FARR Cardiovascular

Question 1

Classic ECG finding in atrial flutter.

Answer 1

“Sawtooth” P waves.

Question 2

Definition of unstable angina.

Answer 2

Angina is new, is worsening, or occurs at rest.

Question 3

Antihypertensive for a diabetic patient with proteinuria.

Answer 3

ACEI.

Question 4

Beck’s triad for cardiac tamponade.

Answer 4

Hypotension, distant heart sounds, and JVD.

Question 5

Drugs that slow AV node transmission.

Answer 5

β-blockers, digoxin, calcium channel blockers.

Question 6

Hypercholesterolemia treatment that leads to flushing and pruritus.

Answer 6

Niacin.

Question 7

Murmur—hypertrophic obstructive cardiomyopathy (HOCM)

Answer 7

Systolic ejection murmur heard along the lateral sternal border that ↑ with Valsalva maneuver and standing.

Question 8

Murmur—aortic insufficiency.

Answer 8

Diastolic, decrescendo, high-pitched, blowing murmur that is best heard sitting up; ↑ with ↓ preload (handgrip maneuver).

Question 9

Murmur—aortic stenosis.

Answer 9

Systolic crescendo/decrescendo murmur that radiates to the neck; ↑ with ↑ preload (Valsalva maneuver).

Question 10

Murmur—mitral regurgitation.

Answer 10

Holosystolic murmur that radiates to the axillae or carotids.

Question 11

Murmur—mitral stenosis.

Answer 11

Diastolic, mid- to late, low-pitched murmur.

Question 12

Treatment for atrial fibrillation and atrial flutter.

Answer 12

If unstable, cardiovert. If stable or chronic, rate control with calcium channel blockers or β-blockers.

Question 13

Treatment for ventricular fibrillation.

Answer 13

Immediate cardioversion.

Question 14

Autoimmune complication occurring 2–4 weeks post-MI.

Answer 14

Dressler’s syndrome: fever, pericarditis, ↑ ESR.

Question 15

IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?

Answer 15

Treat existing heart failure and replace the tricuspid valve.

Question 16

Diagnostic test for hypertrophic cardiomyopathy.

Answer 16

Echocardiogram (showing thickened left ventricular wall and outflow obstruction).

Question 17

A fall in systolic BP of > 10 mmHg with inspiration.

Answer 17

Pulsus paradoxus (seen in cardiac tamponade).

Question 18

Classic ECG findings in pericarditis.

Answer 18

Low-voltage, diffuse ST-segment elevation.

Question 19

Eight surgically correctable causes of hypertension.

Answer 19

Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism.

Question 20

Evaluation of a pulsatile abdominal mass and bruit.

Answer 20

Abdominal ultrasound and CT.

Question 21

Indications for surgical repair of abdominal aortic aneurysm.

Answer 21

> 5.5 cm, rapidly enlarging, symptomatic, or ruptured.

Question 22

Treatment for acute coronary syndrome.

Answer 22

Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin.

Question 23

What is metabolic syndrome?

Answer 23

Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states.

Question 24

Appropriate diagnostic test?
■ A 50-year-old man with angina can exercise to 85% of
maximum predicted heart rate.
■ A 65-year-old woman with left bundle branch block and
severe osteoarthritis has unstable angina.

Answer 24

Exercise stress treadmill with ECG.

Pharmacologic stress test (e.g., dobutamine echo).

Question 25

ECG findings suggesting MI.

Answer 25

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves.

Question 26

Coronary territories in MI.

Answer 26

Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal).

Question 27

A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.

Answer 27

Prinzmetal’s angina.

Question 28

Common symptoms associated with silent Mls.

Answer 28

CHF, shock, and altered mental status.

Question 29

The diagnostic test for pulmonary embolism.

Answer 29

V/Q scan.

Question 30

An agent that reverses the effects of heparin.

Answer 30

Protamine.

Question 31

The coagulation parameter affected by warfarin.

Answer 31

PT.

Question 32

A young patient with a family history of sudden death collapses and dies while exercising.

Answer 32

Hypertrophic cardiomyopathy.

Question 33

The 6 P’s of ischemia due to peripheral vascular disease.

Answer 33

Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia.

Question 34

Virchow’s triad.

Answer 34

Stasis, hypercoagulability, endothelial damage.

Question 35

The most common cause of hypertension in young women.

Answer 35

OCPs.

Question 36

The most common cause of hypertension in young men.

Answer 36

Excessive EtOH.