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Internal Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

pleuritic pain is seen in?

A 
nonspecific
pul embolism
pneumonia
pericarditis
pneumothorax
pleuritis
(all P)
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2
Q

angina pain

A 
tightness, heaviness, pressure
(unlikely to be pinpoint)
not change with change in position
no effect of palpation
pain after perdictable amount of exertion
identical symptoms each attack
radiation
less likely to have symptoms ass with MI(nausea ,sweats, shortness of breath)
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3
Q

diff of 20 mmHg systolic in both arms suggests

A

aortic dissection

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4
Q

CK -Mb and tropononin normalises after how much time after MI?

A

2- 3 days

upto 2 weeks

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5
Q

most imp tesst for the evaluation of the cause of chest pain

A

ECG

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6
Q

CK -MB blood level in MI

A

starts to rise in 4-6 hrs
peaks 12- 24 hrs
normal in 2-3 days

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7
Q

what target HR should be achieved in order to get accurate ex/tredmill stress test

A

85% of predicted max HR(220- patients age)

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8
Q

does stress test show changes in stenosis less than 50%

A

no

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9
Q

when is strss test considered +

A

1.large >2 mm ST depression
2.hypotension(a drop of >10 mmHg SP)
one or both

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10
Q

digoxin and stress test

A

depress ST seg so difficult interpretations

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11
Q

effect of following medicaltion on stress test

  1. BB
  2. antihypertensives like BB,nitoglycerin, alpha blockers
A
  1. blunt the req HR

2. may cause significant htn during exercise

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12
Q

how to distinguish diff ACS

A
  1. STEMI-St elevated
  2. NSTEMI-cardiac biomarker elevated,NSTE
  3. unstable angina-biomarker not raised,NSTE
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13
Q

most common causr of death in MI

A

ventricular fibrillation

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14
Q

which heparin is used in UA/N/STEMI

A

enoxaparin

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15
Q

dressler syndrome

A

pericarditis after MI

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16
Q

areas of infarction and leads seen

A 
inferior-II,III,aVF
anteroseptal-V1-V3
anterior-V2-V4
lateral-I,aVL,V4,V5,V6
posterior-V1-V2
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17
Q

arteries involved in ares of infaction

A 
inferior-right coronary
anteroseptal- LAD
anterior-LAD
lateral-LAD /CFX
posterior-PD
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18
Q

agents which lower mortality in systolic dysfxn

A

ace/arb
BB
spironolactone/eplerenone

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19
Q

agents which improve HF but do not reduce mortality

A

digoxin

diuretics

20
Q

effect of electrolytes on digoxin toxicity

A

hypokalemia/hypomagnesemia: inc

hypercalcemia:dec

21
Q

hypothyroidism effect on digoxin

A

can cause toxicity

22
Q

effect of following on digoxin

  1. quinidine
  2. verapamil,dilteazam
  3. chloestyramine,colestipol
  4. spironolactone
  5. thia,furosemide
A

1,2-inc(dec renal cl)
3
4-inc (inh tubular sec)
5-inc(hypoka)

23
Q

most common presenting complaint of digoxin toxicity

A

git n/v

24
Q

is there any diff among diff drugs in ACEi amd BB

A

no in ACEi

yes in BB(only metoprolol, cravedilol, bisoprolol benefit mortality)

25
Q

when is AICD

A

dilated cardiomyopathy wih a persistant ejection fraction <35%

26
Q

when is biventricular pacemaker used?

A

dilated cardiomyopathy when qrs wider than 120mSec(both ventricles ll not beat in synchrony)

27
Q

kerley b lines indicate

A

interlobular septal edema

28
Q

when is surgery indicated in the following

  1. MR
  2. AR
  3. AS
A
  1. EF<60% ,LVESD>40mm
  2. EF<55% , LVESD>55mm
  3. valve area<0.8cm2(normal 2.5-3)
29
Q

ECG changes in acute pericarditis

A

ST seg elevation with upright T waves
PR depression
no Q waves as in MI

30
Q

becks triad

A

ass with acute cardiac tamponade

  1. low BP
  2. distended neck veins
  3. decreased heart sounds
31
Q

squarr root sign seen in

A

contrictive pericarditid

RCMP

32
Q

features of aortic stenosis murmer

A 
crescendo-decrescendo
severer ,murmur peaks later
S2 quiter
radiates to carotids
pulsus parvus et tardus
33
Q

delta wave in WPW syn represents

A

early ventricular activation

34
Q

best drug in wpw syn

A

procainamide

35
Q

avoid bb,ccb and digoxin in wpw syn

A

yes

36
Q

ecg changes in wpw syn

A

short PR interval

wide QRS complex with intial slurred deflection

37
Q

wide and narrow QRS d/d(><0.12s)

A

1.wide(ventricular cond)
vent tachycardia
wpw
(regular)

2.narrow(atrial)
sinus tachycardia
psvt
AF
mat
AFib(only above 2 irreg rest reg)
38
Q

drugs used in vent tachycardia

A

procainamide
lidocaine
amiodarone

39
Q

torsades de pointes drug

A

lidocaine

40
Q

antiarrythmic drugs that prolong QT

A

disopyramide
quinidine
procainamide

41
Q

adr of amiodarone

A

lung:cough,painful breathing
nerve tox:imbalance,lack cordination,m weakness
thyroid dysfxn(hypo>hyper)
sensitivity to light

long
blue grey discoloration of skin
eyes
-visual impairment
-halo
-blurring
-CORNEAL DEPOSITS
42
Q

nitrates C/I of SP <90 mmHg

A

yes

43
Q

duration of windiw free period in nitrate therapy

A

> 8 hrs to prevent tachyphylaxis

44
Q

what is unique about nebivalol

A

inc NO

no erectile dysfxn as with other BB

45
Q

amiodarone int with digoxin and coumadin

A

prolongs

46
Q

adenosine SE

A

transient dyspnea
non cardiac chest pain
rarely hypotsn

47
Q

encainide
flecanide
propafenone
SE

A

neg inotropism

QRS and PR interval prolongation

Internal Medicine (9 decks)

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