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PANCE > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Tx for Brugada Syndrome is:

A

B blockers

and

ICD

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2
Q

Mitral valve stenosis is most frequently preceded by:

A

Rheumatic fever which causing thickening of the valve leaflet.

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3
Q

Unstable Tachyarrhythmia should be treated with

A

Cardioversion

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4
Q

Pt with HTN + CFH should be prescribed what HTN drug(s)

A

Thiazide + B blockers

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5
Q

Pathophysiology of AO dissection:

A

Tear in the tunica intima

Blood collection b/w tunica intima and tunica media creating false lumen.

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6
Q

Preffered position in patients with pericarditis is

A

Sitting up, leaning forward.

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7
Q

Tricuspid valve stenosis is usually seen in conjunction with

A

Mitral valve stenosis

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8
Q

Presentation of AO dissection is:

A

Sudden onset of tearing chest pain, between scapulas

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9
Q

AO valve regurgitation murmur best heard in what position?

A

Right sternal border (2nd interspace)

Pt. leaning forward.

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10
Q

Medications that can be used to treat HTN in pregnancy are:

A

Labetalol

Methyl Dopa (alph 2 agonist)

any Calcium Channel Blocker

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11
Q

Sx of hypertrophic cardiomyopathy are:

A

Dyspnea on exertion

Syncope/dizziness

Crescendo-decrescendo systolic murmur

S4 gallop

Ventricular stiffness

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12
Q

potassium sparing diuretics and ACE inhibitors used together may produce ________

A

HyperKalemia

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13
Q

Physical findings associated with Pulmonary valve regurgitation are:

A

Mild cases are well tolerated and have few or no symptoms Severe cases may have right ventricular hypertrophy Severe cases may have right heart failure Widely split S2 ECG may show right ventricular hypertrophy

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14
Q

Flutter rate is

A

250-300 bmp

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15
Q

Amyloidosis and Sarcoidosis are known to cause:

A

Restrictive CM

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16
Q

Treatment for DVT in a pregnant pt is:

A

Lovenox

Warfarin/coumadin CAN NOT be used at it crosses the placenta!!!

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17
Q

Sick Sinus Syndrome is treated with:

A

Pacing

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18
Q

Tx of Systolic/Dialated CHF:

A

ARBs or ACE Inhibitors (vasodilators)

Beta Blockers (lowers mortality)

Digoxin (does not lower mortality)

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19
Q

Which medication is contraidicated in pts with inferior MI:

A

Nitroglycerin (reduces preload)

inferior MI may be a Rt side MI which are preload dependend

Nitroglycerin may lead to severe drop in blood pressure

Intravenous hydration is indicated in preload depended MI

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20
Q

Normal mean arterial pressure is:

A

70-100

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21
Q

Valve Locations: Aortic Valve, Pulmonic Valve

A

Aortic 2nd Rt interspace

Pulmonic 2nd Lt interspace

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22
Q

Waterhammer/ Corrigan’s pulse is associated with

A

Aortic Valve Regurgitation

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23
Q

Signs of HyperKalemia seen on ECG are:

A

peaked T waves

QRS widening

p wave flattening

will eventually transform to V tach or V fib if not corrected.

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24
Q

Tx of acute CHF

A

ACE-I

Loop diuretics

Nitrate

Oxygen

Morphine

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25
Q

The type of ischemia that presents with ST elevation is:

A

Prinzmetal Angina

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26
Q

LV apical balloning followed by stress and releaes of catacholamines is known as

A

Taku-Tsubo CM

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27
Q

Systolic (dilated) HF has ______ejection fraction

Diastolic HF has _______ejectin fraction

A

Reduced EF in Systolic

Preserved EF in Diastolic

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28
Q

Sx of cardiogenic shock are:

A

Dysrhythmia

caynosis

Hypotentions

Lung crakles

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29
Q

Posterior heart anatomy is best visualized with

A

Trans Esophageal Echo

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30
Q

HyperParathyroidism produces secondary HTN by means of?

A

Increased Ca2+ concentration produces increased vasocontriction (contraction) of smooth arterial muscle>increases periferal resistance.

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31
Q

S1 sound is synchronized with ______

A

Carotid pulse upstroke

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32
Q

Vasodilator that can cause cyanide poisoning is

A

Nitroprusside

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33
Q

Normal B/P values

A

<120/80

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34
Q

Best imaging modality or pulmonic valve evaluation is

A

TEE

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35
Q

WPW syndrome predisposes a pt to develope

A

A fib

V fib

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36
Q

Symptoms of pericarditis usually include:

A
  1. PLEURITIC CHEST PAIN aka pleurisy (aggravated by a deep breath or lying down) 2.Dyspnea

3 Diaphoresis

4 Fever

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37
Q

Tx for Dilated CM:

A

Promote systolic function by reducing blood pressure:

ACE I

Beta blockers

Diuretics

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38
Q

S1 sound splits into _____ ______ during_______

A

Mitral valve closure (1st)

Tricuspid closure (2nd)

during inspiration

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39
Q

Imaging modalities for thoracic AO dissection include:

A

MRI w. IV contrast

CT w. IV contrast

TEE transesophageal echocardiography used in pts with impaired renal function (who can not have IV contrast administered)

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40
Q

ECG with different morphological p waves corresponds to

A

Multifocal Atrial Tachycardia

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41
Q

Most potent fast HTN reduction medication is:

A

Labetalol

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42
Q

What is Digoxin classified as?

A

Digoxin is a positive ionotrope and negative chronotrope.

It augments pumping while decreasing heart rate.

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43
Q

Valvular murmurs will

improve with Valsalva

and become louder with

A

Leg Raising.

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44
Q
A

1st degree AV Block

PR interval > 0.2

Regular, narrow QRS

no treatment necessary

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45
Q

Primary management of diastolic HF is:

A

controlling the HTN (the cause of diastolic HF)

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46
Q

Murmurs grade VI and higher are always associated with

A

Thrill

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47
Q

Junctiona Rhythm is characterized by:

A

Rate: 40-60

No P waves

Narrow QRS

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48
Q

Best screening test of Conn’s syndrome/Primary Aldesteronism is:

A

High [Aldosterone] / Low [renin]

High Aldesterone/Renin ratio

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49
Q

Treatment for bowel edema is

A

Torsemide (loop diuretic)

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50
Q

Hursh Crescendo-Decresendo ejection/systolic murmur which is heard along the right sternal boarder and may radiate to the carotids bilaterally and the neck:

A

Aortic Valve Stenosis

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51
Q

Mid diastolic low pitch murmur that is best heard at the apex in LLD position is associated with?

A

Mitral Stenosis

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52
Q

Temporal artery is a branch of ?

A

ECA

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53
Q

In patients with true aspirin allergies, ________ should be substituted for aspirin

A

clopidogrel

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54
Q
A
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55
Q

Name of the murmur specific to Pulmonic Regurgitation and pulmonary HTN

A

Graham-Steell murmur

increases with inspiration and dicreases with Valsalva

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56
Q

Most effective step in treating HTN is:

A

weighth loss

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57
Q

normal PR interval

A

0.12-0.2

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58
Q

Mid Systolic Click (three words)

A

Mitral Valve Prolaps (three words)

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59
Q

Tx for A fib is:

A

1st goal - rate control with B blocker, CCB

2nd goal - cardioverision or ablation

3rd goal - anticoagulation (CHADS2 score)

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60
Q

Mitral valve stenosis produces back up flow into the lungs causing?

A

Pulmonary congestion

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61
Q

D-dimer test:

A

Increased D-dimers is indicative of fibrin degradation products.

Negative D-dimers rules out DVT (hight sensitivity)

Positive D-dimers is nonspecific (low specificity)

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62
Q

Sick sinus syndrome

A

disease of the sinoatrial (SA) node

It is associated with tachycardia-bradycardia syndrome

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63
Q

Diastolic and Systolic Heart failure can be differentiated by?

A

Echocardiogram

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64
Q

Tx for cardiogenic shock is:

A

IV fluids

Inotrophic meds (Dopamine - pressor agent)

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65
Q

Stable Sinus Tachycardia can be treated with:

A

Vagal maneuvers

B-blockers

Radio Frequency ablation

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66
Q

Left Atrial enlargements seen on ECG as:

A

biphasic p wave in V1

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67
Q

Rigidity of the heart / hiostological damage to the heart muscle is known as:

A

Restrictive Cardiomyopathy

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68
Q

Digoxin toxicity is monitored by serum ___ levels

A

Potasium (K)

low K worsens Dig. toxicity

Therapeutic serum K level: 0.5-2

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69
Q
A
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70
Q

Impairent of the systolic heart function is knowns as

A

Dilated Cardiomyopathy

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71
Q

Tx of Thrombophlebitis is

A

NSAIDs if the thrombus is below the knee

Enoxaparin is a low molecular weight heparin if the thrombus above the knee

warm compress

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72
Q

Normal QRS followed by two wide QRS is known as:

A

Ventricular Couplet

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73
Q

Diminshed contractility of cardiac myocytes is known as:

A

Dilated CM

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74
Q

Stress Echo finding seen in MI or Ischemia is:

A

Hypokinetic wall motion.

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75
Q

NSAIDS, corticosteroids and MOA inhibitors are known to _______ b/p

A

Increase blood pressure

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76
Q

African American pt should not be prescribed what kind of HTN medication provided that there is no end organ damage?

A

ACE-Inhibitors

(use ARBs instead)

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77
Q

Early diastolic blowing murmur usually corresponds to:

A

Aortic valve regurgitation.

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78
Q

What enlagement/hypertrophy is seen on this ECG:

A

Rt. atrial enlargement.

