Term
| What underlying disease state is likely in a patient with a malar rash and a recurrent DVT? |
|
Definition
Systemic Lupus Erythematosus (SLE) with antiphospholipid syndrome |
|
|
Term
| Calf pain with dorsiflexion of the ankle describes what sign? |
|
Definition
|
|
Term
| What skin condition is commonly associated with venous insufficiency of the lower extremities? |
|
Definition
|
|
Term
| What congenital abnormality should be considered with a child who frequently squats? |
|
Definition
|
|
Term
| What is the medical treatment of patent ductus arteriosus (PDA)? |
|
Definition
|
|
Term
| What are painless lesions on the hands which occur with endocarditis? |
|
Definition
|
|
Term
| What are painful lesions on the hands which occur with endocarditis? |
|
Definition
|
|
Term
| What is the pathognomonic echocardiogram finding in pericardial tamponade? |
|
Definition
| Collapse of the right ventricle |
|
|
Term
| You have performed pericardial centesis. How do you ensure you are in the pericardial space? |
|
Definition
| Blood evacuated from the pericardial space does not clot. |
|
|
Term
| What is the rise in jugular pressure which occurs with inspiration in a patient with pericardial tamponade called? |
|
Definition
|
|
Term
| What are the 3 "D" findings of pericardial tamponade? |
|
Definition
| Distant heart sounds - Distended jugular veins - Decreased arterial pressure |
|
|
Term
| What is the diameter of an aortic aneurysm at which surgical intervention is recommended? |
|
Definition
|
|
Term
| What is the recommended initial treatment for a Stanford type B aortic dissection? |
|
Definition
|
|
Term
| What is the diameter of an aortic aneurysm at which surgical intervention is recommended? |
|
Definition
|
|
Term
| What is the Stanford classification of an aortic dissection of the descending aorta? |
|
Definition
|
|
Term
| What is the Stanford classification of a dissection of the ascending aorta? |
|
Definition
|
|
Term
| What is the initial dose of clopidogrel (Plavix) in acute MI? |
|
Definition
|
|
Term
| Should heparin or enoxaparin (Lovenox) be used for a patient with a CrCl < 15? |
|
Definition
| Heparin (enoxaparin is contraindicated for CrCl < 15) |
|
|
Term
| What diuretic can be used if furosemide is not available? |
|
Definition
|
|
Term
| List 5 side effects of amiodarone. |
|
Definition
-Pulmonary HTN
- Elevated LFTs
- Hypothyroid
- Hyperthyroid
- Iodine allergy |
|
|
Term
| What are the 2 recommended statins for treatment in acute MI? |
|
Definition
| Atorvastatin 80 mg or rosuvastatin 40 mg |
|
|
Term
| What three tests are recommended before starting amiodarone? |
|
Definition
-Thyroid panel
- Pulmonary function testing
- Liver function test |
|
|
Term
| What is the treatment for angina in a patient who is allergic to nitrates? |
|
Definition
|
|
Term
| What is the treatment for Prinzmetal angina? |
|
Definition
|
|
Term
|
Definition
-Stasis
- Hypercoagulable state
- Trauma
= risk of venous thrombus |
|
|
Term
| What is the most likely cause of syncope which occurs after a period of prolonged motionless standing? |
|
Definition
| Neurocardiogenic (vasovagal) |
|
|
Term
| What is the most likely cause of syncope which occurs in a child during an argument? |
|
Definition
|
|
Term
| What is the most likely cause of syncope in an older adult which occurs during an argument? |
|
Definition
|
|
Term
| What is the most likely cause of syncope which occurs while shaving and has an associated bradycardia? |
|
Definition
| Carotid sinus hypersensitivity |
|
|
Term
| What is the most likely cause of syncope which occurs after arising quickly form a chair? |
|
Definition
|
|
Term
| What is the most likely cause of orthostatic hypotension in which there is no reflex increase in heart rate? |
|
Definition
Autonomic dysfunction
(examples: age diabetes) |
|
|
Term
| What does severe elevation of BP without end organ dysfunction define? |
|
Definition
|
|
Term
| What does a BP> 180/120 with end organ dysfunction define? |
|
Definition
|
|
Term
| Use of which antihypertensive medications is cautioned after recent MI? |
|
Definition
|
|
Term
| Use of which antihypertensive medications is cautioned after cataract surgery? |
|
Definition
|
|
Term
| Which antihypertensive medications are contraindicated with bradycardia or heart block? |
|
Definition
-Beta blockers
- Non-dihydropyridine CCB
- Central agents (clonidine) |
|
|
Term
| Which antihypertensive medications are contraindicated with asthma and isolated PAD? |
