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USMLE step2 > Cardiovascular > Flashcards

Cardiovascular Flashcards

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USMLE® Step 1 flashcards
1
Q

Best initial test for valvular disease

A

Echo

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2
Q

Most acurate test for valvular disease

A

Catheterization

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3
Q

Murmurs that do not inclease with expiration

murmurs thar increase with a decrease in preload(standing and valsalva)

A

HOCM

MVP

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4
Q

Drugs that decrease mortality in dilated cardiomyopathy

A

ACEi
ARBs
B-blokers(metoprolol,bisoprolol,carvidelol)
spironolactone(only in III-IV class)

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5
Q

drugs that decrease mortality in HTN

A

Diuretics
CCB
ACEIs
B-blockers

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6
Q

drugs that decrease mortality in ANGINA

A

ASA and B blokers

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7
Q

decrese preaload

A

standing

valsalva

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8
Q

increase afterload

A

hand grip

squad

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9
Q

cannon A waves

A

III degree block

right ventricle infarction

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10
Q

LBBB

A

QRS>200msec
deep S in V1 ,Tall R in I, V5,V6
NEW LBBB COULD BE ISCHEMIA

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11
Q

RBBB

A

QRS>200
RSR´ with wide R in V1
wide S in I,V5,V6

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12
Q

P Pulmonale

A

right atrial

P-amplitude >2.5mm in lead II

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13
Q

P mitrale

A

left atrial
wide P>120 msec in lead II
notched P waves in lead II

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14
Q

LVH EKG findings

A

S in V1 + R in V5 or V6>35mm

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15
Q

RVH EKG findings

A

right axis deviation

R wave in V1>7mm

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16
Q

holosistolyc murmur that increase with inspiration

A

tricuspid regurgitation

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17
Q

holosistolyc murmur ,radiates to axilaincreases with hand grip

A

mitral regurgitation

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18
Q

midsystolic murmur

A

Mitral valve prolapse

it increases with decrease in preload

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19
Q

CHADS

anticoagulation criterai for patients with AF

A 
WARFARIN IF CHADS>2
CHF(1 point)
HTN(1 point)
Age >75(2 points)
DM(1 point)
Stroke or ITA history(2 points)
Vascular disease(1 point)
Age 65-74(1 point)
Sex (female)(1 point)
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20
Q

Aacute AF causes:

PIRATES

A

PIRATES

  • pulmonary disease
  • Ischemia
  • Rheumatic heart disease
  • Anemia/Atrial mixoma
  • Thyrotoxicosis
  • Ethanol
  • Sepsis
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21
Q

most common cardiomyopathy

A

dilated cardiomyopathy

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22
Q

systolic ejection crescendo decresendo murmur that increases with standing or valsalva

A

HOCM

HCM

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23
Q

PCI critaria in unstable angina (TIMI)

A

TIMI>3

  • Age>65
  • Three or more CAD risk
  • known CAD(>50%)
  • ASA use in past 7 days
  • severe angina(2 or more episodes in 24 hours)
  • ST elevatio>0.5mm
  • positive cardiac markers
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24
Q

inferior MI

A

obtain a right-sided ECG

AVOID NITRATES

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25
Q

posterior MI

A

obtain posterior ECG leads(V7-V8)

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26
Q

indications for CABG

A

unable to perform PCI
left main CAD
triple-vessel diase}
depressed ventricualr function

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27
Q

2 hypertension mnemonic

A

CHAPS

cushing syndrome
Hyperaldosteronism
aortic coarctation
pheochromocytoma
Stenosis of renal arteris
OCP
28
Q

Hypertensive emergency tx

A

(>180/120 with end-organ damage)

IV labetalol, nitroprusside ,nicardipine)

29
Q

Hypertensive urgency

A

PO medication

B-blockers
clonidine
ACEIs

30
Q

AAA Tx

A

> 5.5cm Cx

31
Q

Aortic disection Tx

A

A= Cx

B=B-blokers

32
Q

PAD Dx

A

chronic= ABI(ankle-brachial index)

33
Q

CAD risk factors

A
  • DM(WORTS)
  • Tabacco
  • HTN(MOST COMMON)
  • Hyperlipidemia
  • Famili history(only parents and brothers)male45, women>55)
34
Q

tako-tsubo cardiomyopathy

A

MI after overwhelming emotionally stressful event.
angiography is normal
echo=apical left ventricular balloning

35
Q

drgs that decrease mortality in chronic angina

A
  • ASA
  • B blockers(metoprolol,bisoprolol or cavedilol[non especific])
  • nitroglycerin
36
Q

most common cause of dead in CHF

A

arrhythmia/sudden death ( prevented with b-blockers)

37
Q

worst CAD risk factor

A

DM

38
Q

most common coronary disease risk factor

A

Hypertention

39
Q

most dangerous hyperlipidemia

A

increse LDL

40
Q

elevation of troponing following a overwhelming emotional stress

A

tako-tsubo diseae

41
Q

p2Y12 inhibitor for angiplasty

A

ticagrelor or prasugrel

42
Q

most common cause of death in ACS

A

ventricular arrhythmia(tachychardia or fibrillation)

43
Q

inferor wall MI with sudden drop in BP after nitrates

A

IT IS A RIGTH VENTRICULAR INFARCTION

-give high volume fluid and avoid nitroglycerin.

44
Q

most accurate test for CHF

A

multiple-gated acquisition scan (MUGA) or nuclear venticulography

45
Q

implantable defibrilaltor indication inCHF

A

ischemic cardiomyopathy and ejection fraction below 35%

46
Q

biventricular pacemarker indication in CHF

A

EF under 35% dilated cardiomyopathy and QRS above 120 milliseconds

47
Q

most common cause of death in CHF

A

arrhythmias(sudden death)

48
Q

dyastolic disfunction treatment

A

BB and diuretics

49
Q

best inital test in pulmonary edema

A 
EKG
-AF
-atrial flutter
-Ventricular tachycardia
DO SYNCHRONIZED CARDIOVERSION
50
Q

valvualr disease best inital step and most accurate

A

best inital: echocardiogram

most accurate:catheterization

51
Q

valvualr desease ¨general medical treatment

A
  • All get better with diuretics

- REGURGITATION respong better to ACEIs or ARBS

52
Q

surgical replasmetn indication for Mitral regurgitation

A

BIGGER HEART

LVESD above 40mm or EF below 60%

53
Q

surgical replasment indication for Aortic regurgitation

A

EF less thatn 55% or LVESD greater than 55mm

54
Q

increase mortality in CAD

A 
CCB
only used  in special situations:
-bblockers contraindicated(severe asthma)
-princemetal angina
-cocaine induced chest pain
55
Q

auscultation association with ACS

A

S4 gallop

ischemia leading to nocompliance of the left ventricle

56
Q

ST depressions in leads V1 and V2

A

suggestive of a posterior wall myocardial infarction

57
Q

ABSOLUTE contraindications for thrombolytics

A
  • mayor bleedin into the bowel or brain
  • recen surgery(within the last 2 weeks
  • severe hypertension(above 180/110)
  • Nonhemorrhagic stroke within the last 6 months
58
Q

medication contraindicated in HOCM

A

Diuretics

will increase the obstruction

59
Q

endocartis profilaxis with amoxicilin indication

A
  • previous endocarditis
  • uncorrected cyanotid congenital heart disease
  • prostethis valves
  • repaired congenital heart disease with residual defect
  • valvulopathy in a transplanted heart

MVP DOES NOT NEED

60
Q

posterior stroke

A
  • ipsilateral sensory loss of the face, ninth and 10th creneal nerve(VII,XI,X)
  • contralateral sensory loss of the limbs
  • limb ataxia
61
Q

patient already on ASA during stroke

A
  • add dipyridamole or switch to clopidogrel
62
Q

magraine medicaitions contraindicated to convine

A

DO NOT CONVINE triptans with ergotamine

63
Q

most single effective treatment for cluster headache

A

100% oxigen

64
Q

SAH treatmetn

A

EMBOLIZATION its not present amoung teh answers chose clipping

65
Q

most accurate test for guillian barre

A

nerve conduction studies/electromyography

66
Q

msota ccurate test for miastenia gravis

A

alectromyography

67
Q

best initial test for myastenia gravis

A

acetylcholine receptor Ab

USMLE step2 (21 decks)

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