Brainscape's Knowledge GenomeTM

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


See full index

INTERNAL MEDICINE - PLE TOPNOTCH 2020 > CARDIOLOGY > Flashcards

CARDIOLOGY Flashcards

1
Q

What is the first line of treatment to reduce angina?

A

Beta blocker and/or CCB

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

Chest pain that reaches its peak intensity immediately

A
  • Aortic dissection (look for tall, male w/ hyperextensible joints)
  • Pulmonary embolism
  • Pneumothorax
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MOST frequently CITED Abnormality in PE (in addition to sinus tachycardia)

A

S1 Q3 T3 Sign AKA McGinn-White Sign

(SPECIFIC, but insensitive)

A large S wave in lead I, a Q wave in lead III and an inverted T wave in lead III together indicate acute right heart strain.

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

_____ is always the best initial diagnostic test for ischemic-type pain.

A

ECG

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

What is the initial test of choice in herat failure?

A

Echocardiogram

Echocardiography is unquestionably the most important of all tests for heart failure. There is no reliable way to distinguish preserved from reduced ejection fraction. Every patient with heart failure must undergo echocardiography to evaluate EF.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 30-year-old woman with history of rheumatic fever presents to the emergency room with dyspnea and palpitation. On auscultation, there is an opening snap followed by a low-pitched, tumbling, diastolic murmur at the apex.

A

Mitral Stenosis

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

_______ is a selective sinus node inhibitor (If pacemaker current).

A

Ivabradine

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

classic findings for Hypertrophic Cardiomyopathy

A

Septal hypertrophy and systolic anterior motion of the mitral valve

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

Hallmarks of massive PE

A
  • Dyspnea
  • Syncope
  • Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

FOUNDATION for successful Treatment of DVT and PE

A

Anticoagulation

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

What is the best initial test for AS?

A

Transthoracic echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Almost all PRIMARY cardiac malignancies are

A

Sarcomas, commonly in right side (but tumors metastatic to heart are more common)

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

What diagnostic test is used to distinguish unstable angina and NSTEMI?

A

Cardiac biomarkers

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

Capillary pulsation at the root of the nail (Quincke’s pulse)

A

AR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which lipid lowering agent was most likely recently started in a patient who complains of podagra

A

niacin

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

Booming “pistol shot” sound over femoral arteries (Traube sign)

A

AR

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

Critical narrowing of MS is defined as valve surface area of ___

A

< 1cm2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MOST common type of PRIMARY cardiac tumor in all age groups, MOST commonly in the 3rd–6th decade, with female predilection

A

Myxoma (mostly sporadic)

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

Chest pain, ST depression or normal ECG, normal biomarkers. Diagnosis?

A

Unstable Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

_____, an increase in JVP on inhalation, is seen in restrictive cardiomyopathy, constrictive pericarditis, restrictive cardiomyopathy, tricuspid stenosis and RV infarction.

A

Kussmaul Sign

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

FUNCTIONAL CLASSIFICATION OF ANGINA

Inability to carry on any physical activity without discomfort

i.e Angina at rest

A

Class IV

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

Opening snap is observed in ___

A

MS

The opening snap (OS) right after S2 is due to high LA pressure and readily audible in expiration.

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

MOST common cause of DEATH in hypertensive patients

A

Cardiac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sildenafil when taken with ______ can result in

large and prolonged decrease in systemic blood pressure and coronary blood flow in vessels with critical stenosis.

A

Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Chest pain, ST elevation on ECG, very elevated biomarkers

A

STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CLASSIFICATION OF MYOCARDIAL INFARCTION

Myocardial infarction secondary to an ischemic imbalance

• Coronary artery spasm, arrhythmias, anemia, respiratory failure, hypotension and hypertension with or without left ventricular hypertrophy

A

Type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

This is seen in what condition.

A

Infective Endocarditis

Roth Spot - white-centered retinal hemorrhages

Osler’s Node - PAINFUL, red papules on the hands and feet

Janeway Lesions - NON-TENDER erythematous macules on palms and soles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

BEST known INDIRECT sign of PE on transthoracic

echo

A

McConnell’s Sign:

hypokinesis of the RV Free Wall with NORMAL motion of the RV Apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Dihydropyridine calcium channel blocker

(Vascular > Cardiac)

A

Amlodipine

Nifedipine

Felodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Diagnosis of IE is established with certainty

A

Histologically and microbiologically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the best initial therapy for all cases of ACS?