|
Definition
|
|
Term
| Which antihypertensive medications are contraindicated with pregnancy? |
|
Definition
-ACE inhibitors
- Angiotensin II receptor blockers
- Thiazide diuretics
- Direct renin inhibitors |
|
|
Term
| Which antihypertensive medications are contraindicated with renal artery stenosis? |
|
Definition
ACE inhibitors and Angiotensin II receptor blockers
(Note: caution with direct renin inhibitors) |
|
|
Term
| Which anti hypertensive medications can cause pericardial effusion? |
|
Definition
|
|
Term
| What class of medication should you think of when you see the suffix "azosin"? |
|
Definition
Alpha blockers
- example doxAZOSIN |
|
|
Term
| What class of medication should you think of when you see the suffix "dipine"? |
|
Definition
Dihydropyridine calcium channel blockers
- example amloDIPINE |
|
|
Term
| What class of medication should you think of when you see the suffix "sartan"? |
|
Definition
Angiotension II receptor blockers
- example loSARTAN |
|
|
Term
| What class of medication should you think of when you see the suffix "olol"? |
|
Definition
Beta blockers
- example metoprOLOL |
|
|
Term
| What class of medication should you think of when you see the suffix "pril"? |
|
Definition
ACE inhibitors
- example enalaPRIL |
|
|
Term
| Which antihypertensive medication can cause hypertrichosis? |
|
Definition
|
|
Term
| Which antihypertensive medications can cause hyperuricemia? |
|
Definition
Thiazide diuretics
(e.g. Hydrochlorothiazide (HCTZ) - Chlorthalidone) |
|
|
Term
| Which antihypertensive medications can cause hypokalemia? |
|
Definition
| Thiazide diuretics (e.g. Hydrochlorothiazide (HCTZ) - Chlorthalidone) |
|
|
Term
| Which antihypertensive medications can cause edema? |
|
Definition
-Dihydropyridine CCB (e.g. amlodipine nifedipine) - Benzothiazepine CCB (diltiazem)
- Minoxidil |
|
|
Term
| Which antihypertensive medications can cause diarrhea? |
|
Definition
|
|
Term
| Which antihypertensive medications can cause constipation? |
|
Definition
| Verapamil - Central agents (clonidine) |
|
|
Term
| Which antihypertensive medications can cause AV block? |
|
Definition
| Non-dihydropyridine CCB - Central agents (clonidine) |
|
|
Term
| Which antihypertensive medications can cause depression? |
|
Definition
| Beta blockers - Central agents (clonidine) |
|
|
Term
| Which antihypertensive medications can cause bradycardia? |
|
Definition
| Beta blockers - Non-dihydropyridine CCB - Central agents (clonidine) |
|
|
Term
| Which antihypertensive medications can cause cough? |
|
Definition
|
|
Term
| Which antihypertensive medications can cause hyperkalemia? |
|
Definition
| ACE inhibitors - Angiotensin II receptor blockers (ARBs) - Direct renin inhibitors - Aldosterone antagonists (spironolactone) |
|
|
Term
| Which antihypertensive medications can cause angioedema? |
|
Definition
| ACE inhibitors - Angiotensin II receptor blockers (ARBs) - Direct renin inhibitors |
|
|
Term
| What is the treatment for constrictive cardiomyopathy? |
|
Definition
|
|
Term
| What is the most common cause of constrictive cardiomyopathy? |
|
Definition
|
|
Term
| List 6 causes of restrictive cardiomyopathy. |
|
Definition
| Amyloidosis - Hemochromatosis - Sarcoidosis - Scleroderma - Fibrosis - Cancer |
|
|
Term
| List two types of surgical procedures to correct HOCM. |
|
Definition
| Open heart and excision - Alcohol ablation done through cardiac cath |
|
|
Term
| What heart sound will likely be present with HOCM? |
|
Definition
|
|
Term
| List three medications which may be used both to prevent arrhythmia and ease symptoms with HOCM. |
|
Definition
| Diuretics - Beta blockers - Non-dihydropyridine CCB (verapamil or diltiazem) |
|
|
Term
| Once a patient is diagnosed with HOCM what family counseling must be done? |
|
Definition
| Entire family must be screened for HOCM |
|
|
Term
| Angina syncope and heart failure in a child likely represents ____________. |
|
Definition
| HOCM (Hypertrophic Cardiomyopathy) |
|
|
Term
| Angina syncope and heart failure in an adult likely represents _____________. |
|
Definition
|
|
Term
| What condition is right ventricular collapse on echocardiogram pathognomonic for? |
|
Definition
|
|
Term
| What type of heart failure may pericardial tamponade initially present like? |
|
Definition
| Right heart failure: Tamponade looks like right heart failure because the right ventricle is the weakest of the two and collapses first due to the fluid around the heart |
|
|
Term
