Cardiology

Question 1

Mitral regurg will manifest as

Answer 1

increase in LV volume and pressure

Question 2

Order of aortic and pulmonic valves

Answer 2

A2 P2

Question 3

Any one of the following meets dx of MI

Answer 3

Rise or fall in biomarkers with ONE of the following

• ischemia
• Q waves
• ST or T changes
• LBBB
• intracoronary thrombus
• loss of viable myocardium

Question 4

if cardiac biomarkers are initially neg..

Answer 4

remeasure within 8-12 hours after Sx

Question 5

T/F degree of + trops is important for prog

Answer 5

TRUE

Question 6

T/F CArdiac biomarkers are not needed with pt ischemic chest pain and st elevation

Answer 6

TRUE

Question 7

first biomarker to increase
second?
When do trops peak?

Answer 7

Myoglobin and CK isoforms

Trop (peaks 1-2 days) - elevated to 2 weeks

Question 8

Creatine Kinase

peak? for how long?

Answer 8

CKMB - found in heart
increase within 3-12 hours of onset
peak at 24 hours
baseline 48-72 hours

Question 9

Where are ANP and BNP secreted

Answer 9

BNP - ventricles

ANP - cells of atria

Question 10

What is increased if vent cells have high pressure and volume?

Answer 10

ANP and BNP

Question 11

ANP and BNP have __ effects. which is more sensitive to LV?

Answer 11

diuretic, natriuretic, hypotensive, BNP - duh

Question 12

BNP interpretation

Answer 12

> 400 pg/mL = HF

Question 13

NT-pro BNP cut off by age

75

Answer 13

75 = 1800

Question 14

Mg def associated with 4 things

Answer 14

multifocal cellular necrosis
increased platelet aggregation
atherogenesis
card arrhym

Question 15

if Stable Angina presents with _______, send to PCI or CABG

Answer 15

severe sx 
change in Sx severity 
failed med tx 
high risk coronary anatomy 
worsening LV fxn

Question 16

Indication for CABG
L main CA stenosis
Stenosis of prox LAD and Prox cirumflex
___________in ASx/mild/stable angina
_____________in pt with low LV fxn
___________and large area of viable myocardium in high risk area in stable angina
______prox LAD stenosis with EF ______or dem ischemia

Answer 16

L main CA stenosis = 50%
Stenosis of prox LAD and Prox cirumflex = 70%
3 vessel dz in ASx/mild/stable angina
3 vessel and with prox LAD in pt with low LV fxn
1-2 vessel dz and large area of viable myocardium in high risk area in stable angina
>70% prox LAD stenosis with EF

Question 17

LVEF   
normal = 
below normal = 
may confirm HF = 
risk for life threatning irreg beats =

Answer 17

normal = 55-70%
below normal = 40-55%
may confirm HF =

Question 18

cardiac tamponode triad

Answer 18

JVD, muffled heart sounds, hypotension

Question 19

Pt with unstable angina and Sx in office =

Answer 19

send to ED

Question 20

_____ and ____ are most likely to have odd Sx

Answer 20

elderly and diabetics