A

Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Leg pain + Fever + chills usually indicates

A

Cellulitis (not DVT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Chest pain, ST depression or normal ECG, elevated biomarkers. Diagnosis?

A

NSTEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

MOST common congenital cardiovascular cause

of hypertension

A

Coarctation of the Aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

A 70-year-old man presents with chest pain on exertion and shortness of breath for the past 2 months. His wife recalls that her husband had an episode of syncope a month ago. On examination, there is a 3/6 mid-systolic murmur at the second intercostal space at the right sternal border is auscultated and patient had a weak and delayed pulse.

A

Aortic Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

MOST common clinical presentation of myxomas

A

Mimics mitral valve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

MAJOR indication for Surgery in IE

A

Moderate to severe CHF due to valve dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Identify the associated murmur:

  1. crescendo, midsystolic murmur
  2. early diastolic murmur
  3. holosystolic
  4. diastolic murmur after the opening snap
A
  1. AS
  2. AR
  3. MR/TR
  4. MS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

STAGES OF HEART FAILURE

Structural heart disease with prior or current symptoms

i.e Patients with abnormal cardiac structure with exertion dyspnea, fatigue, etc.

A

Stage C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Murmur heard over the femoral artery is known as ______

A

Duroziez sign.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

MOST common acquired cause of thrombophilia

and associated with venous / arterial thrombosis

A

Antiphospholipid-antibody syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

FUNCTIONAL CLASSIFICATION OF ANGINA

Ordinary physical activity, (walking and climbing stairs), does not cause angina

i.e. Angina with strenuous or rapid or prolonged exertion at work or recreation.

A

Class I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

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

A

Serial blood cultures are the most important step in the diagnosis of endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

The ONLY FDA-approved indication for PE fibrinolysis

A

Massive PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What risk factors are associated with increased incidence of Infective endocarditis?

A

Structural heart disease (RHD, VHD), IV drug use, Prosthetic heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

In its MOST SEVERE form, Postphlebitic Syndrome

causes

A

Skin ulceration (especially in medial malleolus of leg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Narrowed pulse pressure

A

AS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

STRONGEST risk factor for stroke

A

Elevated BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

FUNCTIONAL CLASSIFICATION OF ANGINA

Marked limitation of ordinary physical activity.

i.e. Walking one to two blocks on the level and climbing more than one flight of stairs in normal conditions.

A

Class III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The best empiric therapy for infective endocarditis.

A

Vancomycin and Gentamicin

This will cover the most common organisms, which are S. aureus, MRSA, and viridans Streptococci.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

MCC of Systolic HF or HF with reduced EF (HFrEF)

A

CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

FUNCTIONAL CLASSIFICATION OF ANGINA

Slight limitation of ordinary activity

i.e. Walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, in cold, or when under emotional stress or only during the few hours after awakening. Walking more than two blocks on the level and climbing more than one flight of stairs at a normal pace and in normal conditions.

A

Class II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Non-dihydropyridine calcium channel blockers

(Cardiac > Vascular)

A

Verapamil

Diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

If a patient with acute MI presents with new murmur, think of 2 potential conditions: _____ and _____

A

free or septal wall rupture and acute mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

The two most common autosomal dominant

genetic mutations for prothrombotic states

A
  • Factor V Leiden: causes resistance to activated protein-C (which inactivates factors V and VIII)
  • Prothrombin gene mutation: increases prothrombin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Avoid combining _____ and _____ due to risk of heart block, heart failure, and symptomatic bradycardia.

A

non-dihydropyridine CCB (Verapamil and Diltiazem) and beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

MOST common primary malignant pericardial tumor

A

Mesothelioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

reversing agent for warfarin

A

Vitamin K, FFP, 4-factor prothrombin complex concentrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

SECOND MOST frequent cause of DEATH in the

world

A

Stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

The maximum protection against combined

cardiovascular endpoints is achieved with:

A
  • SBP <135-140 mmHg
  • DBP <80-85 mmHg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Definition of resistant HPN

A

BP persistently >140/90 mmHg despite taking three or more antihypertensive agents, including a diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

(+) Lung Pathology + Right sided heart failure

A

Cor Pulmonale

Ruled out if there is Left sided HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the best initial test and often most accurate test for all types of cardiomyopathy?