| What type of heart failure will have an abnormal E-A wave ratio on echocardiogram? |
|
Definition
|
|
Term
| What two populations more commonly have diastolic heart failure? |
|
Definition
| Elderly women and black patients |
|
|
Term
| Digoxin should never be used for which type of heart failure? |
|
Definition
|
|
Term
| List 5 causes of systolic heart failure. |
|
Definition
| CAD (ischemia) - Tako Tsubo - Cocaine - Viral illness - Chemo/radiation |
|
|
Term
| Once a patient on a balloon pump can tolerate a ratio of ___:___ removal may be considered. |
|
Definition
| 3 : 1 - Once patient only requires assist every third beat removal may be considered |
|
|
Term
| What balloon pump setting would be best for initial treatment of the acute patient in cardiogenic shock? |
|
Definition
| 1 : 1 Balloon pump assists with every beat |
|
|
Term
| What is the most likely disorder in a patient with apical ballooning on echo and a presentation similar to MI? |
|
Definition
|
|
Term
| List the major systemic affects of amiodarone therapy? |
|
Definition
| Pulmonary fibrosis - Infiltrative liver disease - Hyper OR hypothyroid state |
|
|
Term
| What will most likely happen to the INR of a patient on warfarin when they are given amiodarone? |
|
Definition
|
|
Term
| What characteristic will be seen in blood which is drawn from with in the pericardial sac during pericardial centesis? |
|
Definition
| Blood does not clot when put into tray (+ clotting = not in the pericardial space) |
|
|
Term
| What is the INR goal for a patient on warfarin for a mechanical heart valve? |
|
Definition
|
|
Term
| What is the treatment for thrombophlebitis? |
|
Definition
| One month of low molecular weight heparin |
|
|
Term
| Orthostasis is defined as a change of > __ mmHg systolic or __ mmHg diastolic BP __ minutes after change from supine to standing. |
|
Definition
| > 20 mmHg systolic or 10 mmHg diastolic BP 2-5 minutes after change from supine to standing |
|
|
Term
| What test should be ordered for a patient with suspected pheochromocytoma? |
|
Definition
| Urine for VMA (Vanillylmandelic acid) |
|
|
Term
| What secondary cause of HTN will present with abdominal bruits? What is the first diagnostic test? |
|
Definition
| Renal artery stenosis - Renal artery doppler is the initial test |
|
|
Term
| Combination therapy with at least 2 agents is recommended for patients with which stage of HTN? |
|
Definition
| Stage 2 HTN - Initiate treatment with 2 or more agents |
|
|
Term
| When treating a patient with hypertensive urgency the goal is not to reduce the BP more than __% in __ hours? |
|
Definition
| Goal is to reduce blood pressure no more than 25% every 1-2 hours |
|
|
Term
| List the classifications of blood pressure as per JNC VII. |
|
Definition
| Prehypertension = 120-139/80-90 - Stage 1 = 140-159/90-99 - Stage 2 = >160/100 |
|
|
Term
| List the NYHA classification of CHF. |
|
Definition
-I asymptomatic
- II symptoms with moderate exertion
- III symptoms with minimal exertion
- IV symptoms at rest |
|
|
Term
| What are the signs of HOCM on exam? |
|
Definition
-Apical lift
- S4 gallop
- Ejection murmur medial to apex |
|
|
Term
| Constrictive Cardiomyopathy occurs by what mechanism? |
|
Definition
| Pericardial sac constricts |
|
|
Term
| Restrictive Cardiomyopathy occurs by what mechanism? |
|
Definition
| Deposition into or between the myocardial cells |
|
|
Term
| What causes the sudden cardiac death in a HOCM patient? |
|
Definition
| Ventricular tachycardia that degenerates into ventricular fibrillation |
|
|
Term
| What maneuver makes the HOCM murmur louder? |
|
Definition
|
|
Term
| What is the treatment for dilated cardiomyopathy? |
|
Definition
Same as systolic heart failure
(- Beta blocker - Loop Diuretic - ACE inhibitor) |
|
|
Term
| Non-cardiac hypoxia (e.g. pneumonia, COPD) commonly causes what arrhythmia? |
|
Definition
|
|
Term
| What arrhythmia can occur with structural changes such as hypertrophy or dilatation of the ventricle? |
|
Definition
|
|
Term
| What two murmurs are most associated with atrial fibrillation? |
|
Definition
-Mitral stenosis
- Mitral regurgitation |
|
|
Term
| What valvulopathy increases afterload? |
|
Definition
|
|
Term
| What murmur is heard with MVP (Mitral Valve Prolapse)? |
|
Definition
|
|
Term
| What heart valve murmur rarely causes a symptomatic problem? |
|
Definition
|
|
Term
| Which electrolyte disorder can increase the chance of digoxin toxicity? |
|
Definition
|
|
Term
What drug can produce blue vision?
