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CVS Recall > Samplex > Flashcards

Samplex Flashcards

1
Q

Characteristics with decreased likelihood of AMI

A

Inframammary
Sharp
Reproducible
Positional
Pleuritic

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2
Q

Top 5 characteristics with increased likelihood for AMI

A

Radiates to R arm/shoulder
Radiates to both arms
Exertion
Radiates to L arm/shoulder
Diaphoresis
Associated with nausea and vomiting

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3
Q

Qualities of severe MR

A

S3
Short rumbling diastolic murmur

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4
Q

MVP location of murmur if:
-posterior leaflet affected
-anterior leaflet affected

A
  • anterior and medial: base of <3
    -posterior and lateral: Apex
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5
Q

Laplace law states what?

A

Tension = (ventricular pressure X diameter) wall thickness

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6
Q

Cannon A waves signify what?

A

Cannon A waves - simultaneous contraction of atrium and ventricles

AV dissociation
3rd AVB
Pulmonary HTN

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7
Q

Which of the following will cause an atrioventricular
block?

A. Hypokalemia
B. Hypomagnesemia
C. Hyperthyroidism
D.Adrenal insufficiency

A

D. Adrenal insufficiency

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8
Q

Arrhythmia with irregular atrial and ventricular rate

A

AFib and MFAT

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9
Q

Narrow complex tachycardia with VA block V> A

A

Junctional tachycardia

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10
Q

Indication for at least 3 months of Warfarin therapy + full dose anticoagulation post MI

A

-Heart failure
-Severe LV dysfunction
-Afib
-Anterior wall infarct
-History of embolism

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11
Q

Angiographic success
after percutaneous interventions

A

Reduction of stenosis to less than 20%

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12
Q

Operative cut-offs for ASCENDING thoracic aneurysm

A

> /= 5.5 cm
0.5 cm growth/yr
4.5 cm for bicuspid AV for AVR due to severe AS or AR
4-5 cm for Marfan syndrome

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13
Q

Operative and endovascular repair cut offs for DESCENDING thoracic aneurysm

A

> 6cm for OR for degenerative reason
5.5 cm consider for endovascular repair

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14
Q

Drug of choice for thoracic aortic aneurysm

A

Beta blocker

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15
Q

Operative cut off for abdominal aneurysm

A

> 5.5 cm

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16
Q

’

Diastolic murmur heard at the left sternal border

A
  • bicuspid aortic valve
    -endocarditis
    -prolapse
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17
Q

Are most arrhythmias associated with palpitations?

A

No

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18
Q

What phase of systolic cycle and grade of murmur is 2D echo warranted?

A

holosystolic and late systolic; grade III and higher

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19
Q

Anticoagulation indications for Afib

A

-prior stroke
-MS
-hypertrophic CM

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20
Q

Warfarin as anticoagulation of choice in what conditions?

A

-Rheumatic MS
-Mechanical valves

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21
Q

Indications for ICD in post MI

A
  • > 40 days post MI, EF < =30%
    -NYHA II-III, EF < 35%
    -> 5 days post MI with HFrEF, NSVT, inducible VT
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22
Q

ECG findings associated with VT

A

-AV dissociation
- R or Rs in AVR
-No rS or Rs in V1-V6

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23
Q

Lab results with worse outcomes in
patients with acute decompensated heart failure

A

BUN > 43 mg/dL
SBP <115
Elevated Trop I
Crea > 2.75 mg/dL

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24
Q

Acute
mitral regurgitation occurring in the setting of acute myocardial
infarction is due to rupture of which papillary muscle>

A

Posteromedial papillary

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25
Q

What type of exercise treadmill test should be done 1 week post MI?

