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ABIM > MKSAP STOCK1 > Flashcards

MKSAP STOCK1 Flashcards

1
Q

What is the frequency of echocardiographic surveillance for asymptomatic moderate aortic regurgitation?

A

Echo q 1-2 years

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2
Q

At what CHA2DS2VASc score is PO anticoagulation recommended in NONVALVULAR Atrial Fibrillation patients?

A

>1

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3
Q

What is the expected hematologic compensation in patients with cyanotic congenital heart disease?

A

Erythrocytosis

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4
Q

Control of what TWO clinical parameters is recommended in patients with heart failure with preserved ejection fraction?

A

Blood pressure and volume!!! Paramount importance cf. to HFrEF (where goal-directed approach important)

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5
Q

What procedures exist for which endocarditis ppx is indicated in high-risk patients?

A

Dental procedures involving manipulation of gingival tissue or the periapical region of teeth OR perforation of the oral mucosa

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6
Q

What is the next best test to evaluate for peripheral arterial disease in a patient with an Ankle-Brachial Index >1.40

A

Great Toe systolic pressure measurement

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7
Q

What is the diagnostic test for acute limb ischemia?

A

Angiography

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8
Q

Indications for early surgical intervention in patients with Native Valve Infective Endocarditis

A

Valve Dysfxn with heart failure; Heart Block; L sided endocarditis caused by S. aureus, fungal or highly resistant bug; Annular or aortic abscess; Persistent bacteremia 5-7 days after abx; Recurrent emboli on abx; and mobile vegetations >10 mm in length

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9
Q

What is the preferred method of imaging for surveillance of bicuspid AoV and associated aortopathy?

A

TTE

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10
Q

What is the most common cardiac abnormality associated with aortic coarctation?

A

Aortic Stenosis (possibly related to Bicuspid AoV)

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11
Q

What syndrome is characterized by elevated eosinophil count without a secondary cause and has evidence of organ involvement?

A

Hypereosinophilic Syndrome

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12
Q

Cardiac Monitoring Device indicated for patients with SYNCOPE?

A

Implantable Loop Event Recorder

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13
Q

What is defined as LOW risk for ASCVD by the Pooled Cohort Equations?

A

<5%

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14
Q

This is the most common cause of reduced left ventricular function in heart transplant patients after the first year?

A

Allograft Vasculopathy

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15
Q

What is the treatment for all asymptomatic patients with SEVERE pulmonary valve stenosis?

A

Valve Repair or Replacement

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16
Q

What is the initial nonpharmacologic therapy for symptomatic PAD?

A

Supervised Exercise Program

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17
Q

What are two hematologic findings consistent with aplastic anemia?

A

Pancytopenia and Severely hypocellular marrow

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18
Q

What is the indicated mgmt strategy for multivessel coronary artery disease and depressed LV function associated with ACS?

A

CABG

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19
Q

What is the indication for mitral valvuloplasty in an asymptomatic patient with severe mitral stenosis?

A

Pregnancy (as it will demand a higher cardiac output!)

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20
Q

What form of atrial septal defect involves the mitral valve?

A

Ostium Primum ASD

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21
Q

What is the treatment of PVC-related cardiomyopathy?

A

Catheter Ablation

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22
Q

What is the recommended frequency of surveillance imaging for stable patients with Marfan Syndrome with aortic root dilation <4.5 cm?

A

6 months after diagnosis and then every 12 months after that

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23
Q

What is the recommended evaluation for patients with new-onset heart failure and risk factors or symptoms of CAD?

A

Either stress testing or catheterization

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24
Q

Therapy for patients with von Willebrand disease before major surgery

A

Factor VIII concentrates containing von Willebrand factor

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25
Q

At what level of 10 year Cardiovascular Risk from the Pooled Cohort Equations is statin therapy indicated?

A

>7.5%

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26
Q

What are THREE indications for cardiac resynchronization therapy?

A

EF <35%, NYHA functional class III-IV symptoms on guideline-directed medical therapy or LBBB with QRS duration >150 ms

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27
Q

What are TWO diagnostic criteria for Brugada Syndrome?

A

> 2 mm Coved precordial ST elevation and SYMPTOMS (i.e. syncope or ventricular arrhythmia)

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28
Q

What pulmonary vein complication is assoicated with catheter ablation for atrial fibrillation?

A

Pulmonary vein stenosis

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29
Q

What is the diagnostic test for a patient with symptomatic stable angina that is no adequately controlled on optimal medical therapy?

