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1
Q

WPW increases the risk of converting into what rhythm?

A

Parasoxymal Supraventricular Tachycardia

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2
Q

A pt on chronic anticoagulation (warfarin) is started on amiodarone. Do you need to make any changes?

A

Reduce warfarin dose by 25%

Amiodarone is a CYP inhibitor, so there will be more warfarin available in the blood stream

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3
Q

A cane dependent pt needs a stress test. What is his best option?

A

adenosine myocardial perfusion imaging

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4
Q

What is the management of a pt with DM and multivessel CAD?

A

CABG

This is preferred over PCI w/ drug eluting stents because they are less likely to have a MI s/p intervention

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5
Q

What heart murmur would you expect in a VSD?

A

Holosystolic murmur at LSB

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6
Q

Which heart defect has a fixed splitting of S2

A

ASD

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7
Q

What should be considered in all patients with DM ages 40-75

A

Starting a statin
Especially if LDL is >190
Heart score w/ 10 year risk determines if they need high or medium intensity statin

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8
Q

Initial management for Hypertrophic cardiomyopathy

A

Beta Blocker

Verapamil or disopyramide can be added if symptoms are persitent

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9
Q

Pt with pleuritic chest pain 3 days s/p PCI

A

Acute pericarditis

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10
Q

Tx for peri-infarction pericarditis?

A

High dose Aspirin

Avoid NSAIDS/colchicine/steroids because they impair cardiac healing and increase risk for ventricular wall rupture

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11
Q

Its with compartment syndrome are at high risk of developing?

A

Rhabdo

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12
Q

What would you do for a pt with new syncope w/o a prodrome but negative ER workup

A

admit
Tele
ECHO
This was most likely cariogenic shock d/t Vtach and could lead to sudden cardiac death if not well managed
May eventually need medication, ablation, and/or pacemaker

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13
Q

Syncope at rest w/o prodrome be concerned for?

A

Cardiogenic syncope 2/2 VTACH
At risk for sudden cardiac death
Admit for obs on tele

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14
Q

What increases risk of VTACH?

A

H/o MI

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15
Q

Treatment for NSTEMI?

A 
antiplatelets x 2 (ASA, clopi)
Metoprolol
AC (heparin)
High dose statin
PCI within 24 hours
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16
Q

If a pt has NSTEMI + JVD, what medicine would you hold?

A

Metoprolol

Further exacerbates the decompensated HF

17
Q

Pt with acute inferior MI develops bradycardia and hypotension. How do you manage?

A

Give atropine - if no improvement give cardiac pacing
Cardiac shock can occur after inferior MI’s (symptomatic brady’s). It tends to be transient but they do need help in the interim

18
Q

Best way to improve blood pressure w/o medication?

A

Weight loss

19
Q

AA male with HFrEF <40% w/o great control on ACEI and Beta blockade. Consider adding which medication?

A

Isosorbide nitrate + hydralazine
Improved mortality benefit in AA
Consider this in CHF patients that cant tolerate lisinopril

20
Q

Patients with connective tissue disease are at risk for what acute cardiac event?

A

MVR d/t chordae tendinae rupture

Present with SOB, hypotension, Tachy, JVD. Acutely cannot move blood forward

21
Q

Young healthy guy, weight loss x 2 months, now coming in with a small artery occlusion. Concerning for?

A

Cardiac myxoma

22
Q

1st line therapy for Afib with RVR

A

Beta blocker or CCB

23
Q

Why do athletes have sinus bradycardia?

A

Increased vagal tone

“athletes heart”

24
Q

Criteria for Bi-ventricular pacing in CHF

A

EF < 35%
LBB with QRS >160ms
presence of syx (ie SOB, peripheral edema)

25
Q

Whats a good idea for an antihypertensive in a guy with BPH?

A

Doxazosin

Improvement in urinary syx and decrease his BP

26
Q

An infant’s mom has GDM and the infant is born with tachypnea and RDS but lungs look ok. Why

A

Transient hypertrophic cardiomyopathy

Temporarily these babies can have CHF d/t intraventricular thickening d/t the increased glycogen in their muscle.

27
Q

Stress test with reversible perfusion defect in the lateral wall of the LV. Which artery is occluded?

A

L circumflex coronary a.

28
Q

EKG criteria to dx a STEMI

A

> 1 mm ST elevation in two anatomically contingent leads (excluding V2, V3)

29
Q

Treatment for cocaine related chest pain?

A

IV benzo

Decrease sympthametic tone

30
Q

Pt with recent cocaine use now has chest pain and focal neuro findings. Negative head CT. What do you do next?

A

Chest CT

Be suspicious of aortic dissection

31
Q

Down syndrome baby turns blue with feeds and has a holosystolic murmur. What are you suspicous for?

A

endocardial cushion defect
Most common cardiac defect in Down’s syndrome
ECHO will reveal defect

32
Q

Which antihypertensives tend to cause lower extremity edema?

A

CCB’s

33
Q

How do you distinguish SVT from Sinus tach on EKG

A

SVT has wide QRS, no p waves

Sinus tach narrow QRS and p waves if not burried

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