A

Heart rate limited TST *as early as 6 days after

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26
Q

Indications for coronary arteriography

A
  1. CSAP severely symptomatic despite med tx
  2. Questionable diagnosis
  3. Survived cardiac arrest
  4. Ventricular dysfunction on non invasive testing
  5. High risk for coronary events + severe findings on non invasive findings
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27
Q

Anti hypertensive with erectile dysfunction side effect

A

Beta blockers

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28
Q

Anti hypertensive contraindicated in HOCM

A

Nitrates

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29
Q

Drugs to give and avoid in Prinzmetal agina

A
  1. Nitrates and CCB first line
  2. Avoid Aspirin
  3. statin may be of benefit
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30
Q

Recommendation for abdominal aneurysm screening

A

Abdominal ultrasound for 65-75 who ever smoked

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31
Q

First line in aortic dissection management and targets

A
  1. Beta blocker (propranolol, esmolol, metoprolol) = target HR 60
  2. Nitroprusside = target SBP <=120
  3. Verapamil/Diltiazem as alternative

**Hydralazine contraindicated

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32
Q

Most frequent sites of PAD

A

Femoral + popliteal > tibia and peroneal > iliac and abdominal aorta

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33
Q

Indication for mitral valvuloplasty while pregnant

A

Severe MS </= 1.5 cm with 1)symptomatic 2)pulmonary HTN

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34
Q

a. Gallavardin effect
b. Carvallo’s sign
c. Graham Steel murmur
d. maladie de Roger

A

a. Gallavardin effect – aortic stenosis
b. Carvallo’s sign – tricuspid regurg
c. Graham Steel murmur – pulmonic regurgitation
d. maladie de Roger – small ventricular septal defect

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35
Q
  1. Severe LV systolic dysfunction
  2. Hypertrophic obstructive
  3. Severe obstructive lung disease
A
  1. Pulsus alterans
  2. Bifid pulse
  3. Pulsus paradoxus
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36
Q

Clinical diagnosis of cardiotoxicity

A

Symptomatic: >5% EF reduction with EF < 55%

Asymptomatic: >10% EF reduction with EF <55%

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37
Q

Antiarrhythmic medications have high potency but slowest kinetics

A

a. flecainide

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38
Q

Postural orthostatic tachycardia syndrome diagnosis

A

> 30 bpm or >120 HR within 10 mins of standing without hypotension

39
Q

Most common form of paroxysmal supraventricular tachycardia

A

AVNRT

40
Q

Usual atrial rate of atrial flutter

A

240-300 bpm

41
Q

Most common electrolyte abnormality associated with premature ventricular contractions

A

Hypokalemia

42
Q

Drugs can be administered in-hospital to augment or unmask ST elevation in affected individuals with Brugada syndrome

A

Flecainide

43
Q

Inotropic agent retains its effectiveness in the presence of concomitant beta blocker therapy

A

Milrinone

43
Q

Symptom confers poor prognosis because of the shortest average time to death after the onset of symptoms

A

HF

44
Q

Traube’s sign

A

Pistol shot at femoral artery

45
Q

Duroziez’s sign

A

To and fro murmur femoral artery

46
Q

Medications that can retard aortic root dilatation

A

Beta blockers and ARB

47
Q

CKD stage V presented with symptoms of acute idiopathic pericarditis, which of the following medications should be avoided

A

Colchicine and anticoagulants

48
Q

Most common cause of large-vessel renal artery occlusive disease

A

Clonidine

49
Q

First line inotropic agent for treatment of pulmonary embolism related shock

A

Dobutamine

50
Q

Recommended appropriate treatment goal for patients with statin therapy

A

30% or greater reduction in LDL-C or LDL-C less than 70mg/dl

51
Q

Diagnosis of HTN in 24 hr BP monitoring

A

Asleep : >/= 120/75
Awake >/= 135/85

52
Q

Target BP with benefits

A

<135-140/80-85

53
Q

Definition of malignant hypertension

A

Syndrome with abrupt increase in BP to those with underlying HTN or sudden onset HTN in a previously normotensive individual

54
Q

Ischemic ST segment response

A

> 0.1 mV flat or downsloping compared to PR segment for more than 0.08 secs

55
Q

Indications to stop TST

A

Symptoms (dizziness, dyspnea, chest discomfort)
ST depression >0.2 mV
SBP fall > 10
Ventricular tachyarrhythmia

56
Q

Mainstay anticoagulation in ACS

A

UFH

57
Q

Different types of MI

A

1 - atherosclerotic
2- Ischemic imbalance
3- Death but biomarkers are unavailable
4- PCI related: >5x elevation if initial is normal; >20% if baseline is elevated + new symptoms/new ECG findings/LBBB
5-CABG: >10x elevation

