palpitations, arythmias, HF, syncope

Question 1

NYCA 1

Answer 1

asymptomatic

Question 2

NYCA 2

Answer 2

symptoms with activity, comfortable at rest

Question 3

NYCA 3

Answer 3

symptoms with less than normal activity, comfortable at rest

Question 4

NYCA 4

Answer 4

Severe symptoms- present at rest

Question 5

management of patients with chronic HF with PRESERVED ejection fraction?

Answer 5

Monitor EF with regular echos

Question 6

management of asymptomatic patients with reduced EF

Answer 6

ACEi + beta blocker

ICD if EF < 30%

Question 7

management of symptomatic patients with reduced EF

Answer 7

• diuretics
• ACEi, beta blocker,
• ICD for certain patients

Question 8

Treatment of primary pneumothorzx with symptoms or > 2 cm?

Answer 8

aspirate or drain

Question 9

Treatment of primary pneumothorax < 2cm and asymptomatic?

Answer 9

discharge

Question 10

Secondary pneumothorax > 2 cm?

Answer 10

drain

Question 11

secondary pneumothorax 1-2 cm

Answer 11

aspirate

Question 12

secondary pneumothorax <1 cm

Answer 12

oxygen and observe

Question 13

indications for valve replacement in aortic stensosi?

Answer 13

• symptomatic patient
• gradient > 50 mmHg
• < 1 m area

OTHERS

• getting mitral valve replacement
• severe LV dysfunction
• CABG/aortic root surg

Question 14

what is mild aortic stenosis?

Answer 14

Gradient < 25 mmhg

-area > 1.5

Question 15

what is moderate aortic stenosis?

Answer 15

• gradient 25-40

- area 1 - 1.5

Question 16

what is severe aortic stenosis

Answer 16

• gradient > 40

- area < 1

Question 17

where is the apex in mitral regurg?

Answer 17

inferiorlateral

and is forceful or thrusting

Question 18

heart sounds in MR?

Answer 18

• soft S1
• loud P2
• S3

Question 19

indications for valve repair in mitral valve regurg?

Answer 19

• symptomatic patient
• NYHA III-IV
• EF falling < 60% rapidly
• LV end-systolic dimension > 45 mmHg

Question 20

mild mitral regurg?

Answer 20

regurg volume < 30ml or < 30%

Question 21

mod mitral regurg?

Answer 21

regurg volume 30-60ml or 30- 50%

Question 22

severe mitral regurg?

Answer 22

regurg volume > 60 ml or > 50%

Question 23

monitoring for mild MR

Answer 23

yearly checkup

Question 24

monitoring for moderate MR

Answer 24

yearly checkup, yearly echo

Question 25

monitoring for severe MR

Answer 25

6 mo exam, history and echo

Question 26

a big V wave is seen with which murmur

Answer 26

tricuspid regurg

Question 27

parasternal heave occurs with which murmur

Answer 27

tricuspic regurg

Question 28

diagnostic criteria for infective endocarditis?

Answer 28

Blood culture + atleast twice
Echo shows endocardial involvmenet

Fever
Evidence from microbiology
Vascular phenomenon
Evidence from immunology
Risk factors

Question 29

Abs for infective endocarditis?

Answer 29

Vancomycin and gentamycin

Question 30

which type of valve replacement does not require warfarin?

Answer 30

bioprosthetic or tissue valve

Question 31

which type of valve replacement DOES require warfarin?

Answer 31

metallic

Question 32

Someone with a metalic aortic valve replacement has an early diastolic murmur. What does this indiacte?

Answer 32

A failing valve

Question 33

HFrEF ?

Answer 33

HF with EF < 40%

Question 34

HFmrEF?

Answer 34

EF 40-49%

Question 35

HFpEF?

Answer 35

EF > 50%