Med 2 Flashcards
An 18-year-old female came in due to chest pain. Most likely the diagnosis is
A. COPD
B. Musculoskeletal Strain
C. Asthma
D. Myocardial Infarction
C. Asthma
A 21-year-old female comes in due to fever and difficulty of breathing. You note a 3/6 murmur and the impression is possible endocarditis. You may do one of the following during examinations.
A. posterior calf pain on active dorsiflexion of the foot against resistance
B. unopposable, “fingerized” thumb
C. non-tender, slightly raised hemorrhages on the palms and soles
D. overlapping of the thumb and fifth finger around the wrist
C. non-tender, slightly raised hemorrhages on the palms and soles
An 18-year-old male came in due to cyanosis of the lower extremities but with pink upper extremities
A. Acrocyanosis
B. Central cyanosis
C. Patent ductus arteriosus
D. All of the above
C. Patent ductus arteriosus
Normally, JVP should remain constant during respiration
A. True
B. False
B. False
A patient comes in and claims he had an arrhythmia in which a surgery was performed. on examination you expect
A. Palmar crease xanthomas
B. Infraclavicular scar
C. Midline sternotomy scar
D. Prominent venous collateral pattern
B. Infraclavicular scar
Patient presents with parvus et tardus carotid upstrokes, a late-peaking grade 3 or greater midsystolic murmur on 2nd right intercostal space
A. Tricuspid regurgitation
B. Mitral regurgitation
C. Aortic regurgitation
D. Aortic stenosis
D. Aortic stenosis
The most accurate noninvasive technique to evaluate the structure and right ventricular ejection fraction of the right ventricle
A. 2D Echo
B. Cardiac CT
C. 12 L ECG
D. Cardiac MRI
D. Cardiac MRI
A 54-year-old male came in for a check-up and you note leathery, cobblestoned skin in the axilla and neck. Impression
A. Tangier disease
B. Loevs-Dietz syndrome
C. Atherosclerosis
D. Marfan’s syndrome
C. Atherosclerosis
Which of the following waveform is venous?
A. Biphasic
B. All of the above
C. Not obliterated with palpation
D. Does not change with posture
A. Biphasic
Apex beat felt at 6th left intercostal space anterior axillary line
a. Normal
b. Left ventricular hypertrophy
c. Right ventricular hypertrophy
d. Left atrial enlargement
b. Left ventricular hypertrophy
The preferred blood vessel to estimate central venous pressure
a. Right internal jugular vein
b. Right external jugular vein
c. Left internal jugular vein
d. Right common carotid artery
a. Right internal jugular vein
Patient comes in and you note blood pressure in the right arm to be 120/80 and left arm 129/68. This is?
a. Normal
b. Suggestive of atherosclerosis
c. Suggestive of coactaion of aorta
d. Suggestive of aortic dissection
a. Normal
JVP normally falls by at least 3 mm Hg with inspiration
a. True
b. False
a. True
On ECG tenting of T waves means possible
a. Hyperkalemia
b. Hypocalcemia
c. Hypokalemia
d. Hypothermia
a. Hyperkalemia
Which among the following will you order if you suspect arrhythmia?
a. 12 L ECG
b. Echocardiography
c. Radionuclide imaging
d. CT scan
a. 12 L ECG
Normal heart sounds
a. S1 and S2
b. S3 in 45 year old
c. S1 and S3
d. S2 and S4
a. S1 and S2
You suspect your 18 year old patient to have patent ductus arteriosus. You should request ____ to confirm the pathology.
a. 12 L ecg
b. Echocardiography
c. Radionuclide imaging
d. CT scan
b. Echocardiography
A 75 year old male comes in complaining of pain over left leg with walking and relief with rest. Patient has
a. Angina
b. Claudication
c. Peripheral venous insufficiency
d. Anxiety
b. Claudication
On ECG prominent U waves means
a. Hyperkalemia
b. Hypocalcemia
c. Hypokalemia
d. Hypothermia
c. Hypokalemia
A 21 year old male comes in with difficulty of breathing and you note bronze discoloration of the skin.
