Cardiology Flashcards by Clyde Silverio

[Diagnosis]

precipitated by exertion, cold, stress

lasting 2-10 minutes, tightness, squeezing, , heaviness,

retrosternal radiating to the neck, jaw, shoulders, arms, epigastric

Stable Angina

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[Diagnosis]

Increasing patter or at rest

more than 30 mins

retrosternal radiating to the neck, jaw, shoulders, arms, epigastric

unstable anguna

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[Diagnosis]

pleuritic, sharp, retrosternal pain toward the cardiac apex radiating to the left shoulder

relieved by sitting up or leaning forward

Pericarditis

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[Diagnosis]

Sudden onset of unrelenting pain

tearing or ripping, knifelike

anterior chest radiating to the back between shoulder blades

loss of peripheral pulses, HPN

Acute Aortic Syndrome

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[Diagnosis]

sudden onset pleuritic chest pain, lateral,

dyspnea, tachypnea, tachycardia, hypotension

Pulmonary Embolis,

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[Diagnosis]

chest pain, characterized as pressure, substernally located

dyspnea, signs of increased venous pressure

Pulmonary hypertension

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[Diagnosis]

sudden onset chest pain, pleuritic
dyspnea, decreased breath sound on one side

Spontaneous pneumothorax

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[Diagnosis]

Burning chest pain lasting 10-60 mins, substernal epigastric,

worst by post prandial recumbency, relieved by antacids

GERD

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[Diagnosis]

pressure/tightness/burning chest pain lasting 2-30mins, retrosterna

closely mimic angina

esophageal spasm

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[Diagnosis]

burning chest pain, 60-90 mins after meals, prolonged, epigastric to substernal relieved with food or antacids

peptic ulcer

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[Diagnosis]

aching, colicky, RUQ pain radiating to the back after a fatty meal

GB disease

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Chest pain that decreases the likelihood of MI

Pain that reaches it peak immediately
Pleuritic
Positional
Tender of palpation

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[Diagnosis]

53M hypertensive, heavy substernal chest pain on exertion, relieved by rest

radiating to the shoulder,

CSAP

Initial Test: ECG
Next: Stress test
First line: beta blocker and CCB

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___ sign

heavy or squeezing, substernal or central

Levine Sign

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[CCS Classification for angina]

Slight limitation, emotions, more than 2 blocks, more than 1 flight of stairs

CCS FC II

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[CCS Classification for angina]

Marked limitation, 1-2 blocks, more than 1 flight of stairs

CCS FC III

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In MI, ECG is needed to assess

LV function
Wall motion
EF
Thrombus

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What drugs can be given for patients who cant exercise

Dobutamine
Adenosine
Dipyridamole

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What is the role of beta blockers in managing chronic angina

Lowers HR, reducing myocardial demand, arterial pressure,
Blocks catecholamine release

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Nicorandil is a 2nd line drug for chronic angina. Its mechanism of action is due to

Dilating the vessels via ATP-sensitive K channels

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____ is a drug used in MI that improves myocardial glucose utilization via inhibition of FA metabolism and increasing the availability of ATP

Trimetazidine

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What are the indications for PCI?

Persistent or symptom limiting angina pectoris despite medical management + evidence of ischemia during stress test

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What are the indication for CABG

3 vessel CAD

2. 2 vessels involving the LAD and LCA

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What are the indications for PCI?

Persistent symptoms of angina despite medical management

2. Evidence of ischemia during stress test

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What is the LDL goal in patients with CAD?

LDL <100

What is the LDL goal for patients with CAD and DM?

LDL <70

What accounts for the automaticity of the cardiac action?

SA and AV nodes

What determines the heart rate?

Slope of phase 4 in SA node

[Pacemaker Potential] opening of hyperpolarization-activated channel permeable to Na and K

Phase 4

[Pacemaker Potential] Rapid depolarization and overshoot; Ca-mediated action potential

Phase 0

[Pacemaker Potential] Final repolarization, increase in K efflux

Phase 3

What is the major site of atherosclerotic disease?

