Internal Medicine Board review (Questions with 100% Verified Answers)

Internal Medicine Board review (Questions with 100% Verified Answers) Worst risk factor CAD - CORRECT ANSWER Diabetes Mellitus Most common risk factor CAD - CORRECT ANSWER HTN In patients with CAD, LDL cholesterol should be kept below...... - CORRECT ANSWER 100mg/dL Metabolic Syndrome X - CORRECT ANSWER -any combination of hyperlipidemia, HTN, hypertriglyceridemia, glucose intolerance, diabetes, and hyperuricemia - underlying mechanism is insulin resistance (d/t obesity) Syndrome X - CORRECT ANSWER -Exertional Angina with normal coronary arteriogram -presents with angina on exertion but have coronary artery stenosis at cardiac catheterization. -exercise testing and nuclear imagine DOES show myocardial ischemia. Exercise ischemia results in what EKG finding? - CORRECT ANSWER ST segment depression due to subendocardial ischemia Stress Echocardiography - CORRECT ANSWER -more sensitive than stress EKG. Can see wall motion abnormalities such as akinesis or dyskinesis -any positive stress test, send patient for cardiac catheterization. Describe the purpose of Thallium 201 in stress tests - CORRECT ANSWER -IV administration of thallium 201 is used to physically look for unperfused tissue. -Viable cardiac muscle cells extract thallium 201 from blood. Any dead or unperfused areas will not show any uptake. Reversible ischemia may be rescued with..... - CORRECT ANSWER -Percutaneous Coronary intervention (PCI) or coronary artery bypass graft (CABG) Describe how IV adenosine and dipyridamole work in a pharmacologic stress test - CORRECT ANSWER -adenosine and dipyridamole cause generalized coronary vasodilation. Because coronary vessels in underperfused regions are already maximally dilated, this generalized vasodilation results in an overall decrease in blood flow to ischemic areas due to the phenomenon of coronary steal