A

Coronary Angiography

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30
Q

What is the first line treatment of acute pericarditis following myocardial infarction?

A

Aspirin

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31
Q

What physical exam finding is useful in distinguishing hepatopathy due to constrictive pericarditis from primary liver disease?

A

Elevated CVP will be seen in constrictive pericarditis

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32
Q

What is the recommended type of stress test for a patient with normal resting EKG?

A

Exercise Stress Testing

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33
Q

What is the diagnosis for an irregularly irregular rhythm with a right bundle branch block pattern?

A

Atrial Fibrillation with Aberrant Conduction

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34
Q

Complication presenting with a new holosystolic murmur and cardiac thrill 3-7 days following acute MI?

A

Ischemic VSD

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35
Q

What are 3 indications for TTE in asymptomatic patients with a murmur?

A

Systolic murmur >3/6, Late or Holosystolic murmur, or diastolic and continuous murmurs

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36
Q

What are the two leading modifiable risk factors for myocardial infarction?

A

Dyslipidemia and Smoking

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37
Q

What is the mechanism of treatment indicated for low-output heart failure following correction of volume overload?

A

Afterload Reduction

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38
Q

What is the treatment of choice for pregnant women with thrombotic microangiopathy of pregnancy?

A

Immediate Delivery

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39
Q

What viral infection is associated with acquired pure red cell aplasia?

A

Parvovirus B19

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40
Q

What is an intervention to help stablize fluctuating INRs while taking warfarin

A

Daily Low dose PO vitamin K

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41
Q

What is the recommended duration of dual antiplatelet therapy following PCI with DES?

A

At least 1 year

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42
Q

What device is used to prevent intravenous line-associated paradoxical air embolism in patients with Eisenmenger Syndrome?

A

Intravenous Line Air Filter

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43
Q

What degree of mortality benefit has been shown for screening for CAD in asymptomatic patients with DM?

A

None (i.e. you don?t do stress or cath) but you should still do the Pooled Cohort equations

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44
Q

What is the diagnostic test if you suspect a macroangiopathic hemolytic anemia?

A

TEE

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45
Q

What is the initial treatment for hemodynamically stable supraventricular tachycardia?

A

Vagal Maneuvers

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46
Q

What are two criteria for implantable cardioverter-defibrillator placement in patients with heart failure?

A

LV EF <35%; NYHA class II/III sx

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47
Q

What are three hematologic findings in patients with Paroxysmal Nocturnal Hemoglobinuria?

A

Hemolytic Anemia; Hypocellular Bone Marrow (hence assoc. with hypoplastic MDS), and lack of CD55 and CD59 surface proteins on cells (flow cytometry)

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48
Q

What controversial cardiac imaging study is useful for clarifying cardiovascular risk in INTERMEDIATE risk patients?

A

Coronary Calcium Scoring

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49
Q

What is the radiologic test indicated in patients with superficial venous thrombophlebitis?

A

Venous Duplex US

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50
Q

What is the most common cause of easy bruising and heavy menses with normal PT and aPTT

A

von Willebrand disease

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51
Q

What are two drug classes indicated for ALL patients with heart failure with reduced ejection fraction (HFrEF)

A

Beta Blockers and ACE inhibitors

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52
Q

What is the recommended next step in mgmt of pts with Pre-excitation (WPW) and syncope?

A

EP study for potential ablation

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53
Q

What is the preferred treatment for severe symptomatic mitral stenosis?

A

Percutaneous Balloon Mitral Valvulplasty; if pregnant and asymptomatic you do it because you expect an increased CO in pregnancy

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54
Q

What are three medications that should be continued indefinitely after acute coronary syndrome?

A

Aspirin, ACE inhibitor, and Statin

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55
Q

What drug class should be discontinued 24-48 hours before cardiac stress testing to diagnose coronary artery disease?

A

Beta Blockers

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56
Q

What therapy is indicated for patients with end stage heart failure who are not candidates for heart transplantation?

A

LVAD

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57
Q

What is the appropriate mgmt of asymptomatic first degree AV block accompanied by RBBB and Left posterior Fascicular block (i.e. Trifascicular block)

A

Clinical Observation

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58
Q

What is the cause of differential cyanosis and clubbing affecting the lower body?

A

Patent Ductus Arteriosus with Eisenmenger syndrome

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59
Q

What is the essential diagnostic test for implanted cardiac device infection?

A

Blood Cultures

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60
Q

What is the recommended frequency of US surveillance of an asymptomatic AAA <5.5 cm in men and <5.0 cm in women?

