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Cardiology > Exam Compilation > Flashcards

Exam Compilation Flashcards

1
Q

Single most important bedside measurement to estimate volume status. Harrison’s 19th ed page 1443

A

Jugular Venous Pressure

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2
Q

Elements of complete cardiac diagnosis. Harrison’s 19th ed page 1439

A

underlying Etiology
Anatomic abnormalities
Physiologic disturbances
Functional disability

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3
Q

NYHA Functional CLASS II. Harrison’s 19th ed page 1440

A

Slight limitation of physical activity

Ordinary activity causes symptoms

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4
Q

Defined as posterior calf pain on active dorsiflexion of the foot against resistance. Harrison’s 19th ed page 1443

A

Homan’s sign

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5
Q

Possible underlying etiologies for cardiac diagnosis. Harrison’s 19th ed page 1439

A

Congenital
Hypertensive
Ischemic
Inflammatory

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6
Q

NYHA Functional CLASS IV. Harrison’s 19th ed page 1440

A

Inability to carry out any physical activity without discomfort
Symptoms at rest

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7
Q

Abdominojugular reflex. Harrison’s 19th ed page 1444

A

Firm and consistent pressure over the right upper quadrant for at least 10 seconds

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8
Q

Possible anatomic abnormalities for cardiac diagnosis. Harrison’s 19th ed page 1440

A

Chambers involved (hypertrophied, dilated or both)
Valves affected (regurgitant or stenotic)
Pericardial involvement
Myocardial infarction

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9
Q

NYHA Functional CLASS I. Harrison’s 19th ed page 1440

A

No limitation of physical activity

No symptoms with ordinary exertion

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10
Q

Positive Abdominojugular reflex. Harrison’s 19th ed page 1444

A

Sustained rise of more than 3cm in JVP for at least 15 seconds after release of the hand

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11
Q

Possible physiologic disturbances for cardiac diagnosis. Harrison’s 19th ed page 1440

A

Arrhythmia
Congestive heart failure
Myocardial ischemia

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12
Q

NYHA Functional CLASS III. Harrison’s 19th ed page 1440

A

Marked limitation of physical activity
Less than ordinary activity causes symptoms
Asymptomatic at rest

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13
Q

Gold standard in the assessment of anatomy and physiology of the heart. Harrison’s 19th ed page 1460

A

Diagnostic cardiac catheterization and Coronary angiography

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14
Q

Causes of Reversed or Paradoxical Splitting of S2. Harrison’s 19th ed page 1447

A 
Left bundle branch block
Right ventricular pacing
Severe AS
HOCM
AMI
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15
Q

Absolute contraindications to Cardiac Catheterization. Harrison’s 19th ed page 1460

A

None

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16
Q

Relative contraindications to Cardiac Catheterization. Harrison’s 19th ed page 1460

A

Decompensated congestive heart failure
Acute renal failure
Severe chronic renal insufficiency
Bacteremia
Acute stroke
Active GI bleeding
Severe uncorrected electrolyte abnormalities
History of anaphylactic reaction to iodinated contrast agents
History of allergy/bronchospasm to aspirin

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17
Q

CHA2DS2-VASc. Harrison’s 19th ed page 1485

A 
C – CHF
H – Hypertension
A – Age  75
D – DM
S – Stroke or TIA, embolus
V – Vascular disease
A – Age 65-75
Sc - Female
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18
Q

Multifocal Atrial Tachycardia. Harrison’s 19th ed page 1485

A

3 distinct P-wave morphologies
HR 100-150bpm
Clear isoelectric intervals between P waves
Usually in chronic pulmonary disease and acute illness

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19
Q

Most common sustained arrhythmia. Harrison’s 19th ed page 1486

A

Atrial fibrillation

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20
Q

Sustained ventricular tachycardia persists longer than? Harrison’s 19th ed page 1489

A

> 30 seconds

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21
Q

Congenital Long QT syndrome Type 1 (LQTS1). Harrison’s 19th ed page 1497

A

One of the most frequent
Abnormality in K channels
Occurs during exertion, particularly swimming

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22
Q

Congenital Long QT syndrome Type 2 (LQTS2). Harrison’s 19th ed page 1497

A

One of the most frequent
Abnormality in K channels
Predisposed by sudden auditory stimuli or emotional upset