58
Q

Criteria for ST elevation

A

Female: V2-V3: >1.5mm
Male > 40: > 2mm
Male < 40: > 2.5mm

*All other leads >1mm

59
Q

NTproBNP or BNP can elevated in what circumstances

A

WARR

Women
Age
Renal dysfunction
R sided HF

60
Q

Cardinal symptoms of HF

A

Fatigue and shortness of breath

61
Q

Main mechanism of dyspnea in HF

A

Pulmonary congestion: Increase in intraalveolar fluid

62
Q

Pathophysiology of long QT syndromes

A

LQTS 1 and 2: K
LQTS 3: Na

63
Q

Settings of long QT occurrence

A

LQT1: Swimming
LQT2: Auditory stimuli/emotional stimuli
LQT3: Sleep

64
Q

Increased risk of long QT

A

QTc > 0.5 s
Female
History of syncope/cardiac arrest

65
Q

Treatment for prolonged QTc

A

Non selective beta blocker (nadolol and propranolol)

66
Q

Decade when idiopathic fibrosis of the AV node starts

A

40 years old

67
Q

Part that is involved in acute anterior MI

A

distal AV node complex resulting in wide unstable escape rhythms

68
Q

Alcohol consumption that leads to chronic alcoholic CM

A

5-6 drinks daily for 10 years

69
Q

Cardiac function can recover after how many months of abstinence

A

3-6 months of abstinence

70
Q

When does PPCM occur?

A

Last trimester until 6 months

71
Q

Risk factors for PPCM

A

-increased maternal age
-increased parity
-mutations in TTN

72
Q

Potential therapy for PPCM

A

Bromocriptine

73
Q

How many years post anthracycline exposure is systolic dysfunction evident?

A

1 yr

74
Q

Therapy for PPCM

A

BB and ACE-i

75
Q

TSAT threshold for hemochromatosis

A

> 60% men
45-50% female

76
Q

Treatment for Takotsubo CM?

A

Nitrates

77
Q

In which infection is cardiac the MC cause of death?

A

Diptheria - 1/2 of cases

78
Q

MC cause of infective cause of CM?

A

Chagas’ Disease - conduction and rhythm problems; thrombogenic LV

Tx:
-HF meds
-Anticoagulation

79
Q

Therapy for all kinds of amyloid?

A

Loop diuretics

80
Q

Medical treatment for HOCM

A

Beta blockade
Non dihydropyridine CCB
Disopyramide

81
Q

Medication that reduce rate of aortic dilatation by blocking TGF B signaling?

A

Angiotensin antagonist

82
Q

Target monitoring parameters for aortic dissection

A

HR ~60
SBP <= 120

83
Q

Treatment for aortic dissection

A

1) IV beta blocker: esmolol/propranolol
2) IV nitroprossuide
3) If Stanford A: emergent surgical correction

84
Q

Debakey and Stanford Classification for Aortic Diseases

A

Debakey
1- Ascending + descending aorta
2. Ascending only
3. Descending only

Stanford
A- Ascending
B- Arch of aorta and/or Descending

85
Q

MC clinical sign of IE?

A

Fever then Heart murmur

86
Q

MC lab finding in IE?

A

Anemia

87
Q

Abx regimen for prosthetic valves IE MSSA and MRSA

A

Gentamicin (2 weeks) and Rif (6-8) weeks for both

MSSA: Nafcillin/oxacillin 6-8 wks
MRSAL Vancomycin 6-8 wks

88
Q

Abx regimen for MSSA and MRSA native valve IE

A

Cefazoloin/Oxacillin +/- Vancomycin if MRSA

89
Q

Emergent/same day OR for IE indications

A

Cardiogenic shock/pulmonary edema
Acute AR with preclosure of MV
Ruptured sinus of valsava in R heart
Rupture into pericardial sac

90
Q

ABI cutoffs and interpretation

A

<0.9 abnormal
0.91-0.99 Borderline
1-1.4 Normal
>1.4 Noncompressove

91
Q

C of CEAP

A

C0 no signs of venous disease
C1 Telangiectasia
C2 Varicose veins
C3 edema
C4 skin changes (hyperpig, eczema)
C5 Healed ulcer
C6 active venous ulcer (C6r recurrent)

92
Q

Indications for surgery for MVP with severe primary MR

A

Symptomatic
LV dysfunction
Recent onset AF
PAH

CVS Recall (2 decks)

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