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Internal Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

ST depressions…

A

Signs of ischemia

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2
Q

Q waves on leads II, III, aVF

A

Inferior wall infarct

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3
Q

ECG shows diffuse ST segment elevation, with chest pain relieved by sitting forward

A

Pericarditis

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4
Q

Most common cause of pericarditis?

A

Coxsackievirus

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5
Q

Features of unstable angina.

A
  • prolonged chest pain that presents at rest, does not respond to nitroglycerin
  • ECG changes (ST depression)
  • minimally elevated cardiac enzymes
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6
Q

Treatment of Prinzmetal angina.

A

Calcium channel blockers

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7
Q

Features of Prinzmetal angina.

A
  • chest pain at rest
  • ST-segment elevations on ECG
  • Cardiac enzymes are normal
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8
Q

Treatment of achalasia.

A

pneumatic dilatation or botulism toxin administration

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9
Q

Mitral stenosis murmur characteristics.

A

Late diastolic blowing murmur (best heard at the apex), with an opening snap.

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10
Q

Aortic stenosis murmur characteristics.

A

Crescendo - decrescendo systolic ejection murmur

  • slow pulse upstroke
  • radiates to carotids
  • leads to syncope, angina, dyspnea on exertion
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11
Q

Aortic regurgitation murmur characteristics.

A

Early diastolic decrescendo murmur

  • widened pulse pressure
  • LVH, LV dilatation
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12
Q

Mitral prolapse murmur characteristics.

A

Midsystolic click, late systolic murmur

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13
Q

Most common etiology of mitral stenosis.

A

Rheumatic fever.

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14
Q

Etiologies for Aortic stenosis.

A

age-related calcification or early onset calcification from bicuspid aortic valve

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15
Q

Etiologies for Aortic regurgitation.

A

Congenital Rheumatic damage
Endocarditis
Aortic dissection/aortic root dilatation
Marfan syndrome

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16
Q

Virchow’s triad.

A

Endothelial damage
Venous stasis
Hyper-coagulable state

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17
Q

Homan sign.

A

Dorsiflexion sign for DVT

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18
Q

Trousseau sign.

A

Migratory superficial thrombophlebitis, classic marker for pancreatic cancer.

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19
Q

How are the effects of ASA, heparin and warfarin monitored?

A

Heparin -> PTT
Warfarin -> PT
ASA -> bleeding time

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20
Q

Reversal agent for Heparin and LMW heparin.

A

Protamine.

21
Q

Causes for vitamin K deficiency.

A
  • Neonate who did not receive prophylactic vit K
  • Malabsorption
  • Alcoholism
  • Prolonged antibiotic used (kills vit K producing bowel flora)
22
Q

Cause of cor pulmonale in young woman with no other medical history or risk factors.

A

Idiopathic pulmonary arterial hypertension.

23
Q

Treatment for Idiopathic pulmonary arterial hypertension.

A 
Parenteral epoprostenol  (prostacyclin)
Antiendothilin (bosentan)
Heart-lung transplant
24
Q

Most common kind of cardiomyopathy.

A

Dilated cardiomyopathy.

25
Q

Etiologies of dilated cardiomyopathy.

A 
Alcohol abuse
Wet Beriberi
Coxsackie B virus myocarditis 
Chronic cocaine use 
Chagas disease
Doxorubicin toxicity
Hemochromatosis 
Sarcoidosis 
Peripartum cardiomyopathy
26
Q

What endocrine disorder causes atrial fibrillation?

A

Hypothyroidism.

27
Q

Triad for WPW.

A
  • Wide QRS complex
  • Short PR interval
  • Delta waves
28
Q

In fetal circulation, highest oxygen content found in:

A

Umbilical vein (brings blood from mother to baby)

29
Q

In fetal circulation, lowest oxygen content found in:

A

Umbilical arteries (brings blood away from baby and back to mom)

30
Q

“2 measurement rule” of HTN:

A

BP should be measured 2 times on each of 2 separate office visits before the diagnosis and pharmacologic treatment of HTN

31
Q

Medications to improve mortality in congestive heart failure:

A
  • ACEI - dose-dependent (limit ventricular remodeling and reduced progression)
  • Beta blockers (reduce risk of sudden death/arrhythmia/remodeling)
  • ARBS
  • Spironolactone (improves survival for Class 3 and 4)
32
Q

Diabetes and ACEIs

A

ACE inhibitors reduce progression of nephropathy and neuropathy

33
Q

Which drugs are used for pregnant woman with HTN?

