Cardiovascular

Question 1

MC pathogen causing acute bacterial endocarditis

Answer 1

S. aureus

Question 2

MC pathogen causing subacute bacterial endocarditis

Answer 2

S. viridans (dental work)

Question 3

3 major Duke Criteria for bacterial endocarditis…

Answer 3

1. blood cx x 2 12 hours apart showing s. aureus, S. viridans, or S. bovis
2. echo showing vegetations
3. new regurg murmur

Question 4

2 cutaneous manifestations of infective endocarditis?

Answer 4

osler nodes (tender “ouchy”)

Janeway lesions (painless macules)

Question 5

2 nailbed changes suggestive of infective endocarditis…

Answer 5

splinter hemorrhage

digital clubbing

Question 6

Tx of infective endocarditis…

Answer 6

IV vanco or ampicillin/sulbactam + aminoglycoside

Question 7

Tx addition for infective endocarditis if prosthetic valve?

Answer 7

add rifampin

Question 8

Coronary artery vasospasms causing transient ST-segment elevations, not associated with clot

Answer 8

prinzmetal/variant angina

Question 9

Tx for prinzmetal/variant angina?

Answer 9

CCB, long acting nitrates

Question 10

arrhythmia with PR interval < 0.20

Answer 10

wolf parkinson white

Question 11

Early wide “bizarre” QRS, no p wave seen

Answer 11

PVC

Question 12

wide QRS complex that is a regular, fast heart rate that arises from improper electrical activity in the ventricles of the heart

Answer 12

VT

Question 13

Erratic rhythm with no discernable waves (P, QRS, or T waves)

Answer 13

VF

Question 14

Tx options for narrow tachy arrhythmias… (5)

Answer 14

CCBs, beta blockers, adenosine or procainamide

synch cardioversion

Question 15

Tx options for wide tachy arrhythmias (2)

Answer 15

synch cardioversion

amio

Question 16

Beck’s triad for cardiac tamponade…

Answer 16

1. hypotension
2. muffled heart sounds
3. JVD

Question 17

2 EKG findings for cardiac tamponade…

Answer 17

electrical alternans

low voltage QRS

Question 18

CXR finding in cardiac tamponade?

Answer 18

water bottle heart

Question 19

CP relieved by sitting or leaning forward…

Answer 19

pericarditis

Question 20

chest pain with shortness of breath, with possible radiation to the neck, jaw, arms, shoulders, and back

Answer 20

ACS

Question 21

Pleuritic CP and dyspnea…

Answer 21

PE

Question 22

severe, tearing (ripping, knife-like) chest pain radiating to the back

Answer 22

TAA/AAA

Question 23

5 emergent causes of CP…

Answer 23

pericarditis
ACS
PE
PTX
TAA

Question 24

ipsilateral chest pain and dyspnea with decreased tactile fremitus, deviated trachea, hyperresonance, diminished breath sounds

Answer 24

PTX

Question 25

CP workup...

Answer 25

EKG, troponin, BNP, CXR, CBC/CMP

Question 26

2 labs for pericarditis...

Answer 26

EKG, ESR

Question 27

2 labs for PE...

Answer 27

D-Dimer, CTA

Question 28

2 labs for PTX

Answer 28

CXR, CT

Question 29

Imaging for TAA

Answer 29

CT Aortogram

Question 30

R and R’ (upward bunny ears) in V4-V6

Answer 30

LBBB

Question 31

R and R’ (upward bunny ears) in V1-V3

Answer 31

RBBB

Question 32

Tx for NSTEMI... (7)

Answer 32

``` beta blockers nitro ASA clopidogrel heparin ACE-I Statin Reperfusion therapy ```

Question 33

Anterior wall MI leads...

Answer 33

I, aVL, V2-V6

Question 34

Inferior wall MI leads...

Answer 34

II, III, aVF

Question 35

Lateral wall MI leads

Answer 35

I, aVL, V5-V6 Reciprocal ST depression in III, aVF

Question 36

Posterior wall MI leads

Answer 36

ST depression V1-V3

Question 37

medications such as ______ and ______ vasodilate the vessels making the fluid come out and will go down to the feet due to gravity

Answer 37

CCBs Alpha blockers

Question 38

Best test to assess for HF...

Answer 38

Echo

Question 39

Systolic left heart failure treatment (3)

Answer 39

ACE-I beta blocker Loop diuretic

Question 40

2 staples of diastolic HF...

Answer 40

lasix | ace-I

Question 41

Tx of choice for HTN emergency...

Answer 41

sodium nitroprusside

Question 42

Tx of choice for hypertensive urgency

Answer 42

clonidine

Question 43

Tx of choice for malignant HTN

Answer 43

hydralazine

Question 44

3 common causes of cardiogenic shock...

Answer 44

acute MI HF cardiac tamponade

Question 45

Pt. presents with: SOB pain radiating from shoulder to chest Pain worse with inspiration and laying down pain better leaning forward distant heart sounds low voltage ekg w. electrical alternans No trauma

Answer 45

pericardial effusion

Question 46

Gold standard dx of PVD

Answer 46

arteriography

Question 47

Harsh systolic ejection crescendo-decrescendo murmur at the right upper sternal border (aortic area) with radiation to the neck and apex heard best by leaning forward with expiration

Answer 47

aortic stenosis

Question 48

Soft, early diastolic blowing murmur along the left sternal border with the patient sitting leaning forward after exhaling

Answer 48

Aortic regurgitation

Question 49

Diastolic low pitched decrescendo rumbling murmur with opening snap heard best at the apex (mitral area) with the patient in the lateral decubitus position

Answer 49

Mitral stenosis

Question 50

Holosystolic high-pitched blowing murmur at the apex (mitral area) that radiates to axilla with a split S2

Answer 50

Mitral regurgitation

Question 51

6 Ps of arterial embolism/thrombosis...

Answer 51

pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia

Question 52

Pt. p/w: Dull pain, erythema, induration of vein, palpable cord

Answer 52

phlebitis/thrombophlebitis