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SURVIVOR'S GUIDE Quick Reviews and Test Taking Skills for USMLE STEP 3
vijay naik
Verlag BookBaby, 2020
ISBN 9781098316419 , 330 Seiten
Format ePUB
Kopierschutz DRM
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Quick Review- Cardiology
| Homocysteine can be metabolized to form what? Homocysteine can be methylated to form? | Cysteine; Methionine |
| What co-factor is needed to convert homocysteine to cysteine? | B6 |
| What do you give a patient with elevated homocysteine? | B12, Folate, B6 |
| Why are calcium channel blockers contraindicated in myocardial infarction? | Reflex Tachycardia |
| What valvular disease is associated with angiodysplasia? | Aortic Stenosis |
| How does endocarditis with septic emboli to the lungs appear? | Nodular Infiltrate with Cavitation |
| Prolonged QRS is also known as? | Bradyarrhythmia |
| Prolonged QT is known as what and can lead to what condition? | Tachyarrhythmia; Torsades |
| What complication can occur days to months after an MI? | Ventricular Aneurysm |
| How do you treat aortic regurgitation? | Afterload reduction- Calcium Channel Blockers |
| Prinzmetal angina occurs mostly in what demographic? | Young females |
| What is a risk factor for Prinzmetal angina? | Smoking |
| How does Prinzmetal angina show up on EKG? | Transient ST elevation |
| What is the treatment for Prinzmetal angina? | Calcium channel blockers or Nitrates |
| What medications are contraindicated in Prinzmetal angina? | Beta blocker and Aspirin |
| How can a ventricular aneurysm present? | Congestive heart failure, arrhythmias, mitral regurgitation and/or thrombus |
| What can an aortic dissection lead to? | Aortic regurgitation |
| What is the PR interval in 1st degree heart block? | PR interval > 0.2 |
| What occurs in constrictive pericarditis? | The pericardium is thickened and there is poor diastolic filling |
| What are the signs and symptoms for constrictive pericarditis? | JVP, Ascites, Hepatic congestion (looks like right sided heart failure), Low Voltage EKG |
| What arrhythmia is most specific for digoxin toxicity? | Atrial tachycardia with AV block |
| Signs and symptoms of Leriche syndrome? | Hip, thigh and buttocks claudication; Impotence; Symmetric atrophy of bilateral lower extremity |
| When can a cholesterol embolization occur? | After a cardiac angiogram |
| What are the signs and symptoms of a cholesterol embolization? | Increased eosinophils in blood and urine; decreased complement; livedo reticularis; acute renal failure |
| How do you diagnose aortic dissection? | Transesophageal echocardiogram |
| What causes stasis dermatitis and what does it result in? | Venous valvular incompetence; venous hypertension |
| What causes the color of the leg in stasis dermatitis? | Hemosiderin deposition |
| What is the best 1st line diuretic? | Hydrochlorothiazide |
| What falls under the category of supraventricular tachycardia? | Multifocal atrial tachycardia, atrial fibrillation, AV nodal reentrant tachycardia, atrioventricular reentrant tachycardia, junctional tachycardia |
| How do you treat PSVTs (narrow QRS complex tachycardia)? | Vagal maneuvers or Adenosine |
| What happens to the murmur in Hypertrophic obstructive cardiomyopathy as preload decreases? | It will increase as preload decreases because of increased outflow obstruction |
| What happens 3-7 days post MI? | Interventricular/papillary/ ventricular wall rupture |
| What does infective endocarditis lead to? | Tricuspid Regurgitation |
| How does a hemodynamically stable supraventricular tachycardia be treated? | Vagal maneuver first, if that doesn’t work then adenosine |
| How do you treat a hemodynamically unstable supraventricular tachycardia? | Cardioversion |
| What happens to cardiac index, left ventricular end diastolic volume and total peripheral resistance in systolic heart failure? | Cardiac index is decreased; Left ventricular end diastolic volume is increased; Total peripheral resistance is increased |
| What happens to Cardiac output, pulmonary wedge capillary pressure and systemic vascular resistance in hypovolemic shock? | Decreased cardiac output, decreased pulmonary capillary wedge pressure and increased systemic vascular resistance |
| What kind of murmur is seen in tricuspid regurgitation? | Holosystolic murmur that increases with inspiration (decreased intrathoracic pressure) |
| What kind of murmur is seen in hypertrophic obstructive cardiomyopathy? | Crescendo-decrescendo murmur with no radiation to carotids and is found in lower left sternal border |
| How does adenosine work in supraventricular tachycardia? | It will increase conduction delay through the AV node |
| What happens to heart rate and blood pressure in hypovolemic shock? | Increased heart rate and decreased blood pressure |
| In heart failure, what does the kidney do to try to compensate? | Activates RAAS, which causes angiotensin 2 to constrict efferent arteriole and then aldosterone absorbs more sodium causing water retention and elevation of total body volume |
| How does cardiac silhouette appear in pericardial effusions? | It is enlarged and looks like a “water bottle” |
| What do you see on physical exam with pericardial effusion? | Non-palpable point of maximal impulse and diminished heart sounds |
| What symptoms can you see in both pericardial effusion and cardiac tamponade? | Hypotension, distended neck veins, muffled heart sounds, positive hepatojugular reflex and pulsus paradoxus. |
| What can infective endocarditis present with? | Systemic arterial emboli, roth spots, osler’s nodes and janeway lesions |
| What is an adverse effect seen with dihydropyridine calcium channel blockers? | Peripheral edema |
| What is strongest influence on long-term prognosis for an ST-elevation MI? | The duration of time that passes before coronary blood flow is restored via PCA or fibrinolysis |
| What is the most important intervention for BP control? | Weight loss Weight loss> physical activity> salt restriction > alcohol |
| What type of murmur do you see in mitral regurgitation? | Holosystolic murmur radiating to axilla and will have a soft S1 |
| What symptoms are seen in aortic regurgitation? | Wide pulse pressure (systolic- diastolic) which patients experience as a “pounding” heartbeat |
| What can pericardial fibrosis cause? | Constrictive pericarditis |
| How does constrictive pericarditis present? | Presents like CHF, positive kussmaul’s sign (increase JVP on inspiration and pedal edema. |
| What is a cause of constrictive pericarditis in developing countries? | Tuberculosis |
| What do you give for nitroglycerine? | Cardiogenic pulmonary edema because it will decrease preload and relieve dyspnea and tachycardia |
| How does cardiogenic pulmonary edema present? | Bibasilar rales and wheezing |
| How does digoxin and furosemide/loop diuretics work in CHF? | It decreases CHF symptoms but does not improve survival |
| What are patients with a history of rheumatic fever at increased risk for? | Risk of recurrent episodes and progression of rheumatic heart disease with repeated infection by group A streptococcus pharyngitis. Need penicillin prophylaxis |
| What are the class 1C anti-arrhythmics? | Flecainide/Propafenone |
| How does class 1C anti-arrhythmics work? | They block sodium channels and has the slowest binding and dissociation from the sodium channels |
| What 1C drug demonstrates... |
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