Cardio week 1 -- BYOJeopardy

Cardiac Channelopathies	Rheumatic Heart Disease	EKG	Leriche Syndrome And Dressler Syndrome And Takatsubos Cardiomyopathy	Misc Cardio	Vasculitis
100 ST-segment elevation ≥2 mm in at least two of the three right precordial leads (V1-V3), with a coved morphology associated with incomplete or complete right bundle-branch block. Name the diagnostic criteria for Brugada syndrome Cardiac Channelopathies 100	100 Name 3 antibiotics that are indicated for treatment of GAS pharygitis in penicillin allergic patients and the dosage and duration Rheumatic Heart Disease 100	100 Catecholaminergic Polymorphic Ventricular Tachycardia http://en.ecgpedia.org/images/c/cd/ECG000033.jpg EKG 100	100 –Inability to maintain penile erection, –Fatigue of both lower limbs, –Intermittent bilateral claudication with ischemic pain –Absent or diminished femoral pulses along with pallor or coldness of both lower extremities. What is the clinical presentation for a patient with Leriche Syndrome Leriche Syndrome And Dressler Syndrome And Takatsubos Cardiomyopathy 100	100 aortic stenosis A pt older than 60 years presents with the gradual onset of: decreased exercise tolerance exertional dyspnea weak carotid pulse with a slow rate of rise harsh systolic murmur, loudest at the right 2nd intercostal space, that radiates to the neck no audible S2 split Misc Cardio 100	100 Takayasu Arteritis A 30-year-old Japanese woman presents with dizziness and weakness. On examination, her blood pressure is 90/60 mm Hg. Her upper extremities are cold. Both of her radial pulses are very weak. On further questioning, her relative says that she has had such several attacks in the past. The angiography reveals narrowing of the brachiocephalic and subclavian arteries. What is the probable diagnosis? Vasculitis 100
200 nadolol, metoprolol,propranolol Name the Class I medications indicated for long QT syndrome Cardiac Channelopathies 200	200 Name all the major and minor Jones criteria Rheumatic Heart Disease 200	200 Electrical alternans in tamponade http://en.ecgpedia.org/images/2/26/ECG000028.jpg EKG 200	200 Pentoxifylline –Methyl xanthine derivative –Lowers blood viscosity •Cilostazol –PDE III inhibitor Name the 2 FDA approved medications used for symptomatic relief of lower extremity claudication Leriche Syndrome And Dressler Syndrome And Takatsubos Cardiomyopathy 200	200 MAT A stable patient with COPD on chronic oxygen, inhaled steroids, long-acting bronchodilators, SABA, and theophylline presents with: palpitations HR>100 EKG: 3 distinct different p-wave morphologies Misc Cardio 200	200 Temporal Arteritis A 70-year-old woman with history of pulmonary TB presents with fever, headache, jaw claudication, and occasional diplopia. Physical examination shows no abnormalities. Her blood counts are normal except for mild anemia, and her erythrocyte sedimentation rate (ESR) is 90 mm/hour. What is the most likely diagnosis? Vasculitis 200
300 loss-of-function SCN5A mutation Name the gene mutation found in patients with Brugada Syndrome Cardiac Channelopathies 300	300 1. Transmitral pressure gradients greater than 10 mm Hg 2. Left atrial enlargement 3. Mitral valve area less than 1.5 cm² 4. Pulmonary pressures greater than 50 mm Hg Name 4 Characteristics of severe mitral stenosis Rheumatic Heart Disease 300	300 hypothermia http://en.ecgpedia.org/images/c/c0/JJ0001.jpghttp://en.ecgpedia.org/images/c/c0/JJ0001.jpg EKG 300	300 Immunologic factors are thought to be of primary importance in PCIS –Pathogenesis begins with myocardial injury that releases cardiac antigensand stimulates antibody formation –The immune complexes that are generated then deposit onto the pericardium, pleura, and lungs, eliciting an inflammatory response Explain the pathogenesis of Dressler's syndrome Leriche Syndrome And Dressler Syndrome And Takatsubos Cardiomyopathy 300	300 Mitral Stenosis A 49-year-old woman presents with a history of gradual onset of reduced exercise tolerance while working out at the gym. She is afebrile and otherwise feels well. Cardiac exam reveals a III/VI diastolic rumbling murmur located at the apex; it is heard best in the left lateral position. What is the most likely diagnosis? Misc Cardio 300	300 Corticosteroids A 64-year-old woman presents with malaise, severe unilateral headache, as well as pain and stiffness in her neck, shoulders, and back. Her appetite is poor, and she has recently lost weight. She has an oral temperature of 100.5-degree F, her hematocrit is 11.8%, and the sedimentation rate is 104 mm/hr. If temporal arteritis were to be demonstrated in this patient, what would therapy consist of?? Vasculitis 300
