General Cardiology Quiz

1. What are the indications for aortic valve replacement in patients with aortic stenosis?

2. What are the signs and symptoms of digoxin toxicity?

3. What are the causes of acute heart failure exacerbations?

4. What are the potential fatal complications of an ascending aortic dissection?

5. What would a new left bundle branch block indicate in a patient with chest pain?

6. What is the long-term complication of childhood Kawasaki’s disease?

7. What is the classic triad of symptoms in aortic valve stenosis and how do they predict mortality if the patient remains untreated?

8. What is the definition of sustained ventricular tachycardia versus non-sustained ventricular tachycardia?

9. What are the contraindications to using dronedarone?

10. What are the three causes of holosystolic murmurs?

11. What is cardiac amyloidosis, what are the causes, and what are the common pathologic findings?

12. How long does troponin I, creatine kinase (CK) and myoglobin remain detectable after a myocardial infarction?

13. What are the complications of a left ventricular aneurysm?

14. Which statin significantly raises the levels of cyclosporine?

15. What causes a fixed split S2 heart sound?

16. When is digoxin indicated for patients with heart failure?

17. What are the main factors to consider when choosing AV blocking agents to control heart rates in patients with atrial fibrillation?

18. What is Brugada Syndrome?

19. What is the definition of unstable angina?

20. What is the ECG criteria for a 1st degree AV block?

21. What is hibernating myocardium and what are the imaging modalities that can detect this?

22. How can hemochromatosis affect the heart?

23. What are the ECG findings of a left ventricular aneurysm?

24. What is the most common ECG finding of a pulmonary embolus?

25. What are the potential side effects of ACE inhibitors?

26. What are the indications for valve replacement in patients with bacterial endocarditis?

27. How is the Law of LaPlace described, including how it relates to cardiac hemodynamics?

28. What is the classification system used for aortic dissections (name two and describe)?

29. What is the treatment or “antidote” for a beta-blocker overdose?

30. How do the heart sounds and murmur of mild mitral stenosis (MS) differ from that of severe mitral stenosis?

31. Historically, which medication is the safest to use during pregnancy to treat hypertension and what are the potential side effects?

32. What do the ACC/AHA guidelines say about the use of non-steroidal anti-inflammatory drugs (NSAIDs) during an acute coronary syndrome?

33. What are the cardiovascular implications of cocaine use (acute and chronic)?

34. What are the Jones Criteria?

35. What are the ECG findings of a secundum type atrial septal defect versus the primum type of atrial septal defect?

36. What is arrhythmogenic right ventricular dysplasia?

37. What are the indications to close an atrial septal defect?

38. What are the contraindications to using flecainide/propafenone?

39. What medical therapy has a class I indication in the treatment of patients with chronic diastolic congestive heart failure?

40. What are the different types of ventricular septal defects?

41. What is “Prinzmetal's angina” and what is the treatment?

42. What are the contraindications to using thrombolytic therapy to treat an acute myocardial infarction?

43. What are four properties that vary between beta-blockers, including examples?

44. What is left ventricular non-compaction?

45. What are the Duke criteria for endocarditis?

46. What are the contraindications to using sotalol?

47. What are the causes of low voltage on an ECG?

48. What are the symptoms of lidocaine toxicity?

49. What is the appropriate method(s) to evaluate a patient with 2:1 AV block?

50. What are the indications to close a ventricular septal defect?

51. What are the stages of ECG changes of hyperkalemia? Include the potassium level and the change that it would correlate to on the ECG tracing.

52. What are the direct thrombin inhibitors and their differences?

53. What are the indications for percutaneous mitral balloon valvuloplasty in patients with mitral stenosis?

54. Which medications lower serum triglyceride levels?

55. What are the grades of diastolic dysfunction measured by echocardiography, and what are the clinical ramifications of each?

56. What is the classic ECG finding of a pulmonary embolus?

57. What medical therapy is indicated to delay the need for surgery in the presence of severe mitral valve regurgitation?