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79
Q

P wave corresponds to

A

Atrial Contraction / Depolarization

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80
Q

Symptoms of giant cell arteritis include:

A

Jaw claudication – pain in jaw while chewing

Scalp tenderness

Visual problems including vision loss and diplopia

Fever

Tenderness

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81
Q

Long QT interval is defined as:

A

greater than 0.45 second

or 11 small squares.

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82
Q

Warfarin/Coumadin

A

Long term anticoagulant Inhibits vitamin K there by inhibits factors II, VII, IX, X

CAN NOT be used in pregnancy

Warfarin is monitored by INR

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83
Q

Rhabdomyolysis - side effect of statin is monitored/detected by the serum levels of

A

Creatinine Kianase

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84
Q

Drug of choice to treat arterial thrombosis is:

A

Cliastazol (antiplatelet)

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85
Q

Pre HTN values

A

120-139 / 80-89

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86
Q

Tx for Sick Sinus Node Syndrome is

A

Pacemaker

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87
Q

First line treatment for primary HTN:

A

BEHAVIORAL MODIFICATIONS

Weight reduction

DASH diet (Dietary Approaches to Stop HTN)

Reduce sodium intake

Increase physical activity

Limit alcohol consumption

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88
Q

chlorothiazide

chlorthalidone

metolazon

are examples of __ diuretics

A

Thiazide Diuretics

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89
Q

Congenital unicuspid or bicuspid aortic valve may lead to:

A

Aortic Valve Stenosis

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90
Q

Life threatening arrhythmias that are seen in athletes are caused by:

A

Hypertrophic Obstructive Cardiomyopathy

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91
Q

Thickened interventricular septum

Outflow obstruction

Small ventricular size

are features of

A

Hypertrophic Cardiomyopathy

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92
Q

Causes of Tricuspid valve regurgitation are:

A

RVH

Ebstein’s anomaly

Tricuspid valve prolapse

Pulmonary hypertension (secondary to left hear failure)

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93
Q

Giant “a” waves are seen in

A

Tricuspid Stenosis

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94
Q

Signs of sx of pulmonary edema:

A

Increase respiratory rate

Pink, frothy productive cough

Cyanosis

Paroxysma Nocturnal dyspnea

Rales, rhonchi, wheezing

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95
Q

Drugs that increase K

ACE - Inhib

ARBs

Beta Blockers

K sparing diuretics (spirolactone)

have what effect on Digoxin toxicity?

A

Reduce toxicity associated with Digoxin.

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96
Q

Treatment of long QT syndrome is:

A

Beta blockers

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97
Q

ECG findings in STEMI include:

A

ST elevation

new LBBB

evolving Q waves

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98
Q

Most common causes of Dilated CM are:

A

CAD>Ischemia

Alcoholism

3rd trimester pregnancy

Toxins

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99
Q

P’s of arterial embolism/thrombosis (PAD) include:

A

Pain

Pallor

Pulselssness

Paresthesias

Poiklothermia (cold feet)

Paralysis

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100
Q

Most commong complicatoin after inferior MI is:

A

arrhythmia

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101
Q

3rd Degree AV block also known as Complete Block

A

Dissociated P and QRS complexes

P waves are separated by regular distance

QRS is separated by regular distance

Requires pacing.

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102
Q

Mid Systolic Click

A

Mitral Valve Prolapse

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103
Q

Machine like murmur (fo and from) is seen in

A

PDA (Patent Ductus Arteriosum)

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104
Q

Most common valvular disorder is:

A

Mitral valve regurgitation

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105
Q

Pt has been on hospital telemetry for a while, what is the earliest sign of MI?

A

Hyperacute T waves

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106
Q

normal QRS lenght is

A

<0.12

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107
Q

Contraindication for nitroglyceride is

A

Hypotention

Sildanefil (Viagra)

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108
Q

B blockers side effects include:

A

Asthma exacerbation

HyperKalemia

N/V

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109
Q
A

Supraventricular Tachyardia

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110
Q

Increase in pulmonary capillary wedge pressures causes:

A

Pulmonary edema

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111
Q

HTN emergencies include:

A

AO dissection

Unstable angine/MI

Ischemic Stroke

Intracrania Hemmorhage

Acute Pulm. Edema.

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112
Q

Definition of the aortic valve regurgitation is:

A

Failure of the aortic valve to remain closed during ventricular diastole. Failure of the aortic valve to prevent the reverse flow from ascending aorta into left ventricle.

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113
Q

Endocarditis may by caused by:

A

Bacterial etiology (most common);

postop valve replacement;

IV drug usage

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114
Q

Tx for Kawasaki disease:

A

High dose Aspirin

Intravenous immunoglobulin (IVIG)

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115
Q

Tx for Diastolic/Hypertrophic CHF

A

B blockers (verapamil, diltiazem)

Diuretics

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116
Q
A

Accelerated Ideoventricular Rate

no P waves

wide QRS

Rate 40-100 (higher than typical ventricular rate)

may be seen several days after MI

do not require any intervention

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117
Q

Symptomatic unstable Sinus Tachycardia should be treated with?

A

Synchronized Cardioversion

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118
Q

Pulmonary congestion causes the following sx:

A

Paroxysmal nocturnal dyspnea (difficulty breathing in supine position) due to fluid accumulation in the lungs.

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119
Q

HTN emergency/Malignant HTN values:

A

>220/125 Severe risk of end organ damage (retina, kidneys, lungs, AO)

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120
Q

HTN is the most common cause of ________heart failure

MI is the most common cause of _________heart failure

A

HTN>Diastolic (Hepertrophic)

MI>Systolic (Dilated)

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121
Q

Long QT is associated with:

A

Torsade

R on T

V tach or V fib

Romano - Ward

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122
Q

Normal QRS followed by wide QRS is knowns as

A

Ventricular Bigemeni

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123
Q

Stable angine is relieved by what medication

A

nitroglycerin

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124
Q

Ductus Arteriousus connects

A

Aorta to Left Pulmonary Artery

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125
Q

Squatting

handgrip

lying down

straight leg raise

have what effect of ventricular volume

A

increase ventricular volume

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126
Q

Holosystolic murmur at lower left sternal border that radiates to sternum and xiphoid is associated with

A

Tricuspid valve regurgitation

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127
Q

AO valve stenosis is a contraindication to undergo what cardiac testing?

A

Stress Test due to possibility of Syncope (passing out) upon physical exertion.

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128
Q

Digoxin toxicity syndrome can be caused by:

A

Digoxin overdose

or

Hypokalemia

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129
Q

Most commong etiology of mitral valve stenosis is:

A

Rheumatic fever which causes leaflet thickening.

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130
Q

Tx for unstable V tach is:

A

Cardioversion

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131
Q
A

Idioventricular Rhythm

Rate: 20-40

no P waves

wide QRS (greater than 0.2 sec.)

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132
Q

HypoCalcemia has what effect on ECG?

A

Prolongates QT interval.

which may lead to Torsade and V fib.

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133
Q
A

Second degree AV block (Type I) aka

Wenchebach/Mobitz Type I

Progressive lengthening of PR interval until QRS complex drops

Longer, Longer, Drop

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134
Q

Short PR<0.8 is seen in

A

Wolf Parkinson White Syndrome

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135
Q

pericardial knock on auscultation is associated with

A

Constrictive pericarditis

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136
Q

Renal Artery Stenosis pathophysiology that produces secondary HTN is:

A

Hypoperfusion of kendeys activates RAAS which elevates B/P.

Decrease secretion of Na+ also produced hypervolemia > HTN

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137
Q

Giant cell arteritis most often affects which artery?

A

Temporal artery

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138
Q

Sx of hyperKalemia include:

A

fatigue or weakness.

a feeling of numbness or tingling.

nausea or vomiting.

problems breathing.

chest pain.

palpitations or skipped heartbeats.

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139
Q

Rheumatic Heart Disease is associated with which valvular pathology?

A

Mitral Valve Stenosis

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140
Q

Most common cause for pulmonic valve regurgitation is

A

Pulmonar Hypertention.

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141
Q
A
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142
Q

Ventricular Systole is between which heart sound?

A

S1 and S2

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143
Q

“Boot shaped heart” seen on X ray cooresponds to:

A

Tetrallogy of Fallot

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144
Q

V tach tx:

A

Unstable V tach > Synchronized Cardioversion

Dead V tach > Unsynchronized Cardioversion

Stable V tach > Lidocaine/Procainamide/Amiodarone

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145
Q

Treatment of choice for HTN emergency is:

A

Labetalol or Nicardipine

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146
Q

Aortic Valve Stenosis Classical Triad of Sx:

A

Dyspnea

Angina

Syncope with exertion

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147
Q

Restrictive Cardiomyopathy produces:

A

diastolic disfunction

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148
Q

U wave after T wave is often seen in

A

HypoKalemia

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149
Q

Tx of choice for hypetrophic CM is

A

Beta blockers

increase diastoic filling of ventricles

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150
Q

Loop dieuretics are (two qualities)

A

Very powerfull

Short acting

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151
Q

Most common location for AAA is:

A

infrarenal

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152
Q

Sx of Restrictive CM are simular to:

A

Right Heart Failure:

JVD

Edema

Ascites

Hepatomegaly

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153
Q

Diastolic rumble is associated with

A

Mitral Stenosis

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154
Q

What cardiac complication is associated with hyperthyroidism?

A

High-output cardiac failure

tx is Propranalol

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155
Q

Significant risk factors for AAA are:

A

Atherosclerosis

CAD

Smoking

Hypertensiono

Hyperlipidemia

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156
Q

Medications that prolong QT interval:

A

macrolides (azithromycin, erythromycin, clarithromycin), fluoroquinolone (ciprofloxacin, ofloxacin, moxifloxacin), trimethoprim-sulfamethoxazole, pentamidine, antifungals (cotrimoxazole, fluconazole, ketoconazole, voriconazole), migraine medications (sumatriptan, zolmitriptan), stimulants (albuterol, epinephrine, dopamine, dobutamine, isoproterenol, methylphenidate, phenylephrine, terbutaline, phenylephrine, pseudoephedrine, cocaine, amphetamine), psychiatric drugs (tricyclics, phenothiazines, citalopram, clozapine, fluoxetine, haloperidol, lithium, methadone, risperidone, quetiapine, sertraline, trazodone, venlafaxine, ziprasidone), class I and III antiarrhythmics, and antihistamines.