|
|
Definition
|
|
Term
| What cardiac drug can cause hypo or hyperthyroidism? |
|
Definition
|
|
Term
| What cardiac drug can produce yellow vision? |
|
Definition
|
|
Term
| What does a Beta blocker do for a post AMI patient? |
|
Definition
| Prevents arrhythmia and reduces cardiac work load |
|
|
Term
| What does an ACE inhibitor/ARB do for a post AMI patient? |
|
Definition
| Decreases afterload to rest myocardium and prevents/decreases remodeling |
|
|
Term
| After a stent, in addition to ASA, what oral antiplatelet agent is used? |
|
Definition
|
|
Term
| What leads represent lateral wall? |
|
Definition
|
|
Term
| What leads represent anterior wall? |
|
Definition
|
|
Term
| What three leads represent inferior wall of the heart? |
|
Definition
|
|
Term
| What lab most sensitive for AMI? |
|
Definition
|
|
Term
| Myocardial damage occurs after how many minutes of ischemia? |
|
Definition
|
|
Term
| Agent of choice for acute angina treatment? |
|
Definition
|
|
Term
| What medication is best for Prinzmetal's angina? |
|
Definition
|
|
Term
| What EKG changes are seen in a patient during a Prinzmetal attack? |
|
Definition
ST elevations which resolve after attack (Persistent elevations suggest MI)
|
|
|
Term
| First medication to give in a patient suspected of having an AMI? |
|
Definition
|
|
Term
| What is a complication of cardiac cath that causes Grey-Turner's sign? |
|
Definition
|
|
Term
| What disorder is most likely in a patient with calf pain with walking that improves with rest? |
|
Definition
Peripheral Artery Disease
|
|
|
Term
| What is calf pain with walking that improves with rest called? |
|
Definition
|
|
Term
| What three criteria define a heart attack? |
|
Definition
- EKG changes
- Chest pain
- Elevated cardiac enzymes |
|
|
Term
| Why are post menopausal women more prone to heart disease? |
|
Definition
Estrogen is cardio protective
|
|
|
Term
| What are the modifiable cardiac risk factors? |
|
Definition
- Smoking
- DM
- Cholesterol
- Blood pressure
- Obesity |
|
|
Term
| What do low ejection fraction and hypertrophic (HOCM) heart have in common? |
|
Definition
|
|
Term
| Stress heart attack (Tako Tsubo) treatment? |
|
Definition
Same as acute myocardial infarction patient
|
|
|
Term
| What happens to renal function during cardiogenic shock? |
|
Definition
Reduced cardiac flow = reduced kidney perfusion this leads to pre-renal failure then ATN if not corrected
|
|
|
Term
| What mechanical intervention can improve coronary perfusion and work load of heart? |
|
Definition
|
|
Term
| Best medication for blood pressure support in cardiogenic shock? |
|
Definition
|
|
Term
| Most common cause of cardiogenic shock? |
|
Definition
|
|
Term
| What medications are recommended for a patient with CAD? |
|
Definition
Beta blocker
and
ACE inhibitor |
|
|
Term
| What are the most common side effects of dihydropyridine calcium channel blockers (amlodipine felodipine)? |
|
Definition
Lower extremity edema
and
headache |
|
|
Term
| Can digoxin be used for HTN? |
|
Definition
|
|
Term
| Which lab value must be obtained before initiating ACE inhibitor therapy? |
|
Definition
|
|
Term
| What HTN med classes can cause bradycardia? |
|
Definition
- Beta Blockers
- Central agents (clonidine)
- Verapamil and Cardizem |
|
|
Term
| What HTN medication may cause a dry cough? |
|
Definition
|
|
Term
| What would a blood pressure of 128/86 by classified as? |
|
Definition
|
|
Term
| First line HTN agent for Diabetic? |
|
Definition
|
|
Term
| What is the medication suggested by JNC VII for a patient who has no compelling indications? |
|
Definition
Diuretic
(Hydrochlorothiazide is the most common) |
|
|
Term
| Adrenal tumor which causes HTN? |
|
Definition
|
|
Term
| What is the likely cause of HTN in a 30 year old female who is still poorly controlled after 3 medications? |
|
Definition
|
|
Term
| Does renal artery stenosis cause primary or secondary HTN? |
|
Definition
|
|
Term
| Meds for chronic diastolic CHF? |
|
Definition
Ace inhibitor
plus
either a beta blocker
or calcium channel blocker |
|
|
Term
| Three meds for acute decompensated CHF? |
|
Definition
- Nitroglycerin
- ACE inhibitor
- Loop Diuretic |
|
|
Term
| Most common cause of Diastolic CHF? |
|
Definition
|
|
Term
| JVD and clear lung fields describes what type CHF? |
|
Definition
|
|
Term
| What is most common cause of right heart failure? |
|
Definition
|
|
Term
| Vitamin deficiency that causes high output cardiac failure? |
|
Definition
|
|
Term
| What congenital abnormality should be considered with a child who frequently squats? |
|
Definition
|
|
Term
| What two calcium channel blockers affect the AV node conduction? |
|
Definition
|
|
Term
|
Definition
- Muffled heart sounds
- JVD
- Hypotension
(seen with pericardial tamponade) |
|
|
Term
| What EKG changes are seen with a ring abscess of the mitral valve? |
|
Definition
|
|
Term
| A patient with pericarditis feels better in what position? |
|
Definition
|
|
Term
| What is most common pathogen causing of subacute endocarditis? |
|
Definition
|
|
Term
| What is the most common skin manifestation seen in endocarditis? |
|
Definition
Petechiae are not specific for infective endocarditis but are its most common skin manifestation
|
|
|
Term
| Roth spots in a drug user are most likely caused by which organism? |
|
Definition
|
|
Term
| What EKG changes are seen in pericarditis? |
|
Definition
Diffuse ST elevations through out all leads
|
|
|
Term
| Rheumatic fever affects which valve first? |
|
Definition
|
|
Term
| What sign distinguishes mitral regurgitation from tricuspid regurgitation? |
|
Definition
Carvallo s sign
(The murmur of tricuspid regurgitation increases in intensity during held deep inspiration) |
|
|
Term
| What is the term for a hoarse voice caused by mitral stenosis? |
|
Definition
|
|
Term
| What physical sign is easily seen with tricuspid stenosis? |
|
Definition
JVD
(Jugular Venous Distension) |
|
|
Term
| Most common cause of tricuspid stenosis? |
|
Definition
|
|
Term
| What is the treatment for mitral valve prolapse? |
|
Definition
