Pericardial disease, Valvular disease, Vascular disease

Question 1

Causes of pericarditis

Answer 1

CARDIAC RIND
Collagen vascular disease
Aortic dissection
Radiation
Drugs
Infections: viruses, Tb
AKI
Cardiac (MI)
Rheumatic fever
Injury
Neoplasms
Dressler's syndrome 2-4 weeks s/p MI

Question 2

Causes of Kussmaul’s respiration

Answer 2

Restrictive cardiomyopathy
Pericarditis
RV infarct
Massive PE
Tamponade

Question 3

Pulsus paradoxus

Answer 3

Decrease in SBP > 10 upon inspiration
Presents w/ tamponade 2/2 restriction of heart expansion leading to bowing of the interventricular septum into the LV, decreasing outflow

Question 4

EKG of pericarditis

Answer 4

Diffuse S-T segment elevations and PR segment depressions followed by T wave inversions

Question 5

Tx of viral pericarditis

Answer 5

ASA + NSAIDs

Question 6

Beck’s triad

Answer 6

Hypotension
JVD
Distant heart sounds

Question 7

Electrical alternans

Answer 7

Alternating QRS amplitude

Seen in pericardial effusion

Question 8

When to get an echo for a murmur

Answer 8

Asymptomatic systolic murmurs DO NOT NEED an echo

Asymptomatic diastolic murmurs ALWAYS need an echo

Question 9

Aortic stenosis physical exam

Answer 9

Pulsus parvus et tardus (weak, delayed carotid upstroke)
Single or paradoxically split S2
Systolic murmur radiating to carotids( RUSB -> carotids)

Question 10

Causes of aortic regurgitation

Answer 10

Infective endocarditis
Aortic dissection
Valve malformations
Rheumatic fever
Connective tissue disorders
Tertiary syphilis

Question 11

Aortic regurgitation physical exam

Answer 11

Blowing diastolic murmur at LSB
Mid-diastolic rumble (Austin Flint murmur)
Midsystolic apical murmur
WIdened pulse pressure -> head bob w/ heartbeat, water-hammer pulse, and femoral bruit

Question 12

Mitral valve stenosis etiology

Answer 12

Rheumatic fever

Question 13

Physical exam of mitral valve stenosis

Answer 13

Opening snap and mid-diastolic murmur at apex

Question 14

Mitral valve regurgitation etiology

Answer 14

Rheumatic fever
Rupture of chordae tendinae following MI
Infective endocarditis

Question 15

Physical exam of mitral valve regurgitation

Answer 15

Holosystolic murmur radiating to the axilla

Question 16

AAA screening

Answer 16

All men 65-75 y/o w/ hx of smoking should be screened by U/S once

Question 17

Treatment of AAA

Answer 17

If < 5 cm, get U/S q 6 months
If > 5.5 cm, surgical repair is indicated

If thoracic, and >6cm, surgery is indicated

Question 18

Aortic dissections associations

Answer 18

HTN, Marfans, Ehler-Danlos, coarctation

Question 19

What murmur can present with aortic dissections?

Answer 19

Aortic regurgitation

Question 20

Virchow’s triad

Answer 20

Endothelial damage, hypercoaguable state, stasis

Question 21

When to get a D-dimer

Answer 21

If pretest probability is low, a negative D-dimer can rule out PE

Question 22

Leriche syndrome

Answer 22

Male impotence 2/2 aortoiliac disease

Question 23

Blue toe syndrome

Answer 23

2/2 cholesterol atheroembolism

Question 24

Lymphedema

Answer 24

Disruption of lymphatic circulation 2/2 LN dissection or parasitic infection

Question 25

Cardiac etiologies of syncope

Answer 25

Valvular lesions, arrhythmias, PE, cardiac tamponade, aortic dissection

Question 26

Non-cardiac etiologies of syncope

Answer 26

Orthostatic/hypovolemic hypotension, neurologic (TIA, stroke), metabolic abnormalities, neurocardiogenic syndromes (vasovagal, micturition syncope), psychiatric

Question 27

How to diagnose syncope?

Answer 27

Tilt-table testing

Question 28

Varicose veins etiology

Answer 28

2/2 venous valve dysfunction