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157
Q

Beck’s triad is:

A

Associated with cardiac tamponade

  1. Hypotension
  2. Jugular venous distention
  3. Muffled heart sounds.
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158
Q

Supraventricular Tachycardia

Atrial Flutter

are known collectivelly as:

A

AV Nodal Re-entry Tachycardia

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159
Q

Harsh, loud, systolic murmur best heard over 2nd or 3rd left interspace is associated with

A

Pulmonic valve stenosis

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160
Q

Reduced luminal volume of the ventricle is seen in:

A

Hypetrophic Cardiomyopathy

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161
Q

Propranol is

A

B1 & B2 blockers that should not be used in pt. with lung disease.

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162
Q

Key radiological feature of thoracic AO dissection:

A

Double barrel AO consisting of true and false lumens.

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163
Q

Methyldopa and Clonidine are examples of

A

Alpha agonists

MoA: inhibit NE release

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164
Q

ACE - Inhibitors adverse effects are:

A

Cough

Angioedema

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165
Q

EKG findings associated with pericardial effusion/Cardiac tamponade:

A

Electrical alternans- QRS complexes that alternate in hight. example:

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166
Q

Angina in aortic valve stenosis is caused by:

A

Poor perfusion due to the low pressure in the aorta and diminished blood flow through the coronary arteries.

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167
Q
A
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168
Q

thyrotoxicosis produces what type of HF

A

high-output heart failure

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169
Q

Tx of Atrial Flutter are:

A

B blockers

Digoxin

Ca channel blockers

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170
Q

Loud S3 is associated with?

A

Mitral valve regurgitation

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171
Q
A
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172
Q

MoA of loop diuretics is

A

Inhibit Na/K/Cl pump at the ascending loop of henle thereby preventing reabsorption of water.

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173
Q

ECG Leads anatomy is:

A
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174
Q

ECG finding of RBBB includes

A

wide QRS

rabbit ears in V1 and V2

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175
Q

Fibric Acid MoA

A

Reduce TG levels

Raise HDL

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176
Q

Bradycardia

A

rate less than 60 bpm

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177
Q

How to determine irregular heart reate on ECG, what is the formula?

A

6 second rule

of QRS within 30 large boxes x 10

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178
Q

Pericardial effusion/Cardiac Tamponade most often caused by:

A

Pericarditis

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179
Q

Valve Locations: Tricuspid Mitral

A

Tricuspid - Left sternal border at the level of 5th interspace

Mitral Apex/Mid clavicular line at level of 5th interspace

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180
Q

Examples of potassium sparing diuretics are:

A

Spironolactone

Amiloride

Triamtereine

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181
Q

X ray fininds corresponding to Restrictive CM

A

Pulmonary vascular congestion

Pleural Effusion

Normal heart size

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182
Q

aTrophine

aDenosine

aMiodorone

A

aTrophine - Tachicardia (increases heart rate)

aDenosine - slows Down the heart

aMiodorone - mellows down (antiarrhythmic)

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183
Q

ACE inhib (MoA) is

A

blocking the conversion of Angiotensin I to Angiotensin II

Decrease of Aldosterone>reduction of Na reabsorption>reduction of volume

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184
Q

Best imaging modality for AAA diagnosis:

A

Ultrasound

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185
Q

Definition of cardiac tamponade is

A

large, rapid or uncontrolled pericardial effusion which reduces cardiac output.

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186
Q

Bisferiens carotid pulse ( a double peak per cardiac cycle is seen in) :

A

Hypertrophic Cardiomyopathy

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187
Q

Which Beta blocker should be used in pt with CHF and Asthama?

A

Metoprolol (Beta 1 selective blocker)

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188
Q

Secondary HTN with hypokalemia is indicative of

A

Conn’s disease/Aldesteronism

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189
Q

low pitched rumbling diastolic apical murmur corresponds to:

A

Mitral stenosis

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190
Q

Powerfull vascular constrictrors are

A

Angeotensin II - most potent

Epinephrine

Norepinephrine

Dopamine

Thromboxane

Endothelin

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191
Q

Management of AAA:

A

Surgical repair if >5.5 cm or expands >0.6 cm per year

Monitor annually if >3 cm.

Monitor every 6 months if >4 cm

Beta blocker

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192
Q

Mitral valve regurgitation can be repaired or replaced?

A

Repaired. In many case the valve can be repaired rather than replaced.

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193
Q

Buerger’s Disease/Thromboangitis obliterans

A

Progressive inflammation and thrombosis of arteries and veins of extremities. Strongly associated with smoking.

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194
Q

definition of Cor pulmonale

A

alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system

closely linked to:

pulmonary embolism

acute respiratory distress syndrome

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195
Q

Roth spots are

A

Associated with endocarditis;

Retinal hemorrhages with white centers

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196
Q

Nitroglycerin side effects include:

A

headache

nausea

low B.P

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197
Q

Mid systolic murmur that radiates to carotids corresponds to:

A

Aortic Valve Stenosis

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198
Q

Locations where S1 and S2 sounds can be heard the best are:

A
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199
Q

what effect Hypothermia has on ECG:

A

Bradicardia

J/Osborne wave

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200
Q

Saw Tuth Pattern on ECG corresponds to

A

Atrial Flutter

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201
Q

Unique ECG feature of hypertrophic obstructive CM is:

A

exaggerated Q waves corresponding to hypertrophic ventricular septum

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202
Q

CHF Classifications

Class I (mild) corresponds to:

A

No sx

No limitatons on physical activity

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203
Q
A

Arterial Flutter

Saw tooth appearance

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204
Q

Causes of mitral valve regurgitation include:

A

Mitral valve prolapse is the most common cause (thin females are most common for mitral valve prolapse)

Rheumatic fever

Myocardial infarction Endocarditis (regurge will also put a patient at increased risk of endocarditis)

Ruptured chordae tendineae (caused by MI or endocarditis most likely)

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205
Q

Presentation of Aortic valve stenosis include:

A

Mid systolic murmur

Syncope

Angina

LVH

Paradoxial splitting of S2 sound during expiration (normal splitting occurs during inspiration).

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206
Q

Brain Natriuretic peptide (BNP) is indicative of:

A

Ventricular Filling Pressure

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207
Q

Downslope ST elevation in V1, V2 and V3

with RBBB are signs of:

A

Brugada Syndrome

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208
Q

Wells Criteria is used to ascess the risk of

A

pulmonary embolism

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209
Q

Reduction of ventricular volume will _______worsen symptoms of Hypetrophic Obstructive Cardiomyipathy

A

Volume reduction with worse/increase sx of HOCM

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210
Q

Damage or prosthetic heart valves most common associated with:

A

Endocarditis

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211
Q

ACE - Inhibitors ________ breakdown of bradykinin (vasodilator)

A

decrease breakdown of bradykinin

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212
Q

Most common cause of hypetrophic cardiomyopathy is:

A

HTN

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213
Q
A
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214
Q

wide arterial pulse pressure is associated with ?

A

Aortic valve regurgitation

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215
Q

What is the classic triad of AAA?

A

Abdominal/back pain,

hypotension and

a pulsatile abdominal mass.

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216
Q

Fibrilation is

A

heart rate of >350

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217
Q

ECG findings of Restrictive CM are unique for:

A

Decrased aplitude caused by histological changes that reduce electrical conduction w/i the heart.

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218
Q

Nifedipine

Amlodipine

Nicardipine

Felodipine

are example of:

A

Dihydropyridine Ca channel blockers.

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219
Q

Tricuspid valve stenosis is usually symptomatic/non symptomatic

A

Non symptomatic

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220
Q

Vaughn-Williams Antiarrhythmic Drug Classifications:

A

Class I - Na channel blockers

IA - Quinidine, procainamide

IB-Lidocaine

IC-Flecanide, propafenone

Class II - Beta blockers (Metoprolol)

Class III - Potassium channel blockers (Amiodarone)

Class IV - Calcium channel Blockers

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221
Q

X Ray finding associated with aortic valve stenosis:

A

Calcified aortic valve.

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222
Q

Mitral valve stenosis produces what type of murmur?

A

Diastolic low pitch murmur, heard best at the apex in LLD position.

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223
Q

Concentric Hypetrophy corresponds to

A

Diastolic HF

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224
Q

Severe decreased right atrial compliance is a feature of:

A

Restrictive CM

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225
Q

Acromegaly causes secondary HTN by means of:

A

High concentratoin of Ca2+ causes the constriction of arterial smooth muscle which increase periferial resistence.

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226
Q

Viruses that often can cause pericarditis include:

A

echovirus (enterovirus), coxsackie (hand-foot-and-mouth dz), flu, HIV

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227
Q

Stage II HNT values are

A

>160/100

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228
Q
A
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229
Q

Stage II HTN treatment involves:

A

Combination of two drugs:

Diuretics + ACE inhib, ARBs, Ca channel blockets, B blockers

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230
Q

Sx and signs of PDA are:

A

Low Diastolic blood pressure

Widended pulse pressure

Machinery like murmur (continuous - both in systole and diastole)

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231
Q

In African American ACE-I should be replaced by:

A

Hydrochlorothizide

(not ABRS)

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232
Q

absent or weak femoral pulses

HTN in UE with hypotention in LE

3 sign on chest X ray

are all features of:

A

Coarctation of Aorta

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233
Q

LVH in aortic valve stenosis is caused by:

A

Excessive force used by left ventricle to pump through stenosed aortic valve.