Reassurance
and
Beta Blockers |
|
|
Term
| During pregnancy what murmur is commonly first discovered? |
|
Definition
|
|
Term
| What are the 3 main causes of mitral and tricuspid regurgitation? |
|
Definition
- Dilatation (Aneurysm)
- Degeneration of leaflets
- Chordae tendineae rupture |
|
|
Term
| What are the two main causes of aortic and pulmonic regurgitation? |
|
Definition
- Dilatation (Aneurysm)
- Degeneration of leaflets |
|
|
Term
| What are the mainstay meds for chronic diastolic heart failure? |
|
Definition
- ACE inhibitor
- Beta blocker or calcium channel blocker
(diltiazem or verapamil) |
|
|
Term
| What are the mainstay meds of acute decompensated heart failure? |
|
Definition
- NTG
- ACE inhibitor
- Loop diuretic |
|
|
Term
| What are the big three meds for chronic systolic heart failure? |
|
Definition
- Beta blocker
- ACE inhibitor
- Loop diuretic |
|
|
Term
| What murmur radiates to the carotids? |
|
Definition
|
|
Term
| Gallavardin Phenomena is associated with what valvulopathy? |
|
Definition
|
|
Term
| Austin Flint murmur is associated with which murmur? |
|
Definition
|
|
Term
| What are the three main symptoms of Aortic stenosis? |
|
Definition
ASH
(Angina - Syncope - Heart Failure) |
|
|
Term
| What are the three main symptoms of Mitral stenosis? |
|
Definition
PHD
(Palpitations - Heart Failure - Dyspnea on exertion) |
|
|
Term
| Aortic stenosis in a 50 year old is likely due to what abnormality? |
|
Definition
|
|
Term
| What murmur has a continuous machinery quality? |
|
Definition
PDA
(Patent Ductus Arteriosus |
|
|
Term
| What finding is pathognomonic for Rheumatic fever? |
|
Definition
Aschoff bodies
(Subcutaneous nodules) |
|
|
Term
| Name the Major Jones criteria. |
|
Definition
-Carditis
- Migratory polyarthritis
- Subcutaneous nodules -
Erythema marginatum
- Chorea |
|
|
Term
| Acute Rheumatic fever occurs after what event? |
|
Definition
|
|
Term
| What condition occurs when congenital cyanotic heart murmurs cause right heart failure? |
|
Definition
|
|
Term
| What murmur is pansystolic and is best heard mid sternal border? |
|
Definition
VSD
(Ventricular Septal Defect) |
|
|
Term
| What is the treatment for a non-surgical cyanotic heart disease causing polycythemia? |
|
Definition
|
|
Term
| Name the 4 components of Tetralogy of Fallot. |
|
Definition
- Pulmonary valve stenosis
- VSD (Ventricular Septal Defect)
- Overriding aorta
- RVH (Right Ventricular Hypertrophy) |
|
|
Term
| What medication can assist in closing an open PDA (Patent Ductus Arteriosus)? |
|
Definition
|
|
Term
| What has high blood pressure equally in arms but lower pressure in the legs? |
|
Definition
|
|
Term
| What murmur has a Left parasternal lift pulmonic area ejection murmur and fixed splitting of S2? |
|
Definition
ASD
(Atrial Septal Defect) |
|
|
Term
| What cardiac abnormality is associated with a bicuspid aortic valve? |
|
Definition
|
|
Term
| A venous ulcer most often forms where? |
|
Definition
|
|
Term
| What mechanism causes varicose veins? |
|
Definition
Non compliant venous valves
|
|
|
Term
| Venous insufficiency is differentiated from right heart CHF in a patient with lower extremity edema by what exam finding? |
|
Definition
A patient in CHF will have JVD
and
hepatojugular reflux |
|
|
Term
| Radiologic test of choice in pregnant woman suspect of pulmonary embolus? |
|
Definition
|
|
Term
| What are two CXR findings in pulmonary embolus? |
|
Definition
- Hamptons hump
- Westermark sign |
|
|
Term
| Patient has DVT and unable to take Coumadin what is next step? |
|
Definition
|
|
Term
| Does pregnancy fit into the Virchows triad? |
|
Definition
Yes
- Pregnancy is a hypercoagulable state |
|
|
Term
| What is most common genetic hypercoagulable state? |
|
Definition
|
|
Term
| Cancer is an example of what part of Virchow's triad? |
|
Definition
|
|
Term
|
Definition
- Stasis
- Hypercoagulable state
- Trauma to vessel |
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Term
| PVD commonly manifests as what symptom? |
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Definition
Calf pain with exertion that relieves with rest (claudication)
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Term
| Initial procedure to evaluate for PVD? |
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Definition
ABI
(Ankle brachial index)
- ABI < 0.8 = PAD
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Term
| What lab is elevated in temporal arteritis? |
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Definition
ESR (erythrocyte sedimentation rate)
- ESR is suggestive but biopsy is definitive |
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Term
| Untreated amaurosis fugax with temporal arteritis leads to what? |
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Definition
Blindness
(High dose steroids most be started ASAP to avoid blindness |
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Term
| What arrhythmia is associated with arterial embolism? |
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Definition
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Term
| A patient has a cold left arm due to arterial clot - what is the most likely valvulopathy? |
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Definition
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Term
| What arm does anginal pain tend to radiate toward? |
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Definition
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Term
| What must be ruled out in a Marfan patient with chest pain radiating to the back? |
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Definition
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Term
| An untreated deep vein thrombosis can lead to what condition? |
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Definition
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Term
| What underlying disease state is likely in a patient with a malar rash and recurrent DVT? |
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Definition
Systemic Lupus Erythematosus(SLE)