A

Echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Sudden, severe calf discomfort suggests…

A

Ruptured Baker’s cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

2D Echo finding of pulmo embolism

A

McConnell’s sign (hypokinesis of the RV free wall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the mainstay of treatment of hypertrophic cardiomyopathy?

A

Beta blockers and diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

reversing agent of Heparin, Enoxaparin, Dalteparin, Fondaparinux

A

Protamine:

100% reversal of UFH

70-80% reversal of LMWH

No effect on Fondaparinux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

MOST frequent SIGN of PE

A

Tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Most common symptom for PE

A

• Unexplained breathlessness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

MOST common tumor of the pericardium

A

Malignant neoplasms from the mediastinum (bronchus, breast, lymphoma, melanoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

The only absolute contraindications to the use of

nitrates are ______

A

hypotension or the recent use of PDE-5 inhibitors, Sildenafil or Vardenafil (w/in 24 hours) or Tadalafil (w/in 48 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Most common type/ characteristics of myxoma

A

Sporadic, solitary, located in the left atrium, often pedunculated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

first line of treatment for severe hypertriglyceridemia.

A

Fibrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Remember “CREST” in acute pericarditis:

A

C – Chest pain

R – Rub (85% of patients)

E – Effusion

S – ST elevation

T – Tamponade (a potential complication of pericarditis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

STAGES OF HEART FAILURE

Structural heart disease but no symptoms

i.e. Patients with previous MI, LVH, asymptomatic VHD

76
Q

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

A

Pump Failure

77
Q

CLASSIFICATION OF MYOCARDIAL INFARCTION

Myocardial Infarction Related to Percutaneous Coronary Intervention (PCI)

78
Q

In IE, the following are independently associated

with INCREASED risk of embolization

A
  • Endocarditis caused by S. aureus
  • Vegetations > 10mm in diameter
  • Infection involving the mitral valve
79
Q

Jarring of the entire body and bobbing motion of the head (De Musset sign)

80
Q

reversing agent of Dabigatran

A

Idarucizumab

81
Q

Virchow’s triad

A
  • Endothelial injury
  • Hypercoagulability
  • Stasis
82
Q

MAJOR advantage of Unfractionated Heparin

A

Short half-life

83
Q

Initial goal in BP reduction in hypertensive emergency

A

reduce MAP by no more than 25% (few minutes – 2 hours) or in the range of 160/100-110.

84
Q

The goal therapy in those with CAD is an LDL of ____

85
Q

For adults with compelling condition (i.e. severe preeclampsia, pheochromocytoma crisis), SBP should be reduced to _______ and _______ in aortic dissection.

A

<140 mmHg

<120 mmHg in aortic dissection

86
Q

MOST frequent SYMPTOM of PE

A

• Dyspnea

87
Q

Type of murmur that always signify structural heart disease?

A

Diastolic murmurs

88
Q

TWO principal indications for insertion inferior vena

caval (IVC) filters

A
  • Active bleeding that precludes anticoagulation
  • Recurrent venous thrombosis despite anticoagulation
89
Q

What is the best test to detect a reinfarction a few days after the initial infarction?

90
Q

first line for symptom improvement of PAD

A

Cilostazol

91
Q

Renal artery stenosis can be due to: ____ or ____

A

atherosclerosis or fibromuscular dysplasia (scarring of the renal arteries)

93
Q

this complication is enhanced when you combine statins with fibric acid derivatives

A

Rhabdomyolysis

94
Q

Bounding and forceful pulse, rapidly increasing and subsequently collapsing (Water-Hammer or Corrigan’s pulse)

96
Q

The most common adverse effect of statin medications

A

liver toxicity

97
Q

Indicative of PRIMARY renal disease

A

Proteinuria > 1000 mg/day and an active urine sediment

98
Q

Indications for CABG:

A
  • Left main coronary artery disease
  • 3 vessel disease + LVEF < 50% or diabetes
  • 2 vessel disease that includes proximal left descending coronary artery
99
Q

cornerstone of pharmacotherapy for HF

A

ACEI and beta blockers

101
Q

Enumerate CHA2 DS2 -VASc RISK ASSESSMENT Score

A

The CHA 2 DS 2 -VASc score can be used to estimate stroke risk in these patients. Anticoagulation is recommended for a score of ≥2 and may be considered for a score of 1.