Epicardial arteries

The main stimulus for vasomotion of epicardial arteries is?

Flow Its role is for transport

The main stimulus for vasomotion of small arteries is?

Pressure Its role is for regulation

The main stimulus for vasomotion of arterioles is

Metabolites its role is for exchange

____% stenosis results in a limitation of the ability to increase flow to meet increased myocardial demand

50%

___% stenosis results in limitation of flow at rest

80%

[Pharma] Irreversible cox1 inhibitor

Aspirin

[Pharma] P2Y12 inhibitor decreasing platelet aggregation

Clopidogrel

[Pharma] 3-hydroxy-3-methytglutaryl CoA reductase inhibitor

Statins (HMG CoA reductase inhibitor) SE: Rhabdomyolysis, myopathy, liver disease

[Pharma] blocks RAAS; can cause hyperkalemia in solitary kidney

ACEI/ARB

[Pharma] vasodilator of peripheral vessels + nodal inhibition

Verapamil/Diltiazem

[Pharma] Reduction of peripheral vascular resistance

CCB | -dipines

[Pharma] What drug is contraindicated in Hypertrophic Obstructive Cardiomyopathy

HOCM

[Pharma] If channel inhibitor

Ivabradine

[Pharma] Stimulates K+ adenosine triphosphate channel

Nicorandil

[Pharma] Anti-ischemic metabolic modulator

Trimetazidine

What are the indications for CABG?

1. Left main coronary artery disease 2. 3 vessel disease + LVEF <50% or DM 3. 2 vessel disease that includes proximal left descending coronary artery

[Diagnose] 52/M smoker HON, severe substernal chest pain radiating to the right arm, diaphoresis chest pain persist despite sublingual nitrates; 130/90, 90 bpm

Dx: ACS Initial: ECG Used to distinguish unstable angina and NSTEMI: cardiac biomarkers

[Diagnose] new-onset angina or worse in frequency, duration or intensity or at rest <30min ECG: ST depression or TW inversion or flattening or normal ECG Trop I: normal

Unstable angina Tx: Medical + PCI before discharge

[Diagnose] new-onset angina or worse in frequency, duration or intensity or at rest <30min ECG: ST depression or TW inversion or flattening or normal ECG Trop I: elevated

NSTEMI Tx: Medical + PCI before discharge

[Diagnose] Angina at rest >30 mins ST Elevation Every elevated troponins

STEMI

[Markers] What cardiac biomarker will first rise in Acute MI?

Myoglobin

what cardiac biomarker is used to determine reinfarction?

CKMB

Dual antiplatelet therapy should last for at least ___ year

1 year

Nitrates cannot be given if the patient took vardenafil for ____ hours

24 hours

Patients cannot take nitrates is they took this PDE5 inhibitor in the past 48 hours

Tadalafil

What is the role of statins in anti ischemic therapy?

Plaque stabilization

[Diagnose] chest pain heavy, squeezing, crushing, occuring at rest, more severe and lasts longer sweating, nausea, anxiety, restlessness, sense of impending doom ST elevation or LBBB or pathologic Q wave

STEMI

The most frequent location of chest pain is beneath ___

xiphoid and epigastrium

[Classification of MI] spontaneous MI

Type 1

[Classification of MI] MI secondary to ischemic imbalance

Type 2

[Classification of MI] MI resulting in death when biomarker values are unavailable

Type 3

[Classification of MI] MI related to PCI

Type 4a

[Classification of MI] MI related to Stent thrombosis

Type 4b

[Classification of MI] MI related to CABG

Type 5

What is the recommended door-to-balloon time to conduct PCI?

within 90 minutes

If you are unable to do PCI in a patient with STEMI within 90 minutes, what is your next step?

administer fibrinolytic therapy within 30 mins of presentation then transfer for angiography

What are the absolute contraindications in to fibrinolytic therapy?

