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Cardio 7 (Edocard)
Step-2
| Question | Answer |
|---|---|
| In which patients are -triptan drugs contraindicated? | pregnancy, CAD, prinzmetals angina |
| Which drugs block transmission through the AV node? | b-blockers, digoxin, and non-dihydropyridines CCBs |
| What causes stones, bones, groans, and psychic overtones? | hypercalcemia |
| Which heart valve should blood be flowing through during systole? | Aortic and Pulmonic |
| What are the systolic heart murmurs? | aortic stenosis, pulmonic stenosis, mitral regurg, tricusbid regurg, and VSD |
| What heart valvaes should blood be flowing through during diastole? | Tricuspid and mitral |
| What are the diastolic heart murmurs? | tricuspid stenosis, mitral stenosis, aortic regurg, and pulmonic regurg |
| Which murmurs can you hear best in the left lateral decubitus position? | mitral murmurs, S3 and S4 |
| Which heart sounds are benign if there is no evidence of disease in the patient? | split S1, split S2 on inspiration, S3 in pt <40, early quiet systolic murmur |
| What PE finding will help you diagnose a patient with HOCM? | Valsalva maneuver, the murmur will get louder |
| How will the murmur change if you induce valsalva in a patient with aortic stenosis compared to a pt with HOCM? | In aortic stenosis the murmur will get quieter. The murmur will get louder in HOCM. |
| What is the next step in the w/u of a low-grade systolic murmur in an otherwise healthy, asymptomatic patient? | no further w/u (usually benign) |
| What is the next step in the work-up of a diastolic murmur in an otherwise healthy, asymptomatic patient? | ECHO (because diastolic murmurs are commonly pathologic) |
| What murmur fits the description: diastolic murmur heard best in the left lower sternum, that increases with inspiration | tricuspid stenosis |
| What murmur fits the description: late diastolic murmur with an opening snap(no change with inspiration) | mitral stenosis |
| What murmur fits the description: systolic murmur heard best in the second right interpace | aortic stenosis |
| What murmur fits the description: systolic murmur best heard in the second left interspace | pulmonic stenosis |
| What murmur fits the description: late systolic murmur best heard at the apex | mitral prolase |
| What murmur fits the description: diastolic murmur with a widened pulse pressure | aortic regurg |
| What murmur fits the description: holosystolic murmur that is louder with inspiration at the left lower sternum | tricuspid regurg |
| What murmur fits the description: holosystolic murmur heard at the apex and radiates to the axilla | mitral regurg |
| In which etiology of restrictive cardiomyopathy is the pathology reversible with phlebotomy? | hemochromatosis |
| What is Kussmaul sign? | JVD with inspiration |
| What is Pulsus paradoxus? | decreased SBP by more than 10mmhg with inspiration |
| What is the mechanism that causes Kussmauls sign? | decreased capacity of RV |
| What is the mechanism that causes Pulsus paradoxus? | decreased capacity of LV |
| In which disease do you commonly see Kussmaul sign? | constrictive pericarditis>>tamponade |
| In which disease do you commonly see Pulsus paradoxus? | cardiac tamponade>>pericarditis |
| Which valvular disease causes LA enlargement and RV? | Mitral stenosis |
| Which valvular disease causes Austin-flint murmur? | Aortic regurg |
| Which valvular disease causes diastolic decrescendo murmur at the right 2nd interspace? | aortic regurg |
| Which valvular disease is caused by contenital defect (like bicuspid aortic valve) | aortic stenosis |
| Which valvular disease is caused by tertiary syphilis? | aortic stenosis |
| Which valvular disease causes weak prolonged pulses as well as crescendo-decrescendo systolic murmur? | aortic stenosis |
| What is the treatment for HOCM? | b-blockers |
| What are the causes of dilated cardiomyopathy? | ABCD: Alcohol, beriberi, coxsackie virus B, cocaine, chagas dz, doxorubicin, HIV, hemochromatosis, Ischemic heart dz, pregnancy |
| What are the causes of restrictive cardiomyopathy? | sarcoidosis, amyloidosis, and hemochromatosis(but more commonly it causes dilated cardiomyopathy) |
| How do you diagnose a patient with restrictive cardiomyopathy? | biopsy |
| ________is the mcc of sudden death in young athletes | HOCM |
| How can you tell if a patient is having an MI or has pericarditis when review their EKG? | ST elevations are seen in both conditions, but in acute pericarditis PR depression and ST elevations in MOST leasts will be present. In MI does not show PR depression and the ST elevations are focal. |
| Most pericardial effusions are ________? | transudates(low proteins, spec gravity <1.012) |
| If an exudative pericardial effusion is collected during pericardiocentesis, need to perform a w/u for ______or__________disease. | neoplasm or fibrotic disease |
| In chronic constrictive pericarditis cardiac cath shows __________pressure in _________chambers. | equal pressure in ALL chambers |
| What is/are the most common causes of chronic constrictive pericarditis? | radiation or heart surgery. |
| What is the treatment for acute percarditis? | treat underlying cause, NSAIDs for pain and inflammation, pericardiocentesis for large effusions, colchicine may be useful for preventing recurrence owing to viral or idiopathic causes |
| Perform an _________to diagnose any suspected valvular lesion. | echocardiogram |
| Which imaging method can you use use to differentiate between restrictive cardiomyopathy and constrictive pericarditis? | CT |
| Hypotension, distant heart sounds, and distended neck veins. This describes _______. | Beck's triad for cardiac tamponade. You should perform an urgen pericardiocentesis! |
| The EKG of a patient with cardiac tamponade will show _____voltage, sinus tachycardia. | Low |
| What is the classic appearance of the heart on a CXR of a pt with pericardial effusion? | enlarged, globular heart ("water bottle shaped") |
| What would you find on a physical exam of a pt with pericardial effusion? | diminished heart sounds and difficult to palpate apical impulses |
| What is the treatment for cardiac tamponade? | immediate pericardialcentesis |
| What disease has signs of heart failure + DM + elevated LFTs? | hemochromatosis |
| Short systolic murmur at the cardiac apex that decreases with squatting and is sometimes associated with benign chest pain and last only a few seconds. | Mitral valve prolapse |
| When might subclinical stenosis from rheumatic heart dz become clinically apparent? | pregnancy (when blood volumen is increased) |
| In what scenarios might you see Kussmaul sign (increased JVD with inspiration) | constrictive pericarditis, restrictive cardiomyopathy, R. ventricular infarct, massive PE, cardiac tamponade (rarely) |
| A 34 y/o female presents to the ER with difficulty breathing and dizziness. Her BP tracing from an arterial line placed in the ER shows a difference >12mmhg in SBP during inspiration. What is this and what is most likely causing it? | Pulsus paradoxus caused by severe asthma |
Created by:
shelybel
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