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Step 2CK > Cardiovascular System 2 > Flashcards

Cardiovascular System 2 Flashcards

1
Q

What should be performed after 6-8 weeks in patients with suspected Kawasaki disease?

A

Echo (to check for coronary artery aneurysms)

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2
Q

How does the measles rash spread?

A

From head to toe

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3
Q

What does squatting do during Tet spells?

A

Increases the systemic vascular resistance

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4
Q

What happens in Tetralogy of Fallot when the pulmonary vascular resistance exceeds the systemic vascular resistance?

A

Cyanosis (R to L shunt)

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5
Q

What’s the tx for Vfib?

A

Defibrillation

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6
Q

When do you give Epinephrine?

A

Vtach

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7
Q

How does the cardiac contour look with acute tamponade (rather than subacute)?

A

Acute has a normal cardiac contour

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8
Q

Is anticoagulation needed in lone paroxysmal Afib?

A

No

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9
Q

What does increased QRS voltage indicate?

A

LVH

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10
Q

Tet spells are due to what VOT?

A

RVOT

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11
Q

What would you check first before performing a renal US?

A

Serum creatinine and urinalysis

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12
Q

What should be suspected in young patients with unexplained AV block?

A

Sarcoidosis

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13
Q

How does B-blocker toxicity present?

A

Bradycardia, hypotension, hypoglycemia, delirium, seizures, cardiogenic shock

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14
Q

How do you treat B-blocker toxicity?

A

Glucagon

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15
Q

How does digoxin toxicity present?

A

Fatigue, nausea, blurred vision, disturbed color perception, cardiac arrhythmias

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16
Q

What does wide splitting indicate (causes a delayed pulmonic sound)?

A

Pulmonic stenosis
RBBB

“Drinking PBR makes you wide”

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17
Q

What does paradoxical splitting indicate (eliminates the split sound)?

A

AS

LBBB

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18
Q

What does increasing hand grip increase?

A

Afterload

“Jerking off the afterload”

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19
Q

What murmurs are increased by hand grip?

A

MR, AR, and VSD

“Mr Arvsd loves jerking off”

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20
Q

What does valsalva decrease?

A

Preload

“To reduce pre-cum, bear down during sex”

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21
Q

What murmurs are increased by valsalva?

A

HOCM

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22
Q

What does rapid squatting increase? (3)

A
  1. Venous return
  2. Preload
  3. Afterload
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23
Q

What murmurs are increased by rapid squatting?

A

MR, AS, and VSD

“Mr ASSvsd loves squats”

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24
Q

Diastolic _____?

A

ARMS &

PRTS

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25
Q

The machine is a ____?

A

PDA

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26
Q

What are the 3 signs of LHF?

A
  1. Orthopnea
  2. Paroxysmal nocturnal dyspnea
  3. Pulmonary edema
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27
Q

What are the 3 signs of RHF?

A
  1. Hepatomegaly
  2. JVD
  3. Peripheral edema
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28
Q

Are the following levels increased or decreased in hypovolemic shock?
PCWP (preload)
CO
SVR (afterload)

A

PCWP: Decreased
CO: Decreased
SVR: Increased

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29
Q

What protozoan can cause megacolon and cardiac disease?

A

T cruzi (Chagas disease)

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30
Q

Remember, the question stem might include a JVD but it might be a normal value! What is the normal range for JVD?

A

Less than 4cm above sternal angle

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31
Q

T/F: Turner’s syndrome can predispose to aortic dissection?

A

True

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32
Q

What is sick sinus syndrome?

A

Age-related degeneration of the cardiac conduction system, leading to bradycardia/tachycardia, pauses, etc

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33
Q

Which EKG reading has irregularly irregular beats with no P waves?

A

Afib

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34
Q

Which EKG reading has a sawtooth-like appearance?

35
Q

Which EKG reading has completely random, drawn-appearing waves?

36
Q

Which EKG reading has a prolonged (>200ms) PR interval?

A

First degree AV block

37
Q

Which EKG reading has a progressively longer PR interval with an eventual dropped QRS?

A

Second degree AV block: Mobitz type I

38
Q

Which EKG reading has randomly dropped QRS?

A

Second degree AV block: Mobitz type II

39
Q

Which EKG reading has complete dissociation of P and QRS wave?

A

Third degree (complete) AV block

40
Q

What conditions have wide splitting?

A

Pulmonic stenosis
RBBB

“Many right wingers are very wide”

41
Q

Which conditions have “paradoxical” aka no splitting?

A

AS
LBBB

“The left has some paradoxical beliefs”

42
Q

Which condition has fixed splitting?

