Cardiovascular III Flashcards
What is the initial treatment of choice for a patient with ventricular fibrillation or pulseless ventricular tachycardia?
Immediate defibrillation (unsynchronized)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/396/a_image_thumb.png?1646160117)
What is the likely cause of bradycardia, AV block, and diffuse wheezing in a CAD patient that has attempted suicide?
Beta blocker overdose
other symptoms include hypotension, hypoglycemia, delirium, seizures, and cardiogenic shock
What is the likely cause of LAD artery occlusion in a patient with recent stent placement in the LAD artery?
Stent thrombosis (likely due to medication non-compliance)
premature discontinuation of antiplatelet therapy is the strongest predictor of stent thrombosis after intracoronary stent implantation
What is the likely cause of syncope in a young patient with occasional chest pain, dyspnea, and a crescendo-decrescendo systolic murmur along the left sternal border without carotid radiation?
Hypertrophic obstructive cardiomyopathy (HOCM)
syncope in HOCM is multifactorial and can be due to outflow obstruction (interventricular septal hypertrophy), arrhythmia, ischemia, or a ventricular baroreceptor response that inappropriately causes vasodilation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/540/a_image_thumb.png?1646160196)
What is the likely cause of the imaging findings below in an IV drug user with a history of fever, cough, and tricuspid regurgitation?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/605/q_image_thumb.png?1646160223)
Septic pulmonary emboli
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/605/a_image_thumb.png?1646160251)
What is the likely diagnosis in a chronic atrial fibrillation patient taking furosemide, metoprolol, digoxin, and warfarin who presents with diarrhea, nausea, decreased appetite, and arrhythmias?
Digoxin toxicity
may also present with vision changes
What is the likely diagnosis in a chronic renal failure patient that presents with pleuritic chest pain that improves when leaning forward?
Uremic pericarditis
the classic ECG finding of diffuse ST elevation is typically absent due to lack of myocardial inflammation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/693/a_image_thumb.png?1646160300)
What is the likely diagnosis in a COPD patient with JVD, hepatomegaly, and pitting edema?
Cor pulmonale
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/743/a_image_thumb.png?1646160331)
What is the likely diagnosis in a hemodynamically unstable patient that presents following a motor vehicle accident with an elevated PCWP that worsens after administration of IV fluids?
Myocardial contusion
an elevated PCWP at baseline should raise suspicion of myocardial contusion (hypovolemic shock would have a low PCWP); urgent echocardigram is required for further evaluation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/791/a_image_thumb.png?1646160365)
What is the likely diagnosis in a hypertensive patient with symptoms of CHF with LV hypertrophy and an ejection fraction of 55% on echocardiography?
Diastolic heart failure (HFpEF)
caused by impaired myocardial relaxation or increased LV wall stiffness (leads to increased LV end-diastolic pressure)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/829/a_image_thumb.png?1646160400)
What is the likely diagnosis in a hypotensive patient requiring IV fluids/pressors to maintain BP that develops cool extremities and the skin findings below?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/924/q_image_thumb.png?1646160430)
Pressor-induced vasospasm (e.g. norepinephrine)
diagnosis is suggested by symmetric duskiness and coolness of all finger tips
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/124/924/a_image_thumb.png?1646160466)
What is the likely diagnosis in a male smoker with chest discomfort and the CXR findings below?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/125/100/q_image_thumb.png?1646160515)
Thoracic aortic aneurysm
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/125/100/a_image_thumb.png?1646160543)
What is the likely diagnosis in a male with a history of SLE that presents with epigastric burning provoked by exertion and relieved by rest?
Atypical angina
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/125/224/a_image_thumb.png?1646160590)
What is the likely diagnosis in a patient 2 months post-MI that presents with CHF and persistent ST elevations/deep Q waves on ECG?
Ventricular aneurysm
may be complicated by a mural thrombus which can lead to systemic embolization
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/125/292/a_image_thumb.png?1646160630)
What is the likely diagnosis in a patient being treated with furosemide and nitroprusside for hypertensive emergency that develops confusion, agitation, and seizures?
Cyanide toxicity
due to nitroprusside; most common in patients with renal insufficiency
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/301/277/a_image_thumb.png?1646252283)
What is the likely diagnosis in a patient on post-MI day 3 that presents with pleuritic chest pain that improves when leaning forward with clear lungs on auscultation?
Peri-infarction pericarditis
ECG typically reveals diffuse ST-segment elevation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/301/319/a_image_thumb.png?1646252315)
What is the likely diagnosis in a patient on post-MI day 3 that presents with sudden-onset pulmonary edema, hypotension, and a systolic murmur (cardiac apex)?
Papillary muscle rupture
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/301/413/a_image_thumb.png?1646252389)
What is the likely diagnosis in a patient on post-MI day 5 that presents with acute onset chest pain and profound shock without signs of congestive heart failure?
Ventricular free wall rupture
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/301/501/a_image_thumb.png?1646252441)
What is the likely diagnosis in a patient on post-MI day 5 that presents with sudden-onset cardiogenic shock and a harsh holosystolic murmur at the left sternal border?
Interventricular septal rupture
left-to-right shunting may manifest as an increase in O2 saturation from the right atrium to the right ventricle
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/301/572/a_image_thumb.png?1646252482)
What is the likely diagnosis in a patient on post-op day 1 status-post CABG that presents with hypotension, tachycardia, and the findings below:
Right atrium: 20 mmHg
Right ventricle: 35/20 mmHg
PCWP: 20 mmHg
Cardiac tamponade
equilibrated intracardiac diastolic pressures suggests cardiac tamponade
![](https://s3.amazonaws.com/brainscape-prod/system/cm/375/301/635/a_image_thumb.png?1646252545)