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234
Q

Diastolic, rumbling murmur heard along lateral left sternal border, increases with insiration, associated with what valvular condition?

A

Tricuspid Stenosis

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235
Q

Bisferiens carotis pulse

loud S4

Systolic murmur

corresponds to

A

Hypertrophic Cardiomyopathy

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236
Q

S2 sound corresponds to closure of

A

Aortic and Pulmonic Valves

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237
Q
A

Complete Heart Block aka 3rd degree AV block

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238
Q

Dry cough that occurs in pt. taking ACE-Inhibitors is caused by:

A

increased bradykinin

which irritates the lungs

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239
Q

Fluid b/w lung lobules seen in the bases during pulmonary edema are known as:

A

Kurley B lines.

definitoin: edematous interlobular septa.

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240
Q

Heparin side effect:

A

HITS: Heparin-induced thrombocytopenia syndrome

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241
Q

What is the most common cardiac cause for cyanosis of children?

A

Tetralogy of Fallot

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242
Q

Leading cause of Restrictive Cardiomyopathy is:

A

Amyloidosis

other causes inlclude:

Sarcoidosis, Hemochromatosis, Gaucher’s ds.

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243
Q

Side effect of alpha receptor blockers

A

Postural hypotension

Syncope

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244
Q

Aortic valve stenosis causes ____ ventricular outflow obstruction and _____ left ventricular hypertrophy

A

Left Left

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245
Q

Treatment for congenital long QT syndrome is

A

B blockers

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246
Q

IV drug users are predispose to develop RT or LT endocarditis with Tricuspid or Mitraval valve regurgitation?

A

RT

Tricuspid Regurgitation.

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247
Q

What medication is contraindicated in the treatment of Prinzmetal’s angina?

A

Beta-blockers.

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248
Q

Tets spells are:

A

episodes of cyanosis, hypoxia, SOB seen in kids with Tetralogy of Fallot

releived by squatting.

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249
Q

Major Duke criteria for endocarditis includes:

A
  1. Positive blood cultures (S. Aureus, S.Viridins, S Bovis, Enterococci)
  2. Positive Echo (New regurgitation, Abscess, oscillating mass)
250
Q

Pathological Opening of the Aortic/Pulmonic will produce

A

Opening Click (systolic sound)

251
Q

Mitral valve prolapse is seen mostly in what type of patients?

A

Young thin females

252
Q

Tx for Afib concurrent with V tach is:

A

IV Cardizem (CCB)

253
Q

Lab work often seen in Giant cell arteritis:

A

Liver function tests – Alk phos elevated

C-reactive protein is elevated

Sed rate elevated

platelets may be low

254
Q

Diastolic opening snap following S2 corresponds to:

A

Mitral valve stenosis (MS=OS)

255
Q

Cardiological signs of HTN are:

A

LVH

Displaced PMI

CHF

256
Q

MS =

(Mitral Stenosis)

A

OS

(Opening Snap)

257
Q

Tietze Syndrome

A

Costochondritis

258
Q

Serious complication of Giant Cell arteritis:

A

Blindness

259
Q

Causes of PAD

A

Atherosclerosis

Smoking

260
Q

Furosemide (Lasix)

Torsemide (Bumex)

Bumetanide (Demedex)

are all ____ diuertices

A

Loop Diuretics

261
Q

Pulsus Paradoxus

A

a drop of more than 10 mmHg in systolic blood pressure during inspiration

Seen in pericarditis / cardiac tamponade

262
Q

Conn’s Syndrome produces secondary HTN by means of?

A

Aldesterone secreting tumor in the cortex of the adrenal gland.

Produces Na+ retention > hypervolemia.

263
Q

Digitalis (digoxin effect) can be seen on ECG as:

A

downsloping ST depression with a characteristic “slurred” appearance;

flattened, inverted, or biphasic T waves;

shortened QT interval.

Digoxin effect is NOT a marker of toxicity

264
Q

Tx of STEMI includes:

A

Aspirin or Clopidogrel (if allergic)

TPA (thrombolitics) - must be given w/i first 3 hours

Heparin

265
Q

INR goal in pt. with A-Fib

A

2.5

266
Q

HOCM can cause sudden

A

death

267
Q

Classical UA sign of HTN is:

A

ProteinUrea (frothy urine)

268
Q

MI and Cardia Arteries:

A

Inferior>RCA

Lateral>Left Circumflex artery (branch of LCA)

Anterior>L anterior Discending artery (branch of LCA)

Posterior>RCA

269
Q

STEMI vs NSTEMI

A

STEMI: total occlusion, transmural (full thickness) MI, tPA are usefull, + enzymes, + ST elevation

NSTEMI: partial vascular occlusion, superficial MI, tPA are not usefull, + enzmems, - ST elevation

270
Q

Dihydropyridine Ca channell blockers (MoA)

A

dilate arterioles

271
Q
A
272
Q

What class of diabetes medications are contraindicated in the setting of heart failure?

A

Thiazolidinediones

273
Q

Pt with HTN + DM should be prescribed what HTN drug(s)

A

Thiazide + ACE inhibitors

274
Q

Causes of aortic valve stenosis include:

A
  1. Calcified aortic valve - most common cause
  2. Congenital valve malformation (bicuspid or unicuspid)
  3. Hypetrophic obstructive cardio myopathy.
275
Q

Two normal QRS folled by wide QRS is known as

A

Ventricular Trigemeni

276
Q

Low levels of which electrolite prolongates the QT interval is:

A

Ca

HyporCalcemia

277
Q

Excentric hypertrophy corresponds to

A

Dilated HF

278
Q

B blockers are contraindicated in what AV blocks?

A

1st AV block

279
Q

Typical EKG findings associated with pericarditis include (2):

A
  1. Diffuse concave-upward ST-segment elevation in multiple leads (exsept in aVR, V1 and III)
  2. Diffuse PR-segment depression examples:
    http: //en.ecgpedia.org/wiki/Pericarditis
280
Q

What cardiac pathology is often seen in pt with Turner’s syndrome?

A

aorta coartation

281
Q

Sinus Tachycardia is often seen in pt’s with:

A

PE

PE=ST

282
Q

Pathological opening of the mitral/tricuspid valves produce

A

Opening Snap (Diastolic sound)

283
Q

Systolic ejection murmur at pulmonic area that radiates to left neck

A

Pulmonary valve stenosis

284
Q

Pharmacological treatment of PAD:

A

vasodilators and antiplatelet medications

Pentoxifyline Cilostazol

285
Q
A

Multifocal Premature Ventricular Contraction

two different wide QRS complexes

286
Q

Tx for stable V tach

A

Amiodarone

Lidocaine

287
Q

R on T phenomenon is

A

Premature beating occuring during the T wave of the regular rhythm.

May lead to Torsade/VT/VF

288
Q

1 AV block does / does no require treatement

A

Does NOT

289
Q

Kawasaki Disease:

A

occures in children under 4 y.o

sx: fever x 5 days

erythem of lips / oral mucosa

conjunctivitis

cx lymphadenopathy

edema / erythem of extermieites

complication: coronary artery disease

290
Q

Management of AO dissection

A

Type A dissection - Surgical emergency

Type B dissection - Medical therapy (beta blockers) unless complications are present

291
Q

Prinzmetal angina will produce what ECG changes:

A

ST elevation

normal enzyme

292
Q

Bacterial Endocarditits most commonly caused by what pathogens?

A

Strep Viridans (+), Staph Aureus (+), Enteroccoci (+), Staph Bovis (+)

293
Q

Increased pulmonary Wedge Pressure is seen in _____ and corresponds to _______

A

Pulmonary Edema

Left Ventricular Pressure

294
Q

INR needs to be checked regulary for pt who are on:

A

Warfarin/Coumadin

295
Q

S2 splitting occurs during:

A

During inspiration S2 sound is split into Aortic valve (first) and Pulmonic valve (second)

296
Q

Junctional Rhythm:

40-60

no p waves

narrow QRS

often caused by:

A

Digoxin Toxicity

Junctional = Digoxin

297
Q

Ventricular contractions

Uncoordinated

Rate of 300-600

no pulse

no true QRS

known as:

A

Ventricular Fibrilation

most common cause of sudden cardian death

298
Q

Prem. Atrail Contracton

vs.

Prem Junctional Contraction

A

PAC will have normal p wave (different from other p waves)

PJC will have a missing or inveted p wave

299
Q

ACE-I actions include:

A

Block converston of Angiotensin I to Angiotensin II

Dicrease aldosterone mediated water retention

Slow myocardial remodeling and fibrosis.

300
Q

Giant cell arteritis is best diagnosed with

A

Temporal artery biopsy

301
Q

HTN values

A

>140/90 on two or more readings at two or more separate occasions separated by at least one week.

302
Q

Cardiac Enzymes

A
303
Q

Most common ECG findings in PE is:

A

Sinus Tachycardia.

304
Q

Two types of Calcium Channel Blockers are:

A

Dihydropirodines

Non-dihydropirodines

305
Q

Stiff ventricle in hypertrophic CM produced ___ sound

Increased diastolic volume in Dialated CM produces ___sound

A

S4

S3

306
Q

Beside HTN, hydrochlorothiazide is also used in:

A

Preventing kidney stones

Osteoporisis (prevent the loss of Ca+)

307
Q

Target INR range for pt on Warfarin/Coumadin

A

INR 2.0-3.0

308
Q

Ventricular rate

A

20-40

309
Q

Nitroglycerin MoA is:

A

reduce oxygen deman

reduct preload and afterload

vasodilation

310
Q

Several consequative PVC is known as

A

A run of VT

Pathologic because the heart is not able to fill up due to the fast contraction.

311
Q

SA node rate

A

60-100

312
Q

Definition of mitral valve prolapse:

A

Superior displacement of mitral valve leaflets into the left atrium.

