Hobbs Questions 2. Flashcards
What is the most sensitive the least specific enzyme used as a cardiac marker?
myoglobin
what cardiac enzyme stays present for the longest period of time after an acute MI?
Troponin
Myocardial Infarctions that are a direct result of acute coronary artery vasospasms are most commonly caused by the ingestion of what illegal substance?
Cocaine
What is the most common cause of death related to myocardial infarction?
Dysrrhythmias
What are the contraindications for the use of beta blockers in an acute myocardial infarction?
severe asthma, advance congestive heart disease, peripheral vascular disease, type 1 diabetes, heart block, severe hypotension
Which of the papillary muslces is most commonly affected following an affected following an acute MI?
posterior papillary muscle of the mitral valve due to its single vessel blood supply
A septal wall myocardial infarction leads to what complication within the heart?
Ventral septal defect
what are the most common causes of high output heart failure?
anemia, thyrotoxicosis, AV fistula
What are the most common causes of low output congestive heart failure?
coronary artery disease/ myocardial infarction, hypertension, valvular heart disease, cardiomyopathy
What’s the most common causes of right sided congestive heart failure?
left sided congestive heart failure
whats the mot common valve involved with infective endocarditis?
mitral valve
What are the retinal hemorrhages with central clearing seen in patients with infective endocarditis?
Roth spots
What are the tender nodules seen on the tips of the fingers and toes in patients who have infective endocarditis?
Osler Nodes
What is considered the gold standard finding in the diagnosis of infective endocarditis?
Valvular vegetations noted on echo
what medication is considered to be the best alternative to use for endocarditis prophylaxis in a patient who is allergic to penicillin?
Clindamycin or Cephalexin
What is the most common infectious etiology for a patient with pericarditis?
Viral, Coxsackie B is the most common
What is the location of the majority of abdominal aortic aneurysms?
Infrarenal
Name the common risk factors for the development of a deep venous thrombosis?
Pregnancy, use of oral contraceptives, immobility, surgery, trauma, neoplasm
What is the volume of blood int eh ventricle at the end of diastole?
Preload
What does stroke volume times heart rate equal?
Cardiac output
What percentage is considered normal for an ejection fraction?
60-80%
What type of cardiac enzyme rises within 4-6 hours, peaks 12 to 20 hours and remains elevated for 2-3 days?
CK-MB
How long does troponin stay elevated following a myocardial infarction?
7-14 days
What is the most common pathogen in endocarditis in persons using IV drugs?
Staphylococcus aureus
What can cause muffled heart sounds, increased JVP pressure and pulsus paradoxes?
Cardiac tamponade
What is classical physical examination findings in a patient with pericarditis?
Pericardial friction rub
What are classic EKG findings in a patient with pericarditis?
ST segment elevation in all leads
What are the three classes of cardiomyopathy?
Restrictive, hypertrophic, and dilated
What is the underlying cause of restrictive cardiomyopathy?
diastolic dysfunciton due to stiff heart musculature
What is the diagnostic evaluation of choice for a patient with suspected aortic stenosis?
Echocardiogram
What new heart murmur would be caused by a myocardial infection that resulted in rupture of the papillary muscle?
Mitral regurgitation
What is the cardiac neuro-hormone that is secreted by the ventricles due to increase in stretch?
Brain Natriuretic Peptide (BNP)
What is the leading cause of death in women older than 50?
Coronary artery disease
In what New York Heart Association classification are the highest levels of BNP?
? 4
What will happen to the murmur associated with hypertrophic obstructive cardiomyopathy if the patient squats?
murmur will decrease in intensity
What is the leading cause of death in women over 50?
Coronary artery disease
What is a common cause of a continuous, machinery type murmur?
Congenital bicuspid aortic valve
What are the two cardinal physical exam features of mitral stenosis?
opening snap end diastolic rumbling murmur
What is the best position to examine a patient who has mitral stenosis?
left lateral decubitus
What endocrine abnormality should be assessed in a patient with new onset atrial fibrillation?
Hyperthyroidism
What is the physiological effect of baroreceptor stimulation?
increased heart rate and increased force of contraction when stimulated by volume depletion
What is the LDL target with known heart disease?
70
What m medical condition has a heart disease equivalent risk for myocardial infarction?
Diabetes Mellitus
What is the most common initial ECG abnormality for a patient who has a positive stress test?
ST segment depression
What condition is associated with a cold spot that reperfuses during the resting? on a thallium scan?
Ischemia
What coronary artery when blocked is associated with the highest degree of mortality?
left main
What are some other reasons for ordering electrophysiologic studies?
used in the assessment of cardiac dysrhthmias and or to treat dysrhythmias with ablation
When in the cardiac cycle does S3 occur?
early diastole
What is the description given for aortic stenosis?
crescendo- decrescendo systolic flow murmur
What are the two most common patient groups that have silent, no chest pain, and cardiac ischemia?
diabetics and elderly
