Cardiology

Question 1

What are the three components of Coronary Artery Disease?

Answer 1

The diamond classification identifies patients’ risk of coronary artery diease based on the symptoms:

1. Substernal Chest Pain
2. Worse with Exertion
3. Better with Nitrates

Question 2

What is the best test for the diagnosis of Coronary Artery Disease?

Answer 2

The best test for the diagnosis of Coronary Artery Disease is

CATHETERIZATION

Question 3

What are the risk factors for an Aortic Aneurysm?

Answer 3

The risk factors for an Aortic Aneurysm include:

male

>65

smoker

HTN

Question 4

What are the signs and symptoms of an AA?

Answer 4

Signs and Symptoms of an AA:

Aortic Aneurysms are most often asymptomatic.

They are seen using an ultrasound while CT scans can be used to monitor

Question 5

At what point should an AA go to surgery?

Answer 5

An AA should go to surgery if it is >5.5 cm or grows more than 0.5 cm in 6 months.

Question 6

systolic crescendo-decrescendo murmer heard best at the left sternal boarder that radiates to the neck

Answer 6

Aortic Stenosis

Aortic Stenosis presents with angina, cycope, or CHF.

Question 7

A holosystolic murmur heard best at the apex of the heart

Answer 7

Mitral Regurgitation

Mitral Regurgitation is caused by an infection or infarction. The murmur will occlude both the S1 and S2 and radiate to the axilla.

Replace valve or treat with LV dilation

Question 8

High pitched blowing, decrecendo murmur best heard during diastole in the 4th intercostal space of left sternal border

Answer 8

Aortic Insufficienncy

Other signs of AI are a widened pulse pressure, water-hammer pulses, pistol-shot pulses, and head bobbing.

Question 9

rumbling diastolic murmur with an opening snap

Answer 9

Mitral Stenosis

caused almost exclusively by rheumatic heart disease. It can lead to CHF, and Afib.

Question 10

What are the indications for CABG?

Answer 10

CABG is indicated in the case of:

1. a blood vessel that has >70% stenosis
2. mainstem equivalent (LAD or 3+ vessel disease)
3. good LV function

Question 11

What are signs of an unstable cardiac patient?

Answer 11

Signs of an unstable cardiac patient include

Chest pain

confusion

CHF

Hypotension

Unstable patients with acute atrial fibrillation are treated with:

Synchronized cardioversion

Question 12

How do you treat unstable cardiac patients?

Answer 12

Treat unstable patients with acute atrial fibrillation (<48 hours) with

Synchronized cardioversion

Question 13

What is the first line treatment for a patient with hypertriglyceridemia?

Answer 13

HMG-CoA reductase inhibitors are the first line treatment for patients with hypertriglyceridemia. If triglyceride levels are still high, you can add Fibric Acid Therapy (the fibrates, gemfibrozil) as an adjunct therapy.

Question 14

What is the first pharmacologic agent used for hypertension in an African American?

Answer 14

diuretics like -thiazides are first line medications for the treatment of stage 2 hypertension.

Question 15

What is stage I HTN?

Answer 15

Stage I HTN

140/90

Treat Stage I

Thiazide>ACE. CCB

Question 16

What is Stage II HTN?

Answer 16

Stage II HTN

160/100

Here is a way to remember the stages:

start with normal (120/80) add 20 to the systolic and 10 to the diastolic

Question 17

A low-pitched, vibratory murmur, heard loudest over the left sternal border. Usually seen in kids

Answer 17

Still’s murmur

Still’s murmur is caused by normal movement of blood through the heart. It will increase in sound with increased blood flow through the heart (lying down).

Still’s murmur is an innocent murmur and needs nothing more than reassurance that its not harmful.

Question 18

When should you avoid giving 81 mg aspirin for coronary vascular disease prevention

Answer 18

Avoid giving aspirin for Aoronary vascular disease prevention in patients with a history of

GI bleeds

Peptic Ulcer Disease

Question 19

How do you treat SVT?

Answer 19

SVT is diagnosed in patients with tachycardia and a narrow QRS complex without a P-wave.

Treat SVT first with vagal maneuvers (carotid massage) and, if unsuccessful, IV adenosine should be administered next