Cardiovascular

Question 1

Definition of unstable angina

Answer 1

new, worsening, occurs at rest

Question 2

Beck’s Triad

Answer 2

for cardiac tamponade (hypotension, distant heart sounds, JVD)

Question 3

What drugs slow HR

Answer 3

BB, CCBs, digoxin, amiodarone

Question 4

Systolic ejection murmur heard along the lateral sternal border that increases with Valsalva

Answer 4

hypertrophic obstructive cardiomyopathy

Question 5

Diastolic, decrescendo, lo pitch, blowing murmur heard best sitting up, worse with handgrip

Answer 5

Austin flint murmur of aortic insufficiency

Question 6

systolic crescendo-decrescendo that radiates into the neck, increases with squatting

Answer 6

aortic stenosis

Question 7

squatting will _______your heart’s __________

Answer 7

increase preload

Question 8

handgripping will ______ your heart’s _________

Answer 8

increase afterload

Question 9

valsalva will _______ your heart’s ____________

Answer 9

decrease preload

Question 10

holosystolic murmur that radiates to the axilla, increases with handgripping

Answer 10

mitral regurgitation

Question 11

diastolic, mid to late lo pitch murmur preceded by an opening snap

Answer 11

mitral stenosis

Question 12

patient in afib/aflutter

Answer 12

if unstable: cardiovert

stable: CCB or BB for rate control + anticoag

Question 13

fever, pericarditis, hi sed rate 2-4 weeks post MI

Answer 13

Dressler syndrome (autoimmune)

Question 14

IVDU with JVD, holosystolic murmur at L sternal border

Answer 14

tricuspid regurg, tx heart failure, replace valve

Question 15

diagnostic test for hypertrophic cardiomyopathy

Answer 15

Echo (thick wall, outflow obstruction)

Question 16

What is pulsus paradoxus

Answer 16

decrease in systolic BP >10 mm Hg WITH INSPIRATION in a patient with cardiac tamponade

Question 17

Pericarditis EKG

Answer 17

lo voltage, diffuse ST elevation

Question 18

Surgically correctable causes of HTN

Answer 18

RAS, coarctation of aorta, pheo, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal dz, hyperthyroidism, hyperparathyroidism

Question 19

Best test for pulsatile abdominal mass with bruit

Answer 19

abdominal US and CT

Question 20

AAA size for surgery

Answer 20

> 5.5 cm or rapidly enlarging, or symptomatic, or ruptured

Question 21

tx for patient with acute coronary syndrome

Answer 21

ASA + heparin + clopidogrel + O2 + morphine + nitro + IV BB

Question 22

What is metabolic syndrome

Answer 22

abdominal obesity, hi TG, lo HDL, HTN, insulin resistance, prothrombotic or proinflammatory state

Question 23

Target LDL in diabetic

Answer 23

<70 mg/dL

Question 24

do a pharm stress test instead of exercise if:

Answer 24

conduction defects, pt has OA, old, unstable angina

Question 25

stress test is + if

Answer 25

angina, ST changes, lower BP

Question 26

MI on an EKG

Answer 26

ST elevation, flat T waves, Q wave presence

Question 27

anterior wall blood supply

Answer 27

LAD

Question 28

inferior wall blood supply

Answer 28

PDA

Question 29

posterior wall blood supply

Answer 29

L circumflex (oblique), RCA (marginal)

Question 30

septum blood supply

Answer 30

LAD

Question 31

Diagnostic test for MI

Answer 31

CK-MB and Troponins (not EKG)

Question 32

young patient with angina at rest, ST elevation, normal enzymes

Answer 32

Prinzemetal angina

Question 33

PE diagnostic test

Answer 33

spiral CT with contrast

Question 34

Reverse heparin OD or post-surgery

Answer 34

protamine sulfate

Question 35

Virchow’s triad?

Answer 35

stasis, hypercoagulability, endothelial damage

Question 36

Figure 3 sign

Answer 36

aortic coarctation

Question 37

water bottle shaped heart

Answer 37

pericardial effusion (look for pulsus paradoxus)