1. Hemorrhage of the brain 2. Other CVD within past year 3. Marked hypertension (>180/>110) 4. Bleeding internally (exclude menses) 5. Aortic dissection is suspected HOMBA

What are the relative contraindications for fibrinolytic therapy?

1. INR >/ 2 2. <2 weeks surgery 3. >10 mins CPR 4. Bleeding diathesis 5. Pregnancy 6. Hemorrhagic ophthalmic condition 7. Active peptic ulcer disease 8. Severe HPN that is controlled 9. Streptokinase <50 days to 2 years

What is the most common cause of out-of-hospital death from STEMI?

VFib

What is the most common cause of in-hospital death from STEMI?

Pump failure

[Diagnosis] 29M with PTB, sharp chest pain aggravated by lying relieved by sitting, high pitched rasping sound on cardiac auscultation. ECG: ST segment elevation with PR-segment depression

Dx: Acute pericarditis Tx: anti-inflammatory with aspirin Avoid anticoagulants since it can cause tamponade

What is the pathognomonic character of pericarditis?

pericardial friction rub

What are the SSx of pericarditis?

1. Chest pain 2. Rub, pericardial 3. Effusion 4 ST Elevation 5. Tamponade

Aside from the diffuse ST segment elevation seen in V2 to V6, what other ECG finding is suggestive of acute pericarditis?

PR-segment depression

What are the ECG changes in acute pericarditis

Stage 1 - widespread elevation of ST segment Stage 2 - ST segment normal Stage 3 - T wave inversion Stage 4 - ECG normal

What antirheumatic drugs can be given to patients with pericarditis?

1. Colchicine 2. Prednisone Given 3 months Colchicine is CI in hepatic and renal dysfunction

[Heart murmur] Next step for: Diastolic or continuous murmur

Echocardiography

[Heart murmur] Next step for: Grade I + II, midsystolic, asymptomatic murmur Normal ECG, Normal CXR

No further workup

[Heart murmur] Next step for: Grade III murmur or holosystolic or late systolic

Echocardiography

[Grading or murmur] Murmur + thrill

Grade IV

[Grading or murmur] Murmur heard with stethoscope lightly pressed on skin

Grade V

[Grading or murmur] Murmur heard with stethoscope slightly above the chest

Grade VI

[ECG Changes: Wall involved] I, aVL, V1-V6

Large anterior wall Proximal LAD

[ECG Changes: Wall involved] II, III, aVF

Inferior wall Distal LAD

[ECG Changes: Wall involved] V1 to V3

Anteroseptal wall Distal LAD

[ECG Changes: Wall involved] V2 to V4

Anteroapical Distal LAD

[ECG Changes: Wall involved] V4 to V6

Posterolateral CircumPlex

[Auscultation] Atrial septal defect is best heard at ____

pulmonic area

[Auscultation] Ventricular septal defect is best seen at

tricuspid area

[Murmurs] Crescendo, midsystolic murmur

Aortic stenosis

[Murmurs] early diastolic murmur

Aortic regurgitation

[Murmurs] holosystolic

Mitral regurgitation | Tricuspid regurgitation

[Murmurs] diastolic murmur after the opening snal

In patients with HOCM, what is the effect of squatting or leg raising to the murmur?

Decreases murmur Same with MVP

In patients with VSD, what is the effect of squatting or leg raising to the murmur?

increases murmur same with AS, AR, MS, MR

What is the effect of standing or valsalva in the murmur of HOCM?

Increases same with MVP

What is the effect of standing or valsalva to the murmur of mitral regurgitation?

decreases murmur Same with AS, AR, MS, VSD

[Diagnose] 70/M chest pain, exertional syncope 3/6 mid-systolic murmur at 2nd ICS, weak and narrow pulse

Dx: AS | Initial test: Transthoracic echocardiogram

___ effect murmur transmitted downward confusing with MR

Gallavardin effect

[Diagnosis] Paradoxical splitting of S2, pulsus parvus et tardus. narrow pulse pressure

What is the echocardiographic finding in AS?

