Cardiology_RR

Question 1

“Sawtooth” P waves

Answer 1

Classic EKG finding in Atrial Flutter

Question 2

Chest pain that is new, is worsening, or occurs at rest

Answer 2

Unstable angina

Question 3

Antihypertensive for a diabetic patient with proteinuria

Answer 3

ACE Inhibitor

Question 4

Hypotension, distant heart sounds, jugular venous distention

Answer 4

Beck’s Triad for Cardiac Tamponade

Question 5

Drugs that slow heart rate

Answer 5

Beta-blockers, Calcium Channel blockers, Digoxin, Amiodarone

Question 6

Hypercholesterolemia treatment that leads to flushing and pruritus

Answer 6

Niacin

Question 7

A systolic ejection murmur heard along the lateral sternal border;
Increases with Valsalva maneuver

Answer 7

Hypertrophic Obstructive Cardiomyopathy

Question 8

Effect of Valsalva maneuver on cardiac function

Answer 8

Decreases preload

Question 9

A diastolic decrescendo, low-pitched, blowing murmur that is best heard sitting up;
Increases with handgrip maneuver;
Associated with an Austin Flint murmur

Answer 9

Aortic Insufficiency

Question 10

Effect of handgrip on cardiac function

Answer 10

Increases afterload

Question 11

A systolic crescendo/decrescendo murmur that radiates to the neck;
Increases with squatting maneuver

Answer 11

Aortic Stenosis

Question 12

Effect of squatting on cardiac function

Answer 12

Increases preload

Question 13

A holosystolic murmur best heard at the apex that radiates to the axilla;
Increases with handgrip maneuver

Answer 13

Mitral regurgitation

Question 14

A diastolic, mid- to late, low-pitched murmur preceded by an opening snap

Answer 14

Mitral Stenosis

Question 15

Treatment for atrial fibrillation and atrial flutter

Answer 15

If unstable, cardiovert.

If stable or chronic, rate control with calcium channel blockers or beta-blockers.

Question 16

Treatment for ventricular fibrillation

Answer 16

Immediate cardioversion

Question 17

An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI

Answer 17

Dressler’s Syndrome

Question 18

How do you treat an IV drug user with JVD and a holosystolic murmur at the left sternal border?

Answer 18

Treat the existing heart failure, and replace the tricuspid valve

Question 19

Diagnostic test for hypertrophic cardiomyopathy

Answer 19

Echocardiogram showing a thickened left ventricular wall and outflow obstruction

Question 20

Describe pulsus paradoxus

Answer 20

A decrease in systolic blood pressure of > 10 mm Hg with inspiration that is seen commonly in cardiac tamponade

Question 21

Low-voltage, diffuse ST_segment elevation

Answer 21

Classic EKG findings in pericarditis

Question 22

Definition of hypertension

Answer 22

BP > 140/90 mm Hg on 3 separate occasions 2 weeks apart

Question 23

What are eight surgically correctable causes of hypertension?

Answer 23

Renal artery stenosis
Coarctation of the aorta
Pheochromocytoma
Conn's Syndrome
Cushing's Syndrome
Unilateral renal parenchymal disease
Hyperthyroidism
Hyperparathyroidism

Question 24

Evaluation of a pulsatile abdominal mass and bruit

Answer 24

Abdominal ultrasound and CT

Question 25

What are the indications for surgical repair of an abdominal aortic aneurysm?

Answer 25

> 5.5 cm,
Rapidly enlarging,
Symptomatic, or
Ruptured

Question 26

What are some medications used in treating acute coronary syndrome?

Answer 26

Aspirin
Heparin
Clopidogrel
Morphine
Oxygen (O2)
Nitroglycerin, sublingual
IV Beta-blockers

Question 27

What are the characteristics of metabolic syndrome?

Answer 27

Abdominal obesity
High triglycerides
Low HDL
Hypertension
Insulin resistance
Prothrombotic or proinflammatory states

Question 28

A 50-year-old man with stable angina can exercise to 89% of his maximal predicted heart rate. What is the most appropriate diagnostic test?

Answer 28

Exercise stress treadmill with EKG

Question 29

A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina. What is the most appropriate diagnostic test?

Answer 29

Pharmatologic stress test (i.e. dobutamine echo)

Question 30

Target LDL in a patient with diabetes

Answer 30

< 70 mg/dL

Question 31

Signs of active ischemia during stress testing

Answer 31

Angina,
ST-segment changes on EKG, or
Decreasing blood pressure

Question 32

EKG findings suggesting MI

Answer 32

ST-segment elevation (depression means ischemia),
Flattened T waves, and
Q waves

Question 33

Coronary territories in MI

Answer 33

Anterior Wall – LAD / Diagonal
Inferior Wall – PDA
Posterior Wall – Left circumflex/Oblique, RCA/marginal
Septum – LAD/Diagonal

Question 34

A young patient presents with angina at rest and ST-segment elevation with normal cardiac enzymes. What is the most likely diagnosis?

Answer 34

Prinzmetal’’s angina

Question 35

Common symptoms associated with silent MIs

Answer 35

CHF, shock, altered mental status

Question 36

Diagnostic test for pulmonary embolism

Answer 36

Spiral CT with contrast

Question 37

When is protamine used?

Answer 37

To reverse the effects of heparin

Question 38

Which coagulation parameter is affected by warfarin?

Answer 38

Prothrombin time

Question 39

A young patient with a family history of sudden death collapses and dies while exercising. What is the most likely diagnosis?

Answer 39

Hypertrophic cardiomyopathy

Question 40

Endocarditis prophylaxis regimens

Answer 40

Oral surgery–amoxicillin for certain situations

GI or GU procedures–not recommended

Question 41

What comprise Virchow’s Triad?

Answer 41

Stasis, hypercoagulability, endothelial damage

Question 42

The most common cause of hypertension in young women?

Answer 42

Oral Contraceptives

Question 43

The most common cause of hypertension in young men?

Answer 43

Excessive EtOH

Question 44

Which cardiac condition reveals the “Figure 3 Sign”?

Answer 44

Aortic coarctation

Question 45

What cardiac condition is commonly associated with the “water-bottle-shaped heart”?

Answer 45

Pericardial effusion. (Be sure to look for pulsus paradoxus to confirm the diagnosis.)