with antiphospholipid syndrome |
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Term
| Calf pain with dorsiflexion of the ankle describes what sign? |
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Definition
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Term
| What skin condition is commonly associated with venous insufficiency of the lower extremities? |
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Definition
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Term
| What is first-line treatment for varicose veins? |
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Definition
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Term
| What is the treatment for phlebitis due to an IV |
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Definition
- Elevation
- Warm compress
- NSAIDs |
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Term
| What is the first medication to be given to a patient with an acute arterial emboli? |
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Definition
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Term
| What valvular abnormality is most commonly associated with a peripheral arterial emboli? |
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Definition
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Term
| What blood pressure medication can make peripheral artery disease symptoms worse? |
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Definition
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Term
| What is the gold standard to evaluate peripheral artery disease? |
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Definition
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Term
| What is the first step and evaluation of a patient with calf pain when he walks that is relieved with rest? |
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Definition
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Term
| Why is it important to treat giant cell arteritis quickly and definitively? |
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Definition
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Term
| What condition is commonly associated with giant cell arteritis? |
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Definition
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Term
| Temporal arteritis is also known as what condition? |
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Definition
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Term
| A 24 year old has a syncopal event. EKG demonstrates a short PR interval with an upswept initial QRS. What underlying condition caused the syncope? |
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Definition
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Term
| A 30 year old male has a syncopal event three days after taking an antibiotic. EKG at the scene reveals ventricular tachycardia. What disease condition do you suspect? |
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Definition
Acquired long QT syndrome due to the antibiotic or medications
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Term
| After running a mile a 16 year old suffers chest pain and syncope. He is asymptomatic in the ER. Examination is normal. What underlying condition do you suspect? |
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Definition
Anomalous coronary artery
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Term
| Upon auscultation of a patient’s carotid artery they become bradycardic with a three second pause. What is the suspected underlying condition? |
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Definition
Carotid sinus hypersensitivity
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Term
| What test can be performed to evaluate neurocardiogenic syncope? |
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Definition
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Term
| A military recruit passes out while standing in formation for a long period of time. What type of syncope is this called? |
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Definition
Neurocardiogenic syncope
a.k.a. Vasovagal syncope |
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Term
| A 13 year old boy passes out while having an argument with his principal. His examination findings are normal. What heart conduction condition do you suspect? |
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Definition
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Term
| A 75 year old patient passes out while having an argument with his landlord over money. What three conditions should you rule out first? |
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Definition
- Acute coronary syndrome
- Ventricular arrhythmia
- Aortic stenosis |
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Term
| What condition is most likely in a patient who suffers syncope associated with standing up suddenly? |
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Definition
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Term
| What hypertension agent is commonly associated with edema in the lower extremities? |
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Definition
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Term
| What blood pressure medicine is commonly associated with impotence in men? |
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Definition
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Term
| Angioedema is commonly associated with what blood pressure agents? |
|
Definition
Ace inhibitors
and
Angiotensin II receptor blockers |
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Term
| What are the three core medications used to treat dilated cardiomyopathy? |
|
Definition
- Ace inhibitor
- Beta blocker
- Loop diuretic |
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Term
| A patient undergoing radiation therapy of the chest is likely to get what type of cardiomyopathy? |
|
Definition
Constrictive cardiomyopathy
