Get your STUDY PANCE on!

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Kinikia
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92178
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Get your STUDY PANCE on!
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2011-06-29 19:47:55
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Pance
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In preparation for the PANCE.
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  1. Which cardiomyopathy is caused by reduced strength of ventricular contraction?
    Dilated cardiomyopathy
  2. In which cardiomyopathy is the LV outflow tract narrowed during systole between the bulging septum and an anteriorly displaced anterior mitral valve leaflet?
    Hypertrophic obstructive cardiomyopathy
  3. In hypertrophic obstructive cardiomyopathy, will you have elevated diastolic pressures or systolic dysfunction? Why?
    You will have elevated diastolic pressures because of a hypertrophic LV. The amount of obstruction is preload and afterload dependent.
  4. Which cardiomyopathy results from fibrosis or infiltration of the ventricular wall?
    Restrictive cardiomyopathy
  5. Which is the most common chronic arrhythmia?
    Atrial fibrillation
  6. What does A-fib look like on an EKG?
    Narrow complex rhythm at any rate, irregularly irregular with no P waves
  7. What medication class commonly used to treate a-fib should be avoided in patients with WPW syndrome?
    CCBs- they may lead to a rate acceleration in patients with antidromic conduction
  8. What etiologies should you consider in new-onset a-fib?
    PIIRATES! P: pulmonary disease including PE; I: idiopathic disease including idiopathic HTN; I: inflammatory disease including pericarditis and pericardial trauma or surgery; R: rheumatic valvular heart disease; A: atherosclerotic CAD; T: thyrotoxicosis; E: ethanol consumption "holiday heart"; S: sick sinus syndrome
  9. What issues must be addressed in every patient with a-fib?
    1. Stability, 2. Rate control, 3. anti-coagulation, 4. anti-arrhythmic drugs, 5. cardioversion
  10. How do you treat a-fib in a patient with hypotension and dyspnea?
    Direct electrical cardioversion (synchronized if possible)
  11. What medications are used to control the ventricular rate of a-fib?
    CCBs (diltiazem and verapamil), B-adrenergic blockers, digoxin, and amiodarone
  12. What medication can be used to cardiovert patients who are in a-fib?
    Ibutilide
  13. Which arrhythmia usually occurs in people with COPD, CHF, atrial septal defect, or CAD?
    A-flutter
  14. Which arrhythmia shows a "sawtooth" pattern of atrial activity in leads II, III, and aVF?
    A-flutter
  15. What is the usual treatment for atrial flutter?
    Chemical conversion with ibutilide or electric cardioversion.
  16. What is the treatment for chronic a-flutter?
    Amiodarone
  17. What is the treatment for a-flutter refractory to usual treatment?
    Radiofrequency ablation
  18. Which conduction disturbance is characterized by refractory conduction of impulses from the atria to the ventricles through the AV node and/or bundle of His?
    Atrioventricular block
  19. What symptoms will you see in a patient with AV block?
    Fatigue, light-headedness, and syncope
  20. What is the treatment for AV block?
    The only effective long-term treatment for AV conduction disorders is cardiac pacing.
  21. What is first-degree AV block?
    PR interval > 0.21 seconds with all atrial impulses conducted
  22. What is second-degree AV block?
    Intermittent blocked beats. Subclassified into Mobitz type I (Wenckbach) and Mobitz type II.
  23. What is Wenckbach?
    AKA Mobitz type I. The PR interval progressively lengthens, with the RR interval shortening, before the blocked beat; this phenomenon is almost always due to abnormal conduction within the AV node.
  24. What is Mobitz type II?
    Intermittently non-conducted atrial beats not preceded by lengthening AV conduction. Usually due to block within the His bundle system.
  25. Which conduction disturbance is due to a lesion distal to the His bundle and associated with bilateral bundle branch block? Is the QRS wide or narrow? What is the ventricular rate?
    Complete (third-degree) heart block. The QRS is wide and the ventricular rate is usually around 50 bpm.
  26. What is the most common mechanism for paroxysmal supraventricular tachycardia?
    Re-entry- which may be initiated or terminated by a fortuitously timed atrial or ventricular premature beat.
  27. How can you treat paroxysmal supraventricular tachycardia?
    With vagal maneuvers. Otherwise, IV adenosine IV CCBs. B-blockers.
  28. Which drug, used for paroxysmal supraventricular tachycardia, can also promote bronchospasm?
    Adenosine, so don't use it in patients with reactive airways disease.
  29. What is the usual treatment for symptomatic patients with sick sinus syndrome?
    Permanent pacing.
  30. What is sick sinus syndrome?
    Sinus arrest, sinoatrial exit block, or persistent sinus bradycardia.
  31. What is the definition of ventricular tachycardia?
    Three or more consecutive ventricular premature beats.
  32. Which congenital heart anomaly is characterized by a subaortic septal defect, RV outflow obstruction, and overriding aorta, and RV hypertrophy?
    Tetralogy of Fallot
  33. What is coarctation of the aorta?
    Narrowing in the proximal thoracic aorta
  34. What is an atrial septal defect? Which is the most common type?
    An opening between the R and L atria. Of the four types, ostium secondum is the most common
  35. What is a patent ductus arteriosus?
    A failure to close or a delay in closure of the channel bypassing the lungs, which allows placental gas exchange during the fetal state.
  36. What test differentiates saphenofemoral valve incompetence from perforator vein incompetence?
    The Brodie-Trendelenberg test
  37. What is the most common cause of secondary hypertension?
    Renal parenchymal disease
  38. When heard in a patient with cardiac disease, what does S3 indicate?
    ventricular dysfunction or atrioventricular (AV) valvular incompetence
  39. What is malignant hypertension?
    Elevated blood pressure associated with papilledema and either encephalopathy or nephropathy; if untreated, progressive renal failure occurs
  40. What is the most common complaint of patients with undiagnosed hypertension?
    Nonspecific headache
  41. What is the treatment of choice for Giardia sp. infection?
    Metronidazole
  42. What sound is the hallmark for prolapse of the mitral valve?
    Midsystolic click
  43. What is the most common cause of acute pericarditis?
    Viral infection
  44. What is the usual treatment for pericarditis?
    NSAIDs
  45. Which leukemia is associated with primitive lymphoid cells?
    Acute lymphocytic leukemia
  46. Which leukemia is associated with Auer bodies?
    Acute myeloblastic leukemia
  47. Which leukemia is associated with absolute lymphocytosis?
    Chronic lymphocytic leukemia
  48. Which leukemia is associated with a left-shift myelopoesis?
    Chronic myelogenous leukemia
  49. Which leukemia is associated with the Philadelphia chromosome?
    Chronic myelogenous leukemia
  50. With what medications can you treat BPH?
    A-adrenergic agonists and 5A-reductase inhibitors
  51. You hear crackles/rales on lung exam. What does this mean?
    Fluid in the small airways or atelectasis, could indicate pneumonia
  52. Crackles/rales are heard when- on inspiration or expiration?
    Inspiration
  53. Ronchi on lung exam- what does this indicate?
    secretions in larger airways, pneumonia

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