Cardiology p 71-80

Question 1

Risk factors for Acute coronory syndrome

Answer 1

HTN, DM, Smoking

Question 2

what is s4 gallop

Answer 2

sound of atrial systole as blood is ejected from atria into ventricle and is associated with Acute coronory syndrome

Question 3

what is kussmaul sign and what is it associated with..

Answer 3

Increase in JVP on inhalation is kussmaul sign

it is associated with constrictive pericarditis or restrictive cardiomyopathy

Question 4

Displaced PMI (point of maximal impulse) is seen in

Answer 4

Left ventricular Hypertrophy and Dilated Caridiomyopathy

Question 5

what is Dressler Syndrome

Answer 5

Pericarditis as a complication after 3 weeks of MI

Question 6

continuous machinery murmur is seen in

Answer 6

Patent Ductus Arteriosus

Question 7

Leads involved in anterior and inferior wall MI

which has the worst prognosis

Answer 7

anterior=ST elevation in leads v2-v4
inferior=ST elevation in leads II, III and avf
anterior wall MI will have the worst prognosis

Question 8

leads involved in posterior wall MI

Answer 8

ST depression in leads v1 and v2

Question 9

tx of premature ventricular contraction and atrial premature complex

Answer 9

none if mg+ and k+ levels are normal….tx wil worsen the outcome

Question 10

what lowers mortality with acute coronory syndrome

Answer 10

Aspirin, Angioplasty and beta blockers

Question 11

indication of clopidogrel

Answer 11

1- intolerance to aspirin

2- pt had angioplasty with stenting

Question 12

Dx test of Acute coronory syndrome

Answer 12

EKG
Myoglobin
CK-MB
Troponin

Question 13

which enzyme is best used to diagnose Reinfarction

Answer 13

CK-MB and also EKG to check for new ST- elevation

Question 14

most common cause of death from MI

Answer 14

V tach comes first and then Ventricular fibrillation treated with electrical cardioversion or defibrillation

Question 15

alternative to clopidogrel

Answer 15

prasugrel, ticagrelor

Question 16

superiority of angioplasty over thrombolytics

Answer 16

survival and mortality benefit
fewer hemorrhagic complications
fewer complications of Myocardial Infarction

Question 17

Complications of MI

Answer 17

RV failure
papillary muscle rupture
interventricular septum rupture
free wall rupture of left ventricle

Question 18

Angioplasty(PCI) is to be performed when

Answer 18

within 90 minutes of arrival of pt.

Question 19

complications of PCI

Answer 19

rupture of coronory arteries on balloon inflation
restenosis/thrombosis of the vessel after angioplasty
hematoma at site of entery into the arter(femoral artery hematoma)

Question 20

what decreases the rate of restenosis

Answer 20

drug eluting stents by local T-cell response

Question 21

what are absolute contraindications to thrombolytics

Answer 21

major bleeding into the bowel (melena) or brain
recent surgery in the last 2 weeks
severe HTN above 180/110
non hemorrhagic stroke within the last 6months

Question 22

thrombolytics in STEMI is to be given when

Answer 22

within 30mins of the patients arrival

Question 23

ACEin/ARB given with what EF

Answer 23

Ejection fraction <40%

Question 24

at what level of LDL, statins is given

Answer 24

LDL > 100mg/dl

Question 25

ST segment depression tx

Answer 25

Aspirin
Heparin(LMWH) (prevents clot formation)
GPIIb/IIIa inhibitors (reduces mortality in ST depression MI)
nitrates
beta blockers

Question 26

names of GP IIb/IIIa inhibitors

Answer 26

Abciximab
Tirofiban
Eptifibitide

Question 27

what condition GP IIb/IIIa inhibitors given in ST elevation ACS

Answer 27

pts who are to undergo angioplasty and stenting

Question 28

tx of STEMI

Answer 28

Aspirin, PCI, thrombolytics, nitrates, beta blockers

Question 29

tx of stable angina

Answer 29

aspirin, beta blockers, nitrates

Question 30

If non ST elevation MI is not better with medicines then we do..

Answer 30

Angiography followed by Angioplasty

Question 31

what do you mean not better with medical treatment of NSTEMI

Answer 31

not better means persistent pain, s3 gallop, CHF, worsening EKG, rising troponin