Internal med cardiology

Question 1

angina pectoris

Answer 1

stable, predictable chest pain that occurs when the heart is under stress

Question 2

treatment of stable angina

Answer 2

goes away with rest and NTG

Question 3

Diagnosis of stable angina

Answer 3

• EKG is the initial test of choice, but can often be normal (could show ST depression)
• stress testing is the best noninvasive test
• coronary angiography is definitive

Question 4

etiology of infectious myocarditis

Answer 4

MC viral and bacterial

Question 5

presentation of myocarditis

Answer 5

• SOB
• CP
• fever/chills
• pericardial friction rub
• tachycardia
• heart failure

Question 6

diagnosis of myocarditis

Answer 6

• echo
• biopsy

Question 7

treatment of myocarditis

Answer 7

• consult cardiology
• NSAIDs
• ACEI/BB

Question 8

etiology of noninfectious myocarditis

Answer 8

• meds
• drugs
• toxic substances

Question 9

MCC of HF

Answer 9

ischemic cardiomyopathy

Question 10

presentation of ischemic cardiomyopathy

Answer 10

systolic HF

Question 11

diagnosis of ischemic cardiomyopathy

Answer 11

echo

Question 12

management of ischemic cardiomyopathy

Answer 12

• revascularization
• defibrillator

Question 13

etiology of dilated cardiomyopathy

Answer 13

• idiopathic
• viral
• bacterial
• genetic

Question 14

presentation of dilated cardiomyopathy

Answer 14

• HF
• arrhythmias

Question 15

diagnosis of dilated cardiomyopathy

Answer 15

• BNP
• echo

Question 16

treatment of dilated cardiomyopathy

Answer 16

• CHF management
• defibrillator

Question 17

presentation of HCM

Answer 17

• CP, syncope, SCA
• murmur louder with valsalva

Question 18

diagnosis of HCM

Answer 18

echo

Question 19

management of HCM

Answer 19

• BB
• septal ablation

Question 20

what should be avoided in HCM?

Answer 20

diuretics and vasodilators

Question 21

etiology of restrictive cardiomyopathy

Answer 21

• amyloidosis/sarcoidosis
• radiation

Question 22

presentation of restrictive cardiomyopathy

Answer 22

RHF

Question 23

diagnosis of restrictive cardiomyopathy

Answer 23

• echo/cardiac MRI
• biopsy

Question 24

treatment of restrictive cardiomyopathy

Answer 24

• treat underlying cause
• diuretics

Question 25

etiology of infective endocarditis

Answer 25

staph aureus

Question 26

s/s of infective endocarditis

Answer 26

* fever/chills * night sweats * murmur * petechiae or splinter hemorrhages * janeway lesions * osler nodes * roth spots

Question 27

MC affected valve in endocarditis in IVDU

Answer 27

tricuspid

Question 28

if a young patient has a stroke, suspect ...

Answer 28

endocarditis

Question 29

major criteria of endocarditis

Answer 29

* positive blood cultures * evidence of involvement on echo * murmur

Question 30

minor criteria of endocarditis

Answer 30

* IVDU * fever * vascular sx * immunologic sx * single positive blood culture

Question 31

diagnosis of endocarditis

Answer 31

* 2 major criteria * 1 major and 3 minor * 5 minor

Question 32

management of endocarditis

Answer 32

* native valve: pen G, gent, vanc * IVDU: naf, gent, vanc * prosthetic valve: rifampin, gent, vanc

Question 33

Endocarditis prophylaxis

Answer 33

amoxicillin for oral procedures, I&D, respiratory procedures

Question 34

diagnosis of HTN

Answer 34

stage 1: 130-139/80-89 stage 2: >140 or >90

Question 35

how to determine if patients need HTN drugs?

Answer 35

* if stage 1: assess ASCVD risk and if over 10%, then treat * if stage 2: treat

Question 36

management of HTN

Answer 36

* non AA: thiazide, ACE/ARB, CCB * AA: thiazide or CCB

Question 37

indications for statin therapy

Answer 37

* prior ASCVD * LDL over 190 * age 40-75 with DM and LDL>70 * age 40-75 without ASCVD or DM, whose LDL is 70-189 and ASCVD is >7.5

Question 38

if prior ASVCD...

Answer 38

high intensity statin

Question 39

if LDL is over 190...

Answer 39

high intensity statin

Question 40

if 40-75 and DM and LDL>70...

Answer 40

* medium intensity statin * high intensity if over 50 and multiple risk factors

Question 41

etiology of pericarditis

Answer 41

viral

Question 42

s/s of pericarditis

Answer 42

* CP worse when laying on back * friction rub * fever * diffuse ST elevation

Question 43

diagnosis of pericarditis

Answer 43

* EKG * echo

Question 44

treatment of pericarditis

Answer 44

NSAIDs

Question 45

major manifestations of rheumatic fever

Answer 45

* carditis * polyarthritis * chorea * erythema marginatum * sq nodules

Question 46

minor manifestations of rheumatic fever

Answer 46

* prior rheumatic fever * polyarthralgia * fever * leukocytosis * evidence of strep infection

Question 47

treatment of rheumatic fever

Answer 47

* PCN G * ASA or NSAIDs