STEP 2 Rapid Review Cardiovascular
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Classic ECG finding in atrial flutter.
"Sawtooth" P waves.
Definition of unstable angina.
Angina is new, is worsening, or occurs at rest.
Antihypertensive for a diabetic patient with proteinuria.
Beck's triad for cardiac tamponade.
Hypotension, distant heart sounds, and JVD.
Drugs that slow AV node transmission.
Beta blockers, digoxin, calcium channel blockers.
Hypercholesterolemia treatment that leads to flushing and pruritus.
Murmur-hypertrophic obscructive cardiomyopathy (HOCM).
Systolic ejection murmur heard along the lateral sternal border that increases with Valsalva maneuver and standing.
Diastolic, decrescendo, high-pitched, blowing, murmur that is best heard sitting up; increases with decreased preload (handgrip maneuver).
Systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (Valsalva maneuver).
Holosystolic murmur that radiates to the axillae or carotids.
Diastolic, mid- to late, low-pitched murmur.
Treatment for atrial fibrillation and atrial flutter.
If unstable, cardiovert. If stable or chronic, rate control with calcium channel blockers or beta blockers.
Treatment for ventricular fibrillation.
Autoimmune complication occuring in 2-4 weeks post-MI.
Dressler's syndrome: fever, pericarditis, increased ESR.
IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Treat existing heart failure and replace the tricuspid valve.
Diagnostic test for hypertrophic cardiomyopathy.
Echocardiogram (showing thickened left ventricular wall and outflow obstruction).
A fall in systolic BP of > 10 mmHg with inspiration.
Pulsus paradoxus (seen in cardiac tamponade).
Classic ECG findings in pericarditis.
Low-voltage, diffuse ST-segment elevation.
Definition of hypertension.
BP > 140/90 on three separate occasions two weeks apart.
Eight surgically correctable causes of hypertension.
- 1. Renal artery stenosis
- 2. Coarctation of the aorta
- 3. Pheochromocytoma
- 4. Conn's syndrome
- 5. Cushing's syndrome
- 6. Unilateral renal parenchymal disease
- 7. Hyperthyroidism
- 8. Hyperparathyroidism
Heartbeat running away.
Boom-ba-doom-boom-boom-ba-doom-boom-bass. (Super bass.)
Evaluation of pulsatile abdominal mass and bruit.
Abdominal ultrasound and CT.
Indications for surgical repair of abdominal aortic aneurysm.
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured.
Treatment for acute coronary syndrome.
Morphine, O2 , sublingual nitroglycerin, ASA, IV beta blockers, heparin.
What is a metabolic syndrome?
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states.
Appropriate diagnostic test for a 50-year-old man with angina who can exercise to 85% of maximum predicted heart rate?
Exercise stress treadmill with ECG.
Appropriate diagnostic test for a 65-year-old woman with left bundle branch block and severe osteoarthritis who has unstable angina?
Pharmacological stress test (e.g., dobutamine echo)
Target LDL in a patient with diabetes
Signs of active ischemia during stress testing.
Angina, ST-segment changes on ECG, or lowered BP.
ECG findings suggestion MI.
ST-segment elevation (depression means ischemia), flattened T waves, and Q waves.
Coronoary territories in MI.
Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal).
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.
Common symptoms associated with silent MIs.
CHF, shock, and altered mental status.
The diagnostic test for pulmonary embolism.
An agent that reverses the effects of heparin.
The coagulation parameter affected by warfarin.
A young patient with a family history of suden death collapses and dies while exercising.
Endocarditis prophylaxis regimins.
Oral surgery--amoxicillin; GI or GU procudures--ampicillin and gentamicin before and after amoxicillin after.
The 6 P's of ischemia due to peripheral vascular disease.
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia.
Stasis, hypercoagulability, endothelial damage.
The most common cause of hypertension among young women.
The most common cause of hypertension in young men.
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