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2020 ABIM studying > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Young woman with history of migraines, chest pain, St segment elevation. Dx?

A

Coronary vasospasm

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2
Q

Young person with chest pain following a party. Dx?

A

Cocaine

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3
Q

Tall, thin person with long arms with acute chest and back pain., normal EKG, aortic diastolic murmur. Dx?

A

Marfan syndrome and aortic dissection

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4
Q

Person who recently traveled or with immobility, Sharp, Pleuritic Chest Pain, Nondiagnostic EKG. Dx?

A

PE

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5
Q

Tall., thin young man who smokes with sudden pleuritic, chest pain and dyspnea. Dx?

A

Spontaneous pneumothorax

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6
Q

Post menopausal women with substernal chest pain following severe emotional stress with St elevation, an unremarkable coronary angiography. Dx?

A

Stress induced cardiomyopathy. Look for characteristic apical ballooning on ventriculogram

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7
Q

Young man with substernal chest pain, deep T wave inversions and a harsh systolic murmur that increases with Valsalva. Dx?

A

Hypertrophic cardiomyopathy

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8
Q

Abrupt pulmonary edema or hypotension and a loud holosystolic murmur and thrill s/p mi. Dx?

A

VSD Or papillary muscle rupture

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9
Q

Sudden hypotension or cardiac death associated with pulseless electrical activity. S/p mi Dx?

A

LV Free wall rupture

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10
Q

Coronary vasospasm Dx and tx?

A

Echocardiography, long acting nitrate, calcium channel blocker

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11
Q

Marfan syndrome and aortic dissection. Dx and tx?

A

MRA, CTA, TEE, immediate surgery for type a dissection

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12
Q

PE Dx and tx?

A

CTA, heparin

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13
Q

Spontaneous pneumothorax Dx?

A

CXR

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14
Q

Stress induced cardiomyopathy. Look for characteristic apical ballooning on ventriculogram Tx?

A

Beta blocker, Ace inhibitor

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15
Q

Hypertrophic cardiomyopathy dx and tx?

A

Echocardiography, beta blocker

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16
Q

Strong family history of premature heart disease + patient has a low HDL. What level is likely to be elevated?

A

Lipoprotein a or Lp(a)

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17
Q

Aortic aneurysm, abdominal associated w/what dz?

A

Atherosclerosis

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18
Q

Aortic aneurysm, ascending or arch associated w/what dz?

A

3º syphilis (syphilitic aortitis), vasa vasorum destruction

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19
Q

Aortic aneurysm, thoracic associated w/what dz?

A

Marfan syndrome (idiopathic cystic medial degeneration)

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20
Q

S3 heart sound

A

↑ ventricular filling pressure (eg, mitral regurgitation, HF), common in dilated ventricles

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21
Q

S4 heart sound

A

Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)

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22
Q

Rapid fire txt: Arrhythmia in damaged cardiac tissue

A

Class IB antiarrhythmic (lidocaine, mexiletine)

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23
Q

Cardiac manifestation of lupus?

A

Marantic/thrombotic endocarditis (non-bacterial)

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24
Q

Constrictive pericarditis MCC?

A

TB (developing world); idiopathic, viral illness (developed world)

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25
Q

Cardiac tumor (adults)? “Tumor plop” on auscultation

A

Metastasis, myxoma (90% in left atrium; “ball and valve”)

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26
Q

Rapid fire assoc: Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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27
Q

Rapid fire assoc: “Delta wave” on EKG, short PR interval, supraventricular tachycardia

A

Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)

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28
Q

What cardiac condition has a loud holosystolic murmur w/ palpable thrill along left sternal border over 3rd or 4th intercostal space?

A

Ventricular septal defect(VSD)

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29
Q

What condition does a patient likely have if on physical exam you hear a loud systolic ejection murmur at the right 2nd intercostal space?

A

Aortic stenosis

30
Q

What degree of stenosis is an indication for carotid endarterectomy in female patients?

A

70-99% stenosis

31
Q

What degree of stenosis is an indication for carotid endarterectomy in male patients who are symptomatic? And asymptomatic?

A

50-99% in symptomatic. 60-99% in asymptomatic

32
Q

Rapid fire assoc: Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

33
Q

Rapid fire assoc:Rib notching (inferior surface, on x-ray)

A

Coarctation of the aorta

34
Q

Rapid fire assoc: “Boot-shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

35
Q

What is the best management in an individual who has overdosed on TCAs and has widened QRS on EKG?

A

Bicarbonate

36
Q

What is the best next step in a patient with aspirin allergy who will be undergoing elective coronary angioplasty?

