Cardiology

Question 1

Pt on Amiodarone.

Monitor levels periodically?

Answer 1

TSH

- can develop hyper or hypothyroidism

Question 2

Patient with Prolong QT now have bacterial sinusitis? Which drug to avoid?

Answer 2

Clarithromycin- interferes with the delayed pectifier potassium current
- increase K in the Myocytes hence delayed cardiac depolarization causing prolong QT

Question 3

JNC 8, first line meds?

Answer 3

• ACE, ARBs, CaCB, Thiazides
• ACE not for AA
• BB NOT first line

Question 4

Pericarditis
Presentation?
Treatment?

Answer 4

Pain relieved by leaning forward
Diffuse ST elevation
Pericardial friction rub

TX: NSAIDS

Question 5

Elderly with HTN, asymptomatic

- test to assess cardiovascular risk?

Answer 5

Lipid panel

ECG is not for asymptomatic patient!!!

Question 6

Seen in Diastolic dysfunction?

Answer 6

Preserved EF

Question 7

Patient with low ejection fraction and MI; <35%
Meds needed?
Meds harmful?

Answer 7

1. ACE, aldosterone receptor antagonist, STATIN
2. Nondihydropyridine CaCB like verapamil and Diltiazem may be harmful due to negative inotrophic effect(weaken the force of muscular contraction)

Question 8

Older patient with AS and Murmur

Most concerning?

Answer 8

Progressive dyspnea + chest pain + dizziness

Question 9

Patient on 3 -5 BP meds
Bruit on the right umbilicals
Increasing creatinine
DX?
Mgt?

Answer 9

Renal artery stenosis

Monitor creatinine

Question 10

Cause of Resistant HTN in adults

Answer 10

1. OSAS
2. Primary Aldosteronism
3. RAS

Question 11

SVT

TX?

Answer 11

Adenosine then Cardiovert

Question 12

When do Dentist need to give Prophylaxis? Four

Answer 12

1. Prosthetic valves
2. Unrepaired cyanotic Congenital heart disease
3. Prev hx of Endocarditis
4. Heart transplant

Question 13

Patient with asymptomatic AS
Mgt?
What if EF is low?

Answer 13

1. RPT echo in 3 yrs

2. give ACE!

Question 14

SVT tx that can be for acute and long term?

Answer 14

Verapamil which is a CaCB

Question 15

32 y/o Patient with chest pain.
ECG shows Acute pericarditis–>PR depression, ST Elevation in I,II,III,aVL, aVF; PR elevation and ST depression in aVR; Sinus Tracy due to pain

TX?

Answer 15

NSAIDS: Indomethacin

Question 16

Patient with Systolic CHF.
Already on ACE and BB
What else can you add to decrease mortality and risk of hospitalization

Answer 16

Spironolactone!

Question 17

25 y/o Male with racing heart
ECG showed narrow QRS complex at a rate of 180
Vasogal and Adenosine did not help
What’s next?

Answer 17

Verapamil or Diltiazem