USMLE Step 2 CK High-Yield
Classic EKG finding in atrial flutter (Ans- "Sawtooth" p waves
Definition of unstable angina (Ans- Angina that is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria (Ans- ACEI
Beck's triad for cardiac tamponade (Ans- Hypotension, distant heart sounds, and JVD
Drugs that slow heart rate (Ans- Beta-blockers, CCBs, digoxin, amiodarone
Hypercholesterolemia treatment that leads to flushing and pruritus (Ans- Niacin
Murmur - hypertrophic obstructive cardiomyopathy (Ans- A systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (i.e. Valsalva maneuver)
Murmur - aortic insufficiency (Ans- 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 (Ans- A systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (i.e. squatting)
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Murmur - mitral regurgitation (Ans- A holosystolic murmur that radiates to the axillar; increases with increased afterload (handgrip)
Murmur - mitral stenosis (Ans- A diastolic, mid to late, low-pitched murmur preceded by an opening snap
Treatment for atrial fibrillation and atrial flutter (Ans- If unstable, cardiovert. If stable or chronic, rate control with CCBs or beta-blockers
Treatment for ventricular fibrillation (Ans- Immediate cardioversion
Dressler's syndrome (Ans- 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?(Ans- Treat existing heart failure and replace tricuspid valve
Diagnostic test for hypertrophic cardiomyopathy (Ans- Echocardiogram (showing a thickened left ventricular wall and outflow obstruction)
Pulsus paradoxus (Ans- A decrease in systolic BP of > 10 mmHg with inspiration; seen in cardiac tamponade
Classic ECG finding in pericarditis (Ans- Low-voltage, diffuse ST-segment elevation
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Definition of hypertension (Ans- BP > 140/90 on 3 separate occasions 2 weeks apart
Eight surgically correctable causes of HTN (Ans- Renal artery stenosis, coarc of aorta, pheo, Conn's, Cushing's syndrome, unilateral renal parenchymal dz, hyperthyroid, hyper parathyroid
Evaluation of pulsatile abdominal mass and bruit (Ans- Abdominal U/S and CT
Indications for surgical repair of abdominal aortic aneurysm (Ans- >5.5cm, rapidly enlarging, symptomatic, ruptured
Treatment for acute coronary syndrome (Ans- ASA, heparin, clopidogrel, morphine, oxygen, sublingual nitro, IV beta-blockers
Metabolic syndrome (Ans- 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 (Ans- Exercise stress treadmill with ECG
Appropriate diagnostic test: 65yo female with LBBB and severe OA has
unstable angina (Ans- Pharmacologic stress test (e.g. dobutamine echo)
Target LDL in a patient with diabetes (Ans- <70mg/dL
Signs of active ischemia during stress testing (Ans- Angina, ST-segment changes on ECG or decreased BP
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ECG findings suggestive of MI (Ans- ST-segment elevation (depression means ischemia), flattened T waves, Q waves
Coronary territories in MI (Ans- 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 (Ans- Prinzmetal's angina
Common symptoms associated with silent MIs (Ans- CHF, shock, AMS
Diagnostic test for PE (Ans- Spiral CT with contrast
Protamine (Ans- Reverses effects of heparin
Prothrombin time (Ans- Coagulation parameter affected by warfarin
A young patient with FHx of sudden death collapses and dies while exercising (Ans- Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens (Ans- Oral surgery - amoxicillin for certain situations; GI or GU procedures - not recommended
Virchow's triad (Ans- Stasis, hypercoagulability, endothelial damage
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