PAEA Internal Medicine EOR: Cardiology Exam Questions With 100% Verified Answers

PAEA Internal Medicine EOR: Cardiology Exam Questions With 100% Verified Answers Q waves on EKG indicate what? - answerold infarct What is the 1st cardiac enzyme to rise? - answerTroponin, elevated 3 hrs post MI and stay elevated up to 10-14 days post MI -Negative Troponin between 6-72 hrs post CP onset indicates strong evidence against MI CK-MB - answerThe MB type is specific to myocardial cells. The CK level will increase approximately 3-4 hours after an MI, peaks at 24 hrs, and stays elevated for 3-4 days. MI treatment - answerMONA (morphine, O2, nitrates, ASA), BB, ACEI, thrombolytics Beck's triad - answerJVD, hypotension, muffled heart tones (tamponade) S/S of systolic HF - answerorthopnea, nocturnal dyspnea, JVD, edema What is diastolic heart failure and what are signs and symptoms of it? - answerventricle can't relax which leads to higher filling pressure, pulmonary congestion and decreased cardiac return Treatment for heart failure - answerdiuretics (1st line for systolic) ACEI (slows dz progression) BB (helpful if HF secondary to ischemia) Spironolactone Digoxin (with systolic HF if uncontrolled on ACEI & diuretics) Dilated Cardiomyopathy - answermost common type of cardiomyopathy; reduced ventricular contraction results in dilation of LV Diagnosis of dilated cardiomyopathy - answerECHO: LV dilation EKG: nonspecific ST and T wave changes CXR: cardiomegaly, pulmonary congestion Hypertrophic Cardiomyopathy - answersmall LV, massive hypertrophy especially the septum, diastolic dysfunction -transmitted genetically Tx for hypertrophic cardiomyopathy - answerBB/CCB, surgical ablation, dual chamber pacing Restrictive Cardiomyopathy - answerLV small/normal with reduced EF; results from fibrosis or infiltration of ventricular wall due to many diff causes like DM, radiation, amyloidosis, etc. S/S of Restrictive Cardiomyopathy - answerdecreased exercise tolerance, advanced dz pts have Rt sided congestive failure, pulmonary HTN NSTEMI - answerresults from incomplete coronary artery occlusion causing ischemia of only the innermost layers of myocardium STEMI - answerresults from full thickness necrosis caused by total prolonged occlusion of coronary artery Stable angina lasts how long? - answersubsides at rest, 15 seconds to 15 minutes Signs of myocardial ischemia - answerST depression inverted T waves Acute myocardial infarct - answerST elevation of 1mm in 2 continuous lead Why do IV drug users get infective endocarditis? - answerprone to development of right side infective endocarditis (pulmonary/tricuspid valves) secondary to injection of nonsterile material into venous circulation S/S of endocarditis - answerfever, AMS, sepsis, dyspnea, stroke due to embolic phenomena Endocarditis physical exam - answerroth spots in eyes (sm white spots on retina surrounded by hemorrhage), new mitral regurg. or aortic insufficiency murmurs, splinter hemorrhages, Osler nodes, janeway lesions. Splinter hemorrhages - answerlinear hemorrhages under nails that represent microemboli Osler nodes - answersmall tender lesions on fat pads of fingers/toes and represents immune complex deposition Janeway lesions - answerpainless, red, macular lesions on hands/feet