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23
Q

Congenital Long QT syndrome Type 3 (LQTS3). Harrison’s 19th ed page 1497

A

Abnormality in Na channels

Sudden death during sleep is a notable feature

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24
Q

Characteristics of chest pain that increases the likelihood of AMI. Harrison’s 19th edition page 99

A 
Radiation to the right arm or shoulder
Radiation to both arms or shoulder
Associated with exertion
Radiation to the left arm
Associated with diaphoresis
Associated with nausea and vomiting
Worse than previous angina or similar to previous MI
Described as pressure
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25
Q

Characteristics of chest pain that decreases the likelihood of AMI. Harrison’s 19th edition page 99

A 
Inframammary location
Reproducible with palpation
Described as sharp
Described as positional
Described as pleuritic
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26
Q

Canadian cardiovascular society classification Class I. Harrison’s 19th edition page 1581

A

Ordinary physical activity such as walking and climbing stairs does not cause angina.
Angina present with strenuous or rapid or prolonged exertion at work or recreation

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27
Q

Canadian cardiovascular society classification Class II. Harrison’s 19th edition page 1581

A

Slight limitation of ordinary activity
Walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, in cold or when under emotional stress or only during the few hours after awakening
Walking more than two blocks on the level and climbing more than one flight of stairs at a normal pace and in normal conditions

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28
Q

Canadian cardiovascular society classification Class III. Harrison’s 19th edition page 1581

A

Marked limitation of ordinary physical activity.

Walking one to two blocks on the level and climbing more than one flight of stairs in normal conditions

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29
Q

Canadian cardiovascular society classification Class IV. Harrison’s 19th edition page 1581

A

Inability to carry on any physical activity without discomfort
Anginal syndrome may be present at rest

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30
Q

First line of therapy in patients with symptomatic Idiopathic Ventricular Tachycardia. Harrison’s 19th edition page 1496

A

B-Adrenergic blockers

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31
Q

Important predictor of patient outcome in Heart Failure. Harrison’s 19th edition page 1501

A

Functional Status

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32
Q

EF of Depressed/Reduced Ejection Fraction. Harrison’s 19th edition page 1501

A

<40%

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33
Q

EF of Preserved Ejection Fraction. Harrison’s 19th edition page 1501

A

> 40-50%

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34
Q

Etiologies of Preserved Ejection Fraction. Harrison’s 19th edition page 1501

A

Pathologic hypertrophy (hypertrophic cardiomyopathy, hypertension)
Aging
Restrictive cardiomyopathy (infiltrative disorders-amyloidosis, sarcoidosis; Storage disease-hemochromatosis)
Fibrosis
Endomyocardial disorders

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35
Q

Etiologies of high-output states of heart failure. Harrison’s 19th edition page 1501

A

Thyrotoxicosis
Beriberi
Systemic AV shunting
Chronic anemia

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36
Q

Etiologies of Depressed Ejection fraction heart failure. Harrison’s 19th edition page 1501

A 
Myocardial infarction
Myocardial ischemia
Hypertension
Obstructive valvular disease
Regurgitant valvular heart disease
Intracardiac (left-to-right) shunting
Extracardiac shunting
Cor pulmonale
Pulmonary vascular disorders
Familial/genetic disorders
Infiltrative disorders
Metabolic disorders
Viral
Chaga’s disease
Chronic brady and tachyarrhythmias
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37
Q

Major cause of Heart Failure in Africa and Asia. Harrison’s 19th edition page 1501

A

Rheumatic Heart Disease

38
Q

Predominant cause of Heart Failure in industrialized countries and is responsible for 60-75% of cases of Heart Failure. Harrison’s 19th edition page 1501

A

Coronary Artery Disease

39
Q

Major cause of Heart Failure in African and African-American Populations. Harrison’s 19th edition page 1501

A

Hypertension

40
Q

Major cause of Heart Failure in South America. Harrison’s 19th edition page 1501

A

Chaga’s Disease

41
Q

Frequent concomitant factor in HF in many developing nations. Harrison’s 19th edition page 1501

A

Anemia

42
Q

Refers to the changes in LV mass, volume and shape. Harrison’s 19th edition page 1503

