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Rosh Review- Hematology Oncology test questions and answers
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Rosh Review- Cardiology with100% correct answers(passed)
What is the adequate anti arrhythmic for patients in Atrial fibrillation with
RVR?
What is the adequate anticoagulant for patients in Atrial fibrillation? -
answer Anti arrhythmic:
Diltiazem or Cardizem (CCBs)
Anticoagulant:
Warfarin (w/ CHAD2VASC score >1)
Anti platelet or anticoagulant considered for CHAD2VASC score of 1
What is the scoring scale used to assess treatment for patients with atrial
fibrillation? - answer CHADS2VASC!
C-CHF +1
H-Hypertension +1
A- Age>65 +1, >75 +2
D- Diabetes +1
S- Stroke history (DVT/TIA/CVA/Thromboembolism) +2
V- Vascular history +1
Female -+1
0- no need for treatment
1- consider anti platelet or anticoagulation
>2- anticoagulation necessary
,What is the INR range for patients taking warfarin for atrial fibrillation? -
answer 2-3 !
What presents with intermittent claudication (pain in a muscle group
induced by exercise and relieved with rest), decreased distal pedal pulses,
cool, shiny extremity with decreased hair?
Dx and Tx? - answer Peripheral Arterial Disease!
Dx:
ABI- Ankle-Brachial Index (measure BP in arm vs leg) <.9% indicates
stenosis , <.4% indicates ischemia --> Simple, quick, noninvasive most
useful screening tool
Arteriography--> Gold standard (visualizes atherosclerosis inducing
ischemia)
US--> noninvasive, used for visualizing stenosis
Tx:
Lifestyle modifications, increased exercise & tobacco cessation
Statins, ASA, Antiplatelets (Clopidogrel, Cilostazol)
Peripheral arterial disease most commonly affects which vessels? - answer
Superficial femoral artery (calf pain)
Aortoiliac system (thigh/buttock pain).
Which of the following features can differentiate myocardial infarction
from pericarditis? - answer Reciprocal changes in EKG!
,Meaning... ST depression in the leads opposing ST elevation!--> ONLY
occurs in MI, will never occur in pericarditis
Ex:
Anterior vs Inferior are reciprocal leads, so if anterior has elevations,
inferior would have depressions
What is Dressler's syndrome? - answer Post-myocardial infarction
pericarditis.
What presents with pleuritic chest pain radiating to back, worse when
laying back, improved when leaning forward, with tachycardia and
pericardial friction rub?
Dx and Tx? - answer Pericarditis!
Dx:
EKG:
Diffuse ST elevations(concave)
May also show PR depression/elevation
Tx:
NSAIDs (Indomethacin)
What is the most common cause of Pericarditis? - answer Idiopathic!!
2nd most commonly cause by
Viral--> Cocksackie!
What cardiac biomarker occurs first?
, Which one is most specific?
Timeline of each? - answer 1st occurring:
Myoglobin
Most Specific:
Troponin I or T
Timeline:
Myoglobin--> 1-2 hours onset, peaks 8-10 hours, gone by 1-2 days
Creatine Phosphokinase (CK-MB)--> 3-12 hour onset, peaks 24 hours, gone
48-72 hours
Troponin --> 3-12 hour onset, peak 24-48 hours, lasts up to 5-14 days
What is the role of beta-adrenergic blocking agents in acute myocardial
infarction? - answer Within 24 hours of presentation reduce the risk of
developing ventricular dysrhythmias!
Which cardiac biomarker is useful for assessing a re-infarction during the
hospital stay? - answer CK-MB , because troponin will last for up to 14
days and therefore would not be good indicator of whether another heart
attack occurred !
What is the earliest ECG sign of MI? - answer hyperacute T waves
What cardiac biomarker has the highest sensitivity and specificity? -
answer Troponin I!
What is the #1 cause of death in the US? - answer Ischemic Heart
Disease!
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