102
Q

_____

reduce myocardial oxygen demand by inhibiting the increases in heart rate, arterial pressure, and myocardial contractility caused by adrenergic activation.

A

Beta Blockers

103
Q

What is the recommended treatment of pericarditis?

A

Anti-inflammatory with aspirin

104
Q

Most myocardial perfusion occurs during this time

105
Q

Door-to-Needle Time (Fibrinolytic Therapy)

A

30 minutes

106
Q

Most common underlying cause myocardial ischemia

and injury

A

Obstruction of coronary arteries by atherosclerosis

107
Q

What treatment should be avoided in acute condition of AR?

A

Beta-blockers because heart rate reduction could prolong the diastole, thus worsening AR.

108
Q

A 22-year-old IV drug user presents with fatigue, shortness of breath and loss of appetite for 2 weeks. He has fever for the past 3 days. On examination, he is febrile, with non-painful erythematous lesions on the palms, tender nodules on the fingers, and murmur.

A

Infective endocarditis

109
Q

How much fluid is necessary to produce cardiac tamponade?

A

May be as small as 200 mL when the fluid develops rapidly (acute) to as much as >2000 mL in slowly developing effusions (chronic)

110
Q

Characterized as >10mmHg inspiratory decline

in systolic arterial pressure. What condition is this observed?

A

Paradoxical pulse or pulsus paradoxus.

Cardiac Tamponade

111
Q

MOST common cardiac tumors in infants/ children

A

Rhabdomyomas and Fibromas

112
Q

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

A

Ventribular fibrillation

113
Q

Useful RULE-OUT Test in DVT and PE:

A

D-Dimer

> 95% of patients with a normal D-dimer (<500ng/mL) do NOT have PE

114
Q

What are the cardinal symptoms of AS?

A

Syncope, angina, dyspnea

115
Q

Most common gas exchange abnormalities in PE

A

• Arterial hypoxemia and an increased alveolar-arterial O 2 tension gradien

116
Q

What is the most common type of cardiomyopathy, caused by ischemia, alcohol, cocaine, MAP, postpartum, Doxorubicin, and Chagas disease.

A

Dilated CMP

117
Q

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

A

Hypertrophic Cardiomyopathy

118
Q

CLASSIFICATION OF MYOCARDIAL INFARCTION

Spontaneous Myocardial Infarction

• Severe coronary artery disease but on occasion nonobstructive or no CAD

119
Q

MAJOR bleeding from warfarin: BEST managed

with

A

prothrombin complex concentrate

120
Q

Unique features of MS at presentation:

A

• Dysphagia (enlarged LA pressing on the esophagus)

• Hoarseness (enlarged LA pressing on the recurrent laryngeal nerve)

• Atrial fibrillation and stroke from enormous LA and hemoptysis (increase LA pressure causing pulmonary venous hypertension and rupture of pulmonary-bronchial venous connections)

121
Q

PROTOTYPIC lesion in infective endocarditis

A

Vegetation

122
Q

OPTIMAL method for diagnosis of prosthetic valve endocarditis, detection of myocardial abscess, valve perforation or intracardiac fistula

A

Transesophageal Echocardiography

123
Q

enlarged right descending pulmo artery. seen in pulmo embolism

124
Q

What is the ankle brachial index ratio diagnostic of Peripheral arterial disease?