58. What is the classic surgical treatment for recurrent tricuspid valve endocarditis in intravenous drug users?

59. What is myocardial bridging and what are its implications?

60. What causes the third heart sound (S3)?

61. What are the three most common indications for permanent pacemaker implantation?

62. What are the contraindications to using fibrinolytic therapy (thrombolytic therapy) to treat an acute myocardial infarction?

63. What classification system can be used to predict mortality in the setting of an acute myocardial infarction?

64. What is the New York Heart Association functional class?

65. What causes a paradoxically split second heart sound?

66. What are the causes of atrial fibrillation and atrial flutter?

67. What are the four stages of the ECG findings in patient with acute pericarditis?

68. What is sick sinus syndrome? Include all of the rhythm manifestations.

69. What are the indications for an early invasive strategy during a non-ST segment myocardial infarction (when should an angiogram be done early)?

70. What are the HACEK organisms that can cause “culture negative endocarditis”?

71. What are the indications for transesophageal echocardiography?

72. What is the tetralogy of Fallot?

73. What are the physical exam findings of cardiac tamponade?

74. What determines the dominance of the coronary arteries (left versus right dominance)?

75. What are the ECG findings of a true posterior myocardial infarction?

76. What increases or decreases the intensity of the first heart sound?

77. What is the coronary calcium score (CCS) used for?

78. What is the plasma N-terminal pro-BNP and how is it used?

79. What are the three common and two less common types of cardiomyopathies?

80. What are the two therapies what may reduces statin mediated myalgias?

81. What is pulsus paradoxus? Describe the physiologic mechanism.

82. What blood test can help distinguish between restrictive cardiomyopathy and constrictive pericarditis?

83 What is the most common cause of mitral stenosis?

84. What is a bisferiens pulse (pulsus bisferiens)?

85. What are the indications for an implantable cardioverter defibrillator (ICD) in patients with hypertrophic obstructive cardiomyopathy (HOCM)?

86. Which beta-blockers are FDA approved for systolic heart failure?

87. Which segment of which leaflet is most commonly involved in mitral valve prolapse?

88. What creates the second heart sound (S2) and describe its characteristics?

89. How is the measurement of b-type natriuretic peptide (BNP) used clinically?

90. What causes the fourth heart sound?

91. What is a “cannon A wave” in the jugular venous pulse?

92. What is a V wave in the jugular venous pulse and when is it accentuated?

93. What causes an accentuated V wave in the left atrial pressure or pulmonary capillary wedge pressure tracing?

94. What is the diagnosis if the right ventricular oxygen saturation is significantly higher than the right atrial oxygen saturation during a right…

95. What is the treatment for an acute ventricular septal defect after a myocardial infarction?

96. How do you distinguish a pericardial knock from an S3 heart sound?

97. What is the most common cause of aortic valve stenosis in patients over the age of 70? Under the age of 70?

98. Which three physical exam findings in patients with aortic stenosis can help determine the severity?

99. What is the most common cause of severe aortic valve regurgitation?

100. What is the Wilkins echocardiographic score for mitral stenosis? What are the components and how are they graded?

101. What are the causes of acute severe mitral regurgitation?

102. What is the mechanism of action of fenofibrate and gemfibrozil?

103. What is the difference between functional and organic mitral regurgitation?

104. What two percutaneous procedures have been experimented with to help treat patients with severe mitral regurgitation without surgery?

105. Which heart valve problem can cause hemoptysis (coughing up of blood)?

106. How would you describe the intensity of a systolic murmur that is easily audible, associated with a thrill, however the stethoscope must remain…