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Term
| In addition to dyspnea on exertion what sign is commonly noted in patients with constrictive cardiomyopathy? |
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Definition
Jugular venous distention
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Term
| Hemochromatosis will lead to what type of cardiac cardiomyopathy |
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Definition
Restrictive cardiomyopathy
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Term
| What is affected in the genetic mutation which occurs in hypertrophic cardiomyopathy? |
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Definition
The genetic mutation is at the sarcomere
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Term
| Chronic alcohol ingestion can lead to what type of cardiomyopathy? |
|
Definition
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|
Term
| What is the difference between constrictive cardiomyopathy and restrictive cardiomyopathy? |
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Definition
- Constrictive cardiomyopathy is the pericardial sac squeezing around the heart
- Restrictive is caused by deposition between the heart muscle cells |
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Term
| A 14 year old boy presents to your office. Upon examination you note an apical lift an S4 gallop. What is the underlying heart condition? |
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Definition
Hypertrophic cardiomyopathy
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Term
| Systolic heart failure is categorized as what type of cardiomyopathy? |
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Definition
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Term
| Name four causes of high output heart failure. |
|
Definition
- Hyperthyroidism
- Severe anemia
- AV shunts
- Thiamine deficiency aka Beriberi |
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Term
| What will auscultation of a patient’s lungs who is in pure right heart failure reveal? |
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Definition
In pure right heart failure, the lungs will be clear to auscultation
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Term
| What condition is the most common cause of right heart failure? |
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Definition
Left heart failure is the most common cause of right heart failure
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Term
| In addition to an ace inhibitor in the treatment of diastolic heart failure, what two medications are preferred? |
|
Definition
Beta Blockers for young patients with hypertrophic cardiomyopathy,
Calcium Channel Blockers for left ventricular hypertrophy due to hypertension |
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Term
| What are the three core medications in the treatment of systolic heart failure? |
|
Definition
- Ace inhibitor
- Beta blocker
- Loop diuretic |
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Term
| Describe the ejection fraction in a patient with systolic heart failure versus a patient with diastolic heart failure. |
|
Definition
- A patient with Systolic heart failure usually has an ejection fraction less than 40%
- Diastolic failure has a preserved ejection fraction |
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Term
| Where will the apical impulse be palpated in systolic heart failure and in diastolic heart failure? |
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Definition
In systolic heart failure, it will be displaced downward into the left.
In diastolic heart failure the apical impulse will be in the mid-clavicular line fifth intercostal space |
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Term
| What condition other than diastolic heart failure is the S4 heart sound is also associated with? |
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Definition
In acute coronary syndrome the ischemia causes the heart muscle to stiffen leading to an S4
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Term
| The S4 heart sound is typically associated with what type of heart failure? |
|
Definition
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|
Term
| The S3 heart sound is typically associated with what type of heart failure? |
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Definition
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|
Term
| Tricuspid stenosis is most commonly caused by what condition? |
|
Definition
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Term
| What murmur do you suspect with an opening snap and a decrescendo diastolic rumble best heard at the apex with the bell of the stethoscope? |
|
Definition
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|
Term
| A Graham steel murmur is associated with what murmur? |
|
Definition
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|
Term
| An Austin Flint murmur is associated with what heart murmur? |
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Definition
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Term
| A 20 year old anxious female presents with a sharp stabbing chest pain. She has a a mid systolic click. What heart murmur do you suspect? |
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Definition
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|
Term
| Epstein anomaly is associated with what heart murmur? |
|
Definition
|
|
Term
| What are the three clinical presentations of mitral stenosis and mitral regurgitation? |
|
Definition
PHD
(Palpitations, Heart failure, Exertional Dyspnea) |
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Term
| What heart murmur presents as a crescendo decrescendo systolic ejection murmur best heard at the upper left sternal border and does not radiate? |
|
Definition
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|
Term
| What is the name of the murmur which is associated with aortic stenosis? |
|
Definition
|
|
Term
What are the three clinical presentations of aortic stenosis?
