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IM > Cardiology > Flashcards

Cardiology Flashcards

1
Q

How do you treat VT?

A

Can be treated with amiadarone or lido

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2
Q

What is the presentation of restrictive cardiomyopathy?

A

Usually right heart failure – increased JVP, hepatomegaly, bilateraly ankle edema etc.
o Usually diastolic heart failure

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3
Q

What is the presentation of right ventricular infarct?

A

Clear lung fields, hypotension, JVD - Kussmaul’s sign (paradoxical rise in JVP on inspiration)

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4
Q

When can digoxin be used in arrhythmia?

A

hemodynamically stable Atrial flutter, Afib, atrial tachycardia

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5
Q

What is the treatment of choice for tricyclic antidepressent overdose to prevent cardiac arrest

A

sodium bicarbonate - activates sodium channels to alleviate QRS prolongation

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6
Q

What is the mechanism of dipyridamole?

A

coronary steal - redistribute coronary blood flow to non diseased areas to diminish perfusion to diseased segments

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7
Q

What are the most common causes of aortic stenosis?

A

senile calcific, bicuspid aortic valve, rheumatic fever

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8
Q

What are some of the common signs of a massive PE?

A

right heart strain - elevated JVP, RBBB,

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9
Q

A patient presents with high output heart failure (systolic murmer, flushed extremities) following traumatic injury to the thigh. this is likely due to..

A

AVF formation at the site of trauma - shunting blood away from extremities resulting in decreased O2 to extremities causing heart failure

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10
Q

What are the causes of high output heart failure?

A

thyrotoxicosis, Paget disease, anemia, thiamine deficiency

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11
Q

A patient presents with chest pain and dilated eyes. What meds should you give, what meds do you avoid?

A

drug induced vasospasm - give nitrates and aspirin but don’t give beta blockers

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12
Q

What are the signs on cardiac exam that indicate pulmonary hypertension?

A

widely split S2, increased intensity of pulmonic component of S2

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13
Q

A patient presents with signs of venous overload, sharp x and y descents on tracing, and pericardial calcifications. What is this/

A

constrictive pericarditis from TB

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14
Q

A patient has signs of megaesophoagus and cardiomegaly plus arrhythmias and tricuspid regurg. What is this and what causes it?

A

Chagas disease causes diastolic and systolic heart failure, caused by trypanosoma cruzi

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15
Q

A patient has a midsystolic click over the left apex and a short murmer that decreases with squatting. What is this?

A

mitral valve prolapse

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16
Q

What are the components of a TIMI score?

A

age over 65, risk factors for CAD, ST seg deviation, elevated biomarkers, ASA in last week, anginal episodes in last 24 hours,

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17
Q

What is endocardial fibroelastosis?

A

congenital abnormality characterized by diffuse fibroelastic thickening of left ventricular endocardium

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18
Q

A patient presents with blue toes and elevating creatinine after an acute MI/stent. This is…

A

cholesterol embolus

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19
Q

When does paradoxical or reversed splitting occur?

A

pts with fixed left ventricular outflow tract obstruction (aortic valve, subaortic stenosis, LBBB)

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20
Q

What patients are eligible for CEA?

A

symptomatic with 70-99% lesions, asymptomatic with 60-99% lesions

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21
Q

How can we use CHADS score to decide if a patient needs anticoagulation

A

if a CHADS-2 score is 1, anticoagulation via aspirin/oral is recommended. If 2, strongly recommended

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22
Q

A patient presents with a decrescendo early diastolic murmer. What is this?

A

aortic regurgitation

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23
Q

A patient presents with NSTEMI - is this patient a candidate for fibrinolytic therapy

A

NO!

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24
Q

What is the treatment for pulseless electrical activity?

A

vascular access, airway stabilization, administration of IV fluids, CPR

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25
Q

What drugs have been shown to improve mortality in patients with heart failure?

A

ACE-Is, spironolactone for patients in class III or IV

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26
Q

What group of gram negative organisms has been shown to cause endocarditis?

A

HACEK organisms

Haemophilus aphrophilus, Aggregatibacter actinomycetocomitans, cardiobacterium hominis, E corredens, Kingella kingae

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27
Q

What are the common side effects of amiodarone?

A

pulmonary toxicity, thyroid dysfunction, hepatotoxicity, corneal deposits, skin changes (blue-gray discoloration)

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28
Q

What medical therapy should be given to a patient with aortic dissection?

A

beta blockers

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29
Q

What is one of the first things that should be done in a patient with an MI who develops a cold leg and persistent ST elevation 2 days afterwards?

A

get ECHO to check ventricle for thrombus

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30
Q

What are the signs of digoxin toxicity?

A

anorexia, nausea, vomiting

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31
Q

How should PVCs post MI be treated?

A

observe - treating them worsens prognosis

32
Q

A patient presents with dyspnea, ankle swelling, proteinuria, easy bruising. she has a pericardial effusion and echo shows heart wall thickening. this is..

A

amyloidosis

33
Q

What are the findings on echo in patients with hemochromatosis?

A

dilated cardiomyopathy, impaired systolic function; associated with skin pigmentation, decreased libido, diabetes

34
Q

What is a classic physical exam finding in patients presenting with MI?

A

new 4th heart sound

35
Q

What is the best way to treat venous insufficiency?

A

frequent leg elevation, exercise and compression

36
Q

What are the causes of pulsus paradoxus?

A

asthma, COPD, cardiac tamponade

37
Q

What medications have been shown to prevent cardiac remodeling in CHF?

A

ACE inhibitors

38
Q

How is hypertensive urgency differentiated from hypertensive emergency?

