Cardio Exam 1 Review Questions

Front 1

What condition does this suggest?
Sharp stabbing chest pain left of the sternum that is worse when a patient takes a deep breath.

Back 1

Pericarditis

Front 2

How is chest pain from pericarditis relieved?

Back 2

sitting up and leaning forward

Front 3

Where does chest pain from angina occur?

Back 3

retrosternal, radiating to jaw, arm & shoulder

Front 4

Chest pain described as squeezing, tightness, pressure, or heaviness along with Levine's sign indicates what condition?

Back 4

Angina

Front 5

How is chest pain from angina relieved?

Back 5

rest & nitro

Front 6

Tearing chest pain with sudden onset is characteristic of what disorder?

Back 6

Aortic Dissection

Front 7

Systolic murmur over the left sternal border & interscapular area indicates ____________

Back 7

coarctation of aorta

Front 8

What are the components of the Tetralogy of Fallot?

Back 8

1)Right Ventricular Outflow Obstruction
2)Membranous VSD
3)Overriding Aorta Over VSD
4)RVH

Front 9

A wide fixed split S2, SOB, and fatigue are symptoms found in __________

Back 9

Atrial Septal Defect

Front 10

Pansystolic murmur, hyperdynamic precordium & thrill on exam is characteristic of ____________

Back 10

Ventricular Septal Defect

Front 11

What type of congenital cardiac defect is seen in Down's Syndrome patient?

Back 11

Atrioventricular Canal VSD

Front 12

A loud continuous machinery sounding murmur is characteristic of ____________

Back 12

Patent Ductus Arteriosus (PDA)

Front 13

What type of murmur is heard with Pulmonic Valve Stenosis?

Back 13

Systolic murmur at left upper sternal border that increases with inspiration

Front 14

Cyanosis, boot shaped heart on x-ray and clubbing is characteristic of ________

Back 14

Tetralogy of Fallot

Front 15

Upper extremity HTN and weak lower extremity pulse is indicative of ____________

Back 15

Coarctation of Aorta

Front 16

What is the most common congenital cardiac defect?

Back 16

Ventricular Septal Defect

Front 17

Pulmonic Valve Stenosis obstructs _________________

Back 17

right ventricular outflow

Front 18

Harsh systolic murmur radiating to the carotids and a soft or absent A2 is indicative of __________

Back 18

Aortic Stenosis (AS)

Front 19

Diastolic, blowing, decrescendo murmur best heard with patient leaning forward after expiration is characteristic of _____

Back 19

Aortic Regurgitation (AR)

Front 20

Austin Flint murmur - low pitched diastolic murmur is characteristic of ___________

Back 20

Aortic Regurgitation (AR)

Front 21

Diastolic low pitched murmur best heard in left lateral decubitus position with bell is characteristic of ____________

Back 21

Mitral Stenosis (MS)

Front 22

Holosystolic murmur radiating to axilla is characteristic of _______

Back 22

Mitral Regurgitation (MR)

Front 23

Midsystolic click followed by a late systolic murmur is characteristic of ___________

Back 23

MVP

Front 24

Diastolic murmur along the left sternal border indicates _________

Back 24

Tricuspid Stenosis

Front 25

Systolic murmur along the left sternal border that increases with inspiration is characteristic of _____

Back 25

Tricuspid Regurgitation

Front 26

Name 3 Class IA anti-arrhythmics

Back 26

procainamide
disopyramide
quinidine

Front 27

Name 3 Class IB anti-arrhythmics

Back 27

Lidocaine
Tocainide
Phenytoin

Front 28

Flecainide & Propafenone are in class ______

Back 28

IC

Front 29

B-blockers are in class _____

Back 29

II

Front 30

Amiodarone, Ibutilide, Sotalol, Bretylium & Dofetilide are class _____

Back 30

III

Front 31

Calcium channel blockers - Verapamil & Diltiazem are class ______

Back 31

IV

Front 32

Adenosine & Digoxin are class __

Back 32

V

Front 33

What is JVP an indicator of? What is considered abnormal?

Back 33

1) right atrial pressure
2) >3-4cm above sternal angle

Front 34

Increased JVP indicates _______

Back 34

increased central venous pressure

Front 35

An increased a-wave indicates _____________

Back 35

Increased resistance to emptying right atrium

Ex: TS, RVH, HTN, anything that makes the heart work harder

Front 36

ST elevation in leads II, III, and aVf indicates ___________

Back 36

inferior MI
Right Coronary Artery

Front 37

Patients with ______ (5) are not candidates for a stress test

Back 37

unstable angina
AMI
severe AS
CHF exacerbation
uncontrolled HTN

Front 38

Stress test is not useful in patients with ______, _______, or abnormal baseline EKG

Back 38

LBBB
LVH

Front 39

What are the cardinal symptoms of Aortic Stenosis?

Back 39

Syncope
Angina
SOB (CHF)

Front 40

Which valve is most often effected by rheumatic fever?

Back 40

Mitral Valve

Front 41

What are the major Jone's Criteria?

Back 41

C--Carditis
A--Arthritis...polyarthritis
S--Sydenham's chorea
E--Erythema marginatum
S--Subcutaneous nodules

Front 42

What are the minor Jone's Criteria?

Back 42

P = Prolonged PR interval-EKG
E = Elevated ESR
A = Arthralgias
C = C-Reactive Protein raised
H = History rheumatic fever or strep

Front 43

What is the treatment for stable angina?