313
Q

Signs of HTN retinopathy include

A

Cotton wool spots

Flame hemmorhages caused by vessel rapture

Papilloedema (indistinct borders of the optic disk)

Arterial thinning (narrowing) / Silver (cupper) wireing

Arterio-venous nicking

314
Q

sx of Digoxin toxicity are:

A

N/V (GI sx)

Geynocomastia

Blurred vision with yello halo

Paroxysmal atrial tachycardia

315
Q

Arterial Septal Defect will be seen on ECG as:

A

Rt bunlde branch block.

316
Q

ECG features of Dilated Cardiomyopathy are:

A

LVH/RVH

317
Q

ECG findings corresponding to aortic valve stenosis:

A

LVH

318
Q

ECG finding of LBBB include:

A

Dog ears in V5 and V6

wide QRS

319
Q

New York Heart Association Classification

A
320
Q

Endocarditis caused by poor dental care is often secondary to:

A

Strep viridans.

321
Q

Definition of wide arterial pulse pressure is:

A

the difference between the systolic blood pressure and the diastolic blood pressure is greater than 40 mmHg

322
Q

Premature Ventricular Contraction (PVC) are treated with:

A

B blockers

323
Q

Definition of Thrombophlebitis is:

A

Inflammation of the wall of the vessel (superficial) secondary to a thrombus.

324
Q

Autosomal dominant disorder

Sudden death

Common among young athletes

typical of:

A

Hypertrophic Obstructive CM

325
Q

Treatment for Patent Ductus Arteriosus is:

A

Indomethacin (NSAIDS)

326
Q
A
327
Q

New sudden onset of Afib is often related to:

A

Thyrotoxicosis.

check thyroid labs

328
Q

ECG finding of Prinzmetal Angina is:

A

ST-elevation in multiple leads

329
Q

Syncope is associated with which valvular condition?

A

Aortic valve stenosis

330
Q

Congenital valve malformation is usually manifested at what age:

A

middle age patient

331
Q

Pathophysiology of AAA includes:

A

Dilatation of tunica media

Failure of connective tissue (elastin and collagen)

332
Q

Murmurs in valvular disorders are

reduced with what manuevers

and

increased with what manuevers:

A

increased with increasing ventricular volume: squating, hand grip, lying down, straight leg raising

reduced with decreaseing ventricular volume: valsalva

333
Q

Young Asian Men

Sudden Cardian Death

seen in:

A

Brugada Syndrome

334
Q

Adverse effect of Nitrates:

A

Hypotention>Tachyardia>Increased Oxygen demand>ST depression on ECG.

335
Q

Tx for stable A fib is:

A

CCB:

Verapamil

Diltaizem

336
Q

Key radiological feature of AO dissection is

A

Intimal flap

337
Q

Treatment of symptomatic V tach is:

A

Electrical Cardioversion

or

Pharm Cardioversion with amiodarone or lidocaine

Long lasting tx is:

Implantable Cardioverter Defibrillator (ICD)

338
Q

Tx for A-Fib

A

Rate Control:

B blockers, Ca channel blockers, Digoxin

339
Q

Chest pain in kids reliefed by squatting corresponds to:

A

Tetrallogy of Fallot

340
Q

Medicaton for Dialted Cardiomyopathy are:

A

Beta blockers and ACE inhibitors.

341
Q

Definition of waterhammer/ Corrigan’s pulse is

A

a pulse that is bounding and forceful, rapidly increasing and subsequently collapsing.

342
Q

BNP (B-type natriuretic peptide) <100 is indicative of:

A

rules out CHF

343
Q

Atrial Septum Defect is caused by:

A

Osteum Secundum

Foramen ovale fails to close

344
Q

Respiratory condition that is often seen in pt’s with Arterial Flutter is

A

COPD

345
Q

Low K or Mg often caues of kind of arrythmia?

A

V tach

no p waves

rate of >100

346
Q

Treatment for WPW is

A

Amiodarone or Sotalol

or Cardiovertion followed by Radio frequency ablation

347
Q

upright posture

standing

valsalva

have what effect of ventricular volume?

A

decrease ventricular volume

348
Q

Hydralazine is

A

Arterial vasodilator used in HTN crisis works by releasing Nitric Oxide (NO)

349
Q

At what time of the day should Statins be taken?

A

Evening

Peak activity of Statins is at midnight.

350
Q

INR for prosthetic valves other than mitral valve should be held at

A

INR 2.0-2.5

warfarin/coumadin

351
Q

Hypercoagulability state can be induced by:

A

Oral birth control medications

Pregnancy

Cancer

Factor V Leiden mutation

Smoking

Prolong immobilization

Recent surgery

352
Q

Homans test:

A

Dorsiflexion of foot with a straight knee

If + indicate of DVT (accurate only in 50%)

353
Q

Persisten Sinus Bradycardia in an elderly

with sx of syncope is collectively known as:

A

Sick Sinus Syndrome

354
Q

Verapamil

Diltiazem

A

Non-dihydropyridine Ca channel blockers.

355
Q
A

Posterior MI:

ST depression in V1 / V2

356
Q

Statins MoA is

A

reduce cholesterol synthesis by inhibiting Hydroxy-methylglutaryl coenzyme (HMG)

357
Q

Apical ballooning of the LV that occures in response to severe stress is known as:

A

Taku-Tsubo Cardiomyopathy/Broken Heart Syndrome

358
Q

Echo feature of Restrictive CM is:

A

Enlarged atria

359
Q

Murmur that’s best heard in LLD position at the apex of the heart?

A

Mitral valve stenosis

360
Q

what the most common cardiact pathology in pt with Down syndrome?

A

Atrioventricular septal defect

361
Q

B blocker that is not contraindicated in pt with COPD/Asthma is:

A

Metropolol

362
Q

CHADS2 score of > 2 requirs anticougulation (INR>2)

what is included in the CHADS2

A

CHF

Hypertension

Age >75

Diabetes

Stroke

363
Q

multifocal atrial tachycardia if often caused by

A

COPD

364
Q

PMI is located at

A

4/5th interspace at the level of mid clavicular line.

365
Q

Treatment for RHF symptoms such as ascites, edema is

A

Loop diuretics

366
Q

Tx for hyperKalemia is:

A

Calcium Cloride or Calcium Gluconate

367
Q

Tx for unstable Paroxysmal Supraventricular Tachycaridia is:

A

IV adenosis

or

Verapamil, Diltiazem (CCB)

368
Q

normal QRS is

A

0.12-0.2

369
Q

Rt. Atrial Enlargement seen on ECG as

A

tall p waves (2.5 mm)

in inferior leads (II, III, AVF)

370
Q

Contraindication for ACE - Inhibitors are:

A

Pregnancy

Bilateral Renal artery stenosis

Do not work well on African American pts, unless renal disease is also present.

371
Q

Classic Xray signs of acute CHF (pulmonary congestion/edema)

A

Butterfly patterns of alveolar edema

Increased interstitial markings

Kerely B lines

Enlarged cardiac silhouette

Effusion (meniscus sign)

Cephalization of flow (vertical distribution of pulm veins)

372
Q

CVA/TIA

unilateral neck pain / sever headache

Miosis / Ptosis (Horner’s syndrome)

is a classic sign of:

A

CCA dissection

373
Q

Diagnostic studies for PAD:

A

ABI <0.8

Arteriogram is a gold standard

374
Q

Catochalamines (Epi & NE) bind to

A

Alpha and Beta receptors.

375
Q
A
376
Q

CT angiogram of the chest with IV contrast is the preferred diagnostic modality in patients with suspected PE unless:

A

elevated creatinine

use V/Q scan instead

377
Q

Cause of A-fib include

A

Thyrotoxicosis

ET(OH) abuse

HTN

CHF

378
Q

Accurate blood pressure requires:

A

No smoking or drinking 30min. prior.

Cuff bladder should be 80% or arm diameter

379
Q

Pharmacological treatment for stage I HTN is

A

Hydrochlorothiazide

380
Q
A

Junctional Rhythm with inverted P waves

381
Q

First initial therapy in Pulmonary edema (Systolic/Dialated HF) is:

A

Loop Diuretics (fast acting)

Furosemide

Bumex

382
Q

Loop Diuretics side effects include:

A

Hypokalemia

Hyponatremia

Gout (elevated uric acid levels)

Ototoxicity

383
Q

Bioprothetic valve replacement (bovine/porcine) does / does not require anti coagulation therapy.

A

does NOT require anti coagulation therapy shorter life span (10-15 years)

384
Q

Capture beats and fusion beats confirm the diagnosis of which cardiac dysrhythmia

A

Ventricular tachycardia

385
Q

What valvular disorder is often seen in young pregnant pt?

A

Mitral Valve Stenosis

386
Q

obstruction or delay of conduction b/w SA node and AV node results in

A

AV nodal Blocks

387
Q

2nd Degree AV Block Type I is also known as:

A

Wenchekbach

Mobitz Type I

388
Q

Definition of Tetrallogy of Fallot is:

A

PROVe:

Pulmonic stenosis,

Right ventricular hypertrophy,

Overriding aorta,

VSD

389
Q

Mid systolic click is often seen in

A

Mitral valve prolapse

390
Q

Side effects of Ca channel blockers are:

A

Constipation

Bradycardia

Edema

391
Q

delta wave on an electrocardiogram is seen in

A

Wolff-Parkinson-White syndrome

392
Q

Unique echo feature of Hypertropic Obstructive CM is:

A

Assymterical ventricular enlargement.

393
Q

Digitalis effect include:

A

Inotropic

controls heart rate with Afib

used in CHF concurrent with Afib.

394
Q

Features of Taku-Tsubo are:

A

casued by stress/catacholamine release

mimicks amteropr MI

normal coronary arteries

self limiting.