A

in hypertensive emergency, end organ damage is present

39
Q

A patient from Cambodia presents with progressive exertional dyspnea, nocturnal cough and occasional hemoptysis. She also complains of irregular heart beats. This is..

A

mitral stenosis secondary to rheumatic fever

40
Q

A patient presents with palpitations, shortness of breath and irregular heartbeat. Additionally, he has bibasilar crackles and pitting edema and a BP of 170/100. This is..

A

diastolic dysfunction (heart failure with preserved heart failure)

41
Q

What are the findings on cardiac exam of pericardial effusion?

A

diffuse point of maximal impulse

42
Q

A patient presents with an opening snap. This is likely…

A

mitral stenosis

43
Q

A patient presents with fixed splitting of the second heart sound. This is associated with..

A

atrial septal defects

44
Q

A patient presents with ST elevations in leads V1-V6 and is at severe risk of sudden death. What vessel is occluded?

A

LAD (affecting anterior myocardium)

45
Q

A patient presents with ST elevation in leads II, III and AvF. What vessels are involved?

A

RCA or LCX - inferior myocardium affected

46
Q

A patient presents with ST depression in V1-V3 and ST elevation in I and AvL. What vessels are involved?

A

posterior MI involving LCX

47
Q

A patient presents with ST depression in V1-V3 and ST depression in I and AvL. What vessels are involved?

A

posterior MI involving RCA

48
Q

A patient presents with ST elevation in I, AVL, V5 and V6. What vessels are involved?

A

LCX

49
Q

A patient presents with ST elevation in V4-V6, hypotension and a 2:1 block. This is

A

RCA occlusion. RV infarction – > hypotension. RC occlusion causes AV block

50
Q

A patient with WPW presents with Afib. What medications should be used to treat?

A

usually treat afib with medications that act at AV node, but drugs like digoxin, verapamil and adenosine will increase conduction through accessory pathway. Therefore, antiarrhytmic like procainemide should be used

51
Q

A 20 year old patient presents with a mid diastolic murmer. What should you do next?

A

EKG - diastolic murmers are abnormal, systolic are usually benign

52
Q

What are the indications for aortic valve replacement?

A

symptomatic

53
Q

What are the side effects of thiazide therapy?

A

decreased tolerance to glucose

54
Q

A patient presents with recurrent episodes of pounding and racing worse when lying supine and lying on the left side. What is the cause?

A

aortic regurgitation

55
Q

What is the parvus et tardus, exertional angina, syncope and dyspnea associated with? How do you diagnose it?

A

aortic stenosis - diagnose with echo

56
Q

A patient presents with midline chest pain, diaphoresis, nausea nad recurrent vomiting. X ray shows a widened mediastinum and moderate left sided pleural effusion with high amylase content. This is..

A

esophageal rupture - high amylase is due to saliva in esophagus contents

57
Q

What are the 5 Hs and Ts of reversible PEA?

A

Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hyper-/hypokalemia, Hypoglycemia, Hypothermia.

Toxins, Tamponade(cardiac),Tension pneumothorax, Thrombosis (coronary and pulmonary), and Trauma.

58
Q

What are the side effects associated with hydralazine?

A

salt and fluid retention, peripheral edema, drug indiced lupus syndrome

59
Q

What are the side effects associated with metoprolol?

A

bradyarrhythmia, bronchoconstriction, weight gain, depression

60
Q

What are possible complications of first degree heart block?

A

higher mortality, heart failure, afib

61
Q

A patient presents with increased PCWP, increased SVR and cold clammy extremities as well as hypotension. This is..

A

cardiogenic shock

62
Q

A patient presents with electrical alternans - this is pathopneumonic for..

A

pericardial effusion

63
Q

A patient presents with chest pain radiating to the back and a difference in BP between 2 arms. What is the next step?

A

TEE for aortic dissection

64
Q

A patient presents with frequent PACs. What should you do?

A

nothing, they’re completely normal

65
Q

An IV drug user presents with aortic regurg and 2:1 2nd degree AV block. This is likely due to..

A

perivalvular abscess

66
Q

The most common location of endocarditis (and thus the most common symptom) is..

A

tricuspid valve - holosystolic murmer

67
Q

A young patient presents with a Left lower sternal border murmer that decreases with squatting. This is __ and it is inherited in an __ pattern

A

HOCM, autosomal dominant

68
Q

What are the common drugs that can increase warfarin’s effect?

A

acetominophen, antibiotics, omeprazole, thyroid hormone, SSRIs

69
Q

What are the common drugs that can decrease warfarin’s effects?

A

Rifampin, carbamazepine, OCPs, ginseng, St. John’s Wort, leafy greens

70
Q

Why do statins cause myalgias?

A

inhibit coenyme Q10 synthesis

71
Q

A patient presents with hypotension, decreased PCWP and increased MvO2. this is..

A

septic shock (MvO2 high due to improper distribution of cardiac output and inability of tissues to extract O2)

72
Q

A patient with allergic rhinitis presents with chest pain, is put on aspirin and beta blockers and his chest pain goes away but he presents with difficulty breathing. What happened?

A

beta blockers exacerbated his athsma, caused bronchoconstriction

73
Q

A young patient presents with severe htn, headaches, epistaxis and LVH. Suspect.. (and check with)

A

coarctation of the aorta - check for brachial femoral delay

74
Q

A patient prevens with symptomatic sinus bradycardia - what is the next step in management?

A

atropine, followed by transcutaneous pacing

75
Q

A patient presents with kidney stones, hypertension and hypercalcemia. This is probably due to

A

primary hyperparathyroidism

IM (24 decks)

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