Back 43

aspirin
nitro
long acting nitrates
B-blockers
Ca+ channel blockers

Front 44

What is the treatment for unstable angina?

Back 44

aspirin
heparin/lovenox
GP IIB/IIIA
Revascularization if meds don't help (CABG, PTCA, Stents)

Front 45

What is the treatment for Prinzmetal's angina?

Back 45

Ca+ channel blockers
aspirin
nitrates

Front 46

What are the LDL goals?

Back 46

LDL < 100 for CAD/CAD equiv

LDL < 130 w/o CAD & >2 cardiac risk factors

LDL < 160 w/o CAD & <2 cardiac risk factors

Front 47

What are the absolute contraindications for thrombolytic therapy?

Back 47

aortic dissection
acute pericarditis
active bleeding
intracranial neoplasm
previous cerebral hemorrhage
cerebral aneurysm
AV malformations

Front 48

What are the relative contraindications for thrombolytic therapy?

Back 48

bleeding diaphysis/coagulopathy
major surgery/trauma/puncture
nonhemorrhagic stroke w/in 6mo
GI bleed w/in 6mo
Severe HTN >180/95
prolonged CRP
pregnancy
proliferative retinopathy

Front 49

Which cardiac enzyme peaks first and lasts the shortest length of time?

Back 49

myoglobin

Front 50

Which cardiac enzyme rises within 3-4 hours and lasts the longest?

Back 50

Troponin

Front 51

A systolic ejection murmur at the left sternal angle that increases with the Valsalva Maneuver is characteristic of __________

Back 51

Hypertrophic Cardiomyopathy

Front 52

____________causes thickening of the LV which results in ________

Back 52

Hypertrophic Cardiomyopathy
decrease in LV outflow

Front 53

SOB, tachycardia, fatigue, distended jugular veins and pulsus paradoxus are symptoms/signs found in ___________

Back 53

Cardiac Tamponade

Front 54

Beck's Triad is associated with Cadiac _______

Back 54

Tamponade

Front 55

What is Beck's Triad?

Back 55

Muffled heart sounds
Distended JVD
Hypotension

Front 56

What are the symptoms of Acute Arterial Embolism?

Back 56

Pain
Pallor
Paresthesias
Paralysis
Poikilothermia
Pulselessness
A-Fib 60-70% of pts

Front 57

What is the recommended therapeutic anti-coagulation prior to cardioversion for A-Fib?

Back 57

>48 hrs or unknown time since AF

anticoagulate 3 weeks prior & 4 weeks following

Front 58

Positive QRS concordance, presence of AV dissociation, capture beats or fusion beats is diagnostic of _____

Back 58

VT

Front 59

Atypical RBBB; monophasic R, QR, RS; triphasic QRS in V1; R to S ratio < 1 is suggestive of ____

Back 59

VT

Front 60

Atypical LBBB; R > 30ms or R to S; nadir or notch is suggestive of ___

Back 60

VT

Front 61

Shift of axis from baseline, history CAD (prior MI, ischemia, or CHF) is suggestive of ____tachycardia

Back 61

Ventricular

Front 62

QRS during tachycardia identical to QRS during sinus rhythm is suggestive of _____tachycardia

Back 62

Supraventricular (SVT)

Front 63

Termination with Adenosine is suggestive of _____tachycardia

Back 63

Supraventricular

Front 64

What are the abnormal values associated with ABI

Back 64

ABI < 0.9 is abnormal
ABI 0.5-0.8 is claudication
ABI < 0.5 pain at rest

Front 65

Abnormalities of ABI can be diagnostic of ________.

Back 65

Coarctation of Aorta

Front 66

What does ABI show?

Back 66

Difference in upper/lower extremity pressures

Front 67

What is Virchow's Triad?
What does it help to diagnose?

Back 67

endothelial damage
venous stasis
hypercoagulation

-DVT

Front 68

What are the lab values associated with primary aldosteronism?

Back 68

*aldosterone/plasma renin >20ng/dL
*Serum aldosterone >15ng/dL
*decreased K+
*decreased renin

Front 69

What are the side effects associated with thiazide diuretics?

Back 69

hypokalemia
hyperuricemia
hyperglycemia

Front 70

What are the side effects associated with ACE-i

Back 70

angioedema
cough
hyperkalemia
rash

Front 71

What are the side effects associated with b-blockers?

Back 71

bradycardia
bronchospasm
depression
fatigue
sexual dysfunction

Front 72

What are the side effects associated with Ca+ channel blockers?

Back 72

lower extremity edema
bradycardia
constipation - verapamil

Front 73

What is the JNS7 guideline for pre-HTN

Back 73

systolic 120-139
diastolic 80-89

Front 74

What is the JNS7 guideline for stage I HTN

Back 74

systolic 140-159
diastolic 90-99

Front 75

What is the JNS7 guideline for stage II HTN?

Back 75

systolic >160
diastolic >100

Front 76

What are the contraindications for a pacemaker?

Back 76

-asymptomatic sinus bradycardia or sinus node dysfunction
-bradycardia during sleep
-1st degree AV block
-asymptomatic Mobitz I second degree AV block
-transient asymptomatic pause during A-fib
-recurrent syncope of unknown origin

Front 77

When is urgent surgery indicated for aortic dissection?

Back 77

-Type A aneurysms
-Type B aneurysms if dissection is continuing or aortic branch is compromised