Western Internal Medicine Test #3

Question 1

What are the early stage symptoms of hypertension?

Answer 1

Headache, dizziness, fatigue, palpitations, ear ringing

Question 2

What are the complications of hypertension?

Answer 2

1. Left ventricle hypertrophy/congestive heart failure
2. Hypertensive brain disease
3. Kidney damage
4. Shrunken retinal arteries/flashing lights/ocular bleeding/optic edema

Question 3

What is the treatment of hypertension?

Answer 3

Diuretics, beta blockers, calcium antagonists, ACEI, alfa blockers

Question 4

What diseases belong to ischemic heart disease?

Answer 4

Coronary heart disease, mycoardial infarction

Question 5

What diseases belong to heart overload?

Answer 5

1. Afterload (pressure load): high blood pressure, aortic stenosis, pulmonary hypertension/stenosis
2. Preload (volume load): valvular disease of the heart, congenital heart disease

Question 6

What are the cardiac sufficiency levels?

Answer 6

Level 1: has cardiovascular disease but no limitation to daily activities
Level 2: has cardiovascular disease and symptoms but only with exertion
Level 3: has cardiovascular disease and limitations to daily activities
Level 4: has cardiovascular disease and symptoms even during rest

Question 7

What are the clinical symptoms of chronic left heart failure?

Answer 7

Pulmonary congestion and low cardiac output
Symptoms: different level of dyspnea, coughing with sputum or blood, fatigue, dizziness, less urination and kidney dysfunction

Question 8

What are the clinical symptoms of chronic right heart failure?

Answer 8

Systemic circulation congestion

Symptoms: bloating, declined appetite, nausea, vomiting, dyspnea after exertion, edema, JVD

Question 9

What are the symptoms of acute heart failure?

Answer 9

Sudden severe dyspnea that lasts 30-40 minutes, grey-pale complexion, purple complexion, sweating, irritability, restlessness, coughing with pink bubbly sputum

Question 10

What are the clinical symptoms of angina pectoris?

Answer 10

Symptoms: radiating chest pain, chest oppression

Question 11

What does the EKG read during an attack of angina pectoris?

Answer 11

Low S-T wave, the T wave is flat or upside down

Question 12

How does angina pectoris and panic attack differ from acute myocardial infarction?

Answer 12

Myocardial infarction lasts longer and usually has shock and fever

Question 13

What is the EKG for premature heartbeat?

Answer 13

Early P wave for atrial premature beat

No P wave for ventricular premature beat

Question 14

What are the symptoms of ventricular tachycardia?

Answer 14

Hypotension, decreased urination, feels faint, inhalation, angina, arrythmia

Question 15

What does the EKG read for ventricular tachycardia?

Answer 15

The heart beats 100-250 times per minute
there is a wide QRS wave that lasts longer than 0.12 seconds
The D wave is not connected to the QRS wave

Question 16

What is the treatment of atrioventricular block

Answer 16

Level 1-2: no treatment

Level 2-3: pacemaker

Question 17

Just know that MS and MI are VERY IMPORTANT, every year there are lots of cases of it

Answer 17

Just know that MS and MI are VERY IMPORTANT, every year there are lots of cases of it

Question 18

Symptoms of AS (atrial stenosis)

Answer 18

Symptoms: dyspnea, angina, faint

Question 19

Diagnosis of AS (atrial stenosis)

Answer 19

Murmur, S2 decreased, right ventricular enlargement

Question 20

Female diagnosed with rheumatic heart disease. Recently for half a year, she has palpitations and SOB after exertion, some of her daily activities have been limited. what is her NYHA level?

Answer 20

Level 3

Question 21

Male, has hypertension for 5 years, has no clinical symptoms, just left ventricular enlargement

Answer 21

Level 2 hypertension

Question 22

Male has chest pain that comes and goes that causes difficulty breathing and lasts for 1-5 minutes. An EKG shows a low S-T wave and the T wave is upside down. What does he have?

Answer 22

Angina pectoris

Question 23

Female, history of rheumatic arthritis. During auscultation you can hear a systolic murmur sound at the heart apex area. The left heart is enlarged, which valve has the problem?

Answer 23

Mitral insufficiency

Question 24

Male, SOB for 3 months, coughing up bubbly pink sputum, the cheeks are dull red and the lips are purplish. There are wet rales in the lungs and a murmur in the heart apex. What does he have?

Answer 24

Mitral stenosis

Question 25

Female, has had rheumatic heart disease for 5 years, now her appetite has declined, she feels nauseas, is vomiting, her urination has declined and her juggular vein is distended. Her right ventricle is enlarged and there is a murmur. What does she have?

Answer 25

Chronic right sided heart failure

Question 26

During auscultation where do you hear the dull sounds?

Answer 26

At rib 2, 4, 4/5, apex

Question 27

Diseases causing left ventricular enlargement

Answer 27

Hypertension, mitral stenosis, aortic stenosis/insufficiency

Question 28

Diseases causing right ventricle enlargement

Answer 28

Chronic right sided heart failure, pulmonary heart disease

Question 29

Diseases causing left atrial enlargement

Answer 29

Mitral stenosis/insufficiency

Question 30

Disease causing right atrial enlargement

Answer 30

Tricuspid stenosis/insufficiency

Question 31

Diseases causing whole heart enlargement

Answer 31

Chronic left sided heart failure