A

Labetolol
Hydralazine
alpha-Methyldopa
(Mg2+ sulfate also lowers BP in Preclampsia)

34
Q

HTN urgency

A

Severe HTN, SBP >180, DBP >120 WITHOUT sxs.

35
Q

HTN emergency

A

1) Malignant HTN: HTN urgency + retinal hemorrhages, exudates or papilledema, or evidence of End-organ-damage
2) HTN encephalopathy: HTN urgency + cerebral edema & non-focal neuro sxs
Tx: IV nitroprusside

36
Q

Secondary HTN in a young man… most likely cause?

A

Excessive alcohol intake

37
Q

Secondary HTN in a young woman… most likely cause?

A

Birth control pills or renal artery stenosis from Fibromuscular dysplasia (p/w bruit and should be treated with balloon angioplasty)

38
Q

Screening test for pheochromocytoma:

A

24-hr urine collection to assess catecholamine products, metephrines, vanillylmandelic acid, homovanillic acid

39
Q

Older patient with renal artery stenosis, most likely 2/2?

A

Atherosclerosis

DO NOT give them ACEIs since it precipitates them to acute renal failure

40
Q

Conn syndrome + HTN

A

Aldosterone-secreting adrenal neoplasm

Labs: high aldosterone, low renin, hypernatremia, hypokalemia, metabolic alkalosis

41
Q

Screening test for Conn syndrome (Hyperaldosteronism)?

A

Plasma aldosterone to Plasma renin activity ratio; ratio greater >30 is indicative of primary hyperaldosteronism

42
Q

Leriche syndrome

A

Combination of claudication of buttocks, buttock atrophy, and impotence in men cause by aortoilliac occlusive disease, requiring aortoiliac bypass graft

43
Q

Management of claudication?

A

Conservative FIRST cessation of smoking, exercise (develops collateral circulation), weight loss, good control of cholesterol, diabetes and HTN, ASA (or clopidogrel if can’t tolerate ASA)

44
Q

Features of chronic mesenteric ischemia

A

Postprandial abdominal pain
Fear of food w/ weight loss
Extensive h/o of atherosclerotic disease
Abdominal bruit
Heme-occult-positive stool
LACK OF JAUNDICE (r/o pancreatic cancer)
CT abdomen is NEGATIVE (raising suspicion for ischemia)

Dx: Angiography of superior mesenteric artery

45
Q

Features of venous insufficiency

A
  • Deep vein thrombosis
  • Varicose veins
  • Swelling in the extremity with pain, fatigability or heaviness
  • Increased skin pigmentation around the ankles with possible skin breakdown and ulceration
46
Q

Superficial thrombophlebitis

A

Pt has a h/o varicose veins, c/o localized leg pain with superficial cordlike induration, reddish discoloration and mild fever.
- NOT A RISK FACTOR for PE
- NO NEED for anticoagulation
Tx: conservative with NSAIDs and warm compresses

47
Q

Subclavian steal syndrome

A

Caused by left subclavian artery obstruction proximal to the vertebral artery, particularly when exercising their upper extremity t/f p/w:
-CNS sxs (syncope, vertigo, confusion, ataxia, dysarthria) 2/2 blood being stolen from vertebrobasilar system
-Upper extremity claudication during exercise
Tx: surgical bypass

48
Q

Thoracic outlet syndrome

A

Caused by obstruction of nerves or blood vessels that serve the arm as the neurvascular bundle passes from the thoracocervical region to the axilla by CERVICAL RIBS or MUSCULAR HYPERTROPHY (classic is young male weight lifters). P/w:

  • Upper extremity paresthesia (nerve impingement)
  • Weakness
  • Cold extremities (arterial compromise)
  • Edema and or venous distention (venous compromise)

Internal Medicine (12 decks)

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