Cards

Question 1

What syndrome consists of triad of - LE claudication, decr femoral pulse, erectile dysfunction

Answer 1

Leriche syndrome

Question 2

Most common cause of quick death after steering wheel accident

Answer 2

Aortic rupture

Question 3

Pts on amiodarone should have what labs checked

Answer 3

Tsh q6m bc risk if hypothy 85%, vs thyrotoxicosis 15%

Hypothyroidism happens bc high iodine deposit

Question 4

Wolff-parkinson-white syndrome and treatment

Answer 4

Ekg shows short PR, delta wave, wide qrs. may get tachyarrhythmias like afib which can cause vfib and then death

Caused by extra conduction between A and V whcihs excites ventricle faster

Precipitant like alcohol

Tx with catheter directed ablation

Question 5

Nitroprusside often used for hypertensive urgency bc potent vaso/venodilator but main risks are what?

Answer 5

Cyanide tox esp with renal failure. Esp if prolonged use or fast infusion. Can cause SEIZURE/AMS.

Tx is stopping and giving SODIUM THIOSULFATE

Question 6

Multifocal atrial tachycardia caused BY

Answer 6

Hypoxia, hypoMg or hypoK, heart disease, COPD

Verapamil is preferred treatment if cant treat underlying cause

Question 7

Treatment of AS (severe, ava

Answer 7

avr no matter age will decr mortality

Ballon vulvolotomy is assoc with HIGH morbidity and only transient efficacy

Question 8

40s to 50s yo woman p/w sob, fatigue, afib, hoarseness, diastolic rumbling murmur, loud S1 due to what heart prob?

Answer 8

Mitral stenosis likely from rheum hd.

Vs noonan syndrome has short stature, facial deform and heart defect

Question 9

30 yo m active jogger wo symp found to have incidental harsh 4/6 holosystolic murmur at 4th left intercostal space with thrill has…

Answer 9

vsd - most likely Small one

40-60% close during childhood

Question 10

How do u monitor for risk of AR dissection in marfans pt?

Answer 10

Tte at dx and q6 months. If aortic diameter>50 mm than replace the aortic root

Question 11

Narrow complex qrs tachycardia with no identifiable q waves

Answer 11

psvt

Question 12

Where can you best hear the heart sounds?
rusb, lusb, apex (midclavicular line between 5th and 6th ribs)
L lower sternal border

Answer 12

Lusb - pulm valve

llSb - tricuspid

Question 13

How to treat TG>500? What if TG

Answer 13

Gemfibrozil. If

Question 14

How to tx cocaine induced mi?

Answer 14

First nitrates, asa, benzo

If no imp then cath them!

Question 15

Dvlp chf after cabg due to

Answer 15

Constrictive pericarditis!
Tx w supportive measures like nsaids and pericardiectomy for refractory cases

Note that amyloidosis would cause incr wall thickness of ventricle

Question 16

Asymp lv dysfunction w ef 35%. What is most imp drug to start

Answer 16

Ace inh.

not spirono which is not rec if asymp!!!

Question 17

Person w stemi gets hypotensive, nausea/weak. Next step is

1) incr preload?
2) incr afterload?
3) ionotrope?

Answer 17

Incr preload ie ivf

Question 18

Intraop hypotension in pheo managed w

Answer 18

Ns ivf bolus

Not pentolamine w is a alpha blocker and worsen hypotension

Prior to procedure need preop alpha block, fluid repletion

Question 19

Pt on sotalol!! And placed on azithro for pna now w ekg showing torsades. What is most likely to cause another ep?

Sinus brady
Fever
Htn

What is tx?

Answer 19

Sinus brady or pauses

Question 20

Best tx for htn in gout pt

Answer 20

Arb like losartan (even if cr 1.2)

Acute gout flare tx is indomethacin or colchicine

Avoid asa which decr renal urate excetion

Question 21

Ivdu w loud holosystolic murmur, petechaie, w headache lethargy neck stiffness has

Answer 21

Mycotic aneurysm- inf of any artery (even cerebral) causing anuerysm and neuro deficit

Tx w abx and surgey

Question 22

Vsd has what heart sound

Asd?

Answer 22

Vsd has holosystolic murmur at left sternal border

Asd has fixed split s2

Question 23

Bicuspid aortic valve found. Next step is

Answer 23

Screen first deg relatives w tte!!

Fu tte in 1-2 yrs

Question 24

Pt w horners syndrome and new onset unilateral headache has

Next step

Answer 24

Carotid artery dissection

Get cta of head and neck

Tx is antiplatete or ac

Question 25

When can u have sex after mi w stent placement?

Answer 25

1-4 wks

Question 26

A woman w mvr and lifelong warfarin now wants baby. What to do w warfarin?

Answer 26

Replace warfarin w lmw heparin during first trimester and before delivery (bc reversible) but can continue due breastfeeding and 2nd-3rd trimester

Question 27

Cocaine induced vasospasm cp and now w persistent htn and already gave benzo. What to give?

Answer 27

Pentolamine a alpha antagonist

Nitropruss is also reasonable

Question 28

When do u need immediate perc intervention for catdiac tamponade?

Answer 28

Pericardiocentesis!

When rv collapse during diastole, ivc full, pulsus paradosus >10 mmhg

Question 29

Sudden cardiac death in teen w cp, palpitations, syncope but normal ekg and echo due to

Answer 29

Anomalous coronary artery!!!

Va brugada see rbbb and ste

Question 30

Man w scoliosis velvety hyperextensibke easily bruised skin w atrophic scars has pulm edema and MR regurg on exam. Dx

Answer 30

Chordae tendonae rupture and has ehlers danlos

Question 31

SE of pioglitazone

Answer 31

Pulm edrma and sodium retention esp in HF pts