|
|
Definition
ASH
(Angina - Syncope - Heart failure) |
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|
Term
| Transposition of the great vessels of an infant is common in mothers with what condition? |
|
Definition
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|
Term
A child with tetralogy of Fallot will often squat when they are short of breath.
Why does squatting increase oxygenation in these patients? |
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Definition
Tetralogy of Fallot is a central cyanosis condition - Squatting temporarily reverses the shunt providing oxygenated blood to the body
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Term
You notice a holosystolic murmur that is heard at the mid sternal border in a child.
What heart murmur do you think this is? |
|
Definition
|
|
Term
| What is the most common cardiac defect? |
|
Definition
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|
Term
| What medication would you administer to a baby with continuous machinery murmur? |
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Definition
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Term
| A 12 year old boy gets calf cramping and pain when running. You note radial femoral pulse lag on examination. What condition do you expect? |
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Definition
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Term
| A patient presents with a pulmonic area ejection murmur with fixed splitting of S2. What are the expected chest X-ray findings? |
|
Definition
Dilated pulmonary arteries
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Term
| We observe a patient with an aortic aneurysm up to what size before we proceed with surgery? |
|
Definition
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|
Term
| What is the anatomical difference between an aortic aneurysm and an aortic dissection? |
|
Definition
- Aortic aneurysm involves all three layers of the artery
- Aortic dissection involves only the intima |
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|
Term
| What is the most common cause of aortic dissection? |
|
Definition
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|
Term
A 75 year old male presents with a severe tearing sensation that radiates to his back.
What is the gold standard test for this disease condition? |
|
Definition
|
|
Term
| What are the three components of Beck’s Triad? |
|
Definition
- Distant heart sounds
- Jugular venous distention
- Hypotension |
|
|
Term
| What heart condition is associated with Beck’s Triad? |
|
Definition
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|
Term
A patient has chest pain worse when he lays flat and an EKG showing ST segment elevations in all leads.
What condition do you suspect? |
|
Definition
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|
Term
| What bacteria that causes endocarditis is most common in IV drug users? |
|
Definition
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|
Term
| What bacteria that causes endocarditis is most common in the general population? |
|
Definition
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|
Term
| Petechiae, Janeway lesions, Osler’s nodes and Roth spots are associated with what disease condition? |
|
Definition
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|
Term
| ASCHOFF bodies are associated with what disease condition? |
|
Definition
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|
Term
| Which cardiac enzyme lasts the longest? |
|
Definition
Troponin lasts the longest
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|
Term
| Which cardiac enzyme peaks first? |
|
Definition
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|
Term
A 55 year old male with DM, HTN and high cholesterol presents with a good cardiac chest pain story, a normal EKG but low positive troponins.
What does he have? |
|
Definition
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|
Term
A patient is admitted for chest pain. MI workup is negative. He has several CAD risk factors and strong family history.
What outpatient evaluation is recommended? |
|
Definition
Walking nuclear stress test
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|
|
Term
| How does ACS often present in an elderly patient? |
|
Definition
|
|
Term
| What type of disease process is CAD? |
|
Definition
Inflammatory disease process
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|
|
Term
| Name the 4 non modifiable risk factors for CAD. |
|
Definition
- Age
- Sex
- Genetics
- Ethnicity |
|
|
Term
| What are the three factors that classify ACS? |
|
Definition
- Chest pain story,
- EKG changes consistent with ACS
- Elevated troponins |
|
|
Term
| What are the disease conditions associated with acute coronary syndrome (ACS)? |
|
Definition
- Unstable angina
- NSTEMI
- STEMI |
|
|
Term
| Does a high blood pressure mean a higher or lower afterload? |
|
Definition
A high blood pressure means higher afterload and more work for the ventricles leading to long term development of left ventricular hypertrophy.
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|
|
Term
|
Definition
Afterload is the pressure the left ventricle needs to overcome in order to open the aortic valve.
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|
|
Term
| If a patient is in atrial fibrillation, do they have preload? |
|
Definition
| In atrial fibrillation there is no preload since the atrium are not contracting. |
|
|
Term
| What is preload and what part of the heart generates preload? |
|
Definition
Preload is the stretch created in the ventricles when the atrium contract and force blood down into the ventricles.
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