

Which HF has Decreased EF, thin ventricular walls, dilated LV chamber, and an S3?

Answer 3

Systolic HF

Question 4

MC valve involved in infective endocarditis not related to IV drug use?

Answer 4

Mitral valve - S. aureus

Question 5

MC valve involved in IV drug related infective endocarditis?

Answer 5

Tricuspid - S. aureus

Question 6

Organism involved in prostetic valve infective endocarditis?

Answer 6

S. epidermis

Question 7

Persisitent fever, malaise, fatigue, anorexia.
New onset murmur.
Osler (Ouch) nodes, Janeway lesions (painless)
Splinter hemorrhages
Roth spots

Answer 7

Infective endocarditis

Question 8

What are two major criteria of the modified duke criteria?

Answer 8

2 positive blood cultures
Positive echo (vegetation, abscess, etc) or new valvular regurgitation.

Question 9

Tx of infective endocarditis for native valve vs prosthetic valve?

Answer 9

Native valve: penicillin + Cetriazone

Prosthetic valve: Vanc + Gentamicin + Rifampin

Question 10

Post MI pericarditis + fever + pleural effusion.

Answer 10

Dressler syndrome

Question 11

Mc caused by idiopathic or viral.
Chest pain, sudden pleuritic, persistent, and worse when laying supine and better when sitting forward.
Pericardial friction rub.
Diffuse ST elevations in the precordial leads with associated PR depressions.

Answer 11

Acute pericarditis

Question 12

Tx for pericarditis?

Answer 12

NSAIDs or Aspirin

If dressler syndrome: Aspirin or Colchicine.

Question 13

Chest pain, decreased muffle heart sounds.

ECG showed electrical alternans and low QRS voltage.

Answer 13

Pericardial effusion.

Question 14

This is a pericardial effusion that increases in size.
What are Beck’s triad?
What is the treatment?

Answer 14

Cardiac tamponade
Beck’s triad: muffled heart sounds, increased JVP, hypotension.
Tx: pericardiocentesis

Question 15

Which bacterial organism is associated with dental disease related bacterial endocarditis?

Answer 15

S. Viridans