43
Q

Are the following levels increased or decreased in cardiogenic and obstructive shock?
PCWP (preload)
CO
SVR (afterload)

A

PCWP: Increased or decreased
CO: Decreased
SVR: Increased

44
Q

Are the following levels increased or decreased in distributive shock?
PCWP (preload)
CO
SVR (afterload)

A

PCWP: Decreased
CO: Increased (sepsis, anaphylaxis) or decreased (CNS injury)
Decreased

45
Q

What are the 6 main causes of JVD?

A
  1. Pulmonary HTN
  2. Pericardial effusion/cardiac tamponade
  3. Tricuspid stenosis
  4. RHF
  5. SVC syndrome
  6. Constrictive pericarditis
46
Q

What’s a complication of cardiac cath within the first 12 hours that results in sudden onset of hypotension and back pain?

A

Retroperitoneal hematoma

47
Q

What imaging study do you do to check for retroperitoneal hematoma?

A

CT scan of abdomen/pelvis without contrast

48
Q

What type of heart defect causes a holosystolic murmur at the left lower sternal border?

49
Q

Can bradyarrhythmias have a widened QRS?

50
Q

What’s the most common heart complication of rheumatic fever?

A

Mitral stenosis

51
Q

What heart chamber can get dilated due to severe MS?

A

L atrium, and this can lead to Afib

52
Q

If you’re having trouble determining whether or not it’s decompensated HF vs tamponade/effusion, what should you check?

A

BP– if it’s high then it’s HF, if it’s low then it’s tamponade/effusion

53
Q

Where is the MI if there is ST elevation in leads II, III, & aVF?

A

Inferior MI

“inFerior”

54
Q

Where is the MI if there is ST elevation or depression in leads I & aVL?

A

Posterior MI

55
Q

Where is the MI if leads V1-V6 are involved?

A

Anterior MI

56
Q

Where is the MI if leads I, aVL, V5&V6 or II, III, & aVF are involved?

A

Lateral MI

57
Q

Which vessel is involved in an anterior MI (leads V1-V6)?

58
Q

Which vessel is involved in an inferior MI (leads II, III, & aVF)?

A

RCA or LCX

59
Q

Which vessel is involved in a posterior MI (leads V1-V3, I or aVL)?

A

LCX or RCA

60
Q

Which vessel is involved in a lateral MI (I, aVL, V5 & V6, or II, III, & aVF)?

61
Q

Which MI shows ST elevation in V4-V6?

A

R ventricle

62
Q

Which vessel is involved in a R ventricle MI (ST elevation in leads V4-V6)?

63
Q

What might cause chest pain in a young adult and shows prolonged QRS on EKG?

A

First degree AV block

64
Q

Is peripheral edema or S3 more specific to HF?

65
Q

Which 2 mineralocorticoid receptor antagonists improve overall survival for HF in symptomatic patients with LV systolic dysfunction?

A
  1. Spironolactone

2. Eplerenone

66
Q

What kind of pulses go along with AR?

A

Bounding “water hammer”

67
Q

What type of drug is clopidogrel?

A

P2y12 receptor blocker

68
Q

What type of drug is apixaban?

A

Factor Xa inhibitor

69
Q

At what diameter of occlusion to AS symptoms become severe?

70
Q

What’s the best imaging study for patients with suspected aortic dissection?

A

CT angiography

71
Q

What is a TTE used to look for?

A

Valvular abnormalities

72
Q

T/F: renal artery stenosis can results in an upper abdominal systolic/diastolic bruit?

73
Q

Would an AAA cause HTN?

A

No; it would likely just be an asymptomatic pulsatile mass

74
Q

What is a common cause of LV hypertrophy?

A

Prolonged HTN

75
Q

What’s the anti-anginal mechanism of nitrates?

A

Systemic vasodilation and decrease in cardiac preload, resulting in a decrease in LV end-diastolic and end-systolic volume, leading to a reduction in LV systolic wall stress which reflects afterload (and therefore a decreased O2 need)

76
Q

Does aortic root dilation in Marfan’s cause an early diastolic murmur, due to AR?

77
Q

What are the symptoms of digoxin toxicity?

A

Nausea, vomiting, diarrhea, vision changes, arrhythmia

78
Q

What do urine metanephrines test for?

A

Pheochromocytoma

79
Q

What does a 24-hour urine cortisol excretion test for?

A

Cushing syndrome

80
Q

What does a high plasma aldosterone/renin ratio indicate?

A

Primary aldosteronism (Conn syndrome)

81
Q

What’s the first step in diagnosing bilateral abdominal masses with HTN?

82
Q

How does acute pericarditis appear on EKG?

A

Diffuse ST elevations (more sloping than STEMI)

83
Q

Why does Tetralogy of Fallot present with a harsh, systolic ejection murmur over the LUSB?

A

Due to pulmonary stenosis

Step 2CK (31 decks)

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