107. What is the main hemodynamic contraindication to surgical repairing severe mitral valve regurgitation?

108. What are the two neurohormonal mechanisms in play in patients with systolic heart failure?

109. What are the causes of acute aortic valve regurgitation?

110. What are the indications to surgically repair the tricuspid valve?

111. What are the complications of pacemaker implantation?

112. Which papillary muscle is most likely to rupture during an acute myocardial infarction and why?

113. Amyl nitrate would have what effect on the murmur of mitral regurgitation?

114. What are the causes of diastolic congestive heart failure with a preserved left ventricular ejection fraction?

115. What percentage of patients with peripartum cardiomyopathy have a recurrence during subsequent pregnancies?

116. What are the status classifications for patients waiting for heart transplantation?

117. What are the indications for surgery in patients with severe mitral valve regurgitation?

118. What causes a widened split S2 heart sound?

119. What is tolvaptan and when is it indicated for heart failure treatment?

120. What is the treatment for digoxin toxicity and when should Digibind (Fab) be given?

121. When is spironolactone indicated in patient with heart failure?

122. What medical therapy for heart failure is recommended when an ACE inhibitor or angiotensin receptor blocker is not able to be used?

123. What is the American College of Cardiology/American Heart Association heart failure classification?

124. What are the indications for biventricular pacing?

125. How does atrial fibrillation effect the ability of a biventricular pacemaker to function properly?

126. What is the most common cause of right heart failure? What are the physical exam findings in left and right heart failure?

127. What are the cardiovascular complications of obstructive sleep apnea?

128. What are the indications for ICD implantation in systolic heart failure patients?

129. What is the mainstay of treatment for the different types of shock (cardiogenic, hypovolemic, distributive)?

130. What is the electrophysiologic mechanism of atrioventricular reentrant tachycardia (AVNRT)?

131. What is the definition of a non-ST segment elevation myocardial infarction?

132. When are beta-blockers contraindicated in heart failure?

133. Compare and contrast the third heart sound and the fourth heart sound (give at least 5 differences and two similarities).

134. Which medications offer a mortality benefit in patients with chronic systolic congestive heart failure?

135. When are beta-blockers contraindicate during an acute myocardial infarction?

136. What is another name for “slow ventricular tachycardia” and what is the clinical implication?

137. What is the treatment for frequent premature ventricular contractions (PVCs) after a myocardial infarction?

138. What are the causes of dilated cardiomyopathy?

139. What are the causes of constrictive pericarditis?

140. What are the causes of congestive heart failure in patients with hypertrophic obstructive cardiomyopathy?

141. What are the indications for surgery in patients with aortic valve regurgitation?

142. What are the two mechanical therapies (non-medication) for hypertrophic obstructive cardiomyopathy (HOCM) and what are their indications?

143. What is the treatment for constrictive pericarditis?

144. What is the pathological finding of hypertrophic obstructive cardiomyopathy (HOCM)?

145. How is hypertrophic obstructive cardiomyopathy (HOCM) treated medically?

146. What are the four main steps in the development of the atherosclerotic plaque?

147. How is hypertrophic obstructive cardiomyopathy (HOCM) genetically transmitted?

148. What is the most common cause of death in young athletes?

149. A systolic ejection click is frequently a finding of what specific heart valve problem?

150. What causes a III/VI crescendo-decrescendo murmur heard at the right upper sternal border that peaks early in systole and does not change with…

151. This arrhythmia is characterized by three different morphology P waves in on 12-lead ECG with a ventricular rate < 100 beats per minute.

152. Describe the murmur of an atrial septal defect (ASD)?

153. How can you distinguish the murmur of aortic stenosis from that of hypertrophic obstructive cardiomyopathy (HOCM)?

154. When can sustained ventricular tachycardia be treated medically and when does it require emergent direct current cardioversion?

155. Which antiarrhythmic drugs prolong the QT interval?

156. Which is the most effective statin to raise the HDL?

157. How does the murmur of mild aortic regurgitation differ from that of severe aortic regurgitation (AR)?

158. What causes a continuous murmur throughout systole and diastole?

159. What is Carvallo’s sign?

160. A post-PVC beat would have what effect on the murmur of aortic stenosis (AS)? What about the murmur of hypertrophic obstructive cardiomyopathy…

161. What are the indications for a left ventricular assist device (LVAD)?

162. What alteration in the heart sounds is heard in a patient having an acute coronary syndrome? What is the physiologic mechanism?