400 Ajmaline, flecainide, procainamide Name the 3 drugs that can be used to induce EKG changes in a patient with suspected Brugada syndrome Cardiac Channelopathies 400	400 anti-streptolysin O (ASO) and anti-DNase B (ADB) titers Name the 2 serologic tests for ARF Rheumatic Heart Disease 400	400 Brugada Syndrome EKG 400	400 Dresslers syndrome A 64-year-old man presents with pleuritic chest pain, mild diffuse joint pain, and fever. When questioned, his chest pain is worse when lying supine than sitting up. The patient had an acute anterior myocardial infarction 12 days prior to presentation, which was treated medically with thrombolytic therapy; he was discharged from the hospital 7 days ago. Past medical history is positive for the recent MI and hypercholesterolemia. Current medications are metoprolol, aspirin, benazepril, and atorvastatin. Except for the atorvastatin, all of the medications were started after his MI. Physical exam reveals temperature of 100.3° F, pulse 100, respiratory rate 22, and blood pressure 128/82. Pulse oximetry is 100% on room air. He appears moderately uncomfortable. Cardiac exam reveals a precordial rub in systole with somewhat muffled heart sounds. There are crackles at the bases of both lungs. He has no peripheral edema, and abdomen is benign. EKG reveals sinus tachycardia with small Q waves in leads V₁- V₃; there is low voltage throughout. Portable chest X-ray reveals small bilateral pleural effusions. What is the most likely diagnosis? Leriche Syndrome And Dressler Syndrome And Takatsubos Cardiomyopathy 400	400 Pickwickian syndrome Name the chronic condition encompassing extreme obesity, hypoventilation, relative hypoxia, polycythemia, and daytime somnolence Misc Cardio 400	400 Thromboangiitis obliterans A 25-year-old male is in his doctor's waiting room. He is smoking a cigarette and using a claw hand. The cigarette smoke is bothering the other patients, so he lets the receptionist know he will be smoking outside. Finally, the receptionist goes outside and brings him into the exam room to be seen by the doctor. She insists that he put out his cigarette. On physical examination, he is found to have a decreased radial pulse. There is ulceration on the digits of his remaining hand. Arteriography shows involvement of small and medium arteries and veins. What is the most likely condition? Vasculitis 400
500 human cardiac ryanodine receptor (RyR2), which is also called the cardiac sarcoplasmic calcium release channel Name the genetic mutation found in 2/3 patients with CPVT Cardiac Channelopathies 500	500 therapeutic warfarin A 35-year-old woman is evaluated during the 14th week of pregnancy. This is her first pregnancy and the first medical appointment during the pregnancy. She has a history of rheumatic mitral stenosis and had a mechanical mitral valve replacement 2 years ago. She has no cardiovascular symptoms. She is taking warfarin. Blood pressure is 110/72 mm Hg and heart rate is 70/min. She has normal prosthetic valve heart sounds and no extra sounds or murmurs. The remainder of the examination is normal. What is the most appropriate anticogulant regimen for this patient? Rheumatic Heart Disease 500	500 Nortriptyline Intoxication http://nl.ecgpedia.org/images/d/d8/ECG_nortr_intox.png Physical exam: Tachycardia Hypotension and orthostasis Fever Altered mental status Ileus Absent bowel sounds Rigidity Dry skin and mucous membranes Mydriasis EKG 500	500 Beta blockers, fluids, and if severe phenylephrine What is the treatment in a patient with Takotsubos Cardiomyopathy that is hypotensive and has left ventricular outflow obstruction? Leriche Syndrome And Dressler Syndrome And Takatsubos Cardiomyopathy 500	500 captopril renal scan An elderly man with diabetes, peripheral vascular disease, mild hypertension, and moderate renal insufficiency presents with progressive worsening of his hypertension over a few weeks. His physical exam is unchanged from prior visits except for the presence of a diastolic bruit in his epigastrium that radiates to the left. His laboratory tests are all unchanged except for hypokalemia. Which of the following would be the best test to order next? Misc Cardio 500	500 Mönckeberg's sclerosis An autopsy is performed on a deceased 67-year-old man. There is pathology in the femoral, tibial, and radial arteries. Histologic sections are taken of the vessels, and it is shown that there is calcification in the media of the vessels. The intima and adventitia of the vessel are unaffected. There is no associated inflammatory reaction. What is this calcification due to? Vasculitis 500
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Catecholaminergic Polymorphic Ventricular Tachycardia

Nortriptyline Intoxication