Family Medicine EOR Exam Prep, Over
1400 Questions and Correct Answers (Exam
Bank) 100% Correct, Updated Fall
2024/2025.
What are the 3 local vasodilators in the heart?
Nitric oxide, adenosine, and oxygen
Vagal maneuvers _______ heart rate in tachyarrhythmias
decrease
During inspiration, left sided stroke volume __________
decreases
Physiologic splitting of S2
inspiration separates S2 into A2 followed by P2; during inspiration, the decreased L-sided venous return
results in an earlier A2 and increased right-sided flow with inspiration results in later P2
L-sided murmurs are best heard at end ___________; R-sided murmurs are best heard at end
__________
expiration; inspiration
>10 mmHg decline in SBP with inspiration
pulsus paradoxus
Pulsus paradoxus is a sign of what conditions?
Cardiac tamponade, tension pneumothorax
Gold standard diagnosis for CAD
Angiography
Gold standard diagnosis for PAD
Angiography
Gold standard diagnosis for AAA
Angiography
Most useful diagnostic study to diagnose heart failure
Echo
,Primary noninvasive test for assessing cardiac anatomy and function
Transthoracic echocardiogram (TTE)
Bruce protocol
Positive exercise stress test if ST depressions, exercise-induced HTN or hypotension, arrhythmias,
symptoms or HR abnormalities occur during testing
Vasodilators used in pharmacologic stress testing
Adenosine or Dipyridamole
Contraindications of pharmacologic stress testing
Bronchospastic disease (e.g. severe asthma and COPD), 2nd/3rd degree heart block or sick sinus
syndrome
Medication used in stress echocardiography
Dobutamine
MC cause of CAD
Atherosclerosis
Most important modifiable risk factor for CAD
Smoking
Valvular diseases that may lead to CAD
Aortic stenosis
Aortic regurgitation
Substernal chest pain usually brought on by exertion
Angina pectoris
Radiation of angina pectoris
Arm (especially ulnar surfaces of forearm and hand)
Teeth
Lower jaw
Back
Epigastrium
Shoulders
Duration of stable angina pectoris
Less than 30 minutes by definition but typically 1-5 minutes
Angina pectoris is relieved with _______ or ________
nitroglycerin or rest
,Classic EKG finding in ischemic heart disease
ST depression
Initial testing of angina pectoris
EKG
Gold standard diagnosis of angina pectoris
angiography
Most useful noninvasive screening tool for angina pectoris
Stress testing
Paroxysmal chest "squeezing" or pressure, often accompanied by a sensation of smothering and a fear of
impending death
Angina pectoris
Duration of unstable angina pectoris
More than 30 minutes
If stable angina is not completely resolved after ______ doses of nitro, unstable angina, MI, or another
diagnosis should be suspected
three doses
Sublingual nitro can be repeated every __ minutes up to __ times
every 5 minutes up to 3 times
Long-acting nitrate therapy should include a daily __-__ hour treatment-free interval to prevent drug
tolerance
8-10 hours
Major adverse effects of nitro
Headache, nausea, light-headedness, and hypotension
First-line therapy for chronic angina
BB
Medication that prolongs exercise duration and time to angina
Ranolozine
Indications for stress testing
Patients with baseline EKG abnormalities
Indications for PTCA
, 1 or 2 vessel disease NOT involving the left main coronary artery and in whom ventricular function is
normal/near normal
Indications for CABG
Left main coronary artery disease, symptomatic or critical stenotic (>70%) 3-vessel disease or decreased
LVEF <40%
1st line drug for chronic management of angina pectoris
beta blocker
Treatment of choice for Prinzmetal angina
CCB
Classic outpatient regimen for angina pectoris
daily aspirin, sublingual nitro, daily BB and statin
Cardioselective beta-blockers
Metoprolol and atenolol
Nonselective beta-blockers
Propranolol and Nadolol
Nondihydropyridines
Diltiazem and verapamil
Contraindications to nitro
SBP <90mmHg, RV infarction, use of sildenafil an other PDE-5 inhibitors
>____% occlusion of coronary arteries can cause pain at rest
>90%
Pericarditis, fever, leukocytosis, and pericardial or pleural effusion usually 1 to 2 weeks post-MI
Dressler syndrome
PE findings of acute coronary syndrome
usually normal; +/- S4
Chest pain + bradycardia may be suggestive of a _________ wall MI
inferior
ST elevations > or equal to 1mm in > or equal to 2 anatomically contiguous leads
STEMI
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