IM Plat- Cardiology Flashcards
Defined as a persistently elevated blood pressure of >140/90 mmHg despite taking >3 anti-hypertensive agents including a diuretic.
Resistant hypertension
PE finding in patients with cardiac tamponade wherein the systolic BP falls by >10 mmHg with inspiration.
Pulsus paradoxus
PE finding in patients with pericardial effusion auscultated as a patch of dullness and increased fremitus below the left scapula.
Ewart’s sign
Triads: Virchow’s triad
Stasis
Endothelial injury
Hypercoagulable state
A PE finding in patients with AI seen as alternate flushing and paling of the skin at the root of the bail while pressure is applied to the tip of the nail.
Quincke’s pulse
Triads: Wolff-Parkinson White syndrome
Widened QRS complex
Short PR interval
Delta wave
What is the most common cause of CHF in industrialized countries?
Coronary artery disease
What is the accepted and unifying hypothesis in the pathophysiology of Metabolic syndrome?
Insulin resistance
What is the loading dose of aspirin in the management of ACS? maintenance dose?
LD: 162-325 mg/day
MD: 72-162 mg/day
What is the major site of atherosclerotic disease?
Epicardial arteries (most common: LAD)
What is the major site of atherosclerotic disease?
Epicardial arteries (most common: LAD)
What is the usual duration of hospitalization for uncomplicated STEMI?
5 days
What are the two cardinal symptoms of heart failure?
Shortness of breath and fatigue
What is a cost-effective diagnostic test to identify non-cardiac causes of heart failure symptoms?
Chest xray
Triads: Dressler’s syndrome
Fever, pleuritic pain, pericardial effusion
What are the 2 cornerstone of modern heart failure treatment?
ACE-inhibitors and Beta blockers
What is the most common artery involved in focal spasms of Prinzmetal angina?
Right coronary artery
This is an increase in the intensity of the holosystolic murmur of tricuspid regurgitation with inspiration seen in patients with cor pulmonale.
Carvallo’s sign
What is the most common artery involved in focal spasms of Prinzmetal angina?
Right coronary artery
Give the 2 absolute contraindications to nitrate use.
Hypotension
Use of sildenafil or similar drugs in prev. 24-48 hrs
Give the 2 absolute contraindications to nitrate use.
Hypotension
Use of sildenafil or similar drugs in prev. 24-48 hrs
What are the indications for coronary artery bypass grafting?
- 3-vessel CAD
- 2-vessel CAD with involvement of LAD
- > 50% stenosis of the left main coronary artery
When is the best time to measure cardiac troponins in patients with suspected ACS?
12 hours after occurrence of first symptoms
What is the alternative drug used to maintain cardiac contractility in patients with contraindications to beta-blockers?
Non-DHP CCB (Verapamil, Diltiazem)
What is the most common cause of out-of-hospital deaths in patients with STEMI?
Ventricular fibrillation
What are the 2 indications for fibrinolysis?
STEMI and new onset LBBB
In the supportive care of patients with STEMI, careful ambulation in the room may start on what day post-MI?
Day 2
Most complications of MI have a bimodal peak and occurs within _____.
1-14 days
What is the most common cause of cardiogenic shock?
Severe LV dysfunction
What vasopressor should you administer to a patient with acute pulmonary edema with SBP
Dobutamine 2-20 mcg/kg/min IV
What vasopressor should you administer to a patient with acute pulmonary edema with SBP
NE 0.5-30 mcg/min IV or
Dopamine 5-15 mcg/kg/min
What is the hallmark of carditis in patients with rheumatic fever?
Valvular damage
Duration of prophylaxis for patients with RF with mild carditis.
10 years after last attack or until 21 years old
Duration of prophylaxis for patients with RF with moderate to severe carditis.
10 years after last attack or until 40 years old
It is a form of endocarditis resulting from hypercoagulable state.
Marantic endocarditis
What is the most specific presentation of rheumatic fever?
Syndenham chorea
Blood cultures of a patient with IE showed growth of MSSA. What is the antibiotic of choice and its duration?
Nafcillin or Oxacillin x 4-6 weeks
Blood cultures of a patient with IE showed growth of MRSA. What is the antibiotic of choice and its duration?
Vancomycin x 4-6 weeks
Blood cultures of a 43-yr old female with prosthetic valve IE showed growth of Staph aureus. What is the antibiotic of choice and its duration?
Vancomycin x 4-6 weeks +
Gentamicin x 2 weeks +
Rifampin x 6-8 weeks
What is the normal ABI?
> 1.0
What is the most common symptom of peripheral artery disease?
Intermittent claudication
Triads: Buerger’s disease
Claudication
Raynaud’s phenomenon
Migratory superficial vein thrombophlebitis
What is the most common cause of midsystolic murmur in adults?
Aortic stenosis
What is the most common cause of midsystolic murmur in adults?
Aortic stenosis
What is the most common congenital cardiovascular cause of hypertension?
Coarctation of the aorta
What is the most common complication of angioplasty?
Restenosis
