Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

usmle step 3 > cardiology > Flashcards

cardiology Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

VSD - murmur?

A

holosystolic murmur w/palpable thrill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

sign of coarctation of aorta on exam?

A

brachial-to-femoral ulse delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

PDA - exam finding?

A

continuous murmur in L infraclavicular area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

most common cyanotic congenital heart defect?

A

tetralogy of fallot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

characteristic anomalies of tetralogy of fallot?

A
  • RV outflow obstruction
  • overriding aorta
  • RV hypertrophy
  • VSD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what defect causes wide, fixed S2 split?

A
  • ASD

- large R-to-L shunts (ASD, ventricular defect, PDA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

newborn decompensates after PDA closes - dx?

A

hypoplastic LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ebstein anomaly - what causes it?

A

Lithium during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ebstain anomaly - what is it?

A

atrialized RV (presents w/tricuspid regurg + cyanosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

fetal hypertrophic cardiomyopathy - caused by what?

A

maternal hyperglycemia (deposits of glycogen in myocardium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TIMI score - variables?

A

1 point for each

  • age >= 65
  • > = 3 risk factors for CAD
  • known CAD w/ >50% stenosis
  • use of ASA in past 7d
  • > = 2 anginal episodes in past 24 hours
  • elevated cardiac biomarkers
  • ST segment deviation >0.5 mm on admission EKG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TIMI low risk 0-2 - next step?

A

stress test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

TIMI intermediate (3-4) or high risk (5-7) - next step?

A

early coronary angio (w/in 24h)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

indications for immediate coronary angio?

A
  • HD instability
  • HF or new MR
  • recurrent CP
  • ventricular arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

mitral stenosis murmur

A

diastolic low pitched rumble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

manuever to bring out mitral stenosis?

A

exhale, lay in left lateral decub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

EKG findings diagnostic of STEMI?

A
  • new ST elevation at the J point in >= 2 natomically contiguous leads w/threshold:
  • – >1mm in all leads except V2/V3
  • –>= 1.5mm in women, >=2mm in men in leads V2/V3
  • NEW LBBB w/clinical presentation of ACS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

acute pericarditis - EKG findings?

A
  • diffuse ST elevation

- PR depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

coronary revascularization is indicated for who?

A
  1. pts w/refractory angina despite max medical tx
  2. pts in whom revasc will improve long term survival
    - – those w/LM coronary stenosis
    - – those w/multivessel CAD (Esp prox LAD) and w/LV systolic dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is ranolazine?

A

anti-anginal agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pt develops cardiogenic shock after STEMI and tx w/nitro + morphine - where is MI?

A

right ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what to do w/pt w/acute inferior MI and RV systolic failure + hypotension?

A

bolus with IVF if JVP is normal/low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which type of MI can cause transient bradycardia or AV block 2/2 increased vagal tone?

A

inferior MI

24
Q

which medication decreases vagal tone?

A

atropine

25
Q

after which type of MI might you need to use an intra-aortic balloon pump?

A

LV dysfunction (LAD, LCx)

26
Q

RVMI w/persistent hypotension despite fluid resuscitation - what do you use?

A
  • dopamine (1st choice)

- dobutamine (@nd choice 2/2 lowering of peripheral vascular resistance)

27
Q

indications for ICD for primary prevention (5)

A
  • fam hx of sudden cardiac death
  • syncope (recurrent or assoc w/exertion)
  • nonsustained VT on Holter
  • hypoT BP response to exercise
  • extreme LVH (>3cm septal wall thickness)
28
Q

indications for ICD for secondary prevention (2)?

A
  • survivors of cardiac arrest

- sustained spontaneous ventricular arrhythmias

29
Q

when perform alcohol septal ablation?

A

pts w/symptoms of HCM refractory to medical therapy

30
Q

what things can impair conduction across AV node?

A
  • ischemia
  • electrolyte abnrmality
  • medications
  • infiltrative dz
  • age-related fibrosis
31
Q

mobitz type 1 - what happens w/PR?

A

progressively prolongs, then drop beats

32
Q

mobitz type 2 - what happens with PR?

A

normal PR, intermittently drop beats

33
Q

mobitz type 1 and 2 - which has higher rate of progression to CHB?

A

type 2

34
Q

sign of pHTN on exam?

A
  • L para-sternal lift, RV heave
  • loud P2, r-sided S3
  • tricuspid regurg
  • JVD, ascites, peripheral edema, hepatomegaly
35
Q

5 groups of pHTN

A

1) pulmonary arterial htn
2) 2/2 L-sided heart dz
3) 2/2 chronic lung dz
4) 2/2 chronic PE
5) 2/2 other (sarcoid, MCTD)

36
Q

diagnostic criteria for pHTN?

A

RHC w/mean pulm aterial pressure >25mmHg

37
Q

How rule out pHTN 2/2 L heart failure?

A

pulmonary capillary wedge pressure <18

38
Q

how treat idiopathic pulm arterial htn?

A
  • endothelin receptor antagonists (bosentan, ambrisentan)
  • PDEs (sildenafil, tadalafil)
  • prostacyclin antagonists (epoprostenol, treprostinil, iloprost)
39
Q

beck triad - what does this refer to?

A

cardiac tamponade

40
Q

beck triad - what are the components?

A
  • hypotension
  • JVD
  • decerased heart sounds
41
Q

pulsus paradoxus - definition / which phase of respiration does pressure change?

A

SBP decreases >10 mmHg with inspiration 2/2 bowing of RV into LV during inspiration

42
Q

cardiac tamponade - physiology?

A

impaired diastolic filling of RIGHT SIDE of heart

43
Q

on TTE - what see in cardiac tamponade?

A

early diastolic collapse of RV and RA

44
Q

Kussmaul sign - what is it?

A

abnormal increase (or lack of decrease) in JVP during inspiration

45
Q

Kussmaul sign - when do you see it?

A
  • constrictive pericarditis

- restrictive CMP

46
Q

TIMI risk score components?

A
  • age > 65
  • > =3 risk factors for CAD
  • known CAD w/>50% stenosis
  • use of ASA in past 7d
  • > =2 anginal episodes w/in preceding 24h
  • elevated trop
    ST-segment deviation >05mm on admission EKG
47
Q

TIMI - what is low risk score?

A

0-2

48
Q

TIMI intermed or high risk score - what is recommendation?

A

cath within 24h

49
Q

inferior wall MI - what see on EKG?

A

ST elevations in II, III, aVF

50
Q

stent thrombosis - most events happen how soon after stenting?

A

30 days

51
Q

hypertrophic CMP w/LVOT obstruction - murmur?

A

systolic murmur

52
Q

who should be on a statin?

A
  • clinically sig. athero
  • – ACS, MI
  • – stable or unstable angina
  • – coronary stent/CABG
  • – stroke, TIA, PAD
  • LDL > 190
  • DM ages 40-75
  • ASCVD risk >7.5
53
Q

if pt w/very high triglycerides (>1000) what give them?

A

fibrate
niacin
fish oil

54
Q

inotropic agents used in heart failure?

A
  • dobutamine

- milrinone

55
Q

which class of chemo agents leads to dose-dependent decline in EF –> dilated CMP?

A

anthracyclines

56
Q

routine testing for initial dx of essential htn?

A
  • CBC
  • BMP
  • UA
  • 12 lead EKG
  • lipids
57
Q

when do workup for secondary htn?

A
  • non-obese non-black pts <30 yo w/ fam hx htn
  • htn starting before puberty
  • severe/refractry htn
  • acute-onset htn

usmle step 3 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions