Cardiovascular

Question 1

Classic ECG finding in atrial flutter

Answer 1

“Sawtooth” P waves

Question 2

Definition of unstable angina

Answer 2

Angina that is new or worsening with no raising in troponin level

Question 3

Antihypertensive for a diabetic patient with proteinuria

Answer 3

Angiotensin-converting enzyme ingibitor

Question 4

Beck triad for cardiac tamonade

Answer 4

Hypotension, distant heart sounds and jugular venous distention (JVD)

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 pruritius

Answer 6

Niacin

Question 7

Murmur —hypertrophic obstructive cardiomyopath

Answer 7

A systolic ejection murmur heard along the lateral sternal border that elevated with lowered preload (Valsalva maneuver)

Question 8

Murmur — aortic insufficiency

Answer 8

Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; elevated with elevated afterload (handgrip maneuver)

Question 9

Murmur — aortic stenosis

Answer 9

A systolic crescendo / decrescendo murmur that radiates to the neck; elevated with elevated preload (squatting maneuver)

Question 10

Murmur — mitral regurgitation

Answer 10

A holosystolic murmur that radiates to axilla: raised with elevated afterload (handgrip maneuver)

Question 11

Murmur —- mitral stenosis

Answer 11

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

Question 12

Treatment for atrial fibrilation and atrial flutter

Answer 12

If untable, cardiovert. If stabele or chronic, rate control with CCBs or beta-blokkers

Question 13

Treatment for ventricular fibrilaltion

Answer 13

Immediate cardioversion

Question 14

Drssler syndrome

Answer 14

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

Question 15

IV drug use with JVD and a holosystiolic murmur at the left sternal border. Treatment?

Answer 15

Treat existing heart failure, and replace the tricuspid valve.

Question 16

Diagnostic test for hypertrophic cardiomyopathy

Answer 16

Echocardiogram (showing a thickenend left ventricular wall and outflow obstruction)

Question 17

Pulsus paradoxus

Answer 17

A lowering in systolic BP of > 10 mmHg with inspiration; seen in cardiac tamponade

Question 18

Classic ECG findings in pericarditis

Answer 18

Low-voltage diffuse ST-segment elevation

Question 19

Eight surgically correctable causes of hypertension

Answer 19

Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn syndrome, Cushing syndrome, unilateral rnal parenchymal disease, hyperthyroidism, hyperparathyroidism

Question 20

Evaluation of a pulsatile abdominal mass and bruit

Answer 20

Abdominal ultrasound and CT

Question 21

Indications for surgical repair of abdominal aortic aneurysm

Answer 21

> 5,5 cma, rapidly enlarging, symptomatic, or ruptured

Question 22

Treatment for acute coronary syndrome

Answer 22

ASA, heparin clopidogrel, morphine, Oé, sublingual nitroglycerin, IV beta-blockers

Question 23

Metabolic syndrome

Answer 23

Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states

Question 24

Appropirate diagnostic test?

* A 50 - year old man with stable angina can exercise to 85% of maximum predicted heart rate

Answer 24

Exercise stress treadmill with ECG

Question 25

Appropirate diagnostic test? | * A 65-year - old woman with left bundle branch block and severe osteoarthritis has unstable angina

Answer 25

Pharmacologic stress test (eg, dobutamine echo)

Question 26

Signs of active ischemia during stress testing

Answer 26

Angina, ST-segment changes on ECG, or lowered BP

Question 27

ECG findings suggesting MI

Answer 27

ST - segment elevation (depression meands ischemia), flattened T wqaves ,and Q waves

Question 28

Coronary territories in MI

Answer 28

Anterior wall (LAD / diagonal), inferior (PDA), posterior (left circumflex/ oblique, RCA/largubak) n seotyl (LAD/ diagonal)

Question 29

A young patient with angina at rest and ST-segment elevation with normal cardiac enzymes

Answer 29

Prinzmetal angina

Question 30

Common symptoms associated with silent MIs

Answer 30

CHF, shock, and altered mental status

Question 31

Diagnostic test for pulmonary embolism

Answer 31

Spiral CT with contrast

Question 32

Protamine

Answer 32

Reversses the effects of heparin

Question 33

Prothrombin time

Answer 33

The coagulation parameter affected by warfarin

Question 34

A young patient with a family history of sudden death collapses and dies while exercising

Answer 34

Hypertrophic cardiomyopathy

Question 35

Endocarditis prophylaxis regimens

Answer 35

Oral surgery--amoxicillin for certain situations; GI or GU procerdures --- not recommended

Question 36

Virchow triad

Answer 36

Stasis hypercoagulability, endotherlial damage

Question 37

The most common cause of hypertension in young woman

Answer 37

OCPs

Question 38

The most common cause of hypertension in young men

Answer 38

Excessive EtOH

Question 39

Figure 3 sign

Answer 39

Aortic coarctation

Question 40

Water bottle-shaped heart

Answer 40

Pericardial effusion. Look for pulses paradoxus

Question 41

Ekg kenmerk bij longproblemen ("P"ulmonair)

Answer 41

"P"eaked P waves

Question 42

Ekg kenmerk bij "M"itralis oorzaken

Answer 42

"M"- shaped P waves

Question 43

Hart auscultatie locaties: mnemonic

Answer 43

All Physcisians Take Money (aorta, pulmonair, triscupidalis, mitralis)

Question 44

Management options for atrial fibrilation: mnemonic

Answer 44

ABCD : anticoagulate; Beta-blokkers to controle rate; Cardiovert/Calcium channel blockers; Digoxin (in refractory cases)

Question 45

Welk nut hebben diuretica en digoxin bij CHF vnl.

Answer 45

symptomatisch verlichten, geen levensreddend voordeel

Question 46

Acute CHV management Mnemonic

Answer 46

LMNOP: Lasix; Morphine; Nitraten; O2; Position (rechtop)

Question 47

S3 galop associatie?

Answer 47

gedilateerde Cardio myopathie

Question 48

S4 galop mogelijks associatie?

Answer 48

hypertrofisch Cardio Myopathie

Question 49

Common causes of chesgt pain

Answer 49

include GERD, angina, esophageal pain, musculoskeletal disorders (costochondritis, trauma) and pneumonia

Question 50

Welke 2 medicatie vertonen levensreddende eigenschappen bij angina pectoris

Answer 50

ASA en beta-blockers

Question 51

Enzymen in bloed bij onstabiele angina? Mnemonic

Answer 51

U Aint got enzymes with Unstable Angina

Question 52

Mnemonic: When your "MOAN"ing from an MI, remember

Answer 52

Morphine, O2, Asa, Nitrogen

Question 53

Wanneer spreek je van dyslipidemia in bloed?

Answer 53

LDL > 130 mg/dl of HDL< 40mg/dL

Question 54

Behandeling Hypertensie: mnemonic

Answer 54

``` ABCD: ACEs/ARBs ; Beta-blockerz; CCBs; Diuretics ```

Question 55

Oorzaken secund. hypertensiemnemonic

Answer 55

``` CHAPS: Cushing; Hyperaldosteronism; Aortic coarctation; Pheochromocytoma; Stenosis of renal arteries ```

Question 56

Hypertensie - emergencies : op welke basis worden ze gediagnosticeerd

Answer 56

Op basis van end - organ damage , niet op basis van bloeddruk

Question 57

Oorzaken van pericarditis: mnemonic

Answer 57

``` CARDIAC RIND: Collagen vascular disease; Aortic dissection; Radiation; Drugs; Infections; Acute Renal failure Cardiac (MI) Rheumatic fever Injury Neoplasms Dressler syndrome ```

Question 58

ST-segment verhogingen in pericarditis onderscheiden zich van MI door?

Answer 58

dat ze niet gelocaliseerd zijn in 1 regio van het hart

Question 59

Beck triad can diagnose cardiac tamponade

Answer 59

JVD Hypotensie Distant heart sounds

Question 60

Onderscheid aorta aneurisma en aortic dissection

Answer 60

aortic aneurism often associated with arteriosclerose, aortic dissection is offen associated with HTN

Question 61

Emergency ascending against descending aortic dissections

Answer 61

ascending are surgical emergencies, descending are still emergencies, but can often be treated medicaly

Question 62

6 P's of acute ischemia

Answer 62

``` Pain Pallor Paralysis Pulse deficit Paresthesias Poikilothermia ```