Cardiology

Quiz and Review 2011

Chanin Peerabool!

 40 yr,female with diuse systemic sclerosis, NYHA FC I , screening echocardiogram for PAH, result RVSP 50 mmHg and proceed to RHC result : mean PAP 45 mmHg aLer vasoracMve agents result mean PAP 30 mmHg and CO is decreased. What is next management? A. Bosentan B. Sidenal C. Beroprost D. Verapamil E. No further management

Cervical Pulse
Pulsus parvus et tardus
AS

Pulsus bisferiens
HOCM,AS and AR,Severe AR

Water hammer pulse

AR

Pulsus paradoxus
Tamponade,constricMve pericardiMs,asthma

Pulsus alternans
Severe LV dysfuncMon

JVP
Giant A wave
PS,PHT,RVF

Canon A wave
AV disso

Giant V wave
TR

Kussmual sign
RCHP,SVC syndrome,PE,ConstricMve pericardiMs

Rapid and deep y descent

RCHP,ConstricMve pericardiMs

 PA catheter!

 Surgery
AAA TAA suprarenal 5 cm infrarenal 5.5 cm growing > 0.5 cm/ yr ascending 5.5 cm descengind 6 cm Marfan 4-4.5 cm growing > 0.5cm/ yr

In which of the following paMents would you recommend a preoperaMve noninvasive funcMonal assessment? A. An emergent repair of a ruptured appendix B. A 65-year-old male before undergoing a caroMd endarterectomy who underwent a coronary artery bypass graL (CABG) 2 years earlier and has had no prior symptoms C. A 62-year-old male with hypertension, hypercholesterolemia, and diabetes mellitus who is having recurrent chest pain with only minimal exerMon before a radical prostatectomy D. A 65-year-old male a prior history of angina but no history of myocardial infarcMon who is planning to undergo an elecMve hip replacement E. A 52-year-old female with no cardiac symptoms and a normal physical exam before a breast biopsy for a newly idenMed mass!

 Who should receive IE prophylaxis?

A. TOF S/P MBTS to replace new braces. B. MVP to tonsillectomy C. ASD S/P closure 4 yr to tooth extracMon D. PDA S/P coil occlusion 8 mo to tooth extracMon E. VSD S/P Dacron graL patch 2 mo to tooth extracMon!