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Cardiology
Internal Medicine
| Question | Answer |
|---|---|
| Hypertension levels: 1. prehypertension 2. stage 1 3. stage 2 | 1. 120/80 to 139/89 2. 14090 to 159/99 3. >160 systolic or >100 diastolic |
| Treatment for stage 2 hypertension. | diuretic with an ACE/ARB/CCB or beta blocker |
| Which populations should have a blood pressure below 130/80? | 1. diabetics 2. renal disease 3. end organ damage: CHF, retinopathy, stroke, PAD |
| 1. Drug to manage hypertension in pregnancy 2. Hypertensive drug contraindicated in pregnancy | 1. alpha-methyldopa, hydralazine 2. ACE inhibitors |
| Patient with chest pain and a difference in blood pressure (>20 mmHg) in both arms | aortic dissection |
| Chest pain with: 1. S4 heart sound 2. acute swelling of legs 3. wide splitting of S2 | 1. myocardial infarction 2. pulmonary embolism 3. RBBB |
| 1. Pleuritic chest pain, reproduced with chest wall palpitation. 2. Chest pain that is relieved by sitting up 3. Pleuritic chest pain, dyspnea and hemoptysis. | 1. costochondritis 2. pericarditis 3. pulmonary embolism |
| Single most important subgroup that carries risk for ischemic heart disease? | LDL cholesterol |
| EKG changes that are typically seen in: 1. angina 2. Prinzemetal's (variant) angina | 1. ST depression 2. ST elevation |
| What indicates a positive stress test? | 1. large (> 2mm) ST-segment depression 2. hypotension (>10 mmHg drop) |
| Which drugs are used in a chemical stress test? | 1. dipyridamole 2. dobutamine 3. adenosine |
| What are the lipid goals for an individual with ischemic heart disease: 1. LDL 2. HDL 3. triglycerides | 1. < 100 2. > 40 3. < 150 |
| What is the pathophysiology of an acute coronary syndrome that differentiates it from stable angina? | acute coronary syndromes have atherosclerosis with superimposed thrombotic occlusion |
| Chest pain with ST elevation and negative cardiac injury panel. | unstable angina |
| Chest pain without ST elevation but with positive cardiac injury panel | NSTEMI |
| Treatment of unstable angina/NSTEMI | 1. aspirin 2. nitroglycerin 3. beta-blocker 4. heparin |
| How long after presentation to hospital should a STEMI undergo PCI? | 90 minutes |
| Recommended discharge medications after acute coronary syndrome: | 1. aspirin 2. β-blocker 3. ACE inhibitor 4. Statin 6. Nitrate 7. Warfarin - only if a-fib or CHF |
| 1. Most common risk factor for CAD 2. Worst factor for CAD | 1. hypertension 2. diabetes |
| What are the following from 1. S3 heart sound 2. S4 heart sound | 1. fluid overload 2. stiffened left ventricle |
| Biomarker for reinfarction soon after a previous MI | CK-MB |
| What are the 3 presentations of aortic stenosis? | 1. syncope 2. CHF 3. angina |
| Most specific EKG finding for pericardtiits? | PR segment depression |
| Treatment of pericarditis | NSAIDs |
| Lifestyle changes has the greatest effect on which part of the lipid profile? | HDL |
| Which leads indicate inferior wall MI? | 1. II 2. III 3. aVF |
| Which thrombolytic should not be given repeatedly? | streptokinase because antibodies develop |
| How do you treat symptomatic bradycardia? | atropine |
| 1. Friction rub after an MI? 2. What is the treatment? | 1. Dressler syndrome 2. aspirin, NSAIDs |
| Common cause of death following MI? | ventricular fibrillation |
| Treatment for STEMI in II, III, aVF? | inferior wall MI treat with fluids |
| Prinzemental's angina 1. diagnosis 2. Treatment | 1. normal stress test and angio 2. nitrates and calcium channel blockers |
| Management for malignant hypertension. | nitroprusside and labetalol to reduce the BP by no more than 25% within 1-2 hours |
| What is malignant hypertension? | acute onset of severe hypertension associated with end-organ damage |
| 1. Hypertension with hypokalemia (2 adrenal causes) 2. Treatment (2) | 1. adenoma - surgical resection 2. bilateral hyperplasia - spironolactone |
| Most common cause of mitral stenosis. | rheumatic fever |
| What is the management for mitral stenosis leading to atrial enlargement? | diuretics and salt-restricted diet are helpfull because they decrease volume of preload |
| Medical management of atrial fibrillation | digitalis to control ventricular rate and anticoagulants |
| Medical management of mitral regurgitation. | 1. arteriole vasodilators (ACE inhibitors) 2. diuretics 3. digitalis |
| Indication for mitral valve replacement from regurgitation | 1. increased end systolic diameter (>40 mm) 2. decreased ejection fraction (< 60%) |
| Patient with mitral valve prolapse complaining of chest pain. What is the medical management? | beta blocker |
| Treatment for aortic stenosis | surgical therapy is indicated for symptomatic patients |
| Indication for aortic valve replacement from regurgitation | 1. increased end systolic diameter (>55 mm) 2. decreased ejection fraction (< 55% |
| How do the following effect blood flow to the heart? 1. squatting 2. valsalva 3. standing | 1. more blood to heart 2. less blood to heart 3. less blood to heart |
| How are the following murmurs effected affected by squatting: 1. regurgitant murmurs 2. stenotic murmurs 3. HOCM 4. MVP | more blood to heart 1. increases 2. increases 3. decreases 4. decreases |
| How are the following murmurs effected affected by valsalva: 1. regurgitant murmurs 2. stenotic murmurs 3. HOCM 4. MVP | less blood to heart 1. decreases 2. decreases 3. increases 4. increases |
| Treatment for dyspnea from HOCM. | slow heart to allow longer filling time 1. β-blocker 2. Ca2+ channel blocker |
| 1. What is Kussmaul sign? 2. What disorders is this seen in? | 1. JVD upon inhalation 2. Cardiac tamponade, restrictive cardiomyopathy, constrictive pericardtitis |
| What the sudden loss of consciousness from hypotension due to a 3rd degree AV block? | Adam-Stoke attack |
| 1. Definitive treatment for Wolff-Parkinson-White 2. Hemodynamically unstable patient with WPW 3. Medical treatment of WPW in stable patients until definitive therapy can be used | 1. radioablation 2. electrical cardioversion 3. procainamide |
| Why should β-blocker, Ca2+ channel blocker and digoxin be avoided in Wolf-Parkinson-White? | they inhibit conduction in the normal conduction pathway |
| Treatment for: 1. Stable ventricular tachycard 2. Unstable ventricular tachycardia | 1. loading dose of amiodarone followed by lidocaine until VT resolves 2. electrical cardioversion |
| Treatment of third degree heart block. | pacemaker |
Created by:
amichael@siumed.edu
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