1. reduced systolic opening of the valve leaflet with thickening 2. LV hypertrophy

What is the role of statins in Aortic stenosis?

Slow down leaflet calcification

[Diagnosis] 62M, HPN Diastolic murmur, high pitched, blowing, on the left sternal border, wide pulse pressure murmur heard over femoral artery

Dx: AR Initial tes: transthoraci echocardiogram Drug that should not be given in acute condition: beta blocker

____ sign murmur heard over the femoral artery. Can be suggestive of AR.

Duroziez sign

What is the associated murmur in syphilis?

What is the associated murmur in patients with ankylosing spondylitis?

____ murmur heard in severe AR; early diastolic rumbling murmur

austin flint AT

____ sign bobbing motion of the head

De musset sign AR

___ sign bounding and forceful pulse, rapidly increasing and subsequently collapsing

Water-Hammer sign or Corrigan's pulse AR

___ sign pulsation at the root of the nail

Quicke pulse AR

___ sign booming pistol shoot sound over the femoral arteries

Traube sign

___ sign pulsating popliteal artery

Lincoln sign

What is the treatment of choice for AR with an EF <55%

Surgery within 24 hours Also if the Left ventricular end systolic diameter goes above 55mm

[Diagnosis] 30M with RHD opening snap, low-pitched, tumbling, diastolic murmur at the apex

Dx: mitral stenosis | Treatment of choice: percutaneous transmitral commisurotomy

What is the earliest CXR finding of mitral stenosis

straightening of the upper left border of the cardiac silhouette

What is the cut-off value to say that there is critical valve narrowing in mitral stenosis?

Valve surface area <1cm2

The opening snap right after S2 in patients with mitral stenosis is best heard upon?

Upon expiration the opening snap is due to high LA pressure

What is the hemodynamic hallmark of mitral regurgitation?

elevated left atrioventricular pressure gradient

___ sign high functional tricuspid murmur

carvallo sign

Aside from SOB and heart failure, patients with MS also present with ___

1. Dysphagia 2. Hoarseness 3. AFib and stroke

What are the DOC for patients with MS?

1. Beta blockers, digoxin, NDHP CCB to slow down HR | 2. Warfarin if with AF (INR 2-3

What is the best initial therapy for MS?

Diuretics

What is the most effective treatment for MS?

Percutaneous mitral balloon valvotomy or valvuloplasty

[Heart Failure] What is the EF for HFrEF?

<40% due to decreased pumping ability

[Heart Failure] What is the EF for HFpEF

>40-50% due to decreased ventricular compliance/relaxation

___ respiration signifies advanced HF

Cheyne-stokes

[Right/Left CHF] bibasal rales pleural effusions pulmonary edema orthopnea, PND Dyspnea

LSHF

[Right/Left CHF] Fluid retention Hepatojugular reflux, peripheral edema hepatomegaly ascites

RSHF

[HFrEF vs HFpEF] displaced PMI, S3 gallop Q waves, decreased EF

HFrEF

[HFrEF vs HFpEF] sustained PMI, S4 gallop LVH, normal preserved EF (>55%) abnormal LV diastolic indices

HFpEF

[NYHA] Symptoms with ordinary activity 2 flights of stairs

Stage II

[NYHA] marked limitation in less than ordinary activity <1 flight of stairs

Stage III

[Stage of heart failure] Structural heart disease with no symptoms

Stage B

[Stage of heart failure] Structural heart disease with prior or current symptoms

Stage C

[Stage of heart failure] Refractory HF; occurs at rest

Stage D

Drug class with mortality benefit in HF

1. ACEi in HFrEF | 2. Beta blockers - Carvedilol, Bisoprolol, Metoprolol succinate

[Pharma for HF] angiotensin receptor-neprilysin inhibitor

Sacubitril/Valsartan

[Diagnosis] Dyspnea, orthopnea, cyanosis, elevated JVP, Hepatomegaly ECG: tall p-waves, RAD, RVH CXR: enlarged pulmonary artery Echo: RA/RV enlargement

Cor pulmonale

What is the best initial test for cases of cardiomyopathy?

