Part 1

Question 1

Acute arterial occlusion
-intervention
-gold standard for dx
-common causes of occlusion

Answer 1

dx:
*angiography—GS
*others: EKG (AF), echo (clots, MI, valve regurg)

tx:
** Anticoagulate with IV heparin (bolus followed by constant infusion)

If not limb-threatening then call the vascular surgeon for angioplasty, graft, or endarterectomy

Mitral stenosis and AFIB

Question 2

WPW
-clinical intervention
-what not to give

Answer 2

DONT GIVE: adenosine or CCB

GIVE: amio, or Radiofrequency ablation

Question 3

chlorthalidone

Answer 3

thiazide like diruetic for essential HTN

Question 4

indapamide

Answer 4

thiazide like diuretic for essential htn

Question 5

SE ACEI

+/- in perg?

Answer 5

cough
angioedema
hyperkalemia

CONTRA in preg

Question 6

SE CCB

Answer 6

leg edema

Question 7

SE of hydralazine

Answer 7

SLE like effects
pericarditis

Question 8

Define malignnat HTN

Answer 8

DBP >140
papilledema and either encephalopathy or nephropathy

Question 9

screening for AAA

Answer 9

one-time screening for abdominal aortic aneurysm by ultrasonography in men ages 65 to 75 years who have ever smoked

Question 10

initial image of choice for AAA and TAA

*GS for AAA

Answer 10

AAA=us 1st
GS=angio
TAA=CT

Question 11

when to do surgery for AAA

Answer 11

even if asympto
>5.5 or expands 0.6 cm per yr

Question 12

67-year-old female with a severe throbbing headache and visual impairment in the left eye. The patient describes worsening of pain with chewing or combing her hair.

Answer 12

giant cell arteritis
*jaw claudication
*Visiaul impairment
*scalp tenderness
*elevated ESR

KEYYYYY

Question 13

tx and dx for giant cell arteritis

what is it assoc with>

Answer 13

*temporal artery biopsy
*

assoc with polymalgia rheumatica

Question 14

Leriche syndrome

Answer 14

refers to a buildup of plaque in the iliac arteries → claudication, impotence, decreased femoral pulses

Question 15

ankle-brachial-index (ABI) unde what is PVD
-normal?

Answer 15

<0.9= PVD

1-1.2 normal

Question 16

mainstay of tx for PVD

Answer 16

cilostazol**

ASA

Plavix

rosuvastatin, smoking cessation, structured exercise

Question 17

mc type of cardiomyopathy

Answer 17

dilated

Question 18

S3

Answer 18

dilated cardiomy

Question 19

tx for dilated cardiomyopathy

Answer 19

TX: βblocker + ACE + Loop Diuretic

AABCD
anticoagulants, ACE-I, β-blockers, calcium channel blockers, and diuretics/ digoxin )

Question 20

The murmur becomes louder when the patient performs a Valsalva maneuver and decreases with squatting.

Answer 20

HOCM

*autosomal dominant

Question 21

s4

Answer 21

hocm

Question 22

what to avoid with tx for HOCM

Answer 22

-anything that lowers prelload
nitrates + diuretics, ACE inhibitors, angiotensin II receptor blockers) because these decrease LV size and worsen LV function

dig=CONTRA

Question 23

tx to close pda

Answer 23

indomethacin

Because Prostaglandin E-2 is responsible for keeping the ductus patent - inhibitors of prostaglandin will close it

Question 24

most common pathologic murmur in childhood

Answer 24

vsd

Question 25

2-week-old newborn brought to the ER by his mom who reports a sudden loss of consciousness during feeding and crying. She also has noticed that the infant’s lips have turned blue on three occasions during feeding.

Answer 25

tetrollagy

Question 26

tof features

Answer 26

Four features: PROVe P ulmonary Stenosis R ight ventricular hypertrophy O verriding aorta V entricular septal defect

Question 27

The only difference between NSTEMI and unstable angina is

Answer 27

elevated cardiac enzymes in NSTEMI