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Cardiology – Awesome
Random
| Question | Answer |
|---|---|
| No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath). - which NYHA class? | I |
| Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath). - which NYHA class? | II |
| Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea. - which NYHA class? | III |
| Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases. | IV |
| flank or back pain and persistent hypotension after cardiac catheterization | suspicion of a retroperitoneal bleed, which usually results from a proximal puncture of the common femoral artery in the setting of ongoing anticoagulation; dx with CT abd if pt is stable enough for scanner |
| most common cardiac defect after rheumatic fever | mitral stenosis |
| risk assessment tool that would provide the most accurate prediction of cardiovascular risk in women | Reynolds risk score, better because it includes family history and high-sensitivity C-reactive protein, which will bump up some women's risk |
| S3 gallop, pulmonary crackles - think of what | decompensated CHF |
| cumulative dose of doxorubicin in excess of 550 - likely to have what | doxorubicin-induced dilated cardiomyopathy |
| pulsus paradoxus greater than xx mm Hg means cardiac tamponade | greater than 10 |
| Radiation-induced constrictive pericarditis typically manifests with... | right-sided findings of heart failure disproportionately greater than that of left, BNP nl to slightly elevated |
| when to use glycoprotein IIb/IIIa inhibitor eptifibatide | when ACS and TIMI 5 to 7 |
| treatment of chronic stable angina (typical CP with exertion, no sx's at rest) | β-blocker dose is adjusted to achieve a resting heart rate of approximately 55 to 60 beats/min and approximately 75% of the heart rate that produces angina with exertion |
| when to use Ranolazine | considered in patients who remain symptomatic despite optimal doses of β-blockers, calcium channel blockers, and nitrates. |
| who should NOT use ranolazine | metabolized by cytochrome P-450 system. don't use in hepatic impairment, QT prolongation, or with other drugs that inhibit the cytochrome P-450 system (diltiazem and verapamil) |
| woman with exertional chest pain and evidence of left ventricular hypertrophy and strain on electrocardiogram (ECG) - what test to do next | Stress ECHO - can't just do EKG stress because baseline abnl EKG would prevent accurate interpretation |
| LBBB on EKG - what stress test to do? | left bundle branch block needs pharmacologic stress, rather than exercise stress, is preferred because stress tests that depend on increasing heart rate have an increased incidence of false-positive anteroseptal reversible defects on nuclear imaging |
| renovascular hypertension secondary to fibromuscular dysplasia - how to dx and tx | Dx with Catheter-based kidney angiography, tx with Percutaneous transluminal kidney angioplasty |
| “string of beads” appearance of the involved renal artery | fibromuscular dysplasia causing likely renovascular HTN |
| All patients with an acute coronary syndrome should receive (5 drugs) | nitrates, a β-blocker, aspirin, clopidogrel (unless an increased risk of bleeding exists), and a statin |
| patients with a high TIMI risk score (5-7) should receive (2 drugs) | anticoagulation therapy (unfractionated heparin, low-molecular-weight heparin [LMWH], or bivalirudin) and a glycoprotein IIb/IIIa inhibitor, such as eptifibatide |
| when should someone with LDL < 130 still get statin? | when sCRP > 0.2 -> they should get rosuvastatin |
| Name a glycoprotein IIb/IIIa inhibitor | abciximab (ReoPro) eptifibatide (Integrilin) tirofiban (Aggrastat) |
| when should you give clopidogrel? | All NSTE-ACS should receive a statin and a P2Y12 inhibitor (such as clopidogrel). Clopidogrel should be given as a loading dose (300 mg or 600 mg) at hospital admission and then 75-mg daily at least 1 year regardless of the need for PCI or CABG. |
| When should you give a glycoprotein IIb/IIIa inhibitor | patients at intermediate or high risk (TIMI score ≥3), |
| What should you do with Plavix if patient needs a CABG | If CABG is ultimately required, clopidogrel should be discontinued and CABG should be postponed for 5 to 7 days in order to avoid perioperative bleeding. |
| Eight high-risk features that would require you to treat a patient with acute pericarditis in the hospital | TIPCAT with pericarditis falling FW toward the hospital. Tamponade, Immunocompromised, Pericardial effusion, Cardiac biomarker elevation, Anticoagulation meds, Trauma |
Created by:
christinapham
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