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MSP999 Card-1
USMLE WORLD Card 1
Question | Answer |
---|---|
Class of drug that can cause edema | Ca channel blockers |
Should be avoided in RV infarct/symptoms | nitrates/JVD, clear lungs hypotension and inferior MI |
What is needed in RV dysfunction | increase preload |
What is needed in Left ventricle failure | decrease preload |
Management of left ventricle failure | loop diuretics and nitrates acutely |
B blockers and Ca Channel blockers what kind of inotrope | negative |
Acute treatment of cardiogenic pulmonary edema | nitrates |
High dose metopralol has what effect | can hit B2 and cause bronchoconstriction |
First step in A fib treatment/why | rate control/ get LV dilation and decreased EF with Afib |
Premature atrial beats diagnosis/ management | premature p wave, different morphology, no QRS width changes/ anxiety, CHF, caffeine, electrolyte/ nothing |
Low grade fever, fatigue, rumble in atria, diastolic rumble at apex, may have neurologic symptoms think | left atrial myxoma hitting the mitral valve |
Paroxysmal supraventricular tachycardia include intial management | vagal maneuvers or adenosine |
Adenosines other role | bring out p waves with an unsure diagnosis of Afib or a flutter |
HF with decreased CI, increased TPR and increased LVED | systolic |
Inferior Wall MI vessel | RCA |
Anterior Wall MI vessel | LDA |
Lateral Wall MI vessel | LCX |
Posterior Wall MI vessel/ fiunding on EKG | LCX or RCA/ both V1-V3 depression, LCX I and aVL elevation, other depression |
Consequence of RCA MIs/ often see | get hear block form disrupting the AV node/ bradycardio and hypotendsion |
Management of lone A fib | rate control, rhythm control if it occurs often but no need to anticoagulant |
Conservative Venus stasis treatment | stockings, exercise, leg elevation |
Transient ST elevation with angina is/ occurs time wise. rx | priametals or variant angina/ night/ calcium channel blocker or nitrate |
Mechanism of niacin flushing | prostaglandin vasodialation |
In young person, creasdon decresadon murmo on left sternal border with no radiation to carotids is | hypertrophic cardiomyopathy with ventricular septal hypertrophy. |
Have left ventricular HF but normal EF you have/ long term get | diastolic dysfunction / atrial dilatation going into atrial fibrillation |
Complication of Aortic dissection / see in those with | stroke, horers, arotic insuficincent, MI , percardia effusion, hemothorax, leg ischema pai, abdominal pain/ chronic hypertension |
Asymmetric kidney size, flash pulmonary edema and increase in creatine by 30% with ACE/ARB think | renal vascular disease |
Hypertensive urgency/emergency | 180/120 + with no end organ symptoms/ malignant hypertension (hemorrhage and exudates) or hypertensive encephalopathy |
Amiodarone side effects | pulmonary fibrosis, hepatotoxicity, corneal deposits, hyo>hyperthyroidism |
Best way to effect blood pressure in obese/ non obese | weight loss/ fruit and vegetable diet (DASH diet) |
BUN when urea is bad | above 60 |
Isolated aortic stenosis in elderly from | age related sclerosis |
High pitched murmur 2nd right intercostal space usually radiates to the carotids/ cause in young person | aortic stenosis/ congenital bicuspid valve |
Syncope believed to be related to AS exercise EKG/ management | no, can induce an arrhythmia/ symptomatic AS requires valve replacement |
Pansystlic murmur loudest at the apex and radiates to th axilla is | Mirtal regurgitaiotn |
Can get abnormal motion of the mitral valve leaflets with/ give valslva | hypertohic cardiomyopathy/ increases |
Isaloted systolic hypertension in the elderly significant for | stiffning of the arteries/ thiazide, ace of calcium channel blocker |
Makes digoxin more toxic/ effect | hypokalemia/ V tach May cause V tach accidentally due to electrolytes/ loop diuretics (hypokal, hypomag). PVC management |
Dijixon use in arthmia | only atrial |
Trartment of choice for third degree heart block | pace maker |
Sudden plueritc chest pain and on OCD think | PE with infection |
Hold 48 hours before stress test / before a vasodilator test | BB/ 12 hours before vaso. CaChB and intrates/ dipyrimadole/ caffine |