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STEP2 Cardiovascular

Cardiovascular UWORLD

QuestionAnswer
What are common findings or signs in CXR in pulmonary embolism (PE)? 1. Westmark sign 2. Hamton hump 3. Fleischner sign
Westmark sign on CXR in PE patient Peripheral hyperlucency secondary to oligemia resulting in collapse appearance of vessel distal to occlusion
Hamton sign --> Peripheral, wedge-shaped opacity representing pulmonary infection
Fleischner sign --> Enlargement of the pulmonary artery due to ↑ pressure proximal to the PE
How is a right ventricular MI most commonly presented? Epigastric pain and nausea, and commonly seen with hypotension and bradycardia
What test is to be obtained to confirm Right Ventricular MI? Right-sided precordial ECG
What does a percutaneous intervention mean? Procedure to open-up the blocked coronary arteries
What valvular condition is of high-risk in pregnant women, and preferably surgically repaired prior pregnancy? Mitral stenosis
How is statin-therapy beneficial for atherosclerotic patients? Reduce risk of MI and ischemic stroke
What is the NBSM in a patient that is intolerant to the first-attempt for high-statin therapy? Switch to other high-intensity statin or to a moderate-intensity statin
AFIB overall can lead to: Atrial dilatation and/or conduction remodeling
What are common risk factors for AFIB? Age, systemic HTN, valvular disease, CAD, DM, and smoking. Obesity and OSA are also risk factors
What are the main complications post-MI? 1. Papillary muscle rupture 2. Interventricular septum rupture 3. Free wall rupture 4. Left Ventricular aneurysm
Which coronary is most likely involved in post-MI papillary muscle rupture? RCA
What is the timeline associated with post-MI papillary muscle rupture? 3-5 days
What are the main clinical findings of post-MI papillary muscle rupture? Pulmonary edema, respiratory distress, NEW SOFT systolic murmur Hypotension/cardiogenic shock
What coronaries are most likely involved in post-MI interventricular septum rupture? Apical LAD or basal RCA
What are the most significant findings in post-MI interventricular septum rupture? New HARSH HOLOSYSTOLIC murmur with thrill hypotensive/cardiogenic shock
What are the echo findings in post-MI interventricular septum rupture? Left-to-Right shunt
What is the associated timeline for post-MI interventricular septum rupture? 3-5 days
What is the timeline for post-MI free wall rupture? 5 days up to 2 weeks
Which coronary artery is most likely affected in post-MI free wall rupture? LAD
What are the main clinical findings of post-MI free wall rupture? Cardiac tamponade due to pericardial effusion
What is the associated timeline for post-MI left ventricular aneurysm? Up to several months
Which coronary is most likely involved in post-MI left ventricular aneurysm? LAD
What are the clinical findings associated with post-MI left ventricular aneuyrsm? HF, angina, and ventricular arrhythmias
What are echo findings seen in LV aneurysm post MI? Thin and dyskinetic myocardia walls
What are the common cardiac/arterial causes of acute limb ischemia? AFIB, LV thrombus, and IE
What is the example of arterial thrombosis causing acute limb ischemia? PAD
What are the 6 P's of acute limb ischemia? Pain Pallor Paresthesia Pulselessness Poikilothermia Paralysis
What is the first and main clue to diagnose acute limb ischemia out of the 6 P's? Pulselessness
What is the initial management for limb ischemia? Anticoagulation (e.g., heparin)
What are the secondary management options for severe acute limb ischemia refractory to anticoagultion? Thrombolysis and surgery
What type of shock may be seen as result of a MI? Cardiogenic shock
What is the etiology of cardiogenic shock due to MI? Impaired left ventricular contractiity
What are the hemodynamic changes in CO (cardiac index) and PCWP in cardiogenic shock? CO is reduced and PCWP is elevated due to failure of forward blood flow.
What is the management of pulseless electrical activity or asystole? Uninterrupted CPR along with vasopressor therapy, to maintain adequate cerebral and coronary perfusion
Created by: rakomi
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