Mcmicheal review questions Flashcards
What is the diagnostic test of choice for heart failure? what do you see on CXR?
echo
kerley B lines
What finding do you see during the excercise stress test that gives you positive/abnormal results?
> 2mm ST depression and or hypotension
The formula is calculated by EDV-ESV?
sv
Name three modifiable risk factors for atherosclerosis, name three non-modifiable risk factors for atherosclerosis?
mod: HTN, dyslipidemia, DM, tobacco abuse, obesity, sedentary lifestyle
non-mod: age, male gender, strong family histor of CAD, genetic conditions that pre-dipose
what is the word for a pulse that alternates strong and weak can be a sign of percardial effusion?
pulsus alternans
Palpable left parasternal lift, loud S2, right sided S4 sound, holosystolic murmur?
cor pulmonale
What is the difference between a nuclear stress test and a stress echo?
nuclear stress is looking at the blood flow to the heart muscle
stress echo is looking at the wall motion of the heart
what is the difference between Type I and Type II ischemia?
Type I ischemia is caused by atherosclertoic plaque rupture snd thrombus formation, leading to acute coronary syndrome and type 2 ischemia is due to increased myocardial oxygen demand without sufficient oxygen supply
Which GDMT medication reduces the risk of cardiovascular death and hospitalization with reduced EF?
Entresto, ARNI
What is the gold standard to evaluate coronary artery anatomy? What two tools can give more specific measurement of degree of stenosis?
cardiac catheterization, IVUS and iFR
What is the word for edema that is caused by venous insufficiency and improves the elevation or compression hose?
dependant edema
mid systolic mumur that decreases with squatting, increases with standing, and increases with valsalva
HOCM
Cresendo-decresendo systolic ejection mumur heard best at the right upper sternal border with radiation to the carotid?
aortic stenosis
Provides information about the function of the right side of the heart and pulmonary circulation?
Pulmonary artery pressure
holosystolic murmur heard best at the apex, radiates to the axilla
mitral regurg
This abnormal sound occurs at the end of diastole and results form the atrial contraction against a non-compliant stiff ventricle
S4
What are some devices that can be used to improve heart failure symptoms and mortality?
outpt: CRT, ICD
inpt: IABP, Impella, LVAD
What medications are part of GDMT?
beta blocker, ACEI/ARB vs ARNI, MRA, SGLT2 inhibitor
The ability of muscle fibers to shorten against a given load, approximated by ejection fraction?
contractility
What would you treat Prinzmetal patients with?
CCB or Nitrates
What is the word for dyspnea that occurs immediately on assuming a recombent positon? and how do we document it?
orthopnea, document on how many pillows with the patient sleeps with
Measures the cardiac output relative to the a person body surface area
cardiac index
Reflect the average pressure in a person’s arteries during one cardiac cycle?
Mean Arterial pressure
Which measurement provides information about the filling pressure on the right side of the heart?
CVP
Which test has the best prognostic value for the risk of CAD?
CT coronary calcium scan
What is the diagnostic study of choice to look at the mitral valve?
TEE
Which area of the heart is supplied by the LAD? LCX? RCA?
LAD: apical, anterolateral, septal
LCX: anterolateral, posterior
RCA: inferior, posterior, apical
A patient arrives to the ED with chest pain and is found to have ST elevations on EKG. What is the first steps for treatment? Then what?
MONA, 90 ins to cath lab or 120 min to PCI available facility. Consider thrombolysis in meantime during transfer
A patient presents with complaints of fatigue and SOB with strenuous activities but ok with mild activity and at rest. Which NYHA class is the patient?
NYHA Class II
What is the word for an uncomfortable aware of difficult breathing?
dyspnea
