MISC last minute cards for boards

Question 1

MC primary cardiac tumor and where does it classical arise.

They secrete what vasoactive substance which may lead to const. sx

Answer 1

Myxoma

IL-6

Question 2

second mc primary cardiac tumor and

third mc

Answer 2

lipoma

paplillary fibroelastoma

Question 3

Where do myxoma’s generally arise

Answer 3

fossa ovalis in the left atrium

Question 4

Associated syndrome with myxoma (<5%)

Answer 4

Carney complex = myxoma + pigmented skin lesions adnd endocrine overactivity. It is AD

Question 5

reoccurance after myxoma removed surgically

Answer 5

5-10% need semi annual screening until first 4 years out when this risk decreases.

Question 6

dumbell appearance of intra-atrial seputm

Answer 6

lipomatous hypertrophy (on both sides of the fossa ovals

Question 7

cardiac tumor that is common with tuberous sclerosis

Answer 7

Rhabdomyoma

Question 8

Rhabdomyoma is commonly associated with this genetic condition

Answer 8

tuberous sclerosis

Question 9

MC primary malignant tumor of the heart

2. what is their most common location

Answer 9

sarcoma, the most frequently seen are angiosarcoma

2. left atrium

Question 10

1. 2 MC primary malignant tumors

2. MC metastitic tumors (6)

Answer 10

1. sarcomas and lymphomas

2. lung, melanoma, breast, renal, esophagus lymphoma/leukemia

Question 11

3 secondary causes of hyperlipidemia

Answer 11

1. nephrotic syndrome
2. drugs esp cyclosporine
3. hypothyroid

Question 12

4 clinical ASCVD risk groups and statin strength for its 40-75

Answer 12

1. DM - mod (high if ASCVD > 7.5)
2. CAD/PAD -high
3. ASCVD risk > 7.5% mod (high)
4. FH ldl > 190 or > 160 on treatment -high

Question 13

How define high vs. mod intensity statin and what are they

Answer 13

> 50% reduction in LDL is high intensity.
30 < 50% is mod.

High Lipitor 80 or rosuva 40
Mod atorva 10 or 20 rousva 5 or 10, silva 20-40, prove 40-80, pitta 2-4, lova 40, fluva XL 80

Question 14

When can use a mod dose statin

Answer 14

ASVD risk > 7.5 or DM without elevated ASCVD risk.

Question 15

when use lower intensity statin

Answer 15

in general wouldn’t use them

Question 16

NNT for high vs. low intensity stat

Answer 16

ARR 2.2% 1/.002 = 1 in 40

Question 17

NNH for causing DM

Answer 17

100.

Question 18

limit for intermediate ASCVD risk calc for statin

Answer 18

5-7.5% IIa to add a statin

Question 19

what groups have the ascvd lower risk than calculator

Answer 19

Older with lower comorbidities, East Asian , high SES, hispanics

Question 20

What additional risk features can get you on a statin if your other things don’t

Answer 20

1. ASCVD RISK 5-7.5
2. LDL > 160
3. HS CRP > 2
4. CAC > 300
5. ABI > 0.9

Question 21

Underestimated risk of ASCVD

Answer 21

s. asian
HIV
systemic inflammatory

Question 22

mod elevated TAG do we need to do anything (ie 220)

Answer 22

Do nothing or increase statin dose to full dose.

Question 23

ACCORD with fenofibrate +statin

Answer 23

did nothing

Question 24

Major negative fenofibrate troial

Answer 24

accord. fibrates didn’t change mort

Question 25

Niacin not only didnt improve mortality with its improved HDL it led to these SE

Answer 25

increased dm (which was likely the problem), infection and bleeding

Question 26

double statin rule

Answer 26

rule of 6’s, 6% reduction

Question 27

Zetia imporevit

Answer 27

ACS pts lowered compiste

lowers cholesterol by 20%

Question 28

pcsk9 are approved for which patients

Answer 28

Those with clinical ASCVD or FH

Question 29

consensus statement from ACC when can you use a second lipid lowering med

Answer 29

when in one of the 4 risk groups ASCVD, DM, ASCVD risk > 7.5%, or FHish with LDL of >=190 and lipids not at goal (>70) or didn’t get a 50% reduction

Question 30

can’t use ascvd risk calc for 10 yr risk until

Answer 30

40

Question 31

3 genes for FH

Answer 31

LDL-R, apoB, PCSK9

Question 32

LDL for herterozygous and homozygous FH

Answer 32

hetero 190-400 (1:250), homo > 400 (1:400)

Question 33

definite dx of FH on PE

Answer 33

tendinous xanthoma

Question 34

when niacin, omega 3, or fibrates use based on current gl

Answer 34

only in extreme hyper tag based on current guidelines