A

Ventricular remodeling

43
Q

Dyspnea occurring in the recumbent position. Harrison’s 19th edition page 1503

A

Orthopnea

44
Q

Alterations in LV chamber geometry in LV remodeling. Harrison’s 19th edition page 1503

A

LV dilation
Increased LV sphericity
LV wall thinning
Mitral valve incompetence

45
Q

Alterations in myocyte biology in LV remodeling. Harrison’s 19th edition page 1503

A 
Excitation-contraction coupling
Myosin heavy chain (fetal) gene expression
B-adrenergic desensitization
Hypertrophy
Myocytolysis
Cytoskeleton proteins
46
Q

Myocardial changes in LV remodeling. Harrison’s 19th edition page 1503

A 
Myocyte loss (necrosis, apoptosis, autophagy)
Alterations in extracellular matrix (matrix degradation and myocardial fibrosis)
47
Q

Caused by redistribution of fluid from the splanchnic circulation and lower extremities into the central circulation with a resultant increase in pulmonary capillary pressure. Harrison’s 19th edition page 1503

A

Orthopnea

48
Q

Described as increase in intensity of the holosystolic murmur of tricuspid regurgitation with inspiration. Harrison’s 19th edition page 1506

A

Carvallo’s sign

49
Q

Most common cause of right sided Heart Failure. Harrison’s 19th edition page 1506

A

Left Heart Failure

50
Q

Parameters are associated with worse outcomes in patients with Heart Failure. Harrison’s 19th edition page 1508

A

BUN > 43mg/dL
SBP < 115mmHg
Serum creatinine > 2.75mg/dL
Elevated Troponin I

51
Q

Useful to support clinical decision making regarding the diagnosis of Heart Failure and establishing prognosis or disease severity in chronic heart failure. Harrison’s 19th edition page 1505

A

B-Type natriuretic peptide (BNP)

N-terminal pro-BNP (NT-proBNP)

52
Q

Conditions that can cause false negative result to BNP and NT-proBNP. Harrison’s 19th edition page 1505

A

Obesity

53
Q

Conditions that can cause false positive result to BNP and NT-proBNP. Harrison’s 19th edition page 1505

A

Old Age
Renal impairement
Women
Right HF from any cause

54
Q

Components of Tetralogy of Fallot. Harrison’s 19th edition page 1526

A

Malaligned VSD
Obstruction to RV outflow
Aortic override of the VSD
RV hypertrophy

55
Q

Physical findings of Aortic Stenosis. Harrison’s 19th edition page 1531

A 
Pulsus parvus et tardus
Anacrotic “shudder”
Accentuated a wave in the JVP
Systolic thrill at the base of the heart to the right sternum
Parodoxical splitting of S2
S3 and S4
Ejection (mid) systolic murmur
56
Q

Carotid arterial pulse rises slowly to a delayed peak. Harrison’s 19th edition page 1531

A

Pulsus parvus et tardus

57
Q

A palpable thrill more commonly over the left carotid arteries. Harrison’s 19th edition page 1531

A

Anacrotic “shudder”

58
Q

Normal mitral valve orifice. Harrison’s 19th edition page 1539

A

4-6cm2

59
Q

Mitral valve area of patients with severe MS. Harrison’s 19th edition page 1539

A

1-1.5cm2

60
Q

Most common primary MALIGNANT cardiac tumor. Harrison’s 19th edition page 1577

A

Sarcoma

61
Q

Most common primary cardiac tumor. Harrison’s 19th edition page 1577

A

Myxomas

62
Q

Door-to-needle time. Harrison’s 19th edition page 1605

A

30 minutes

63
Q

Goal of reperfusion therapy. Harrison’s 19th edition page 1605

A

TIMI grade 3

64
Q

Thrombolysis in Myocardial Infarction (TIMI) Grade 0. Harrison’s 19th edition page 1605

A

Complete occlusion of the infarct-related artery

65
Q

Thrombolysis in Myocardial Infarction (TIMI) Grade 1. Harrison’s 19th edition page 1605

A

Some penetration of the contrast material beyond the point of obstruction but without perfusion of the distal coronary bed

66
Q

Thrombolysis in Myocardial Infarction (TIMI) Grade 2. Harrison’s 19th edition page 1605

A

Perfusion of the entire infarct vessel into the distal bed, but with flow that is delayed compared with normal artery

