, USMLE Step 1 High Yield Exam ||
Questions & 100% Correct Answers
MCC of dead after a MI - ANSWER - 0-24 hours: arrythmia (Vfib), HF, cardiogenic
shock.
3-14 days: free wall rupture > cardiac tamponade.
> 2 weeks: Dressler syndrome: autoimmune attack to healed tissue.
Pulsus Paradoxus - ANSWER - decrease in amplitude of systolic blood pressure by >10
mmHg during inspiration. seen in cardiac tamponade, asthma, obstructive sleep
dyspnea, pericarditis, and croup.
FROM JANE (Bacterial Endocarditis) - ANSWER - Fever
Roth spots
Olser Nodes
Mumur
Janeway lesions
Anemia
Nail-Bed hemorrhage
Emboli
PDA (close w indometacin, keep open w prostaglandins) - ANSWER - continous
machine like murmur. loudest at S2. often due to congenital rubella or prematurity. Best
heard at left infraclavicular area.
Mitral Stenosis - ANSWER - follows opening snap, decrease interval between S2 and
OS correlates w increase severity. Often occurs secondary to rheumatic fever.
Enhanced by maneuvers that increase LA return (expiration).
Aortic Regurgitation - ANSWER - decrescendo diastolic murmur con present with
bounding pulses and head bobbing. increase murmur with hand grip and vasodilators
decrease murmurs.
Mitral valve prolapse - ANSWER - Late systolic crescendo murmur with midsystolic
click. most frequent valve lesion best heard over the apex. can predispose to infective
endocarditis. best heard with maneuvers that decrease venous return (standing,
valsalva)
Ventricular Septal Defect - ANSWER - holosystolic murmur loudest at tricuspid area,
accentuated with hand grip maneuver due to increase after load.
Aortic Stenosis - ANSWER - crescendo-decrscendo systolic ejection murmur. loudest at
base radiates to carotids.
"Pulsus parvus et tardus" pulses are weak with delayed peak.
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