Comp Exam, Latest Questions With
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2024/5.
Vagolytic (atropine) or positive chronotrope (epi or dopamine) - ANSWER- Tx for
unstable bradycardia leading to hypotension, shock, AMS, angina, or HF
Synchronized cardioversion (or antiarrhythmic i.e. Amiodarone, B blocker) - ANSWER-
Tx for unstable tachycardia w hypotension, shock, AMS, angina, or HF
Adenosine - ANSWER- Initial medication of choice for stable PSVT
(Stable) Valsalva > adenosine > B blocker or CCB > (unstable) synchronized
cardioversion > ablation - ANSWER- Treatment course of PSVT
Procainamide, amiodarone, or sotalol - ANSWER- Tx for significant, stable tachycardia
w wide QRS
Electric cardioversion - ANSWER- Tx for hemodynamic/symptomatic unstable a fib
Anticoag (heparin or enoxaparin & warfarin or dabigatran) + rate control x 3-4 wks
before cardioversion - ANSWER- Tx of stable a fib w hx/risk of thrombus
Heparin w cardioversion - ANSWER- Tx of stable a fib w no risk/hx thrombus
W HF: digoxin, amiodarone
W/o HF: B blocker or CCB - ANSWER- Tx rate control for a fib
Amiodarone - ANSWER- Chemical cardioversion for a fib
Electric cardioversion - ANSWER- Tx for hemodynamic/sx unstable atrial flutter
Digitalis, CCB, B blockers - ANSWER- SSS is exacerbated by
>.21 s - ANSWER- First degree heart block PR interval
Mobitz II & 3rd degree HB - ANSWER- Which conduction blocks require pacing
Dilated cardiomyopathy; genetic & ETOH - ANSWER- MC cardiomyopathy; MCC's
,Hypocontractility of L.V. Apex - ANSWER- Takotsubo pathology
Microscopic myocardial abn - ANSWER- What causes HOCM arrhythymia
Fibrosis infiltration of ventricles d/t collagen defect dz (amyloidosis), radiation, DM -
ANSWER- Restrctive CM causes
S3, passive filling of atrium to ventricle - ANSWER- Heart sound heard in dilated CM
Right sided CHF - ANSWER- What does advanced restrictive CM cause
LV dilation/dysfxn w high diastolic pressures, low CO - ANSWER- What does advanced
dilated CM cause
Mild cardiac enzymes; cardiac cath shows hypocontractility of LV & patent coronary
arteries - ANSWER- Diagnostics of Takotsubo
ETOH abstinence, CHF supportive tx - ANSWER- Tx for dilated CM
Supportive care, NO inotropes - ANSWER- Tx for Takotsubo
B blockers & CCB > ablation > pacing/defibrillator - ANSWER- Tx for HOCM
Diuretics, symptomatic - ANSWER- Tx for restrictive cardiomyopathy
Idiopathic (90%) or viral infxn - ANSWER- MCC's of acute pericarditis
ESR - ANSWER- Post MI pericarditis shows high ____
Electrical alternans (alternating amplitude on EKG) - ANSWER- EKG finding of
pericardial effusion becoming tamponade
Acute: pericardiocentesis, Recurrent: pericardial window
inflmn only- steroids/NSAIDS - ANSWER- Tx for pericardial effusion
Streptococcus viridans, staph aureus - ANSWER- MCC native valve infective
endocarditis
S. Aureus; tricuspid - ANSWER- MCC IVDU IE; MC valve
Acute- S. Aureus
1st 2 mo post op- fungi or gram - - ANSWER- MCC prosthetic valve IE
Fever, nonspecific sx (cough, dyspnea, arthralgia), stable murmur, osler nodes,
janeway lesions, roth spots - ANSWER- Sx of IE
,2 + blood cx
Echo
New murmur - ANSWER- Duke Major Criteria Infective Endocarditis
Fever (>100.4)
Vascular phenomena (emboli or pulmo infarxn)
Immuno phenomena (glomerulonephritis, Osler, Janeway, Roth)
+ blood cx not meeting major criteria - ANSWER- Duke Minor Criteria IE
2 major
1 major 3 minor
5 minor - ANSWER- Clinical Criteria for Infective Endocarditis
2-3 wks post B-hemolytic strept pharyngitis - ANSWER- When does rheumatic heart dz
occur
Mitral (75%), aortic (30%) - ANSWER- MC valves affected by rheumatic heart dz
JONES (joints, heart, nodules, erythema marginatum, sydenham's chorea) - ANSWER-
Major Jones Criteria for Rheumatic Heart Dz
Fever, polyarthralgia, ESR, CRP - ANSWER- Minor Jones Criteria for Rheumatic Heart
Dz
IM PCN & strict bed rest
Salicylates reduce fever and relieve joint pain
PPx: benzathine PCN Q4W - ANSWER- Tx for rheumatic heart dz
Pain, pallor, paresthesia, pulselessness, poikoilothermia, paralysis - ANSWER- Acute
arterial occlusion threatens limb viability and causes:
Intermittent claudication (foot/lower leg pain) with exercise relieved by stress > pain at
rest - ANSWER- Initial Sx of PAD
Doppler US
ABI (<0.9 BAD)
Angiography: gold standard - ANSWER- Diagostics for PAD
D/c tobacco, B blocker, ACEI, statin, antiplt (clopidogrel, ASA) > revascularzn -
ANSWER- Tx of PAD
Greater saphenous vein
Superficial venous insuff & valvular incompetence - ANSWER- MC site of varicose
veins
MCC of varicose veins
, Stasis, vascular injury, hypercoagulability - ANSWER- Virchow's triad
Total hip replacement, prolonged bedrest, OCP, hormone replacement th - ANSWER-
Causes of DVT
Swelling, heat, and redness over affected area - ANSWER- Sx of DVT
Duplex US (d dimer) - ANSWER- Preferred study (& lab) for DVT
Venography - ANSWER- Definitive dx for DVT
Pulmonary CT angiography - ANSWER- Gold standard dx for PE
Enoxaparin (LMWH) or UFrx heparin then warfarin - ANSWER- Tx of DVT
Progressive edema at ankle, itching, dull pain
Shiny, thin, atrophic skin with dark pigment (brawny)
Ulcers MC above ankle - ANSWER- Sx of chronic venous insufficiency
Wet compress, hydrocortisone cream, zinc oxide - ANSWER- Tx of stasis dermatitis
(CVI)
Medium & large vessels; @ w polymyalgia rheumatica - ANSWER- What does giant cell
arteritis affect and MC @
U/l temporal h/a, scalp tender, jaw claudication, throat pain, diplopia; shoulder & pelvic
girdle pain - ANSWER- Sx of giant cell arteritis
High dose prednisone (1-2 b4 taper) & low dose ASA - ANSWER- Tx of giant cell
arteritis
Atherosclerosis; abdominal below renal artery - ANSWER- MCC aortic aneurysms; MC
type
65 y/o male smoker w CAD, emphysema, and renal impairment - ANSWER- Classic
picture of aortic aneurysm pt
Substernal, back, or neck pain
Dyspnea, stridor, cough ,dysphagia - ANSWER- Sx of thoracic aortic aneurysm
Abdominal US - ANSWER- Study of choice for abdominal aneurysm
CT/MRI - ANSWER- Study of choice for thoracic aneurysm
Endovascular or open surgical repair - ANSWER- Tx for aneurysm (only effective)
