cardiology/renal/repro 1-27 54%

Question 1

relation of aorta and IVC

Answer 1

right side-IVC and left side-aorta

Question 2

75 year old pt with a fib and past history of thromboembolic dz, give warfarin and not heparin because

Answer 2

heparin is used to for antiplatelet therapy in pts under 75 w/o past history of thromboembolic dz and low risk of a fib. give warfarin for higher risk pts

Question 3

drug that can replace captopril if pt has cough is losartan and not exenatide or sitagliptin because

Answer 3

captopril and ACE I can be replaced with and ARBs losartan
exenatide-is glucagon like peptide (GLP-1) used to treat DM2.
sitagliptin is dipeptidyl peptidase-4 inhibitor (DPP-4) used to treat DM2

Question 4

what is used to measure cardiac function after MI:

• 8 hrs
• 8-24hrs?

Answer 4

• troponin T or troponin I

- CK-MB or total creatine kinase

Question 5

primary force of coronary artery flow?

Answer 5

aortic pressure not ventricular contraction

Question 6

removal or kidney or any organ causes CO and TPR and total renal blood flow and BP to

Answer 6

CO decreases, TPR increases, total renal flow decreases, BP remains constant b/c organs are arranged in parallel.
1/total resistance=1/R1 +1/R2 + 1/R3

Question 7

pt with red, swollen, tender breast with firm mass has dermal lympathic invasion by cancer cells and not epidermal invasion or fat necrosis because

Answer 7

pt has inflammatory breast cancer-cancer cells invade dermal lymphatics and cause pea d-orange
epidermal invasion by cancer cells-Paget’s disaese
fat necrosis-follows trauma can sometimes be confused with breast cancer

Question 8

drug that an vasodilate and decrease relaase of insulin

Answer 8

diazoxide-K+ channel opener, used for emergency HTN and hypoglycemia caused by hyperinsulinism.

Question 9

endocarditis complicated by staph aureus will likely result in pulmonary abscess and not mitral valve stenosis because

Answer 9

staph aureus will have vegetations on the tricuspid valve which can break of (septic emboli) into pulmonary circulation.
mitral valve stenosis is seen in rheumatic fever group A strep

Question 10

compensated aortic coarctation.

Answer 10

flow above and below level of coarctation is normal. resistance changes to compensate.

Question 11

renal failure in the presence of HTN and anemia is caused by ADPKD and not renal cell carcinoma because

Answer 11

ADPKD can cause HTN b/c of renin release and lack of EPO, renal cell carcinoma does not cause HTN

Question 12

pentoxifylline

Answer 12

lowers blood viscosity and improves RBC flexibility- used to treat intermittent claudication (cramp in leg due to arterial clot), side effects- dyspnea and mild hypotension

Question 13

increase in pulse pressure

Answer 13

increase in systolic pressure-arteriolosclerosis. normal is 40 (120-80`)
decrease in diastolic pressure- PDA (blood flows from flows from ductus to pulmonary artery) or aortic regurg (back flow during diastole)

Question 14

decrease in pulse pressure

Answer 14

mitral valve stenosis, aortic pressure is constant but atrial pressure during diastole increases

Question 15

infectious dz leading to aortic aneurysm due to destruction of vasa vasorum

Answer 15

syphillus

Question 16

pt with abdominal distention and marroon colored stool has what? what is one feared complication?

Answer 16

liver disease which can lead to portal HTN and variceal rupture (rupture of azygous vein-a major out like for esophageal vein which can become engorged from connect to hepatic portal vein)

Question 17

thiazide causes an increase in ALD and not serum Na+ because

Answer 17

it block NaCl channel in DCT. leading to salt wasting, ALD will increase in an effect to retain salt and can cause a decrease in K/H levels

Question 18

newborn with transposition of great vessels should be given alprostadil and not idomethacin because

Answer 18

idomethacin would close PDA while alprostadil or misoprotol will keep it open (PGE1 analog)

Question 19

diastolic decrescendo murrmur on lower left sternal border

Answer 19

aortic regurg

Question 20

veinal drainage of right ovary. left

Answer 20

pampinform plexus-overian vein, IVC

pampinformplexus-overian vein-renal vein-IVC

Question 21

cervix veinal dramage

Answer 21

cervical vein-uterine vein-external iliac vein

Question 22

holosystolic apical murrur that radiates to axilla and accompanied by a thrill,

Answer 22

mitral regurg. maya lso have wide splitting of S2 b/c of early closure of aortic valve

Question 23

systolic ejection murrur, thrill, harsh, and radiates to carotids

Answer 23

aortic stenosis

Question 24

diastolic murrmur with love S1 and opening snap below S2

Answer 24

mitral stenosis

Question 25

high pitched pansystolic murrmur in 4th intercostal space parasternal region, increased during respiration and reduced in standing position and during valsalva maneuver

Answer 25

tricuspid regurg

Question 26

verapamil

Answer 26

Ca2+ blocker, used to control rapid atrial fib and flutter, prefered in pt wirh pulomnary dz b/c not bronchospasm effect of beta-blockers

Question 27

complication of MI after

• 4-8 wks
• 5-7 days
• before 5 days

Answer 27

• ventricular aneruysms
• interventricular septal rupture
• left ventricular free wall rupture

Question 28

heart condition associated with SLE

Answer 28

Libman-Sacks endocarditis