125
Q

GOLD standard for evaluation and identification

of renal artery lesions

A

Contrast Arteriography

126
Q

_____ are the major site of atherosclerotic disease.

A

epicardial coronary arteries

127
Q

Typical pain in Pericarditis

A
  • Retrosternal and is aggravated by coughing, deep breaths, or changes in position – all of which lead to movements of pleural surfaces
  • Worse in the supine position
  • Relieved by sitting upright and leaning forward
129
Q

focal oligemia. seen in pulmo embolism

130
Q

STAGES OF HEART FAILURE

Refractory HF

i.e. Patients with marked symptoms at rest despite optimal therapy

131
Q

Widened pulse pressure

132
Q

DEFINITIVE diagnosis of PE depends upon visualization of an intraluminal filling defect in more than one projection

A

Pulmonary Angiography

133
Q

CXR finding of cardiac tamponade

A

“water bottle sign”

134
Q

MOST often involved in metastasis to the heart

A

Pericardium > myocardium > endocardium or cardiac valves

135
Q

MCC of Diastolic HF or HF with preserved EF (HFpEF)

A

Hypertension

136
Q

hemodynamic hallmark of MS

A

Abnormally elevated left atrioventricular pressure gradient (hemodynamic hallmark)

137
Q

CLASSIFICATION OF MYOCARDIAL INFARCTION

Myocardial Infarction Related to Coronary Artery Bypass Grafting (CABG)

138
Q

STAGES OF HEART FAILURE

At high risk for HF.

i.e. Patients with CAD, HPN, DM, use of cardiotoxins, family history

139
Q

USUAL cause of death from pulmonary embolism

A

Progressive right heart failure

140
Q

CLASSIFICATION OF MYOCARDIAL INFARCTION

Myocardial Infarction Related to Stent Thrombosis

• Detected by coronary angiography or autopsy

141
Q

Principal imaging test for the diagnosis of PE

A

Chest CT with IV contrast

142
Q

CLASSIFICATION OF MYOCARDIAL INFARCTION

Myocardial Infarction Resulting in Death When Biomarker Values Are Unavailable

• Cardiac death with symptoms suggestive of myocardial ischemia and presumed new ischemic ECG changes or new left bundle branch block, but death occurring before sample could be obtained or before cardiac biomarker could rise

143
Q

wedge-shaped opacity at lung periphery. Seen in Pulmo embolism.

A

Hampton hump

144
Q

How is the diagnosis of endocarditis made?

A

Duke’s criteria:

  • Presence of 2 major, or
  • 1 major and 3 minor, or
  • 5 minor criteria
145
Q

Lincoln sign is seen in whar valvular disease?

A

Aortic Regurgitation

146
Q

Most common location of pericardial cysts

A

Right cardiophrenic angle

147
Q

What is the earliest chest x-ray findings of MS?

A

Straightening of the upper left border of the cardiac silhouette

X ray findings:

  • enlarged cardiac shadow
  • straightening of left heart border
  • double right heart border
  • splaying of carinal angle
148
Q

What treatment should be avoided in pericarditis?

A

Anticoagulants

Anticoagulants should be avoided because their use could cause bleeding into the pericardial cavity and tamponade.

Anticoagulants potentially could cause tamponade in the presence of acute pericarditis (as manifested by either pain or persistent rub) and therefore should not be used unless there is a compelling indication.

149
Q

What are the BBs beneficial for HF?

A

Carvedilol, Bisoprolol and Metoprolol succinate

Metoprolol and Bisoprolol are beta-1 specific antagonists.

Carvedilol is a nonspecific beta-blocker that also has alpha-1 receptor blocking activity.

150
Q

In the absence of a high risk for bleeding, patients with NSTE-ACS should receive ______

A

platelet P2Y receptor blocker (Clopidogrel, Ticagrelor, Prasugrel)

151
Q

Paradoxical / reverse splitting of S2. Pulmonary valve then Aortic valve

152
Q

This score predicts risk of stroke in AF.

A

CHA2DS2VASc score

153
Q

MAJOR Disadvantage of Unfractionated Heparin

A

Achieving target aPTT is empirical & may require repeated blood sampling and heparin

154
Q

MOST common preventable cause of death among hospitalized patients

A

pulmo embolism

155
Q

Squatting and leg raising would decrease the murmur of ____ and ____

A

Hypertrophic Obstructive Cardiomyopathy and Mitral Valve Prolapse

156
Q

Perivalvular Infection is MOST common with

A

AORTIC valve infection

157
Q

Most common symptom of DVT

A

Cramp or “charley horse” in the lower calf

158
Q

What is the target LDL value in all patients with proven CAD? if the patient has diabetes?

