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UWorld Step 2 > IM Cardio - Rd 2 > Flashcards

IM Cardio - Rd 2 Flashcards

1
Q

Acute MR can occur w/acute MI, what does this cause physiologically in the heart?

A

Increased LV ED pressure (Filling pressure)

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2
Q

What presents w/anorexia, N/V/ADB pain with weakness and confusion?

D/t what?

A

Digoxin toxicity

Amiodarone interaction

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3
Q

What is isolated systolic hypertension?

D/t what?

A

Systolic BP > 140 w/diastolic BP < 90

Increased stiffness or dec elasticity of the aortic and arterial walls in elderly pts

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4
Q

Fibromuscular dysplasia MC involves what arteries?

A

Renal
Carotid
Vertebral

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5
Q

Scleroderma renal crisis presents how?

peripheral blood smear can show what?

A

Acute RF and Malignant HTN (HA, blurry vision, nausea)

MAHA w/schistocytes and thrombocytopenia

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6
Q

Young woman with recurrent HAs, very high BP, and subauricular systolic bruit has what?

A

FMD

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8
Q

Cardiac tamponade is d/t what physiologically?

A

Dec LV preload
Dec SV
Dec CO

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9
Q

Beta blockers are contraindicated in what setting of ACS?

A

Pulmonary edema (acute decompensated HF)

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10
Q

What murmur is best heard along the Left sternal border at the 3rd and 4th ICS while pt is sitting up, leaning forward, and holding a breath in full expiration?

A

AR

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11
Q

What are reentrant ventricular arrhythmias?

MC cause of what?

A

Ventricular fibrillation

Sudden cardiac death

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12
Q

What can cause pulsus paradoxus?

What is it?

A

Cardiac tamponade, Asthma, COPD

Dec in systolic BP > 10 on Inspiration

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13
Q

What RF is associated with the highest rate of aneurysm expansion and rupture in a pt with enlarged ABD aneurysm?

A

Cigarette smoking

NOT uncontrolled HTN

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14
Q

What does the ECG show in a LV aneurysm?

A

Persistent ST elevation, deep Q waves

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15
Q

MOA of dobutamine?

A

Dec in LV end-systolic volume

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19
Q

Pt that presents w/signs of pericardial effusion should have pericardiocentesis when?

A

Hemodynamically unstable
Cardiogenic shock
Cardiac tamponade

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20
Q

Pt with a knife injury to the thigh can develop what?

How can this effect the heart?

A

AV fistula

High-output cardiac failure causing increased preload

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20
Q

What is a synonym for HOCM?

How does the murmur present?

What symptom can manifest early?

A

Inter Ventricular septal hypertrophy

Crescendo-decrescendo systolic murmur at left sternal border w/out radiation

Syncope

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22
Q

What diseases present with High Output Heart Failure?

A 
Anemia
Hyperthyroidism
Beriberi
Paget disease
AV fistula
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23
Q

Pt that has AFib and develops acute arterial occlusion should have been prophylaxed with what?

A

Apixaban or any anticoagulation

24
Q

Development of AV block in a pt w/IE should raise suspicion for what?

What symptom do they most likely have?

A

Perivalvular abscess

Syncope

24
Q

What arrhythmia is most specific for digitalis toxicity?

A

Atrial tachycardia w/AV block

25
Q

Young pt (late 20’s or early 30s) that presents w/very high HTN and symptoms of HA and epistaxis has what?

A

Coarctation of aorta

26
Q

Bicuspid aortic valve can cause what uncommon finding in young adult pts?

A

AR d/t valvular leaflet abnormalities

26
Q

Pt that has palpable b/L ABD masses with morning HAs, HTN and normal Cr function w/FHx of early death by father has what?

A

ADPKD

HTN generally PRECEEDS the decline in renal function

27
Q

Pts with Portal vein thrombosis/compression do NOT have what key feature?

A

JVD

28
Q

+ hepatojugular reflex indicates what?

A

TR
HF d/t non-valvular cause
Constrictive pericarditis
Cardiac tamponade

28
Q

What has the highest sensitivity for diagnosing CHF?

What has a very high specificity?

A

BNP

S3

31
Q

Pulsus parvus et tardus is what?

Seen in what?

A

Dec pulse amplitude and delayed pulse upstroke

AS

31
Q

Older pt that has sinus pauses, Inc PR interval and Inc QRS duration that presents w/syncope may have what?

A

Sick sinus syndrome
Bradyarrhthymia
AV block

31
Q

What is unsynchronized cardioversion?

A

Defibrillation

31
Q

Pt that is on anti-arrhythmic meds and presents w/progressive dyspnea, nonproductive Cough, b/L inspiratory crackles, and CXR showing b/L lung infiltrations primarily involving the middle lung fields has what?

D/t what?

A

Amiodarone-induced interstitial pneumo it is

too much loop diuretics

32
Q

Pt that has undergone CABG and the next day presents w/equalization of pressures (RA, RV, PCWP all similar around 20) and HoTN has developed what?

Best next step?

A

Cardiac tamponade

Echocardiogram

33
Q

Pt w/LE swelling that is worse in the evening has what?

What treatment is most likely to relieve the pt’s symptoms?

What effect does smoking have?

A

chronic venous insufficiency

Frequent leg elevation

NONE

33
Q

What presents w/persistent ST-elevation after a recent MI and deep Q waves?

A

Ventricular aneurysm

33
Q

What are the classic sx of pericarditis?

A

Pleuritic chest pain, fever, pericardial friction rub

34
Q

Pt that has decompensated HF, what is the body doing to compensate?

A

Activate RAAS —> constrict efferent arteriole

35
Q

What pts should have electrophysiology testing done?

A

1st degree AV block with PROLONGED QRS

36
Q

How do you treat sustained monomorphic V Tach (SMVT) if the pt is stable?

Unstable?

A

IV amiodarone

Cardioversion

37
Q

Young pt that has unexplained HTN should get a detailed H&P, what should the workup be next?

A

UA —> looking at protein and Cr
CMP
Lipid profile
Baseline EKG

39
Q

Spotty calcifications along the left heart border indicates what?

Commonly caused by what?

A

Constrictive pericarditis

Prior cardiac surgery

40
Q

Pts w/a 10-year atherosclerotic cardiovascular disease risk > what should be treated with statin?

What age group?

A

> 7.5

40-75

43
Q

Acute aortic dissection that progresses to syncope can be d/t what complication?

A

Cardiac tamponade (pericardial fluid accumulation)

44
Q

What kind of drugs used to treat AFib can cause use dependence leading to widening of the QRS complex?

A

Class IC —> flecainide

45
Q

What is a long QT in men?

Women?

A

> 450 msec

> 470 msec

50
Q

Amyloid cardiomyopathy is a type of what?

What additional symptoms can be present?

A

Restrictive cardiomyopathy

CHF, proteinuria, LVH

UWorld Step 2 (17 decks)

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