UWorld Cardiology Flashcards
Patient presents with transient vision loss, unintentional weight loss, and diastolic murmur.
Diagnosis?
Cardiac myxoma
Patient presents with fatigue, dyspnea on exertion, cachexia, and signs of right-sided heart failure, along with flushing and secretory diarrhea.
Diagnosis?
Carcinoid heart disease
What is the initial recommended treatment for high risk stage 2 hypertension?
Ace inhibitor + calcium channel blocker
What blood pressure medication is added when a patient is already taking ACE inhibitor and calcium channel blocker?
Thiazide diuretic
Does the catheter with a catheter associated DVT always need to be taken out?
Not if it’s functional and the access is difficult.
What ECG abnormality may be associated with a large ASD?
Right bundle branch block
Does a large ASD cause left ventricular hypertrophy?
No (it typically causes right ventricular hypertrophy)
What is the most common cause of unexpected mortality in patients undergoing cardiac catheterization?
Retroperitoneal hemorrhage
If a patient needs a stent and is allergic to aspirin what should you do?
Aspirin desensitization prior to stenting as patients need to be on dual anti-platelet therapy starting at least 2 hours prior to stent placement.
What is the most likely cause of shock if a patient with pulmonary artery catheterization shows low cardiac index and high systemic resistance and pulmonary capillary wedge pressure?
Cardiogenic shock
Glucocorticoids given early for viral pericarditis are associated with a higher rate of recurrence.
True or false?
True
NSAIDS given early for viral pericarditis are associated with a higher rate of recurrence.
True or false?
False
Colchicine given early for viral pericarditis are associated with a lower rate of recurrence.
True or false?
True
Can S3 be heard in normal young adults?
Yes
How long does it take to recover left ventricular function in stress cardiomyopathy (Takotsubo cardiomyopathy)?
8 - 12 weeks
Do patients with paroxysmal SVT in WPW syndrome present with hypertensive crisis?
No
Patients with hypertensive crisis during routine outpatient procedures should be tested for silent pheochromocytoma.
True or false?
True
Do antiarrhythmic drugs have a role in the management of multifocal atrial tachycardia?
No
Is dental extraction a “high risk of bleeding procedure”?
No
Does warfarin need to be held for a dental extraction?
No
In athlete’s heart what is the left ventricular wall thickness?
12 mm or less
In athlete’s heart is the left ventricular hypertrophy symmetric or asymmetric?
Symmetric
In hypertrophic cardiomyopathy what is the left ventricular wall thickness?
15 mm or more
In hypertrophic cardiomyopathy is the left ventricular hypertrophy symmetric or asymmetric?
Asymmetric
Are infiltrative cardiomyopathies associated with heavy proteinuria?
Yes
Can patients with acute aortic dissection present with Horner’s syndrome?
Yes
Do patients with vasovagal syncope need further testing?
No
Should patients with acute myocardial infarction who has already received thrombolytics be transferred to a PCI capable hospital?
Yes - as soon as possible.
How often does reocclusion occur after successful thrombolytic therapy for acute myocardial infarction?
20 - 30% of patients
What reduces the peripheral edema caused by calcium channel blockers?
Addition of ACE inhibitors or ARBs
Does calcium channel blocker related edema respond well to thiazide diuretics?
No
Should you do a pericardiocentesis in a patient with a cardiac tamponade secondary to an acute aortic dissection?
No (high mortality due to increased bleeding and shock; instead the patient needs to be diagnosed and taken to surgery)
How do you diagnose carotid sinus hypersensitivity?
Carotid sinus massage
Patient presents with shoulder pain, Horner’s syndrome, and hand muscle weakness/atrophy.
Diagnosis?
Pancoast tumor
Patient presents with worsening peripheral edema or anasarca and extreme fatigability, especially in response to exertion. Physical examination shows an elevated jugular venous pressure, pulsus paradoxus, Kussmaul’s sign, and pericardial knock.
Diagnosis?
Constrictive pericarditis
What is the gold standard for diagnosing superior vena cava syndrome?
Bilateral upper extremity venography
Patient presents with dyspnea, head fullness, facial/arm swelling, or chest wall edema that may worsen with bending or lying down. Patients may also develop episodic syncope or presyncope.
Diagnosis?
Superior vena syndrome
What is the initial test of choice for superior vena cava syndrome?
CT chest with contrast
What murmur is usually heard with the patient in the sitting position and disappears with supine position and by maintaining pressure on the ipsilateral internal jugular vein?
Venous hum
Should a beta blocker or radiofrequency ablation be used as first line for treatment of atrial flutter (with tachycardia)?
Radiofrequency ablation
Which ARB is associated with a lower risk of gout?
Losartan
Which class of anti-hypertensives is associated with a lower risk of gout?
Calcium channel blockers
Which secondary cause of resistant hypertension is associated with flash pulmonary edema?
Renal artery stenosis
What is the preferred modality to diagnose renal artery stenosis?
MR or CT angiogram
Are pregnant women with obstructive lesions (aortic stenosis, etc) more at risk of maternal or fetal complications compared to those with regurgitant lesions (aortic regurgitation, etc)?
Yes
Which anticoagulant is preferred during pregnancy?
Low molecular weight heparin
Can paroxysmal atrial fibrillation cause paroxysmal nocturnal dyspnea?
Yes
How should bradycardia and asystole during the nocturnal hours be evaluated?
Overnight polysomnography (sleep study)
Are obstructive sleep apnea-mediated bradycardia and asystole indications for permanent pacemaker implantation?
No
What does the estimated 10 year cardiovascular risk need to be to benefit (primary prophylaxis) from aspirin?
More than 10%
Is bridging with unfractionated heparin required in case of mechanical aortic valve with no additional risk factors?
No
Is bridging with unfractionated heparin required in case of mechanical aortic valve with additional risk factors?
Yes
Is bridging with unfractionated heparin required in case of mechanical mitral valve?
Yes