Echocardiography

What is the best initial therapy for HOCM?

beta blockers

[Types of cardiomyopathy] Impaired systolic function EF <30% Dilated LV wall

Dilated CM

[Types of cardiomyopathy] Impaired ventricular filling EF 25 to 50% normal to decreased LV wall dimension + RH failure

Restrictive CM

[Types of cardiomyopathy] Septum hypertrophy EF >60% Decreased LV wall dimension, LV is thick + angina, syncope

Hypertrophic CM

What is the leading cause of sudden death in young healthy athletes

hypertrophic CMP

[Diagnosis] septal hypertrophy + systolic anterior motion of the mitral valve

HOCM

[Diagnosis] chest pain, progressive dyspnea, distended jugular veins, muffled heart sounds, pulsus paradoxus, bp 70/50

Dx: Cardiac tamponade

How will you say that it is a paradoxical pulse?

>10mmHg inspiratory decline in systolic arterial pressure

Pathognomonic CXR for cardiac tamponade?

Water bottle sign

ECG finding in cardiac tamponade?

electrical alternans

[Diagnosis] 65/M smoker, pain on both calves after walking a few blocks, resolves with rest. femoral and dorsalis pedis are diminished bilaterally, cool to touch, shiny

Dx: PAD Initial test: ABI Pain + pallor + pulselessness = arterial occlusion

What is the ABI cut off value in duplex UTZ to say its PAD?

<0.9 Severe ischemia - <0.5

What is the most accurate test to diagnose PAD?

Arteriography

What is the first line drug for symptom improvement in PAD?

Cilostazol Second line - pentoxifylline

[Diagnosis] 50F, leg swelling and sudden onset dyspnea with pain on inspiration. previous surgery < 2 weeks, 110/70 110 bpm RR 30

Dx: Pulmonary Embolism Most appropriate test: chest CT with contrast

Virchow's triad is composed of ___

1. Endothelial Injury 2. Venous stasis 3. Hypercoacuable state

What are the variables in Well's score for PE?

1. DVT SSx 2. Alternative dx less likely PE 3. HR > 100 4. Immobilization 3 days, surgeru withint 4 weeks 5. Prior PE or DVT 6. Hemoptysis 7. Cancer

What are the variables in Well's score for DVT?

1. Active CA 2. Paralysis 3. Bedridden > 3 days; major surgery <12 weeks 4. Tenderness along deep veins 5. Entire leg swelling 6. Unilateral calf swelling >3cm

What is the rule out test in PE?

D-dimer

[CXR Finding in PE] Focal oliemia

Westermark sign

[CXR Finding in PE] enlarged RDPA

Palla sign

[CXR Finding in PE] wedge-shape opacity at lung periphery

Hampton hump

What are the ECG findings in PE?

1. Sinus tachycardia 2. S1Q3T3 3. T wave inversion in V1 to V4

McConnell sign in 2DE for PE means there is

Hypokinesis of the RV free wall

[Pharma: Dyslipidemia] Cholesterol absorption inhibitor

Ezetimibe

[Pharma: Dyslipidemia] Bile acid sequesteran

Cholestyramine

[Pharma: Dyslipidemia] upregulates lipoprotein lipase to increase breakdown of VLDL and chylomicrons

Fibrates (gemfibrozil, fenofibrate)

[Pharma: Dyslipidemia] CPK levels must be checked in patients taking this drug combination due to rhabdomyolysis as most common adverse effect

Rhabdomyolysis Statin + fibric acid derivative (Gemfibrozil)

