Valves and Sounds
Right sided heart murmurs _________ (increase/decrease) in intensity during inspiration.
Increase
What is one of the EKG findings consistent with a STEMI?
ST-segment elevation of ≥1 mm in ≥2 contiguous limb or chest leads
ST-elevation equivalents include new LBBB or posterior MI (tall R waves and ST depressions in V1-V4)
What anticoagulant is used for prosthetic heart valves?
warfarin
What is the definition of infertility?
inability to conceive after 1 year of intercourse without contraception in women <35 years and after 6 months in women ≥35 years
What is the heroic sled dog that helped run the diphtheria anti-toxin to remote alaskans in 1925?
Balto
HCM murmurs ______ (increase/decrease) in intensity with Valsalva maneuver and on standing from a squatting position.
Increase
chest discomfort with NORMAL cardiac biomarkers with possible nonspecific ECG changes, ST-segment depression, or T-wave inversion.
What is the target INR for a ball-in-cage aortic prosthetic valve with thromboembolism risk factors?
3.0
How is testosterone deficiency diagnosed?
two 8:00 AM total testosterone levels below the reference range
Dr. Albert Sabin got an oral vaccine for this approved in 1961 in the US, what is the vaccine?
Polio
Which disease processes does paradoxical splitting occur?
LBBB, HCM, and severe AS
What TIMI score indicates to start medical therapy immediately AND early revascularization?
TIMI 3-7
In patients needing anticoagulation with warfarin for a mechanical valve prosthesis, name two of the four risk factors that make them high risk for thrombosis?
Mitral prostheses
multiple prosthetic valves
A fib
previous thromboembolic events
Name three of the 4 recommended anti-hypertensives to give in a pregnant patient?
methyldopa, β-blockers (except atenolol), calcium channel blockers, and hydralazine.
This person created a chest drain valve to help soldiers in Vietnam but is more known for a lifesaving measure
Heimlich
What are two of the three indications for aortic valve replacement where transcatheter aortic valve implantation is preferred over a surgical aortic valve replacement?
What two risk factors makes a patient ineligible to start Prasugrel?
Prasugrel contraindicated in patients age ≥75 years OR history of CVA/TIA
In those patients that are high risk for thrombosis with a prosthetic heart valve requiring surgery, how long before the surgery do you hold the warfarin and what is the recommended post op management for anticoagulation
stop warfarin 4 to 5 days before surgery and begin bridging anticoagulation with IV heparin
Resume IV heparin within 24 hours after surgery. Warfarin is also reinitiated after surgery, and heparin is discontinued when INR is therapeutic
What is the most common cause of secondary amenorrhea?
pregnancy
Morphine was named after Morpheus, the Greek god of what?
Sleep
Name two of the three indications for aortic root repair?
When PCI is not available and cannot be achieved within 120 minutes with transfer, patients should receive thrombolytic agents. What are the two most commonly encountered contraindications?
Active bleeding OR high risk bleeding
BP >180/110 mm Hg is a contraindication, but if the blood pressure is lowered, treatment is possible.
1952
A 30 year old female with HTN on lisinopril and T2DM on metformin is planning on getting pregnant. What medication changes need to be made?
This procedure was used to treat diabetic retinopathy in the 1960s
pituitary ablation