Cardiology boards ABIM COMPLETE EXAM
QUESTIONS AND ACCURATE ANSWERS
|ALREADY PASSED!!
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Terms in this set (216)
What is a positive stress Flat or Down sloping St-segment depression >1 mm
test occurring 80 msec after j point
St segment depression > 2 mm, ventricular
When to stop a stress test tachycardia, drop in SBP > 15, chest pain, dyspnea,
lightheadedness
Stress test of choice with a Myocardial perfusion imaging with adenosine,NOT
LBBB or ventricular exercising!
pacing?
Know the algorithm for See page 5-3,figure 5-1
stress testing
When to not use History of VT, severe HTN, Low BP, poor echo images
doutamine for stress
Bronchospasm, severe valvular dysfunction, severe
When to not use
carotid stenosis, 2nd degree heart block, theophylline
adenosine for stress
dependent
Normals for PA catheter RA <7, RV 30/7, PCWP 3-11
pressures
PA cath findings in Diastolic pressures elevated and equalized in all
tamponade or restrictive chambers, low BP
pericarditis
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Elevated RA and PA pressures, decreased or nl PCWP,
PA cath findings with RV
hypotension, and inferior MI. R side is
AMI
decompensated, cannot fill L side of the heart
PA cath findings in Elevated PCWP, RA pressure, and decreased
cardiogenic shock SBP/cardiac output
PA cath findings in mitral Elevated RA, PA (very elevated), PCWP, nl SBP
stenosis with RV failure
PA cath findings in Elevated PA, RA pressures, nl PCWP, SBP
pulmonary HTN
decrease in systolic BP of more than 10mmHg with
normal inspiration; palpated as weakened pulse with
Pulsus paradoxus
inspiration along with more heart contractions to
pulse beats
What conditions give you Constrictive or restrictive pericarditis, asthma, tension
pulsus paradoxus? pneumothorax
What gives you pulsus Aortic regurgitation, HOCM
bisferiens (two systolic
peaks per cycle)
What causes pulsus Severe LV dysfunction
alternans
What causes pulsus tardus Aortic stenosis
-standing/valsalva - decreased cardiac filling,
decreases most murmurs except MVP and HOCM
How do positional
-squatting/ lying down - increase cardiac volume,
maneuvers affect blood
increased murmurs except MVP, HOCM
flow and murmurs
-sustained handgrip - increases systemic resistance,
decreases murmur in HOCM, AS
What causes a physiologic Increased blood volume in the RV prolongs systole
split S2 and delays pulmonary valve closure
What causes a fixed split Pulmonary stenosis, PE, LV pacer, RBBB, MR (early AV
S2 closure), ASD, RV failue
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What causes a paradoxic LBBB, RV pacing, HOCM
split S2
Rapid LV filling - acute ventricular decompensation,
What causes an S3?
severe AR or MR
KNOW - S3 with LV ...
dysfunction is a poor
prognostic factor
Decreased ventricular compliance during atrial
contraction - ischemic heart dz, AS, MR, HOCM,
What causes a S4?
hypertrophic or diabetic cardiomyopathy, HTN heart
dz, concentric LVH
Can you have a S4 with No - no atrial contraction
atrial fibrillation?
A wave - atrial contraction
X descent - atria relax, RV fills rapidly
What are the parts of the Bottom of x descent is TC valve closure
venous waveform? V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens, passive emptying into
ventricle
What gives elevated a and Pulmonary HTN, RV infarction
v waves
Large r side v waves Septal rupture
Large v waves TR (right), MR (left)
Constrictive pericarditis, restrictive cardiomyopathy,
Rapid x and y descent
tamponade (x descent only, loss of y descent)
Large a waves TS,severe RVH (on right), MS
AV disassociation - complete heart block, ventricular
Cannon a waves
pacing
Slow Y descent Delayed atrial emptying - TS
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