163. What are the two most common indications for a permanent pacemaker implantation?

164. What are the diagnostic criteria for ventricular tachycardia?

165. What is the treatment for left ventricular free wall rupture?

166. What causes a split S1 heart sound and/or a widened split S1 heart sound?

167. What is the TIMI risk score?

168. Which antiarrhythmic drug can cause drug induced lupus erythematosus?

169. What maneuvers can increase the intensity of the murmur of mitral valve regurgitation?

170. What is the most common narrow complex tachycardic arrhythmia besides atrial fibrillation or atrial flutter?

171. This arrhythmia is characterized by three different morphology P waves one 12-lead ECG with a ventricular rate > 100 beats per minute.

172. What is the mainstay of treatment for multifocal atrial tachycardia (MAT)?

173. What is the difference between the CHADS 2 score and the CHADS 2 Vasc score to predict the risk of stroke in patient with atrial…

174. Which antiarrhythmic drugs are considered safe in the setting of LV systolic dysfunction?

175. What is a glycoprotein IIb/IIIa inhibitor?

176. What is the difference in the electrophysiologic mechanism of atrial fibrillation and atrial flutter?

177. What are the three main concerns with long-term amiodarone use?

178. What is the treatment of polymorphic ventricular tachycardia (VT)?

179. What are the two main drugs indicated to treat sustained ventricular tachycardia? Which two drugs can be used, but are not commonly utilized?

180. What is the difference in the electrophysiologic mechanism of second degree type I AV block and second degree type II AV block?

181. What is the medical therapy for a patient with Wolff-Parkinson-White syndrome (WPW) and atrial fibrillation?

182. When a patient clenches a fist in the center of his or her chest to describe the pain related to angina pectoris, it is called what?

183. What are the causes of myocardial infarction not related to the typical atherosclerotic process?

184. What is the mechanism of action of ezetimibe and when is it indicated?

185. What is the definition of acute coronary syndrome?

186. What are the indications to use thrombolytic therapy to treat an acute myocardial infarction?

187. When are beta blockers not indicated during an acute coronary syndrome?

188. What are the mechanical complications of myocardial infarction?

189. What is Dressler’s syndrome?

190. What is the mechanism of stroke after an anterior myocardial infarction?

191. What is the ECG finding of an acute mid LAD occlusion (be specific)?

192. Which coronary artery can an ascending aortic dissection affect?

193. What is the average patency duration of a saphenous vein bypass graft?

194. What is the average patency duration of a LIMA bypass graft?

195. What is the leading cause of death during an acute myocardial infarction?

196. What is the treatment for acute severe mitral regurgitation from a rupture papillary muscle after a myocardial infarction?

197. How would you describe the intensity of a very loud diastolic murmur?

198. Which is the most effective statin medication in regards to LDL reduction?

199. What conditions commonly mimic the symptoms/findings of an acute myocardial infarction?

200. What are the indications for ACE inhibitors during an acute myocardial infarction?

201. How is the S1 and S2 heart sound best auscultated?

202. What is the appropriate treatment for frequent PVCs during or after an acute coronary syndrome?

203. What is the appropriate treatment for an accelerated idioventricular rhythm during or after an acute myocardial infarction?

204. What is the mechanism of action of ranolazine?

205. What are the indications for coronary artery bypass grafting?

206. What is the Duke Treadmill Score? How does it predict survival?

207. What are the indications for coronary CT angiography?

208. What are the indications for eplerenone during an acute myocardial infarction?

209. Which cardiac biomarker would be ideal to detect re-infarction in patients 4-10 days post initial myocardial infarction?

210. Name the thrombolytic medications and their differences.

211. What does the term “atherosclerosis” mean (definition and origin of the term)?

212. What is the major side effect of fenofibrate?

213. What maneuvers can be done to alter the timing of the click in mitral valve prolapse?

214. Which statin is the safest to use in the setting of liver disease?

215. How should someone describe an episode of ventricular tachycardia?

216. What proportion of acute coronary syndromes are silent? What percent do not have classic symptoms? What patient populations most commonly have…