What are the 4 statin benefit groups

1. Clinical ASCVD 2. LDL-C > 190mg/dL without secondary cause 3. Primary prevention with DM 4. Primary prevention without DM by ASCVD risk >/ 7.5%

[Pharma: Dyslipidemia] PCSK9-inhibitor

Evolocumab

[Pharma: Dyslipidemia] CETP-inhibitor

Torcetrapib

[Pharma: Dyslipidemia] first line treatment for severe hypertriglyceridemia

Fibrates

[Pharma: Dyslipidemia] What is the contraindication for cholestyramine

TG > 500

[Hypertension] What medications should be avoided in patients with gout?

Thiazide diuretics

[Hypertension] What is the most common cause of secondary hypertension

primary renal disease

[Hypertension] In BP measurement, the length and width of the cuff should be _____ of the arms circumference

80%, 40% released at a rate of 2-3mmHg inflate to 30mmHg above expected SBP

[Pharma: Hypertension] Can cause sexual impotence, diabetes, gout, hyperuricemia

Thiazide diuretics can cause hypokalemia

[Pharma: Hypertension] Can cause hypokalemia, hypocalcemia, hypomagnesemia, metalbolic alkalosis

Loop diuretics

[Pharma: Hypertension] can cause gynecomastia

Spironolactone

[Pharma: Hypertension] contraindicated in sick sinus syndrome

beta blocers

[Pharma: Hypertension] beta blocker with NO potentiating effect

Nebivolol

[Pharma: Hypertension] can cause sedation, xerostomia, CNS side effects rebound HPN on withdrawal

Clonidine Methydopa Reserpine

[Diagnosis] Hematuria, urinary symptoms, elevated crea, cast on UA, abdominal mass

Renal parenchymal disease

[Diagnose] Abrupt onset hypertension or worsening or difficult to control flash pulmonary edema, early onset HPN abdominal bruits

renovascular disease

[Diagnose] hypertension with spontaneous hypokalemia; adrenal mass

primary hyperaldosteronism

[Diagnose] Resistant HPN, snoring, apnea, day-time sleepiness, obesity

OSA

[Hypertension] SBP > 180 DBP >120 No TOD

Hypertensive Urgency

[Hypertension] SBP >180 DBP >120 With TOD

Hypertensive emergency Admit to ICU

What is the target SBP for patients with Hypertensive emergency + aortic dissection?

<120

What is the target SBP for patients with hypertensive emergency + compelling condition

<140

What is the target DBP for patients without compelling condition

1. Not more than 25% in the 1st hour, then if stable 2. 160/100 mmHg in the next 2 to 6 hours 3. Then to normal following 24 to 48 hours

What is the most common sustained arrythmia

What is the ECG finding in AF?