A

Aspirin desensitization. Pts undergoing elective angioplasty should be pre-treated with aspirin and clopidogrel.

37
Q

Systolic ejection murmur (crescendo-decrescendo)

A

Aortic stenosis

38
Q

Muffled heart sounds, distended neck veins, hypotension

A

Beck triad of cardiac tamponade

39
Q

What is the ideal LDL goal in CAD patients or CAD equvialent patients?

A

Less than 70 mg/dl

40
Q

What is the leading cause of sudden cardiac death in young athletes?

A

Hypertrophic cardiomyopathy

41
Q

Chest pain, pericardial effusion/friction rub, persistent fever following MI Dx?

A

Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 2 weeks to several months after acute episode)

42
Q

Chest pain with ST depression on EKG

A

Unstable angina (- troponins) or NSTEMI (+ troponins)

43
Q

Which two murmurs decrease in intensity with leg raising and squatting?

A

Hypertrophic obstructive cardiomyopathy (HOCM) and Mitral valve prolapse (MVP)

44
Q

Which type of beta blockers are okay to give to patients with hypertension and asthma? BAMN

A

Cardioselective beta blockers (metoprolol, atenolol, bisoprolol, nebivolol)

45
Q

Which congestive heart failure medication is used for symptomatic relief but does not decrease mortality?

A

Furosemide (Lasix)

46
Q

What two conditions are associated with bisferiens (biphasic pulse) pulse in the carotids?

A

Aortic regurgitation and hypertrophic cardiomyopathy

47
Q

What is the valvular abnormality that can result from dissection of the ascending aorta?

A

Aortic regurgitation

48
Q

What is the valvular condition most commonly associated with pulsus tardus in the carotids?

A

Aortic stenosis

49
Q

What is the treatment of choice for unstable pt with wide complex tachycardia?

A

Immediate synchronized cardioversion

50
Q

Within what age range does USPSTF recommend one-time screening for AAA in men with a smoking history?

A

65 to 75 years

51
Q

Achilles tendon xanthoma Dx?

A

Familial hypercholesterolemia (decreased LDL receptor signaling)

52
Q

Bounding pulses, widening pulse pressure, diastolic heart murmur, head bobbing

A

Aortic regurgitation

53
Q

What is the classic echo finding in hypertrophic cardiomyopathy?

A

Systolic anterior motion of mitral valve.

54
Q

What drug class is contraindicated in multifocal atrial tachycardia MAT?

A

Beta blockers

55
Q

What is the most common mutation seen in patients with HOCM?

A

Beta myosin heavy chain mutation

56
Q

How is sudden death prevented in patients with HOCM?

A

ICD implantation

57
Q

Calcifications of pericardium on chest imaging

Dx?

A

Constrictive pericarditis

58
Q

You must treat asymptomatic LV systolic dysfunction with ejection fraction less than 40% with what two medications?

A

Ace Inhibitors and beta blockers

59
Q

What drug toxicity causes patients to present with GI disturbances, neurologic dysfunction, vision changes, electrolyte imbalances & cardiac arrhythmia?

A

Digoxin

60
Q

What is the earliest and most sensitive sign of cardiac tamponade?

A

Right atrial collapse

61
Q

What is mcconnell sign and what is it suggestive of?

A

Right ventricular dilation and free wall hypokinesia with sparing of the Apex. Acute pulmonary embolism

62
Q

Murmur?

Systolic murmur best heard at right upper sternal border

A

Aortic stenosis

63
Q

murmur? Diastolic murmur best heard at L upper sternly border

A

aortic regurg

64
Q

Murmur? Opening snap followed by low pitched diastolic murmur at apex best heard in L lat decubitus

A

mitral stenosis

65
Q

pansystolic murmur w/palpable thrill

A

VSD

66
Q

Fixed,,split second heart sound

A

ASD

67
Q

dx? RV heave, wide, fixed splitting of 2nd sound, midsystolic pulm flow or ejection murmur, R axis Deviation and incomplete R bundle branch block

A

ASD

68
Q

What are the EKG findings of ASD?

A

R axis Deviation and incomplete R bundle branch block

69
Q

What are the 3 components of Beck’s triad? What diagnosis is this classic of?

A

Hypotension, Distended neck vv, muffled heart sounds. Cardiac Tamponade

70
Q

What medication needs to be added to DAPT in pts >65, w/hx of UGI bleed, PUD, active h pylori?

A

PPI

71
Q

What drug is absolutely contraindicated in atrial fibrillation?

A

Digoxin

2020 ABIM studying (12 decks)

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