A

Every 6 to 12 months

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61
Q

What are 4 potential complications associated with bicuspid aortic valve?

A

Aortic Stenosis, Aortic Regurgitation, Infective Endocarditis, and Aortopathy (dissection or aneurysm)

62
Q

What is the recommended frequency of echocardiographic monitoring for patients with asymptomatic severe aortic stenosis?

A

Every 6 to 12 months

63
Q

What is the treatment of choice for a hemodynamically stable patient with possible transient constrictive pericarditis?

A

Anti-Inflammatory agents

64
Q

What phosphodiesterase inhibitor can be used for symptomatic PAD?

A

Cilostazol

65
Q

What are three indications for aortic valve replacement in patients with aortic regurgitation?

A

Symptoms, LV dilation (LV end diastolic width), and LV EF <50%

66
Q

What are two drug classes indicated for ALL patients with PAD?

A

Antiplatelet Agent (Aspirin) and a Statin

67
Q

What is the recommended mgmt of an incidentally discovered atrial septal aneurysm?

A

No further evaluation or intervention

68
Q

What is the HALLMARK physical exam finding associated with upper extremity peripheral arterial disease?

A

Difference in the systolic blood pressures between the two arms

69
Q

What is the clinical entity in which patients experience persistent symptoms and hemodynamic derangements after treatment of a symptomatic pericardial effusion?

A

Effusive Constrictive Pericarditis

70
Q

What is a classic infection associated with increased risk of sepsis and eath in patients with hereditary hemochromatosis?

A

Vibrio vulnificus

71
Q

What benign cardiac tumor associated with constitutional symptoms and neurologic sx due to systemic embolization?

A

L atrial myxoma

72
Q

What are two treatment options for cardiogenic shock?

A

IV vasoactive medications vs. Device-Based hemodynamic support (IABP)

73
Q

What is the preferred type of prosthesis in patients requiring valve replacement with a contraindication to anticoagulation?

A

Bioprosthesis

74
Q

What is the first line treatment for a patient taking warfarin who has significant bleeding?

A

4 factor Prothrombin Complex Concentrate (PCC- Kcentra) and IV vitamin K

75
Q

What is the most common structural valvular disorder associated with Tetralogy of Falot repair?

A

PR- Pulmonic Valve Regurgitation

76
Q

Four Conditions in which transfusion is NO LONGER indicated in patients with Sickle Cell dz

A

Uncomplicated Pregnancy; Routine painful crises; Minor Surgery WITHOUT anesthesia; and asymptomatic anemia

77
Q

What is the immediate therapy indicated for patients presenting with acute heart failure and volume overload?

A

Diuretic Therapy- preferably with a loop diuretic

78
Q

What is the optimal time for first follow-up appointment following discharge for patients hospitalized for heart failure?

A

Within 7 days

79
Q

What is the most common endocrine cause of reversible heart failure?

A

Hyperthyroidism (always check a TSH)

80
Q

In addition to aspirin what are three drug classes indicated as long therapy for patients following MI?

A

Statins, Beta Blockers, and ACE inhibitor

81
Q

What is the duration of anticoagulation therapy for patients with unprovoked proximal DVT or PE with low or moderate bleeding risk?

A

Longterm Anticoagulation

82
Q

What are two angiographic indications for CABG in patients with angina who remain symptomatic despite optimal medical tx?

A

Left Main Disease; Multivessel disease with proximal LAD involvement

83
Q

What pulmonary contraindication exists to pharmacologic vasodilator stress testing?

A

Active Bronchospasm

84
Q

What length of corrected QT interval is associated with Torsades de Pointes?

A

>500

85
Q

What are two possible treatments for “low-pressure” cardiac tamponade?

A

Normal Saline (volume) and obviously and definitively, pericardiocentesis

86
Q

What is the alternative therapy for patients with venous thromboembolism and recent bleeding?

A

IVC filter

87
Q

What clinical parameter is associated with HIGH RISK for recurrent peripartum cardiomyopathy in subsequent pregnancies

A

Persistent LV dysfunction

88
Q

What is the initial treatment indicated for patients with PFO and cryptogenic stroke?

A

Antiplatelet therapy with Aspirin

89
Q

What abnormality is associated with fixed splitting of S2, midsystolic murmur and right ventricular heave?

A

Ostium Secundum Atrial Septal Defect

90
Q

What is the preferred treatment for asymptomatic severe mitral regurgitation with reduced LV function and suitable valve anatomy?

A

Mitral Valve Repair

91
Q

What vaccination reduces the risk of furture cardiovascular events in patients with existing cardiovascular disease?