67
Q

Thrombolysis in Myocardial Infarction (TIMI) Grade 3. Harrison’s 19th edition page 1605

A

Full perfusion of the infarct vessel with normal flow

68
Q

Absolute Contraindications to the use of fibrinolytic agents. Harrison’s 19th edition page 1605

A

Cerebrovascular hemorrhage at any time
Nonhemorrhagic stroke or other cerebrovascular event within the past year
BP > 180/110
Suspicion of Aortic dissection
Active internal bleeding (excluding menses)

69
Q

Relative Contraindications to the use of fibrinolytic agents. Harrison’s 19th edition page 1605

A

Use of anticoagulants (INR2)
Recent invasive or surgical procedure (<2 weeks)
Prolonged cardiopulmonary resuscitation (>10mins)
Known bleeding diasthesis
Pregnancy
Hemorrhagic ophthalmic condition
Active peptic ulcer disease
History of severe hypertension that is currently and adequately controlled
Previous use of streptokinase (5 days to 2 years)

70
Q

Most frequent complication to the use of fibrinolytics. Harrison’s 19th edition page 1605

A

Hemorrhage

71
Q

Most serious complication to the use of fibrinolytics. Harrison’s 19th edition page 1605

A

Hemorrhagic stroke

72
Q

Myocardial Infarction Type 1. Harrison’s 19th edition page 1602

A

Spontaneous myocardial infarction

73
Q

Myocardial Infarction Type 2. Harrison’s 19th edition page 1602

A

Myocardial infarction secondary to an ischemic imbalance

74
Q

Myocardial Infarction Type 3. Harrison’s 19th edition page 1602

A

Myocardial infarction resulting in death where biomarker values are unavailable

75
Q

Myocardial Infarction Type 4a. Harrison’s 19th edition page 1602

A

Myocardial infarction related to percutaneous coronary intervention (PCI)

76
Q

Myocardial Infarction Type 4b. Harrison’s 19th edition page 1602

A

Myocardial infarction related to stent thrombosis

77
Q

Myocardial Infarction Type 5. Harrison’s 19th edition page 1602

A

Myocardial infarction related to coronary artery bypass grafting (CABG)

78
Q

Killip class I. Harrison’s 19th edition page 1607

A

No signs of pulmonary or venous congestion

79
Q

Killip class II. Harrison’s 19th edition page 1607

A 
= Moderate heart failure
Rales
S3 gallop
Tachypnea
Signs of failure of the right side of the heart
Venous congestion
Hepatic congestion
80
Q

Killip class III. Harrison’s 19th edition page 1607

A

= severe heart failure

pulmonary edema

81
Q

Killip class IV. Harrison’s 19th edition page 1607

A 
Shock with systolic pressure <90mmHg
Peripheral vasoconstriction
Peripheral cyanosis
Mental confusion
Oliguria
82
Q

Symptom that confers the worst outcome in patients with Aortic Stenosis. Harrison’s 19th edition page 1532

A

Congestive Heart Failure

83
Q

Treatment of choice for Acute Aortic Regurgitation. Harrison’s 19th edition page 1536

A

Surgery

84
Q

Leading cause of mitral stenosis (MS). Harrison’s 19th edition page 1539

A

Rheumatic fever

85
Q

Cardiac murmurs that increases when Standing and Valsalva maneuver. Harrison’s 19th edition page 1448

A

Systolic murmur of HCOM

Murmur of MVP

86
Q

Mitral Valve Prolapse. Harrison’s 19th edition page 1539

A

More common in young women (15-30yrs)
Posterior mitral leaflet is more commonly affected
Murmur is increased by standing and Valsalva maneuver

87
Q

Beck’s Triad. Harrison’s 19th edition page 1573

A

Hypotension
Soft or absent heart sounds
Elevated JVP (prominent x descent, absent y descent)

88
Q

Most common toxin implicated in chronic dilated cardiomyopathy. Harrison’s 19th edition page 1562

A

Alcohol

89
Q

Most common drugs implicated in toxic cardiomyopathy. Harrison’s 19th edition page 1562

A

Chemotherapy agents

90
Q

Treatment of Constrictive Pericarditis. Harrison’s 19th edition page 1576

A

Pericardial Resection

Cardiology (2 decks)

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