MCCQE1 Internal Medicine| 105 Questions|
With Complete Solutions
STABLE angina definiton correct answer: substernal "gripping"
chest pain or pressure on exertion, relieved w/ rest or NTG
One vessel disease treatment correct answer: Tx β-blocker +
aspirin + nitrates
two vessel treatment correct answer: Tx β-blocker + aspirin +
nitrates vs PTCA OR CABG
three vessel disease correct answer: Tx CABG
what is involved in a pharmacological stress test correct answer:
: IV adenosine, dipyridamole, or dobutamine can stress the heart
in place of exercise
The cardiac markers- when do they pick which is most specific?
correct answer: CK-MB: peaks in 24 hrs and lasts 2-3 days,
good for recurrence Troponin I: peaks in 24 hrs and lasts 1-2
weeks, most specific
Difference between left-sided and right-sided CHF? correct
answer: Left-sided CHF: dyspnea, orthopnea, PND
Right-sided CHF: pitting edema, hepatic congestion, JVD,
ascites
,NYHA classificaitons in order correct answer: NYHA class I:
sx only w/ vigorous activity (e.g. sports) NYHA class II: sx w/
moderate activity (e.g. stairs)
NYHA class III: sx w/ ADLs NYHA class IV: sx at rest
CHF classes and treatment correct answer: class I → Tx loop
diuretic + ACE inhibitor • class II-III → add β-blocker
• class IV → add digoxin
what is PAC and how do we treat? correct answer: early P wave
that looks differently than other P waves, tx is reassurance
Afib correct answer: acute, stable → anticoagulate + • rate
control w/ Ca-blockers
• then cardioversion
MAT correct answer: ooks like AFib but the P waves are
variable, need 3 different P waves for dx
ETIOLOGY OF MAT correct answer: Etiology: end-stage
COPD (MCC)
wpw, what is the characteristic wave and how do we treat
correct answer: "delta wave" reflects accessory conduction
pathway from atria to ventricles, tx is ablation
VTACH TRAETMENT correct answer: Sustained VTach: lasts
>30 sec, always symptomatic
Nonsustained VTach: lasts <30 sec, usually asx
Torsades de pointes: rapid, polymorphic VTach due to QT
prolongation
, sustained → Tx IV amiodarone • nonsustained → reassurance •
torsades → Tx IV mag sulfate
VFIB tx correct answer: • Tx immediate defib + CPR, then •
continue IV amiodarone
sinus brady tx correct answer: usually insignificant; if sx → Tx
• atropine (blocks vagus nerve)
first degree meaning and tx correct answer: PR interval >0.2 ..
needs reassurance
DCM management correct answer: echo and CXR to diagnose
and tx for CHF AN HEART TXP
HCM presentation correct answer: exertional dyspnea and
sudedn deaht, murmur enhanced by decrease preload eg
handgrip and valsalva
HCM dx correct answer: echo and family hx, asx aoid exercise,
sx beta blcokers vs myomectomy vs pacemaker implantaiton
RCM dx correct answer: INFILITRAITON OF
MYOCARDIUM AUSING DEREASED OCMPLICANCE, TX
IS UNDERLYING CAUSE
MYOCARDITIS correct answer: USAULYL
ASYMPTOMATIC, PRESNET WITH EVER, CHEST PAIN
AND PERICARDITIS
With Complete Solutions
STABLE angina definiton correct answer: substernal "gripping"
chest pain or pressure on exertion, relieved w/ rest or NTG
One vessel disease treatment correct answer: Tx β-blocker +
aspirin + nitrates
two vessel treatment correct answer: Tx β-blocker + aspirin +
nitrates vs PTCA OR CABG
three vessel disease correct answer: Tx CABG
what is involved in a pharmacological stress test correct answer:
: IV adenosine, dipyridamole, or dobutamine can stress the heart
in place of exercise
The cardiac markers- when do they pick which is most specific?
correct answer: CK-MB: peaks in 24 hrs and lasts 2-3 days,
good for recurrence Troponin I: peaks in 24 hrs and lasts 1-2
weeks, most specific
Difference between left-sided and right-sided CHF? correct
answer: Left-sided CHF: dyspnea, orthopnea, PND
Right-sided CHF: pitting edema, hepatic congestion, JVD,
ascites
,NYHA classificaitons in order correct answer: NYHA class I:
sx only w/ vigorous activity (e.g. sports) NYHA class II: sx w/
moderate activity (e.g. stairs)
NYHA class III: sx w/ ADLs NYHA class IV: sx at rest
CHF classes and treatment correct answer: class I → Tx loop
diuretic + ACE inhibitor • class II-III → add β-blocker
• class IV → add digoxin
what is PAC and how do we treat? correct answer: early P wave
that looks differently than other P waves, tx is reassurance
Afib correct answer: acute, stable → anticoagulate + • rate
control w/ Ca-blockers
• then cardioversion
MAT correct answer: ooks like AFib but the P waves are
variable, need 3 different P waves for dx
ETIOLOGY OF MAT correct answer: Etiology: end-stage
COPD (MCC)
wpw, what is the characteristic wave and how do we treat
correct answer: "delta wave" reflects accessory conduction
pathway from atria to ventricles, tx is ablation
VTACH TRAETMENT correct answer: Sustained VTach: lasts
>30 sec, always symptomatic
Nonsustained VTach: lasts <30 sec, usually asx
Torsades de pointes: rapid, polymorphic VTach due to QT
prolongation
, sustained → Tx IV amiodarone • nonsustained → reassurance •
torsades → Tx IV mag sulfate
VFIB tx correct answer: • Tx immediate defib + CPR, then •
continue IV amiodarone
sinus brady tx correct answer: usually insignificant; if sx → Tx
• atropine (blocks vagus nerve)
first degree meaning and tx correct answer: PR interval >0.2 ..
needs reassurance
DCM management correct answer: echo and CXR to diagnose
and tx for CHF AN HEART TXP
HCM presentation correct answer: exertional dyspnea and
sudedn deaht, murmur enhanced by decrease preload eg
handgrip and valsalva
HCM dx correct answer: echo and family hx, asx aoid exercise,
sx beta blcokers vs myomectomy vs pacemaker implantaiton
RCM dx correct answer: INFILITRAITON OF
MYOCARDIUM AUSING DEREASED OCMPLICANCE, TX
IS UNDERLYING CAUSE
MYOCARDITIS correct answer: USAULYL
ASYMPTOMATIC, PRESNET WITH EVER, CHEST PAIN
AND PERICARDITIS
