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Cardiology > CHF and CMP > Flashcards

CHF and CMP Flashcards

1
Q

Several nonspecific measures may be important, including avoidance of exercise, electrocardiographic monitoring, antiarrhythmic drugs in selected patients, treatment of HF, and anticoagulation in pts with…

A

myocarditis

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2
Q

The definitive diagnosis of myocarditis can be made only by …

A

endomyocardial biopsy

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3
Q

The most frequently implicated viruses in … are Coxsackie B virus, adenovirus, hepatitis C, cytomegalovirus (CMV), echovirus, influenza virus, Epstein-Barr virus (EBV), and the viruses of childhood exanthematous diseases.

A

myocarditis

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4
Q

The most successful therapeutic regimen of the patient with ascites is the combination of single morning oral doses of… (2 drugs), beginning with 100 mg and 40 mg, respectively.

A

spironolactone and furosemide

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5
Q

Muscular dystrophy (Duchenne, Becker, Emery-Dreifuss) can be associated with… (CV conditions)

A

cardiomyopathy and cardiac rhythm disturbances.

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6
Q

… is most frequently used in severe, medically refractory heart failure and cardiogenic shock and should not be routinely used in sepsis because of the risk of hypotension.

A

Dobutamine

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7
Q

This invasive procedure is performed every 6-12 months post cardiac transplant:…

A

coronary angiography.

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8
Q

… is the name given to the pathologic ventricular dilatation that occurs after AMI.

A

Ventricular remodeling

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9
Q

A minority of CHF patients with severely impaired renal function need… (intervention).

A

fluid restriction

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10
Q

A minority of CHF patients with significant hyponatremia need… (intervention).

A

fluid restriction

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11
Q

Although routine use of… in patients with mild CHF is not recommended, it may be reasonable to use this agent in place of K replacement in those with diuretic-induced hypokalemia.

A

spironolactone

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12
Q

In order to initiate a progressive exercise program, CHF patients need a…

A

submaximal or maximal monitored exercise test.

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13
Q

In patients presenting with acute CHF decompensation, the dose of beta-blockers should be reduced… % and tapered gradually if necessary.

A

50

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14
Q

The vasodilator heart failure trial (V-HeFT) was the first large scale trial in CHF showing a reduced mortality by 34% in patients treated with…

A

hydralazine 50mg and isosorbide dinitrate 40mg q6h.

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15
Q

… (morphology) is the greatest in endurance sports like rowing and cycling.

A

Athletic hypertrophy

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16
Q

The combination of furosemide and a… can be especially helpful when edema is refractory to either agent alone.

A

thiazide

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17
Q

Any patient with… cardiomyopathy should be strongly counseled against future pregnancies.

A

postpartum

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18
Q

A minority of CHF patients with refractory fluid retention need… (intervention).

A

fluid restriction

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19
Q

The only use for calcium blockers in CHF is for… , but not for CHF itself, and the only drug should be amlodipine.

A

angina or HTN

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20
Q

High… intake in patients on diuretics increases potassium loss and exacerbate hypokalemia.

A

salt

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21
Q

When the sum of the posterior wall and septum widths divided by the end-diastolic LV diameter is more than… , in a patient with CHF and normal EF, it can be assumed that diastolic dysfunction, LV hypertrophy or infiltrative cardiomyopathy is present.

A

0.45

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22
Q

This class of diuretics… is contraindicated in patients allergic to sulfonamide-derived drugs.

A

thiazide diuretics

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23
Q

… , apart from being the most widely used calcium blocker in hypertrophic cardiomyopathy, has a beneficial effect on angina and dyspnea and also improves exercise capacity.

A

Verapamil

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24
Q

… (class) most often are used to treat patients with impaired cardiac function and medically refractory heart failure, but their vasodilatory properties limit their use in hypotensive patients.

A

Phosphodiesterase inhibitors (amrinone and milrinone)

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25
Q

Digoxin is used in chronic heart failure when the patients are in sinus rhythm and still… despite optimal therapy with diuretics (including spironolactone), ACEI, and BB.

A

symptomatic

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26
Q

The first time a study showed that calcium blockers can be safely administered in CHF patients was PRAISE I on… (drug).

A

amlodipine

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27
Q

The characteristic gross pathology of… is dilation of all four chambers.

A

idiopathic dilated cardiomyopathy (IDCM)

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28
Q

… is the most common INHERITED CV dz, affecting 1:500 general population.

A

HCM (hypertrophic cardiomyopathy)

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29
Q

Chagas’ disease, disease of South and Central America caused by the parasite Trypanosoma cruzi, causes in 10-30% of patients serious or fatal inflammation of the brain and… (CV condition).

A

myocarditis.

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30
Q

… is characterized by a decrease in the E/A ratio and a prolonged E deceleration time.

A

Early stage LV diastolic dysfunction

31
Q

… is characterized by a restrictive pattern with a high E/A ratio and a shortened E deceleration time.

A

Late stage LV diastolic dysfunction

32
Q

Patients with LVEF<30% measured at least 1 month after AMI or 3 months after coronary intervention is class IIa indication for…

A

ICD therapy. (ACC/AHA/NASPE guidelines)

33
Q

The natural role of… is to attenuate the release and peripheral actions of noradrenaline, renin and vasopressin.

A

natriuretic peptides

34
Q

Hyponatremia may occur in severe CHF and is a sign of…

A

worse prognosis.

35
Q

An increase in the amplitude of the R wave and a decrease in the depth of the S wave in the right precordial leads (V1 and V2), causing an increase in the R:S ratio greater than 1 occurs in…

A

RVH.

36
Q

The most effective intervention for relief of symptoms in CHF is…

A

exercise training.