A

Annual Influenza vaccine

92
Q

What is the recommended agent for treatment of acute, uncomplicated vaso-occlusive pain episodes in patients with sickle cell disease?

A

Opioids for pain, Hydroxyurea

93
Q

What is the treatment of choice for most patients with symptomatic severe aortic stenosis?

A

Surgical Aortic Valve Replacement (SAVR)

94
Q

What are the 4 risk groups with an indication for statins?

A

1) pts with clinical ASCVD 2) Pt with LDL >190 3) Pt age 40-75 with DM 1 or 2 and 4) Pt age 40-75 with 10 yr ASCVD risk >7.5%

95
Q

Most common cause of secondary erythrocytosis?

A

Hypoxemia

96
Q

What is the initial imaging of choice for patients with suspected mitral regurgitation?

A

Transthoracic Echocardiography

97
Q

Name two diseases that have prolonged aPTT that correct fully with a mixing study

A

Hemophilia A (Factor VIII def) and Hemophilia B (Factor IX def, Christmas Dz)

98
Q

What is the diagnostic test of choice for Chronic Thromboembolic Pulmonary HTN (CTEPH)

A

VQ scan

99
Q

What adjunctive antiplatelet agent is indicated for patients undergoing thrombolysis for STEMI?

A

Clopidogrel

100
Q

What is the most sensitive diagnostic test for suspected folate deficiency?

A

Homocysteine level

101
Q

Recommended initial radiologic test for patients with Multiple Myeloma who are experiencing low back pain

A

Skeletal Survey

102
Q

What is the prophylactic intervention for patients at high risk of sudden death from HOCM?

A

Implantable Cardioverter-Defibrillator

103
Q

What is the recommended treatment for patients with liver disease and INR >1.5 before undergoing CVC placement

A

None

104
Q

What is the indication for immediate repeat echocardiogram for ALL patients with valvular heart disease?

A

Change in clinical status

105
Q

What genetic mutation occurs in half of patients with idiopathic Budd-Chiari syndrome?

A

JAK2 V617F activating mutation

106
Q

What congenital valvular abnormality is characterized by an aortic ejection sound with either a systolic or diastolic murumur?

A

Bicuspid Aortic Valve

107
Q

What are two laboratory findings associated with Cold Agglutinin Disease

A

Erythrocyte clumping that disappears with warming; positive direct antiglobulin (Coombs) test

108
Q

What is the recommended frequency of aortic imaging in patients with a bicuspid aortic valve and an aortic root diameter >4.5 cm?

A

Every Year

109
Q

What diagnosis is associated with chest pain, ST elevation, elevated cardiac biomarkers and wall motion abnormalities of mid-apical L ventricle but with normal angiography?

A

Stress Cardiomyopathy (Takotsubo CMO)

110
Q

What is a possible definitive treatment for Mobitz Type I second degree AV block associated with acute coronary syndrome?

A

Reperfusion (lytics or PCI)

111
Q

Peripheral Blood Smear finding in pseudothrombocytopenia

A

Platelet clumping

112
Q

What is the physiologic impact of overdiuresis in patients with Hypertrophic Cardiomyopathy?

A

It will increase the dynamic left ventricular outflow tract obstruction

113
Q

What is the duration of anticoagulation therapy in patients with a first provoked venous thromboembolism?

A

3 months

114
Q

What is the first line therapy for a bleeding patient with acquired hemophilia and high titers of inhibitor?

A

Recombinant Activated Factor VIIa

115
Q

These are the two first line antianginal therapies for stable angina pectoris

A

Beta-blockers and nitrates

116
Q

Indications for testing offspring of a patient with factor V Leidin mutation

A

None

117
Q

Three hematologic findings characteristic of B thalassemia

A

Hemolytic Anemia, Microcytosis (nl RDW) and target cells on smear

118
Q

What is the mgmt of nonbleeding patients with ITP and a platelet count >30 k?

A

Clinical Observation

119
Q

What are the indications for thrombophilia testing in a patient with a first provoked thromboembolic event?

A

None

120
Q

What are the thresholds for repair of abdominal aortic aneurysms in men and women?

A

5.5 cm in men and 5.0 cm in women

121
Q

What is a congenital cardiac condition that may cause platypnea-orthodeoxia syndrome?

A

Patent Foramen Ovale

122
Q

What is the diagnostic test for Hereditary Spherocytosis?

A

Osmotic Fragility Test

123
Q

What is the preoperative function of an implantable cardioverter-defibrillator to prevent false detection of a tachyarrhythmia due to electrical interference (i.e. the Bovie)?

