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CV Seminar Test
CV Seminar Test
57
Medical
Graduate
02/14/2013

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Term
34yowf c h/o tobacco presents with severe substernal anginal S&S. Watching TV and pain was not related to exertion. ECG shows ST elevation. Dx?
Definition
Prinzmetal Angina
Term
Prinzmetal's angina is caused is...
Definition
Caused by vasospasms at rest
Term
What is the Tx of choice for Kawasaki's?
Definition
High dose ASA + IVIG
Term
What test needs to be be completed at the time of Dx, as well as serially along the course of Kawasaki's?
Definition
Echo
Term
Which is not a diagnostic criteria for Kawasaki's?
Definition
Fever <6d
Term
Which of the following can cause necrotising mediastinitis?
Definition
Head and Neck infxns
Term
Which of the following is NOT a risk factor for necrotising mediastinitis?
Definition
Asthma
Term
What is the best Dx test for necrotising mediastinitis?
Definition
CT of the thorax
Term
What are the 4 determinants of CO?
Definition
HR, Preload, Afterload, Contractility
Term
What is the Dx test of choice for cardiac tamponade?
Definition
Echo
Term
What are the components of Beck's Triad?
Definition
Hypotension, Muffled heart sounds, +JVD
Term
Assuming that you have an aortic dissection that is dissecting both distally and proximally to the subclavian artery, which Debakey Class?
Definition
Type I
Term
Same patient as above, Stanford Class?
Definition
Type A
Term
How would you BEST go about Tx a symptomatic pt with an acute rupture of aortic aneurysm and aortic dissection?
Definition
Emergent replacement of the ascending aorta and immediate BP control
Term
Aortic dissection can be ruled out in a hypotensive pt with a normal CXR?
Definition
False
Term
Pt presents to ER c/o acute onset, stabbing chest pain. No h/o renal dysfxn. The imaging TOC for this pt is?
Definition
CT
Term
Aortic dissection is suspected, and pharmacotherapy initiated. Which med would you give first?
Definition
Esmolol
Term
The diagnosis of PVA can be verified by all of the following procedures except what?
Definition
Exercise stress test
Term
Which of the following meds is contraindicated in the Tx of PVA?
Definition
Propanolol
Term
In the presence of anginal episodes, which of the following pts would most likely have a Dx of PVA?
Definition
28yo F c PMH of migraines and SH of cigarette smoking
Term
Which of the following is not a cause of A Fib?
Definition
Hypothyroidism
Term
Which of the following pts can undergo cardioversion without prior anticoagulation if in AFib?
Definition
AFib for <48 hrs
Term
What is recommended INR range for Coumadin therapy?
Definition
2.0-3.0
Term
What is the initial elevation of Cardiac Troponin I?
Definition
3-12hrs
Term
What is the most specific cardiac enzyme indicating myocardial ischemia?
Definition
CK-MB
Term
What HTN meds can lead to acute angioedema as a side effect?
Definition
ACEi - "prils"
Term
Common causes of constrictive pericarditis include all of the following except what?
Definition
Sinusitis
Term
Initial Tx of constrictive pericarditis include what?
Definition
Diuresis
Term
Which of the following is a diagnostic finding consistent with constrictive pericarditis?
Definition
Pericardial thickening >4mm seen on cardiac MRI
Term
Which anti-hypertensives are contraindicated in Tx of prevention of PPCM?
Definition
ACE-I and ARBS
Term
What is the peripartum time frame required for the Dx of PPCM?
Definition
During the last month of pregnancy or within 5mths of delivery
Term
What are the S&S of PPCM?
Definition
Peripartum dyspnea, chest discomfort, dizziness, and decreased exercise tolerance
Term
Which of the following is NOT a risk factor for endocarditis?
