PA Challenge Bowl

What is the term for chest pain due to coronary artery vasospasm?

Prinzmetal's angina (Variant angina)

Name the condition associated with the following EKG changes: slurred upstroke to the QRS (delta wave) and a broad QRS

Wolf-Parkinson-White Syndrome

A heart rate of greater than how many beats per minute indicates tachycardia?

>100

What condition is associated with Osborne waves and a prolonged QRS on EKG?

Hypothermia

Name the diagnosis associated with the following EKG changes—Wide QRS complexes with rabbit ears in V5 and V6, diffuse ST segment elevation

Left bundle branch block

What is the likely diagnosis in a patient with tearing/ripping, stabbing chest or interscapular back pain often associated with ischemic or neurologic deficits and BP differences between arms

Aortic Dissection

What are the 2 cardiovascular abnormalities associated with Marfan's syndrome?

Mitral valve prolapse, Aortic dissection/aortic regurg

What is the most common type of primary heart tumor?

Myxoma (most common location-L atrium)

Name 2 causes of resistant hypertension.

Drug-induced, obstructive sleep apnea, primary aldosteronism, CKD, Renal artery stenosis

What is the term for the sign involving clenched fist over mid-sternum?

Levine sign

What is the name for orange/yellow cholesterol emboli on fundoscopic exam?

Plaques of Hollenhorst

What is the term for the ring around iris associated with ↑cholesterol in patients < 50 yoa.

Arcus Senilis

Where is the normal location for PMI?

5-6th intercostals space, mid-clavicular line

What measurement is consistent with a normal PMI?

6 to 8 cm

What is the name of sign that shows ↑ JVP with inspiration?

Kussmaul sign

Name 2 abnormalities seen on exam with ophthalmoscope due to longstanding hypertension.

AV nicking, copper wiring

Xanthelasma is an indication of what condition?

↑ lipids

What cardiovascular abnormality most likely associated with a holosystolic radiates to the apex

Mitral Regurgitation

What is the most common location of Aortic Dissection?

proximal ascending aorta

Name the condition may cause a widened mediastinum on chest x-ray and it is more common in men.

Aortic aneurysm

At what measurement is surgery considered for thoracic aneurysms?

> 7 cm

At what measurement is surgery considered for abdominal aneurysms?

> 4 cm

The classification of Aortic aneurysm (Stanford) Type A-involves indicates involvement in what location?

ascending aorta

What is the measurement of normal aorta?

Ascending 3 cm, descending < 2 cm

What is the measurement for normal Cardiac Output (CO)?

5 L/min

What cardiovascular abnormality most likely associated with a mid-late systolic click?

Mitral Valve Prolapse (MVP)

Which class of antihypertensive is indicated for treatment of hypertension in a patient with diabetes mellitus?

ACE Inhibitor

At what area of auscultation is an S4 most likely to be heard?

Left Sternal Border

What cardiovascular abnormality is most likely to cause a diastolic murmur with an opening snap?

Mitral Stenosis

A heart rate of less than how many beats per minute indicates bradycardia?

What cardiovascular abnormality most commonly causes a systolic murmur that radiates to the carotids?

Aortic Stenosis

What is the term used to describe the difference between systolic and diastolic pressure?

Pulse Pressure

What is the most likely pathologic cause of a loud P2 sound?

Pulmonary Hypertension

P waves on EKG signify what physiologic event?

Atrial depolarization

QRS complex on EKG signifies what physiologic event?

Ventricular depolarization

Which cardiovascular condition is associated with an irregularly irregular rhythm without discernable p waves?

Atrial fibrillation

Which arrhythmia is associated with > 3 p wave morphologies?

Multifocal Atrial Tachycardia

What is the name of the criteria used to aid in the diagnosis of Rheumatic fever?

Jones Criteria

Name the most common heart rhythm associated with sudden, non-traumatic cardiac arrest?

Ventricular Fibrillation

What is the most common cause of right ventricular failure?

Left ventricular failure

What is the most common cause of death within a few hours of a myocardial infarction?

Cardiac dysthythmias

What is the most common cause of:

Mitral stenosis

Rheumatic heart disease

What is the most common cause of:

Mitral regurgitation

Rheumatic heart disease

A myocardial infart in which anatomical location is most likely to cause papillary muscle dysfunction?

Inferior

What is the treatment for pericarditis?

Aspirin Q4 hours x 2 weeks (alternatives: Ibuprofen, indomethacin)

What are the most common organisms involved in endocarditis of IVDA?

Staph aureus

Name the 3 most common organisms involved in bacterial endocarditis?

Strep viridians

Staph aureus

Enterococcus

What is the most common cause of multifocal atrial tachycardia?

COPD exacerbations

A pulse that is palpable in this area relates to a systolic BP of at least?

Radial pulse

Femoral pulse

Carotid pulse

80mmHg

70 mmHg

60 mmHg

What is the treatment for ventricular fibrillation?

Defibrillation, epinephrine or vasopressin

What is the treatment for stable narrow complex PSVT?

Vagal maneuver, adenosine

What lab parameter is used to monitor Warfarin (Coumadin®) therapy?

PT/INR

An Austin Flint Murmur is characteristic of what cardiovascular abnormality?

Aortic Regurgitation

What is the most likely cause of a machinery murmur of is best heard best at 2nd left intercostal space?

Patent Ductus Arteriosus

Name the class of medication that is used for the management of Raynaud's.

Calcium channel blockers

What is the treatment for cardiac tamponade?

Pericardiocentesis

Name the most likely cause of sudden death in a young athlete.

Hypertrophic cardiomyopathy

What event causes heart sound S1?

Mitral valve closing

What EKG findings are expected in a patient with Prinzmetal's angina?

ST elevation

Name the condition associated with notching of the ribs and difference in blood pressure in the arms.

Coarctation of the Aorta

What electrolyte abnormality is associated with tall, peaked T waves on EKG?

Hyperkalemia

What are the components of Beck's Triad?

Muffled heart sounds, hypotension, distended neck veins

(indicative of pericardial tamponade)

What is the treatment of Torsades de Pointes?

Magnesium Sulfate 1-2 grams

Name the components of the triad of symptoms associated with aortic stenosis?

Syncope, Angina, Heart Failure

Given the location of EKG abnormalities, what is the most likely location of ischemia?

Leads II, III, & aVF

Inferior

Given the location of EKG abnormalities, what is the most likely location of ischemia?

V1 and V2

Septal

Given the location of EKG abnormalities, what is the most likely location of ischemia?

V3, V4, & sometimes V2

Anterior

Given the location of EKG abnormalities, what is the most likely location of ischemia?

Leads I, aVL, V5, & V6

Lateral

What location of infarction causes tall R waves in V1 &V2

Posterior

J waves observed on EKG are associated with what condition?

Hypothermia

Name the arrhythmia presents as a "saw tooth pattern" on EKG.

Atrial flutter

What medication is commonly associated with facial flushing?

Niacin/Nicotinic Acid

What is the likely diagnosis in a patient with sudden onset of shortness of breath and EKG changes including sinus tachycardia, S1 & Q3 pattern, & T wave inversion in V1-V3?

Pulmonary Embolism

What arrhythmia causes a delta wave on EKG?

Wolff-Parkinson-White (WPW)

Which electrolyte abnormality causes prolongation of ST segment and QT interval?

Hypocalcemia

What is the Ankle-Brachial index (ABI) used to detect?

Vascular Impairment

What heart sound may be a normal variant in young athletes but may indicate volume overload in patients over 40 years of age?

S3

What class of medication may cause a persistent, dry cough?

ACE Inhibitors

What is the goal INR for a patient on Warfarin therapy for a prosthetic heart valve?

2.5-3.5

Name the abnormality associated with a systolic murmur best heard at the apex and radiates to the left sternal border.

Ventral Septal Defect (VSD)

Name the class of medication useful for the treatment of Raynaud's syndrome?

Calcium Channel Blockers

What is the likely diagnosis in a 60 year old female with a unilateral headache with scalp pain and pain with movement of the jaw?

Temporal Arteritis (Giant Cell)

Name the method of diagnosis and the treatment of temporal arteritis.

Temporal artery biopsy; Corticosteroid

What lab abnormality is associated with temporal arteritis?

Elevated Erythrocyte Sedimentation Rate (ESR)

What is the feared complication of temporal arteritis?

Permanent vision loss

What is the most common cause of right heart failure?

Left heart failure

What is the best class of medication to provide afterload reduction in patients with heart failure?

ACE Inhibitors

What is the antidote for Heparin?

Protamine Sulfate

What type of antihypertensive is indicated for a patient with BPH?

Alpha blockers

What types of antihypertensives are contraindicated in pregnancy?

ACE Inhibitors, ARBs

What type of antihypertensive may worsen BP in patients with bilateral renal artery stenosis?

ACE Inhibitors

Which antihypertensive has the potential to worsen gout?

Thiazides

Which antihypertensive is indicated in the treatment of HTN in pregnancy?

Methyldopa/Aldomet

What are the normal measurements of the following on EKG?

PR interval

Qwave

QRS

0.2 ms.

What is the most common chronic arrhthymia?

A. Fib

How many consecutive PVCs define ventricular tachycardia?

> 3

What is the treatment for paroxysmal SVT?

Carotide massage; adenosine

What is the treatment of V.fib?

Defibrillation

What syndrome is associated with pathologic mitral valve prolapse late systolic murmur with mid systolic click predisposing to regurgitation?

Barlow's Syndrome

The lateral rectus muscle of the eye is innervated by which cranial nerve?

VI (Abducens)