Cardiology Qs

Question 1

Pharmacologic vasodilators?

Can can this adverse effect during stress testing? Therefore contraindicated in a which pateints?

Answer 1

dipyridamole, adenosine, and regadenoson

bronchospasm

those currently wheezing

Question 2

Surgical aortic valve replacement is indicated for?

Answer 2

symptomatic patients with severe aortic stenosis OR asymptomatic patients with severe aortic stenosis and LV systolic dysfunction (LV ejection fraction <50%)

Question 3

When should the warfarin goal be reduced to 2-2.5?

Answer 3

If warfarin is used as an anticoagulant during triple therapy (in a pt without mechanical valves)

Question 4

Severe MV stenosis but asymptomatic - when is intervention indicated?

Answer 4

planned pregnancy or MVA<1 with amenable valve

Question 5

Patients with medically refractory frequent PVCs or should undergo catheter ablation if?

Answer 5

develop left ventricular dysfunction

Question 6

BB for pregnancy?

Answer 6

labetalol

Question 7

AV nodal blocking agents that do not need to be stopped for stress test?

Answer 7

CCBs

Question 8

Minimal criteria for adequacy for an exercise stress test?

Answer 8

85% of the age-predicted maximal heart rate and maximal metabolic demand

Question 9

Role for Cilostazol?

Answer 9

PAD - improves pain-free walking and overall walking distance in patients with claudication

Question 10

Cilostazol contraindication?

Answer 10

heart failure or a left ventricular ejection fraction below 40%

Question 11

Medications for pericarditis that are not recommended Post MI?

Answer 11

NSAIDs and Colchicine

Question 12

Typical EKG for atrial fibrillation with aberancy?

Answer 12

irregularly irregular rhythm with a typical right bundle branch block

Question 13

Appropriate screening interval for an asymptomatic 1st° relative of a patient with HCM?

Answer 13

Every 5 years

Question 14

Caveat in dealing with patients with Eisenmenger syndrome?

Answer 14

All IV lines need air filters

Question 15

When do patients with asymptomatic mitral regurgitation require valve replacement?

Answer 15

asymptomatic patients with chronic severe mitral regurgitation and mild to moderate LV dysfunction (ejection fraction of 30%-60% and/or LV end-systolic dimension ≥40 mm).

Question 16

When does A type B aortic dissection require surgery?

Answer 16

complicated type B aortic dissection defined by refractory pain or hypertension, rapid aneurysmal expansion, rupture, or malperfusion syndrome.

Question 17

In patients with severe pulmonary valve stenosis, when is valve intervention recommended?

Answer 17

all the time - regardless of the presence or absence of symptoms.

Question 18

Which HF patients should get a ICD? Who is excluded from this?

Answer 18

NYHA functional class II and III symptoms, ejection fraction less than or equal to 35% on guideline-directed medical therapy, and a life expectancy of at least 1 year

Class IV symptom pateints are excluded - ICDs are not indicated in this population except in patients who are awaiting transplantation or undergo placement of a mechanical circulatory device.

Question 19

When should patients with HCM get an ICD placed?

Answer 19

any of the following risk factors for sudden cardiac death:

(1) Wall thickness ≥30 mm;
(2) previous cardiac arrest
(3) blunted blood pressure response or hypotension during exercise;
(4) unexplained syncope;
(5) nonsustained ventricular tachycardia on ambulatory electrocardiography
(6) family history of sudden death due to HCM.

Question 20

Anti-platelet agent to use with thrombolytics?

Answer 20

Clopidogrel (no proven benefit of ticagrelor or prasugrel)

Question 21

Follow-up for a young patient with a bicuspid aorta?

Answer 21

reassessment need if the aortic root or ascending aorta dimension is 4.0+ cm,

Annual evaluation should occur if the aortic diameter is greater than 4.5 cm.

Question 22

EKG Contraindications to exercise stress testing?

Answer 22

LBBB, a paced rhythm, or baseline ST-segment depression greater than 1 mm,

Question 23

hen should aspirin NOT be given for primary prevention in a diabetic?

Answer 23

low cardiovascular risk (men younger than 50 years and women younger than 60 years without other major risk factors such as hypertension or tobacco use).

Question 24

Diagnostic test for restrictive pericarditis in a patient with a inadequate echo?

Answer 24

hemodynamic study with cardiac catheterization

Question 25

When to pursue a cardiac cath after stress testing?

Answer 25

high-risk features on exercise stress testing Duke treadmill score below −11, hypotension, severe ST-segment depression, or early-onset angina.

Question 26

When is Surgery to repair or replace the ascending aorta in adults with a bicuspid aortic valve is recommended?

Answer 26

when the ascending aorta diameter is greater than or equal to 5.5 cm or progressive dilatation (occurs at a rate of 0.5 cm per year or greater)

Question 27

The bare metal stent is pleaced – how long is the course of plavix?

Answer 27

One year if after ACS one month otherwise

Question 28

Pt with ICD, and is having surgery in the vicinity of her device. Manager in a pacemaker?

Answer 28

reprogramming to an asynchronous mode (to prevent sensing) disabling of the shocking

Question 29

Echo based classification of severity of mitral stenosis?

Answer 29

mean gradient > 5 - 10

mitral valve area < 1.5

Question 30

Pt with MS - type of intervention?

Answer 30

Valve Valvuloplasty

Valve replacement only if unsuccessful or unable to preform valve replacement