Hypercholesterolemia treatment that leads to flushing and pruritus Correct Answer: Niacin
Murmur - hypertrophic obstructive cardiomyopathy Correct Answer: A systolic ejection murmur heard
along the lateral sternal border that increases with decreased preload (i.e. Valsalva maneuver)
Murmur - aortic insufficiency Correct Answer: Austin Flint murmur, a diastolic, decrescendo, low-
pitched, blowing murmur that is best heard sitting up; increases with increased afterload (i.e.
handgrip)
Murmur - aortic stenosis Correct Answer: A systolic crescendo/decrescendo murmur that radiates to
the neck; increases with increased preload (i.e. squatting)
Murmur - mitral regurgitation Correct Answer: A holosystolic murmur that radiates to the axillar;
increases with increased afterload (handgrip)
Murmur - mitral stenosis Correct Answer: A diastolic, mid to late, low-pitched murmur preceded by an
opening snap
Treatment for atrial fibrillation and atrial flutter Correct Answer: If unstable, cardiovert. If stable or
chronic, rate control with CCBs or beta-blockers
Treatment for ventricular fibrillation Correct Answer: Immediate cardioversion
Dressler's syndrome Correct Answer: An autoimmune reaction with fever, pericarditis and increased
ESR occurring 2-4 weeks post-MI
IV drug use with JVD and holosystolic murmur at left sternal border. Treatment? Correct Answer:
Treat existing heart failure and replace tricuspid valve
Diagnostic test for hypertrophic cardiomyopathy Correct Answer: Echocardiogram (showing a
thickened left ventricular wall and outflow obstruction)
Pulsus paradoxus Correct Answer: A decrease in systolic BP of > 10 mmHg with inspiration; seen in
cardiac tamponade
Evaluation of pulsatile abdominal mass and bruit Correct Answer: Abdominal U/S and CT
Indications for surgical repair of abdominal aortic aneurysm Correct Answer: >5.5cm, rapidly
enlarging, symptomatic, ruptured
Treatment for acute coronary syndrome Correct Answer: ASA, heparin, clopidogrel, morphine,
oxygen, sublingual nitro, IV beta-blockers
Metabolic syndrome Correct Answer: Abdominal obesity, high triglycerides, low HDL, hypertension,
insulin resistance, prothrombotic or proinflammatory states
Appropriate diagnostic test: 50yo male with stable angina can exercise to 85% of maximum predicted
heart rate Correct Answer: Exercise stress treadmill with ECG
Appropriate diagnostic test: 65yo female with LBBB and severe OA has unstable angina Correct
Answer: Pharmacologic stress test (e.g. dobutamine echo)
Target LDL in a patient with diabetes Correct Answer: <70mg/dL
Signs of active ischemia during stress testing Correct Answer: Angina, ST-segment changes on ECG
or decreased BP
ECG findings suggestive of MI Correct Answer: ST-segment elevation (depression means ischemia),
flattened T waves, Q waves
Coronary territories in MI Correct Answer: Anterior wall (LAD/diagonal), inferior (PDA), posterior (left
circumflex/oblique, RCA/marginal), septum (LAD/diagonal)
A young patient with angina at rest and ST-segment elevation with normal cardiac enzymes Correct
Answer: Prinzmetal's angina
Common symptoms associated with silent MIs Correct Answer: CHF, shock, AMS
Diagnostic test for PE Correct Answer: Spiral CT with contrast
Protamine Correct Answer: Reverses effects of heparin
Prothrombin time Correct Answer: Coagulation paramter affected by warfarin
A young patient with FHx of sudden death collapses and dies while exercising Correct Answer:
Hypertrophic cardiomyopathy
, Endocarditis prophylaxis regimens Correct Answer: Oral surgery - amoxicillin for certain situations; GI
or GU procedures - not recommended
A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with
clothing or jewelry Correct Answer: Contact dermatitis
Presents with a herald patch, Christmas-tree pattern Correct Answer: Pityriasis rosea
Pinkish, scaling, flat lesions on the chest and back; KOH prep has a "spaghetti-and-meatballs"
appearance Correct Answer: Tinea versicolor
Four characteristics of a nevus suggestive of melanoma Correct Answer: Asymmetry, border
irregularity, color variation, and large diameter
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