A

Disable the Shock Function

124
Q

What is the type of transfusion for patients with platelet transfusion refractoriness?

A

HLA-matched platelets

125
Q

What are the two recommended tests for men and non-menstruating women with Iron Deficiency Anemia

A

Colonoscopy and EGD

126
Q

What is the recommended initial study for evaluating chest pain in patients with an intermediate risk of coronary artery disease and normal baseline EKG?

A

Exercise Stress test

127
Q

What is the initial treatment indicated for uncomplicated Type B acute aortic injury

A

Medical therapy (Beta blockade and arterial vasodilator)

128
Q

What pretransfusion erythrocyte treatment is used to reduce risk of transfustion associated GVHD?

A

Irradiation

129
Q

What is the recommended treatment for patients aged 60 years or older with essential thrombocythemia or platelet count > 1 million

A

Hydroxyurea + Aspirin

130
Q

What is the recommended hemoglobin threshold for transfusion for hospitalized pt

A

<7

131
Q

What are FOUR FINDINGS on resting EKG that preclude exercise stress testing?

A

LBBB, Paced rhythm, Preexcitation (WPW), and ST depression >1 mm at baseline

132
Q

What is the indication for use of high-sensitivity CRP testing for cardiovascular risk stratification?

A

Intermediate Risk for CV disease

133
Q

What is the cardiac monitoring device indicated for patients with infrequent episodes of palpitations not associated with syncope?

A

30 Day Event Monitor

134
Q

What is the minimum duration of antiplatelet therapy following placement of a Bare Metal Stent?

A

At least 4 weeks

135
Q

What is the congenital abnormality characterized by upper extremity hypertension and radial artery to femoral artery pulse delay?

A

Aortic Coarctation (assoc. with Turners 45 XO)

136
Q

What is the diagnostic study of choice for evaluating perivalvular abscesses in patients with infective endocarditis?

A

Transesophageal Echocardiograpy TEE

137
Q

This is the treatment of nonbleeding patients taking warfarin with INR >9

A

Withold warfarin and give PO vitamin K

138
Q

What is the threshold platelet transfusion in nonbleeding patients with chemotherapy induced thrombocytopenia?

A

<10k

139
Q

What is the characteristic murmur associated with aortic regurgitation?

A

Diastolic Decrescendo murmur

140
Q

What is the diagnostic study indicated for evaluation of possible ischemic disease in pts with intermediate probability and normal ST segments on resting EKG?

A

Exercise Stress Testing

141
Q

What are the three initial antithrombotic therapie sfor NSTEMI?

A

Aspirin, P2Y12 inhibitor (clopidogrel) and heparin

142
Q

Common scoring system used to assess pretest probability for heparin-induced thrombocytopenia

A

The 4T score

143
Q

What is the appropriate mgmt of patietn with high risk score on exercise stress testing?

A

Cardiac Catheterization

144
Q

Which family members of patients with Hypertrophic Cardiomyopathy should undergo echocardiographic screening?

A

Alll first degree relatives

145
Q

Preferred mgmt of nonbleeding pts who have supratherapeutic INR less than 9

A

Withold one or two doses of warfarin but not vitamin K

146
Q

What is the mgmt of accelerated idioventricular rhythm occuring within 24 hours of reperfusion therapy?

A

None

147
Q

Treatment indicated for acute dissection of the ascending aorta (Stanford Type A)

A

Surgical Repair

148
Q

What are two medications shown to improve symptoms and reduce mortality in black patients with NYHA class III or IV heart failure sx ON MAXIMAL THERAPY?

A

Hydralazine and Isosorbide dinitrate (NOT a replacement to BB, ACE, and spironolactone but ADJUNCTIVE)

149
Q

What is the preferred treatment for COMPLICATED type B aortic dissection

A

Immediate Aortic Repair (whereas medical mgmt indicated for uncomplicated type B aortic dissection)

150
Q

What are the components of “Triple Therapy” for a patient with atrial fibrillation who just underwent PCI?

A

Anticoagulant (i.e. Warfarin for afib) + Aspirin + another antiplatelet agent (Clopidogrel or Prasugrel)

151
Q

What is the MGMT of small membranous VSD without heart enlargement, pulmonary HTN, Hx of endocarditis, or valvular regurgitation?

A

Clinical Observation

152
Q

What is the most common dose-limiting side effect of anthracycline drugs?

A

Cardiotoxicity

ABIM (9 decks)

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