395
Q

Dressler Syndrome aka Postcardiac injury syndrome is caused by (4):

A
  1. MI
  2. Open heart surgery
  3. Pericardiotomy
  4. Trauma to pericardium.
396
Q

Dressler Syndrome is typically presented by (5):

A
  1. Pleuritic chest pain
  2. Pericarditis
  3. Pericardial effusion
  4. Fever
  5. Pericardial friction rubs

Dressler Syndrome is also known as Postmyocardial infarction syndrome

397
Q

Digitalis toxicity is associated with what rhythm

A

Junctional Rhythm.

398
Q

main treatment for Bradyarrhythmias is:

A

Atropine

399
Q

Pharmacological treatment for pulmonary congestion includes:

A

Diuretics

Vasodilators

400
Q

Bundle of Kent is associated with

A

WPW syndrome

401
Q

Dual antiplatelet therapy consists of:

A

Clopidogrel(plavix) + apsorin

Decrease risk of coronary artery stent thrombosis.

402
Q

Treatment for pericarditis is:

A

Treat the underlying issue. High dose of NSAIDs

403
Q

Tender cord like structure at affected vein is associated with

A

Thrombophlebitis

404
Q

LVH with narrow LVOT is a feature of:

A

Hypertrophic Obstructive CM

405
Q

Diagnosis of HTN requires __ seperate readings

A

3 separate readings.

406
Q

Non raptured AAA are

A

Not symptomatic.

407
Q
A

V tach

requires Cardioversion

408
Q

Powerful vasodilators are:

A

Nitric Oxide (NO)

Prostaglandins

Bradykinin

409
Q
A

Mobitz II aka

2nd Degree AV Block type II

410
Q

Example of Inherited autosomal dominant cardiomyopath

A

Hypertrophic Obstructive CM

411
Q

Cushing syndrome has what effect of K concentration

A

causes HypoKalemia

412
Q

Supraventricular Tachyarrhythmias include:

A

Sinus

Atrial

Junctional node

arrhythmias

413
Q

Eisenmenger’s physiology is:

A

Large Patent Ductus Arteriousus that produces pulmonary HTN

414
Q

The drug the decreases mortality in CHF is

A

ACE-I

Potassium sparing diuretics

B blockets (metaprolol, carvedilol) - efficacy is inversily proportional to the ejectoin fraction. The lower the EF the hight the efficacy (higher decrease of mortality)

415
Q

Duke Criteria for diagnosis of endocarditis:

A

Two major findings

or

One major finding + three minor findings

or

Five minor findings

416
Q

what effect NSAID have on CHF?

A

Non-steroidal anti-inflammatory drugs are associated with an increased risk of heart failure exacerbation, increased renal dysfunction and impairment of the response of angiotensin converting enzyme inhibitors and diuretics.

417
Q

Physical findings of Cardiac tamponade include:

A

Hypotension

Paradoxical pulse pressures –a drop of more than 10 mmHg in systolic blood pressure during inspiration

Jugular venous distension

Tachycardia

Tachypnea

Narrow/low pulse pressure (difference b/w systolic and diastolic blood pressures)

Decreased heart sounds

Water bottle heart on chest X-ray

418
Q

Typical presentation AAA rapture:

A

Flank pain,

hypotension,

pulsatile abdominal mass

Tearing pain radiating to the back = AAA RAPTURE

419
Q

Mitral Valve Prolapse produces

A

Mid Systolic Click

Systolic Crescendo murmur

preload up > murmur down

preload down > murmur up

420
Q

Kussmaul sign

A

paradoxical rise in jugular venous pressure (JVP) on inspiration

signs of right heart dysfunction.

421
Q

Young Asian Men

A

Brugada Syndrome

422
Q

S4 sound is typically seen in what cardiomyopathy?

A

Hypertropic CM

423
Q

Cause of aortic valve regurgitation are:

A

Infective Endocarditis > distruction of the aortic valve

Rheumatic heart disease > enlargement of the valve ring Aortic dissection>propagates and damages the aortic valve

HTN>increased b/p in AO exerts reversed pressure on the aortic valve causing it to regurgitate HTN>cause LV dilatation which stretches the valve ring producing regurgitation

Mafan Syndrome>connective tissue disorder>AO root disease

424
Q

Conn’s Syndrome/Aldesteronism produces secondary HTN by means of:

A

increased retention of Na+ and secretion of K+

resulting in hypervolemia and hypokalemia

425
Q

Prozosin & Terazosin are medications that can be used in

A

BPH

HTN caused by pheochromocytoma

426
Q

Ezetimibe MoA

A

Inhibits intestinal absorption of cholesterol.

427
Q

features of Supraventricular Tachycardia

A

very regular

Narrow QRS

p waves may be hiding/missing

rate 140-240

May be caused by SA, AV or Junctional node

428
Q

CHF with A-fib is indicative for what medication?

A

Digitalis aka Digoxin

429
Q

Giant cell arteritis is often seen concurrent with what medical condition?

A

polymyalgia rheumatica (multiple joint pain)

430
Q

The target INR for a mechanical mitral valve is ___,

whereas a mechanical aortic valve is ___.

A

3-3.5 mitral

2.5-3 aortic

431
Q

ARBs MoA is

A

Block antiotensin II receptors producing vasodilation

Don not increase bradykinin (like ACE inhib)

432
Q

Sudden death, seen in young athletes is usually secondary to:

A

Hypertrophic Obstructive CM and arrhythmia caused by it.

433
Q

Opening Snap after S2 is associated with

A

Mitral Stenosis

(MS=OS)

434
Q

Tx for SVT is:

A

IV adenosine or

verapamil

Cardioversion for symptomatic SVT

435
Q

Atrail Flutter definition:

A

Regular narrow QRS

atrail rate of 250-350

Sawtooth pattern

caused by conduction delay

436
Q

Physical finding associated with Mitral valve regurgitation?

A

Pansystolic blowing murmur at the apex and radiating to the axilla

Loud S3 Midsystolic click

Brisk carotid upstroke Rales secondary to pulmonary congestion

A-fib

Left ventricular hypertrophy

437
Q

Physical findings of Mitral Valve Stenosis include:

A

Opening snap following S2 sound (MS=OS)

Diastolic low pitch murmur

Pulmonary congestion (back up from left atrium into the lungs).

Lung Rales (secondary to pulm. congestion).

Paroxysmal nocturnal dyspnea.

Tachycardia

438
Q

Classes of AntiArrhythmics

A
439
Q

Digoxin (digitalis) toxicity syndrome is seen on ECG as:

A

Bradyarrhythmia

PR prolongation

can lead to Torsad De Point

440
Q

Non-dihydropyridine Ca channel blockers (MoA)

A

Slows Heart rates

and

Dilate arterioles

441
Q

Gynecomastia and Hyperkalemia are side effects of:

A

Aldesterone Antagonists:

spirolactone

epleronone

442
Q

Angiotensin Receptor Blockers (ARBs) icnlude:

A

Losartan

Valsartan

443
Q

Torsades de pointes is

A

caused often by low Mg

should not be treated with antiarrhythmics

correct electrolyte imbalance

444
Q

Giant “v wave” is seen in

A

Tricuspid Regurgitation

445
Q

Normal BNP in a pt. suspicious of having acute CHF will

A

exlude CHF.

446
Q

HTN for pt. with DM, renal or vascular disease is defined as:

A

BP>130/80

447
Q

Conn’s syndrome is best seen on:

A

CT/MR will show adrenal adenoma/hyperplasia

448
Q

Floppy, myxomatous mitral valve is also known as

A

Mitral Valve Prolapse

449
Q

Side effects of thiazide diuretics include

A

Hyponatremia

Hypokalemia

Hypocloremia

Gout (increase levels of uric acids)

Hyperglycemia

HyperCalcemia

450
Q

Features of Cardiogenic Shock are:

A

Decreased CO

Hypoxia

Hypotension

Altered mental status

Cyanotic extrimities

Faint pulses

Oliguria

Low cardiac index (stroke volum x heart rate / body surface are)

451
Q

Crescendo-decrescendo systolic murmur along the upper left sternal border is seen in what cardiomyopathy?

A

Hypetrophic Obstructive Cardiomyopathy.

452
Q

Treatments for Arrhythmias are:

A

Sinus Brady > Atropine

Sinus Tach >Cardiov (unstable) or B block ( sx)

SVT>adenosine, IV 6 mg

Atrial Flutter > Abutilide

A Fib > B blockers, CCB, warfarin

PVC > B block

V tach > Amiodorone, cardioversion

T fib > defibrilation

453
Q

S1 sound represents the closure of which valves?

A

Mitral and Tricuspid valves

454
Q

With inspiration murmurs associated with which valvular pathologies become louder

A

Tricuspid valve stenosis and regurgitation.

455
Q

Pharmacological management of AAA and AO dissections is:

A

Beta blockers.

456
Q

Secondary HTN caused by RAS in elderly pt is usually due to:

A

Renal artery atherosclerosis

457
Q

Secondary HTN caused by RAS in young pt is usually due to:

A

Fibromuscular Dysplasia

458
Q

Pre Hypetension Values are:

A

120-139 / 80 -89

459
Q

Echo findings corresponding to aortic valve stenosis:

A

aortic valve deformity

LVH

460
Q

what drug is contraindicated in non-STEMI

A

tpa (Tissue plasminogen activator)

461
Q

AV rate

A

60-40

462
Q

Pathophysiology of wide pulse pressure associated with aortic valve regurgitation is:

A

This regurgitant flow of blood from Aorta into LV which causes a decrease in the diastolic blood pressure in the aorta, and therefore an increase in the pulse pressure (difference b/w systolic and diastolic pressures)

463
Q

Hypovolemia, Tachycardia, Valsalva, Arrhythmia, vasodilatatoin drugs will ___________sx of HOCM

A

worsen/increase sx of HOCM

464
Q

Adverse effects of B blockers is:

A

Bronchospasm

Should not be used in COPD/ASTHMA pts.