A

LDL < 100 mg/dl (< 70 mg/dl if the patient has diabetes)

159
Q

A 29-year-old man with pulmonary tuberculosis presents with sharp chest pain, aggravated by lying but relieved by sitting forward. There’s a high-pitched rasping sound on cardiac auscultation. No jugular venous distention seen. An ECG shows diffuse ST-segment elevation with PR-segment depression.

• What is the most likely diagnosis?

A

Acute pericarditis (TB pericarditis)

160
Q

most common adverse effect of Fibrates

161
Q

Has become a second- line diagnostic test for PE

A

Lung scanning

162
Q

Acute limb ischemia presents with the 6P’s:

A

Pain, Pallor, Paresthesia, Paralysis, Pulselessness, Poikilothermia

163
Q

Minor Criteria for Endocarditis

A
  • Predisposing condition: abnormal valve or abnormal risk of bacteremia
  • Fever
  • Vascular phenomena: septic arterial or pulmonary emboli, mycotic aneurysms, intracranial hemorrhage, Janeway lesions

• Immune phenomena:

Glomerulonephritis, Osler nodes, Roth spots, rheumatoid factor

  • Positive blood cultures not meeting major criteria
  • Positive echocardiogram not meeting major criteria
164
Q

Diamond-shaped crescendo-decrescendo mid-systolic murmur

A

Aortic Stenosis

165
Q

Statin + Gemfibrozil = increases risk for ______

166
Q

CLASSIC signs of PE

A
  • Tachycardia
  • Low-grade fever
  • Neck vein distention
167
Q

A 62-year-old man with history of hypertension complains of fatigue and shortness of breath. On physical examination, there’s a high-pitched, blowing, diastolic murmur on the left sternal border and widened pulse pressure. A murmur is also heard over the femoral artery.

A

AORTIC REGURGITATION

168
Q

Door-to-Balloon Time (PCI)

169
Q

Consider ____ if there is deterioration of

renal function associated with ACEi.

A

Renal Artery Stenosis

170
Q

enumerate the “Beck triad”

A

o Hypotension

o Soft or absent heart sounds

o Jugular venous distention

171
Q

Examples of High output HF

A
  • Beriberi
  • Anemia
  • Thyrotoxicosis
  • AV fistula
172
Q

example of Angiotensin Receptor-Neprilysin Inhibitor (ARNI). It is a new drug class used in patients who continue to be dyspneic despite using the initial pharmacologic regimen. Provides mortality benefit for systolic dysfunction.

A

Sacubitril/Valsartan

173
Q

Treatment of pericarditis.

A
  • Aspirin (2-4 g/d) plus gastric protection with Omeprazole.
  • NSAIDs (Ibuprofen, Indomethacin),
  • Colchicine and Glucocorticoid (Prednisone).
  • If recurrent, frequent, and disabling, pericardial stripping may be necessary.
174
Q

anti lipid drug safe for pregnant

A

Cholestyramine (Bile acid sequestrant)

175
Q

MOST common abnormality in PE on ECG

A

T-Wave Inversion in Leads V1 to V4

176
Q

50% of endocarditis cases associated with injection drug use are LIMITED to

A

Tricuspid valve

177
Q

What is the most important reason is for using statins?

A

it has the greatest mortality benefit.

178
Q

Major Criteria for infective endocarditis

A
  • Sustained bacteremia by an organism known to cause endocarditis
  • Endocardial involvement documented by either echocardiogram (vegetation, abscess, valve perforation, prosthetic dehiscence) or clearly established new valvular regurgitation
179
Q

Most common cause of MS

A

Rheumatic Fever

180
Q

most common etiology of secondary hypertension.

A

Primary renal disease

181
Q

TWO determinants of arterial pressure

A

Cardiac output and peripheral resistance

182
Q

Test of CHOICE to detect perivalvular abscess

A

TEE with color Doppler

183
Q

MOST common tumors of the VALVES

A

Papillary Fibroelastomas

184
Q

Austin flint murmur – “rumbling sound”

A

in severe AR (functional MS)

185
Q

Warfarin Embryopathy = MOST Common with

exposure during

A

6 th to 12 th week of gestation

INTERNAL MEDICINE - PLE TOPNOTCH 2020 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions