USMLE Cardiovascular System Practice Flashcards

Comprehensive question and answer flashcards covering key cardiovascular topics from the board review lecture transcript.

What medication is indicated for stroke and systemic thromboembolism prevention in a patient with paroxysmal atrial fibrillation?

Apixaban

What is the immediate definitive management for a patient presenting with an acute ST-segment elevation myocardial infarction ($\text{STEMI}$)?

Aspirin and immediate cardiac catheterization

What is the most common cause of secondary hypertension in an obese patient who presents with daytime fatigue and frequent nighttime awakenings?

Obstructive sleep apnea

What is the preferred first-line pharmacologic treatment for patients with congenital long QT syndrome?

Propranolol

What physical examination finding on cardiac auscultation during inspiration is characteristic of severe aortic stenosis?

Soft and single S2

What is the most appropriate management step prior to pregnancy in a patient with symptomatic severe rheumatic mitral stenosis ($\text{valve area} \le 1.5\,\text{cm}^2$)?

Percutaneous mitral intervention followed by pregnancy

What post-myocardial infarction complication occurring $3$ to $5$ days after an inferior MI presents with acute severe mitral regurgitation and sudden pulmonary edema?

Papillary muscle rupture

What initial pharmacologic agent is used to reduce blood pressure and aortic wall shear stress in acute aortic dissection?

Labetalol

What is the immediate management step for acute, sudden lower extremity limb ischemia caused by arterial thromboembolism?

Intravenous heparin infusion

What treatment should be initiated in a neonate presenting with severe cyanosis from a ductal-dependent congenital heart defect?

Prostaglandin E1

What is the most common congenital heart anomaly seen in patients with Turner syndrome?

Bicuspid aortic valve

What physical examination sound heard at the left sternal border is typical of uremic pericarditis in advanced chronic kidney disease?

Pericardial friction rub

What phenomenon causes regional myocardial ischemia during pharmacologic stress testing with adenosine?

Augmentation of flow in nonobstructed vessels (coronary steal)

What classic chest x-ray finding is seen in adult patients with coarctation of the aorta?

Erosions of the inferior costal surfaces (rib notching)

What potential toxicity should be monitored in a patient receiving a high-dose or prolonged infusion of sodium nitroprusside who develops confusion and seizures?

Cyanide toxicity

How does creation of an arteriovenous fistula alter systemic vascular resistance (afterload), venous return (preload), and cardiac output?

Decreases afterload, increases preload, and increases cardiac output

What diagnostic evaluation should be performed in a child diagnosed with Kawasaki disease to screen for coronary artery involvement?

Echocardiogram

What initial pharmacologic agent is indicated for acute viral or idiopathic pericarditis?

Ibuprofen plus colchicine

What is the single most important factor determining overall survival in out-of-hospital sudden cardiac arrest due to ventricular fibrillation?

Time to rhythm analysis and defibrillation

What primary vascular mechanism is responsible for isolated systolic hypertension in elderly individuals?

Rigidity of the arterial walls (decreased arterial compliance)

Which aldosterone receptor antagonist has been shown to reduce mortality in patients with heart failure with reduced ejection fraction following an acute myocardial infarction?

Eplerenone

What nonpharmacologic intervention produces the largest average reduction in blood pressure in hypertensive patients?

DASH (Dietary Approaches to Stop Hypertension) diet

What is the definitive management for acute Type A aortic dissection?

Emergent surgical repair

What condition should be suspected in a patient post-femoral artery embolectomy who presents with severe calf pain out of proportion to exam and pain with passive muscle stretch?

Compartment syndrome

What effect does the strain phase of the Valsalva maneuver have on the intensity of the systolic murmur in hypertrophic cardiomyopathy?

Increases the murmur intensity

What metabolic abnormality is commonly observed in infants with DiGeorge syndrome ($22\text{q}11.2$ deletion)?

Hypocalcemia

What is the most common congenital cardiac defect found in infants with Down syndrome (Trisomy 21)?

Complete atrioventricular septal defect

Which drug class prevents left ventricular remodeling and dilation following an acute myocardial infarction?

Angiotensin-converting enzyme (ACE) inhibitors

What antiarrhythmic medication is preferred for hemodynamically stable atrial fibrillation in a patient with Wolff-Parkinson-White syndrome?

Procainamide

What prophylactic medication is indicated for secondary prevention of recurrent acute rheumatic fever?

Penicillin

What clinical syndrome presenting with chest pain and apical ballooning on echocardiography is triggered by severe emotional or physical stress?

Stress-induced cardiomyopathy (Takotsubo cardiomyopathy)

What anatomical structures are the primary origin of ectopic electrical foci causing atrial fibrillation?

Pulmonary veins

What is the initial treatment to restore blood pressure and left ventricular filling in acute right ventricular myocardial infarction?

Normal saline bolus (intravenous fluid resuscitation)

What condition post-cardiac catheterization presents with livedo reticularis, blue toes, elevated serum creatinine, and peripheral eosinophilia?

Cholesterol embolism

What is the first-line treatment for acute anaphylaxis presenting with hypotension and bronchospasm?

Intramuscular epinephrine