465
Q

Acute Mitral Regurgitation is oftern caused by:

A

MI

possibel mechanism is:

rupture of the chordae tendineae, papillary muscle, or valve leaflet

466
Q

Murmurs in HOCM are

reduced with what manuevers

and

increased with what manuevers:

A

reduced with increasing ventricular volume: squating, hand grip, lying down, straight leg raising

inrcreased with decreaseing ventricular volume: valsalva

467
Q

Nitroprusside

A

Arterial and Venous vasodilator works by releasing Nitric Oxide (NO)

468
Q

CK-MB returns back to normal after MI in __days while Troponin returns in ___ days.

A

CK-MB retuns in few days

Triponins returns in a week

(if repeated MI is suspected within a week of the original, check CK-MB)

469
Q

What are some anticholinergic side effects?

A

Dry mouth,

blurred vision,

constipation, urinary retention

drowsiness, sedation

red flashes, hyperthermia.

470
Q

Best initial test for pt suspected of having endocarditis is:

A

Blood cultures

471
Q

Causes of pericardial effusion:

A

viral myopericarditis (simultaneous infection of heart muscle and pericardial tissue)

metastatic malignancy (lung and breast)

autoimmune disease (lupus)

renal failure

bleeding (hemopericardium)** commonly considered a separate syndrome

472
Q
A

Premature Ventricular Contraction

473
Q
A
474
Q

Diastolic B/P is determined by

A

Peripheral arterial resistance.

475
Q

multifocal atrial tachycardia is often seen in pt with

A

COPD

476
Q

Murmur that’s best heard in pt. leaning forward?

A

AO valve regurgitation

477
Q

Endocarditis is mostly of __________ origin while Pericarditis is usually ____________ origin.

A

Bacterial Viral

478
Q

Mitral valve regurgitation cause back flow of blood into __ atrium during systole or diastole?

A

Left

Systole

479
Q

Blood volume in the system is determined by:

A

Na+ concentration

Mineralcorticoids

Atrial natriuretic peptide (ANP)

480
Q

Physical findings associated with endocarditis (6)

A

1 New or changed murmur

2 Splinter(nail) hemorrhages

3 Janeway lesions

4 Osler nodes

5 Roth spots

6 Petechia (purple spots)

481
Q

Gynecomastia is a side effect of which medication?

A

Spironolactone (Aldosterone Antagonist)

482
Q

Treatment for Giant Cell arteritis:

A

High dose of oral prednisole (40-60 mg daily)

483
Q

Sick Sinus Syndrome

(bradycardia, syncope, palpitation)

tx is:

A

Pacemaker.

484
Q

Endocarditis prophylactic treatment for high risk patients undergoing procedures is

A

Amoxicillin

485
Q

Definition of PANSSTOLYC/HOLOSYSTOLIC murmur is?

A

Systolic murmur that starts at S1 and continues through S2 sound.

486
Q

Tx for A fib is:

A

CCB

B blockers

Digoxin

487
Q

DM produces secondary HTN by means of?

A

Hyperglycemia damages arterial wall making is less complient.

488
Q

Tricuspid valve stenosis produces ___murmur

A

Diastolic

489
Q

Nitroglyceride is

A

venous vasodilator

490
Q

Risk factors for AAA are (syndromes):

A

Marfan’s syndrom

Ehlers-Danlos type IV

491
Q

Pseudoaneurysm

A

Localized tear in arterial wall.

492
Q

Abnormal blood work in endocarditis is:

A

Low complement level

493
Q

DVT anticoagulation protocol:

A

Heparin to Warfarin/coumadin bridge:

Start with Low Molecular Weight Heparin

Continue with Warfarin for up to 12 month

494
Q

Mose common cause of mortality in pt with CHF is:

A

Ventricular arrhythmia

495
Q

Crescendo-Decrescend Diastolic Murmur head at 3rd or 4th left interspace is associated with?

A

Pulmonic Regurgitation

496
Q

Types of AO dissection

A

Ascending AO dissection - type A

All other dissections - type B

Type A is more common than type B.

497
Q

Burning disproportional pain after trauma is known as:

A

Reflex Sympathetic Dystrophy / Complex Regional Pain syndrome

498
Q

tx for Digoxin toxicity includes:

A

Administer K

Digibind (if SNS or ECG sx are present)

499
Q

Essential HTN is usually diagnoses in what ages?

A

b/w 25 and 55 y.o.

500
Q

Apixaban is anticoagulatn that is used in

A

Pregnancy

501
Q

If giant artery cell arteritis is suspected the next step is:

A

High-dose corticosteroids

502
Q

Hyper or Hypo Thyroidism produces secondary HTN by means of:

A

HyperThyroidism produces increased expression of adrenergic receptors>vasoconstricution; also causes increased cardiac output.

HypoThyroidsim produced Na+ retention>hypervolemia.

503
Q

Causes of secondary HTN include:

A

Drugs Chronic kidney disease

Primary aldosteronism

RAS

Cushing’s or long term corticosteroid use –one cause here is from retained salt and fluid

Pheochromocytoma –Epinephrine secreting tumor.

Coarctation of the aorta

Thyroid or parathyroid disease

Pregnancy

Carcinoid Syndrome

Hormone Replacement Therpy

Sleep Apnea

Lead poisoning

Porphyria

504
Q

Mechanical valve replacement does / does not require anti coagulation therapy.

A

does not require anti coagulation therapy

505
Q

Dyspnea on exersion

Paroxysmal Nocturnal Dyspenea

SOB

are signs of which CHF

A

Left side

506
Q

Sinus Bradycardia may be caused by what medication?

A

Beta Blockers

507
Q

Cardiac Stenting requires what medications:

A

Aspirin

and

Clopidogrel

508
Q

Wide Pulse Pressure is defined as

and associated with

A

Large diference b/w systolic and diastolic pressures

Aortic Valve Regurgitation

509
Q

Cardiogenic shock (diminished hear CO) is usually due to:

A

MI

CHF

CM

Cardiac tamponade

510
Q

ARBS bind to which receptors

A

AT 1

511
Q

Mitral valve has __leaflets?

A

Two

512
Q

Short PR interval w/o delta waves seen on ECG corresponds to:

A

Lown-Ganong-Levine Syndrome

causes A fib or V tach

same tx as WPW

513
Q

Junctional Rhythm is often caused by what medicatoin?

A

Digitalis

514
Q

Symptomatic Sinus Bradycardia should be treated with?

A

Atropine

515
Q

Bilat hip and buttuck claudication

Erectile disfunction

absent femoral pulses

known as:

A

Leriche’s syndrome

516
Q

Aortic valve stenosis is very similar to what coronary condition?

A

Atherosclerosis. Calcification of the aortic valve leaflet lead to Aortic valve stenosis (most common cause)

517
Q

Physiological Sinus Arrhythmia is

A

caused by vagus activation/deactivation

Inspiration > increases HR

expiration > decreaes HR

518
Q

Most common cause for Mitral Valve Stenosis is

A

Rheumatic heart disease

519
Q

Location of PMI/apex is

A

Level of 5th inerspace Mid clavicular line

520
Q

Osler nodes

A

Associated with endocarditis;

Painful, raised lesions on the pads of fingers and toes;

Depositions of immune complexes;

521
Q

Spirolactone MoA

A

Inhibits Aldosterone>Increase Na extretion

causes hyperKalemia

522
Q

S wave in lead I

q wave in lead III

inverted T in lead III

Sinus Tachycardia

are all features of:

A

PE

523
Q

Empiric endocarditis treatment is

A

IV vancomycin OR ampicillin/sulbactam (unasyn) PLUS aMinoglycoside (gentoMicin, streptoMicin)

524
Q

Second Degree AV Block Type II / Mobitz II

features:

A

Normal PR intervals

Intermitten dropped QRS

associated with syncope

requires pacing

525
Q

Causes of Pulmonary valve regurgitation

A

Pulmonary hypertension

Endocarditis

Rheumatic

heart disease

MI

Plaqueo

Iatrogenic

526
Q

Axis deviation is determined by looking at which leads?

A

Lead I

and

AVF

527
Q

Physical findings that are typical of Tricuspid valve regurgitation are:

A

Jugular venous distention with v waves

Peripheral edema

Ascites

528
Q

Pulmonic valve murmurs decrease/increase with inspiration?

A

decrease

529
Q

pulmonary artery wedge pressure is measured?

A

A Swan-Ganz catheter

530
Q

Endocarditis sec. to post op valve replacement is caused by:

A

Staph aureus;

Fungi;

Negative bacteria

531
Q

Causes of Tricuspid Valve Regurgiation include:

A

RVH

Pulmonar Hypertension

Ebstein’s anamoly

Pacemaker leads

Tricuspid endocarditis

532
Q

Myocarditis is caused by:

A

Coxsackie B virus

arvovirus B12

Echovirus

533
Q

S1 souund is ______ frequency best heard with ____

S2sound is _______ frequency best heard with____

A

Low, bell

Hight, diaphragm

534
Q

Beta blockers effects are:

A

Reduces heart rates

allows more time for diastolic fillings

MoA: inhibits Na/K-ATPase

535
Q

Ebstain Anomaly

A

defect in which the tricuspid leaflets attach to the right ventricular wall, leading to a larger than normal right atrium and smaller than normal right ventricle. Ebstein’s anomaly is also commonly associated with an atrial septal defect, patent foramen ovale and the pre-excitation, re-entrant conduction defect of Wolff-Parkinson-White syndrome.