37
Q

The most common etiology for CHF in adults is…

A

CAD.

38
Q

… are LV structures more easily visualized in patients with cardiomyopathy and dilated hearts than in normal hearts.

A

The pseudochordae

39
Q

In normal individuals, early velocities exceed later velocities and the E to A ratio is typically greater than…

A

1.2.

40
Q

Predicting RVH from ECG: the sum of S in V5 or V6 plus R in V1 is greater than…

A

1 mV (10 mm)

41
Q

The follow-up in asymptomatic patients with mitral stenosis consists of echocardiography only when…

A

there is a change in the clinical status.

42
Q

Predicting RVH from ECG: R in V1 is equal to…

A

0.7 mV (7 mm)

43
Q

R wave < S wave in V6 occurs in…

A

RVH.

44
Q

Predicting RVH from ECG: R in V1 is equal to… when associated with RBBB.

A

1.5 mV (15 mm)

45
Q

Predicting LVH from ECG using Cornell voltage criteria for WOMEN requires that the sum of S in V3 plus R in aVL is greater than…

A

2.0 mV (20 mm)

46
Q

Predicting LVH from ECG using Cornell voltage criteria for MEN requires that the sum of S in V3 plus R in aVL is greater than…

A

2.8 mV (28 mm)

47
Q

A new class I indication supports adding … to standard medical therapy (including ACE-I and beta-blockers) in BLACK PATIENTS with NYHA functional class III or IV HF.

A

an isosorbide dinitrate-hydralazine combination

48
Q

Predicting LVH from ECG using Sokolow-Lyon index requires that the R wave in aVL is greater than or equal to…

A

1.1mV (11 mm)

49
Q

In the RALES randomized, placebo-controlled trial of… significantly reduced mortality risk among patients with severe heart failure and left-ventricular systolic dysfunction (N Engl J Med 1999; 341:709).

A

25 mg daily of spironolactone

50
Q

This review found no significant difference between… (class) and ACEIs in all cause mortality or hospital admission in people with New York Heart Association class II–IV heart failure.

A

angiotensin receptor blockers

51
Q

Phenylephrine (Neosynephrine®) is contraindicated if the SVR is…

A

> 1200 dynes x sec/cm5

52
Q

Some authors recommend keeping the SVR approximately… to avoid excessive afterload and to minimize complications from profound vasoconstriction.

A

700 to 1000 dynes x sec/cm5

53
Q

… is used most commonly to treat septic shock.

A

Norepinephrine

54
Q

… is most often used in hypotension due to sepsis or cardiac failure, where it should be started at 2 mcg/kg per minute and then titrated to a desired physiologic effect rather than a predicted pharmacologic range.

A

Dopamine

55
Q

Characteristics of patients in whom… is strongly supported by RCTs are: sinus rhythm, LVEF 120ms, NYHA functional class III or IV and on maximal pharmacological therapy for heart failure.

A

CRT

56
Q

… is useful in the setting of hypotension with an SVR <700 dynes x sec/cm5 (eg, hyperdynamic sepsis, neurologic disorders, anesthesia-induced hypotension).

A

Phenylephrine (Neosynephrine®)

57
Q

In…, there is diastolic flattening of the ventricular septum so that the left ventricular geometry in diastole assumes a D shape rather than circular geometry. Because this is a low-pressure phenomenon, the left ventricle becomes circular in early systo

A

a pure volume overload

58
Q

… results in flattening of the septum both in diastole and systole.

A

A right ventricular pressure overload

59
Q

… is characterized by paradoxical anterior motion of the septum in systole, with preserved myocardial thickening.

A

The postoperative septum; it is a phenomenon seen in any form of cardiac surgery in which the pericardium has been opened

60
Q

The postoperative septum resolves in… after surgery.

A

3 to 5 years

61
Q

A strong association between … class and both maternal and fetal complications was found in patients with valvular heart disease.

A

NYHA functional

62
Q

Heart failure with normal systolic function but abnormal diastolic relaxation accounts for … of patients presenting with congestive heart failure.

A

30 - 40 %

63
Q

Patients with dilated CMP, QRDS>120ms, EF<35%, and severe CHF (NYHA III-IV) despite optimal medical therapy should undergo…

A

CRT (cardiac resynchronization therapy).

64
Q

The most common of infiltrative cardiomyopathy is …

A

cardiac amyloidosis.

65
Q

All patients undergoing… will need therapy for their lipid abnormalities due to higher than expected risk of atherosclerotic events.

A

organ transplant

66
Q

The therapy of choice for familial Mediterranean fever is… shown to prevent both the acute febrile attacks and the development of amyloidosis.

A

colchicine

67
Q

A trial of colchicine or a genetic search for pyrin mutation could establish the diagnosis of…

A

familial Mediterranean fever.

68
Q

The prophylaxis in familial Mediterranean fever consists of daily…

A

colchicine.

69
Q

If a patient with HAPE (high altitude pulmonary edema) can not descent and receive supplemental oxygen, administration of oral… is recommended.

A

nifedipine

70
Q

To prevent HAPE (high altitude pulmonary edema), slow ascent, supplemental oxygen and… prophylaxis are indicated.

A

nifedipine

71
Q

The use of long-term oxygen therapy is indicated in patients with PaO2 less then… without evidence of cor pulmonale.

A

55

72
Q

The use of long-term oxygen therapy is indicated in patients with PaO2 less then… if evidence of cor pulmonale exists.

A

60

73
Q

… is characterized on intestinal biopsy by deposits of birefringence with polarized light after staining with Congo red.

A

Amyloidosis

Cardiology (12 decks)

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