Definition
Daily aspirin therapy
Term
45yom presents LE edema and says he's had to sleep on extra pillow for the past few weeks. He mentions that he has been told he has a bicuspid aortic valve. On PE, you notice track marks on his arms, crackles in the bases of his lungs, and an early diastolic decrescendo murmur. What radiographic findings would support your Dx of aortic insufficiency due to endocarditis?
Definition
Cardiomegaly and aortic root dilatation
Term
When a pt receives a mechanical heart valve, what type of drug wil they need for the rist of their lives?
Definition
Anticoagulants
Term
A 72yo recently widowed female is hospitalized with an acute anterior MI. Echo reveals left ventricular apical ballooning, yet cardiac cath reveals clear coronary arteries. What is the most likely Dx?
Definition
Takotsubo cardiomyopathy
Term
45yo smoker is obese, does not exercise, and consumes a high fat and high sodium diet. He was recently diagnosed with angina by his healthcare provider. What lifestyle change will have the best long-term improvement to his risk profile?
Definition
Cessation of smoking
Term
52yo male with no significant PMH and no current complaints undergoes a screening EKG. The rhythm strip shows 5-6 beat runs of wide QRS complexes. Which of the following meds should be administered now?
Definition
Amiodarone
Term
Which cardiac enzyme rises first in an AMI?
Definition
Myoglobin
Term
Mrs. SJ is a 60yowf. She presents to your clinic for an annual PE. She smokes 3 packs/day but exercises 3X/wk. her mother died at age 57 of an AMI. Today her BP is 120/86. How many cardiac risk factors?
Definition
3
Term
A pt presents with CP and SOB. On EKG he has ST segment elevation in leads I, aVL, V3, V4, V5 and V6. What is the location of this AMI?
Definition
Anterolateral
Term
What are painful, red, raised lesions found on the hands and feet called?
Definition
Osler nodes
Term
IV drug use is a risk factor for endocarditis, especially involving the tricuspid valve
Definition
False
Term
What is a common EKG finding with Aortic Stenosis?
Definition
LVH
Term
What is the common triad of symptoms for Aortic Stenosis?
Definition
Syncope (often exertional), angina, and heart failure
Term
What is the Tx of choice for WPW syndrome?
Definition
Catheter ablation
Term
Which of these is NOT a classic EKG finding of someone with WPW syndrome?
Definition
Peaked T Waves
Term
Which physiologic method of conduction through an accessory pathway will present with EKG abnomalities?
Definition
Anterograde/antidromic
Term
4 month old presents to your clinic with tachycardia, tachypnea and is small on the growth chart. ECG reveals R atrial enlargement, hypertrophy and axis deviation. Auscultation reveals fixed split S2 and pulmonary flow murmur. What congenital heart defect would you suspect the most in the pt?
Definition
TAPVR
Term
Where is the most common location of septal defect in TAPVR?
Definition
Foramen Ovale
Term
What is the most worrisome type of anomalous venous return condition?
Definition
Infracardiac TAPVR
Term
If you suspect a pt to have a primary cardiac tumor, which is it most likely to be?
Definition
Atrial Myxoma
Term
73yowf presents with SOB, unintentional wt loss and fatigue. Echo shows a tumor in the Left Atrium. The pt remembers that her mother had this problem, too. Which of the following might you also find to explain this familial trend?
Definition
Pigmented skin lesions and Endocrine Neoplasia
Term
80yowf reports to our clinic c/o fatigue. She has an elevated sedimentation rate, and signs of peripheral embolization. Echo reveals a left atrial myxoma. Which of the following might you hear on physical exam?
Definition
Diastolic murmur
Term
Which of the following is not a S&S of myocarditis?
Definition
Cough on a daily basis
Term
Definitie Dx of myocarditis requires what?
Definition
Endomyocardial Bx
Term
You suspect myocarditis in a middle-aged man that presents with nonspecific chest and abdominal pain. Which of the following would be a plausible Echo finding to strengthen your Dx?
Definition
Dilated right atrium, pulmonary HTN, EF 20%, Apical hypokinesis
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