Cardiology

Question 1

***HIGH OUTPUT CHF is due to

Answer 1

Thyrotoxicosis
Anemia
Berri Berri
Pagets disease

Question 2

Peaked T waves on EKG

Answer 2

Hyperkalemia (like eiffel tower)

Question 3

Pericarditis presentation

Answer 3

pain relieved by sitting leaning forward, worse when supine
PND
Idiopathic but can be post viral

Question 4

Cardinal symptoms of aortic stenosis

Answer 4

dyspnea, angina, exertional syncope

Question 5

Treatment for sinus bradycardia

Answer 5

Atropine 1 mg

Question 6

Treatment of PSVT

Answer 6

Vagal maneuver
Adenosine 6 mg
If unsuccessful with Adenosine, cardiovert

Question 7

Wandering atrial pacemaker/ Multifocal Atrial Tachycardia EKG

Answer 7

3 distinct P wave morphology, common in patients with COPD

Question 8

CHADS 2 in Afib (most common arrhythmia)

Answer 8

CHF
HTN
Age >75
DM
Stroke/TIA (2 points)
if two or more put on Warfarin INR 2-3

Question 9

*** Only way to reverse a dilated cardiomyopathy

Answer 9

Stop alcohol consumption

Question 10

Acyanotic congenital heart disease

Answer 10

Left to right shunt
ASD
VSD
PDA

Question 11

Cyanotic Congential heart disease

Answer 11

Right to left shunt
Tetrology of Fallot
Transposition of great arteries

Question 12

Most common congenital heart malformation

Answer 12

VSD

presents with holosystolic murmur

Question 13

PDA presentation and treatment

Answer 13

PDA connects aorta and pulmonary artery
WASHING MACHINE murmur
treat with Indomethacin (prostaglandin inhibitor) to close shunt

Question 14

Tetrology of Fallot

Answer 14

Pulmonary Stenosis
RVH
Overriding aorta
VSD
Presents with Tet spells and systolic ejection murmur
CXR with boot shaped heart
Treat with prostagladins to keep ductus open

Question 15

Transposition of great arteries CXR

Answer 15

Egg on a String

Question 16

*** Modified Jones criteria for diagnosis of Rheumatic Fever

Answer 16

Need 2 major OR 2 minor + 1 major
Major: arthritis, carditis/valvulitis, CNS involvement, Erythema MArginatum, Sydenham’s chorea
Minor: Fever, Arthralgia, Elevated ESR, Leukocytosis, PR elongation, previous rheumatic fever

Question 17

Screening for AAA

Answer 17

US for all men above age 65 who have smoked or have a relative with AAA repair
surgically repair if >5 cm

Question 18

6 P’s of limb ischemia

Answer 18

Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia

Question 19

*** Virchow’s Triad

Answer 19

Venous statsis, injury to vessel wall, hypercoagulable state

Question 20

Thromboangiitis Obliterans (Buerger’s disease) presentation

Answer 20

vasculitis of hands and feet with ischemia
STRONG association with smoking
men 30’s-40’s

Question 21

Dressler syndrome

Answer 21

After MI get pericarditis 2-5 days post

Presents with pericardial friction rub, chest pain relieved by sitting slumped forward

Question 22

Beck’s Triad

Answer 22

Cardiac Tampanode:
Hypotension
JVD
Muffled heart sounds

Question 23

Infective Endocarditis in IVDU (valve and microbe)

Answer 23

tricuspid and staph

Question 24

signs and sx of infective endocarditis

Answer 24

Heart murmur, fever, hematuria, splenomegaly
JANEWAY lesions: palms and soles, non painful
OSLER nodes: on fingers tips, painful
roth spots on eyes

Question 25

Neural control on heart rate

Answer 25

SNS increases heart rate and force of contraction

PNS via VAGUS nerve decreases heart rate, inhibits SA node

Question 26

Contraindications to tPA or other thrombolytics

Answer 26

previous intracranial bleed, CVA in last 3 months, aortic dissection, uncontrolled HTN >180/100, surgical procedure 2 weeks prior, bleeding diathesis, pregnancy

Question 27

*** the only modifiable risk factor in cardiovascular disease

Answer 27

smoking

Question 28

Printzmetal’s angina

Answer 28

from coronary vasospasm
presents with angina at rest that comes in cycles
Treat with CCBs!

Question 29

Treatment of coronary vasospasm

Answer 29

Calcium channel blockers
avoid beta blockers as they leave alpha 1 receptors unopposed which lead to vasoconstriction (don’t use beta blockers in cocaine associated MI either)