1. Absence of discrete P wave | 2. Irregularly irregular ventricular contraction

What are the components of the CHA2DS2-VASc risk score?

``` CHF - 1 HPN - 1 Age >/75 -2 DM - 1 Stroke or TIA - 2 Vascular disease - 1 Age 65 to 75 - 1 Sex - Female -1 ```

What is the estimated annual stroke score in CHA2DS2VASc 2?

2.2%

What is the estimated annual stroke score in CHA2DS2VASc 4?

4.0%

What is the estimated annual stroke score in CHA2DS2VASc 4?

3.2%

What is the DOC for pharmacologic cardioversion in patients with AF and with structural heart disease?

Amiodarone

What is the DOC for pharmacologic cardioversion in patients with AF without structural heart disease?

1. Flecainide 2. Ibutilide 3. Propafenone

When will you do an electrical cardioversion in patients with AF?

Recent onset AF (<48 hours)

What is the antidote of Dabigatran?

Idarucizumab

What is the most important step in the diagnosis of endocarditis?

Serial blood cultures

What are the components of Duke's Criteria?

1. Fever 2. Roth Spot 3. Osler node 4. Murmur 5. Janeway lesions 6. Anemia 7. Nail-bed hemorrhage 8. Emboli

Based on Duke's criteria, how will you say that the patient has endocarditis?

1. 2 major 2. 1 major + 3 minor 3. 5 minor

What are the major criteria in Duke's?

1. Sustained bacteremia 2. Endocardial involvement 3. New valvular regurgitation

What are the minor criteria in Duke's?

1. Abnormal valve/risk of bacteremia 2. fever 3. Vascular phenomena 4. Immune phenomena 5. Positive blood culture not meeting the major criteria 6. Positive echocardiogram

What is the best empiric therapy for endocarditis?

vancomycin and gentamicin

Serial blood cultures to diagnose endocarditis should be taken ___

1. 3 two bottle blood set 2. Separated by at least 2 hours 3. Different sites

[Most commons] myocardial perfusion occurs during this time

Diastole

[Most commons] anterior chest MSK pain

costochondral and chondrosternal syndrome

[Most commons] presenting complaint of aortic dissection

Sudden onset of severe sharp pain

[Most commons] preventable cause of death among hospitalized patients

[Most commons] most severe form of postphlebitic syndrome

Skin ulceration

[Most commons] autosomal dominant genetic mutations for prothrombotic states

1. Factor V Leiden | 2. Prothrombin gene mutation

[Most commons] acquired cause of thrombophilia and associated with venous/arterial thrombosis

APAS

[Most commons] gas exchange abnormality in PE

arterial hypoxemia and increased A-a gradient

[Most commons] usual cause of death from PE

Progressive right heart failure

[Most commons] symptom of DVT

charley horse or cramp

[Most commons] most common symptom for PE

Unexplained breathlessness

sudden, severe calf discomfort suggests

Ruptured Bakers cyst

[Most commons] frequent symptom of PE

dyspnea

[Most commons] sign of PE

tachypnea

leg pain, fever, chills

Cellulitis

Tachycardia, low grade fever, neck vein distention

Dyspnea, syncope, hypotension

massive PE

[Most commons] frequently cited ECG abnormality in PE

S1Q3T3 sign

[Most commons] abnormality in PE on ECG

T wave inversion in leads V1 to V4

principal imaging test for the diagnosis of PE

CT with IV contrast

second-line diagnostic test for PE

lung scanning

Best known indirect sign of PE

mcConnell sign

Definitive diagnosis of PE

Pulmonary angiography

Foundation for successful treatment of DVT and PE

anticoagulatin

Major advantage of UFH

short half life

Warfarin embryopathy most common exposure during ___ AOG

6th to 12th week AOG

Two principal indications for IVC filters

1. Active bleeding that precludes anticoagulation | 2. Recurrent venous thrombosis despote anticoagulation

Two determinants of arterial pressure

1. Cardiac output | 2. Peripheral resistance

Strongest risk factor for stroke

elevated BP

Indicative of primary renal disease

Proteinuria > 1000 mg/day active urine sediment

Gold standard for evaluation and identification of renal artery lesions

Contrast arteriography

most common congenital cardiovascular cause of hypertension

CoA

what is the definition of resistant hypertension?

BP >140/90 despite more than 3 antihypertensive agents

Prototypic lesions in IE

vegetation

IE in drug users usually affect ____ valve

tricuspid valve

Optimal method for diagnosis of prosthetic valve endocarditis, valve perforation or fistula

transesophageal echocardiography

Test of choice to detect perivalvular abscess

TEE with color doppler

Most common valve affected in perivalvular infection

aortic valve infection

most common tumor of the pericardium

malignant neoplasm from the mediastinum

Most common primary malignant pericardial tumor

mesothelioma

most common primary cardiac tumor in age groups

myxoma

most common clinical presentation of myxoma

mimic MV disease

most common cardiac tumors in infants and children?

rhabdomyoma and fibroma

Most often involved in metastasis to the heart

pericardium > myocardium> endocardium or valves