536
Q

Sx of chronic venous insufficiency are often relieved by:

A

leg elevation

537
Q

clenched fist held over the chest is known as

A

Levine’s signs of MI

538
Q

S3 sound is produced when

A

overfilled ventricle (hight diastolic pressure) is filled during diastole

539
Q

Janeway lesions

A

Associated with endocarditis; Painless, macular (spot) lesions on palms and soles

540
Q

Symptoms of mitral valve prolapse are:

A

Palpitations

Chest pain

Anxiety Dizziness

541
Q

Nicotinic Acid / Niacin MoA

A

Decrease productioin/release of VLDL

cause flushing

542
Q

INR for mechanical mitral vavle should be held at

A

INR 2.5-3.5

warfarin/coumadin + aspirin 81 mg.

543
Q

Digoxin and Dobutamine are:

A

Positive Inotrophes

Increase heart contractility/force of myocardial contraction

Used in Systolic HF

Preserve intracellular Ca

544
Q

MoA of Paradoxical/Pathological S2 splitting

A

No splitting during Inspiration

Expiration produces paradoxical splitting:

Pulponic component first

Aortic compoent second

545
Q

X ray presentation of thoracic AO dissection is:

A

widening of the aortic silhouette

546
Q

Elevated JVP with giant a waves are seen in what valvula disorder

A

Tricuspid Valve Stenosis

547
Q

HTN emergency needs to be corrected w/i:

A

one hour

b/p should be lowered by no more than 25%

548
Q

Tx for long QT includes:

A

correcting electrolites

B blockers

ICD

pacers

549
Q

Aorta Coartation is depicted on chest X-ray by:

A

Fifure 3 sign.

550
Q

MoA Thiazide Diuretics is

A

Acts on distal convoluted tubule by inhibiting Na/Cl transporter thereby reducing reabsorption of water.

551
Q

MoA of potassium sparing diuretics is:

A

acts on collectiong duct, inhibits Na/K exchanger

552
Q

Takayasu’s Arteritis

A

Pulseless Disease

Seen in young asian females

Affect aortic arch and great vessels

Tx: corticosteroids

553
Q

Which drug is contraindicated in pt who is under the influence of cocaine and experiences chest pain with ECG changes?

A

B blockers.

554
Q

Electrolite that is often low in pt. with Prinzmetal angina is:

A

Mg

555
Q

ECG findings corresponding to LVH:

A

R wave in V5 or V6 + S wave in V1 >35 mm

556
Q

infants born to diabetic mothers often have what cardiac pathology?

A

Transposition of great vessels.

557
Q

Prozosin

Terazosin

are examples of what drugs?

A

Alpha Receptor blockers

used for HTN caused by pheochromacytoma; BPH

558
Q

Positive finding for myocardial ischemia during an exercise stress test is:

A

2 mm downslopping ST-segment depression

559
Q

WPW ECG features are:

A

Wide QRS

PR interval is short

Wave Delta

560
Q

q waves seen on ECG are often idicative of:

A

Old MI

561
Q

HTN emergency treatments are:

A

Labetalol (alpha and beta blocker)

Nicardipine (CCB)

Esmolol (beta blocker)

Clevidipine (CCB)

562
Q

Cushing syndrome produces secondary HTN by means of?

A

Petiutary tumor that

563
Q

best initial choice for treating hypertension in African-American patients is:

A

calcium-channel blocker

thiazide-type diuretic

564
Q

Virchow triad:

A

Associated with DVTs

  1. Venous injury
  2. Hypercoagulability
  3. Venous statis
565
Q

Hypetrophic Cardiomyopathy causes:

A

diastolic disfunction

566
Q

Dobutamine (positive ionotrop) is used in CHF under what circumstences?

A

When initial therapy (oxygen, loop diuretics, morphine) does not improve the sx.

MoA: dilate peripheral arteries and decrease afterload

567
Q

a new LBBB is equivalent to:

A

STEMI

568
Q

Boot shaped heart seen on X ray is a sign of:

A

Tetralogy of Fallot

569
Q

Stage I HTN values are

A

140-159/ 90-99

570
Q

Standing Valsalva will increase ___________ and ___________ in what valvular conditon?

A

Mid systolic click and late systolic murmur in Mitral valve prolapse

571
Q

Definitation of Pramature Atrial Contraction is:

A

premature different p wave that comes together with normal QRS and followed by compensatory pause

572
Q

S4 seen in Hypertrophic Obstrictive CM

will ____ with valsalva and ______with squatting

A

increase with valsalva

decrease with squatting

573
Q

Lead I -

AVF +

corresponds to which axis deviation

A

Right Axis Deviation

seen in: RVH, Lt MI, tall think poeple (Marfan)

574
Q

Tx for Pulm Edema

A

O2 - first step

Diuretics (Lasix/furosemide)

Morphine

Dobutamine (ionotrop - increases contractility)

575
Q

Clonidine important side effect is

A

Rebound HTN if discountinued abruptly.

576
Q

Heparin MOA:

A

Fast onset

Amplifies antithrombin III which inhibits factor Xa of coagulation cascade.

Heparin is monitored by aPTT

577
Q

MoA of Clonidine is:

A

Alpha 2 agonist

578
Q

Presentation of Thrombophlebitis is:

A

Tender cord like structure at affected vein.

Pain Erythema

579
Q

Loop Diuretics are contrainidcated in pt with what drug allergy?

A

Sulfa

580
Q

Medications that are known to prolong QT are:

A

Clarithromycin
Erythromycin
Chloroquine
Pentamidine

Haloperidol
Chlorpromazine

581
Q

Wide S2 split is associated with

A

Pulmonic Stenosis

and

Pulmonic Regurgitation

582
Q
A
583
Q

what effect B blockers have on CHF?

A

Slow heart rate

Decrease HTN > decrease afterload

Decrease stress on the hears

Rise the EF

Reduct LV size

584
Q

Fluid Retention

Ascites

Edema

Hepatic congestion

are signs of what CHF?

A

Right sided heart failure.

585
Q

Side effects of potassium sparing diuretics are

A

HyperKalemia

Ototoxiicty

Gout

586
Q

MI blood markers are:

A

Troponins I - most specific test. Elevates 3-12 hours.

Creatine kinase (CK-MB)

587
Q

Lead I +

AVF -

corresponds to which axis deviation?

A

Left Axis Devation

seen in: LVH, HTN, HF, Obesity

588
Q

What effect NSAIDs have on pt with CHF

A

Worsen the sx.

589
Q

Mitral valve regurgitation produces what kind of murmur?

A

Pansystolic/holosystolic blowing murmur best heard at the apex radiating to the axilla.

590
Q

Mirtal valve Prolapse and HOCM

will become louder with Valsalva

and less evident with

A

leg raising.

591
Q

Adenosine is usually given to treat __

A

Supraventricular Tachycardia

592
Q

Aortic valve stenosis corresponds to ___ murmur Aortic valve regurgitation correspond to ___ murmur

A

Crescendo-Decresendo MILD SYSTOLIC ejection

Early DIASTOLIC blowing

593
Q
A

Normal SA rhythm on the top

A fib rhythm on the bottom

594
Q

Compensatory pause on ECG is seen in

A

PAC

595
Q

Irregularly irregular corresponds to

A

Atrial Fibrilation

596
Q

Heparin-induced thrombocytopenia syndrome:

A

Plateletes become activated and stick to each other resulting in:

Thromboses

Platelete consumption leading to thrombocytopenia

Hemorrhage

597
Q

Hypetrophic CM is caused by__________while hypertrophic Obstructive CM is caused by ___________

A

HTN > hypertrophic

Genetic predisposition > hypertrophic obstructive

598
Q

RV lift

RBBB

RVH

split and fixed S2

systolic ejection murmur (2nd and 3rd interspace)

are features of:

A

Atrail Septal Defect

599
Q

side effects of Nitrates is:

A

Throbbing headaches sec to arterial dialation in the head.

600
Q

Treatment for aortic valve stenosis include:

A
  1. Aortic valve replacement
  2. Ballon valvuloplasty
  3. Ross procedure (aortic valve is replaced with pulmonary valve; pulmonary valve is replaced with cadaver’s valve).
601
Q

Sx of PAD

A

Claudication

Tingling

Numbness

Ulcers

Hair loss on the affected extermity.

Week PT and DP pulses

602
Q

Definition of Ejection Fraction is

A

Stroke Volume (volume of ejected blood) /

end diastolic volume

603
Q

Mitral Valve Prolapse is associated with what type of mumur?

A

Late systolic murmur

604
Q

Lead I +

AVF +

corresponds to which axis deviation?

A

No axis deviation.

605
Q
A

Junctional Rhythm with missing P waves

606
Q

Systolic B/P is determined by

A

Cardiac Output

607
Q

Color change in digits in response to cold temp is called:

A

Raynaud’s dz

608
Q

Location of the AO valve stenosis murmur is

A

Rt. sternal border (level of the 2nd intespace)

609
Q

On ECG WPW syndrome can be recognized by seeing

A

Delta waves (slurred upstroke)

610
Q

Short PR interval seen in WPW syndrome and higher contractility will have what effect on S1 sound?

A

S1 will be louder

611
Q

Cardiogenic shock requires what tx:

A

Vassopressors or ionotrophic agents

Not fluid

612
Q

Orthostatis hypotention without increase in heart rate is caused by:

A

Autonomic Insufficiency - impared sympathetic nervous system

613
Q
A
614
Q

Orthostatis hypotention with increase in heart rate is caused by:

A

Hypovolemia caused by either exsessive diuressis or addrenal insuffeciency.

615
Q
A
616
Q

tx for Hyperkalemia is:

A

nebulized albuterold

calcium gluconate

glucose solution

sodium bicarbonate

617
Q

side effect of IV lidocaine?

A

neurological toxicity

including siuzeres

618
Q
A
619
Q

Diltiazem and verapamil are contraindicated in:

A

systolic heart failure

acute MI

620
Q

Beta blocker is indicated for chronic or acute cardiac problems?

A

Chronic only

contraindicated in Acute

PANCE (20 decks)

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