a. Osler Weber Rendu Syndrome
b. Advanced mitral stenosis
c. Hemochromatosis
d. Advanced right heart failure
c. Hemochromatosis
Who among the following patients probably had a high grade arrhythmia?
a. 45 male with midline sternotomy
b. 21 year old male with horizontal infraclavicular scar
c. 65 year with prominent venous discoloration
d. 35 year with palmar crease xanthoma
b. 21 year old male with horizontal infraclavicular scar
Fixed wide splitting of S2
a. Normal
b. Secundum atrial septal defect
c. Left bundle block
d. Aortic stenosis
b. Secundum atrial septal defect
This waveform is reflective of right atrial presystolic contraction
a. A wave
b. V wave
c. X descent
d. Y descent
a. A wave
An 18 year old male comes in with dark dusky lip. Possible etiology:
a. Large atrial septal defect
b. Peripheral vascular disease
c. Large patent ductus arteriosus
d. Aggravated B blocker
a. Large atrial septal defect
Enlargement of left ventricle can be seen on ECG by looking at height of
a. P wave
b. QRS complex
c. ST segment
d. PR interval
b. QRS complex
A 55 year old male had myocardial infarction 1 month ago and you want to assess myocardial viability. you request
a. 12 L each
b. Echocardiography
c. Radionuclide imaging
d. CT scan
c. Radionuclide imaging
A 80 year old male comes in due to easy fatigability. On auscultation 4/6 mid to late systolic murmur at 2nd right intercostal space radiating to the carotids
a. Aortic stenosis
b. Aortic regurgitation
c. Mitral stenosis
d. Tricuspid regurgitation
a. Aortic stenosis
This feature is suggestive of atherosclerosis
a. Pseudoxanthoma elasticum
b. High arched palate
c. Orange tonsils
d. Bifid uvula
a. Pseudoxanthoma elasticum
All heart failure patients have rales and crackles
a. True
b. False
b. False
What do you call the heart failure with an ejection fraction of 40-50% is called?
HEART FAILURE with MILDLY REDUCED EJECTION FRACTION
What is the previous name of heart failure with a reduced ejection fraction?
SYSTOLIC HEART FAILURE
What condition/disease/comorbidities could present both heart failure with low ejection fraction and normal ejection fraction?
HYPERTENSION
What ethnicity will have the highest prevalence of heart failure?
AFRICAN and AFRICAN AMERICAN
Edema is a symptom of Heart Failure
A. True
B. False
TRUE
HFpEF was previously named as?
DIASTOLIC HEART FAILURE
Which continent will have the highest heart failure secondary to Rheumatic Heart Disease?
AFRICA and ASIA
Where does renin is secreted?
JUXTAGLOMERULAR CELLS
What infectious disease is found in the South American population and brings about heart failure?
CHAGAS DISEASE
Where do you find the 3 baroreceptors?
AORTIC ARCH
VENTRICLE
CAROTID SINUS
What do you need in order for the patient for the relaxation of the myocardium to occur?
ATP
What are the 3 beta blockers used in heart failure?
CARVEDILOL
BISOPROLOL
METOPROLOL SUCCINATE
Nitrates are venodilators.
A. True
B. False
TRUE
Which drug is important in the management of heart failure with preserved EF which improves better survival?
SGLT2 INHIBITORS
What microorganism is found in the gut of the patient with heart failure causing pain and belatedness because of inflammation?
GRAM NEGATIVE BACTERIA
What is the description of the P wave in the dilated left atrium?
MCDONALD SIGN
Nitroprusside will have an effect in both arteries and veins.
A. True
B. False
TRUE
What are the 4 bumps in the left border of the heart?
AORTIC KNUCKLE
MAIN PULMONARY ARTERY
LEFT ATRIAL APPENDAGE
LEFT VENTRICLE
What are the 3 conditions that will have a similar pathway to heart failure?
HYPERTENSION
CORONARY ARTERY DISEASE
CARDIOMYOPATHY
What mineralocorticoid can cause gynecomastia?
SPIRONOLACTONE
