Cardiology Quiz Based on Pocket Medicine

A concise reference guide intended for medical house officers, designed to offer rapid and thoughtful initial approaches to common clinical scenarios.

A type of practice that emphasizes the use of the best available evidence in making clinical decisions.

The period of a physician's training following medical school, during which they gain experience in clinical practice.

The initial process of evaluating a patient's health status and identifying possible diagnoses.

A proposed treatment plan for a patient's condition.

A physician who specializes in the medical care of the kidneys, including diagnosis, treatment, and prevention of kidney diseases.

A physician who specializes in the diagnosis, treatment, and prevention of disorders affecting the brain, spinal cord, and peripheral nerves.

A physician who specializes in the diagnosis and treatment of diseases of the circulatory system, including heart disease, stroke, and hypertension.

A physician who specializes in the diagnosis and treatment of diseases of the immune system.

A physician who specializes in the diagnosis and treatment of diseases of the blood, bone marrow, and lymphatic system.

A physician who specializes in the diagnosis and treatment of diseases affecting the joints, muscles, and bones.

A physician who is trained in the diagnosis and treatment of diseases of the lungs and respiratory system.

A physician who specializes in the diagnosis and treatment of cancers.

Determine if the heart is beating too fast (tachycardia) or too slow (bradycardia), and assess the rhythm by examining the P waves, their regularity, and the relationship between P waves and QRS complexes.

Measure the intervals between the different waves and complexes (PR, QRS, QT) on the ECG. Also determine the axis, which indicates the direction of electrical activity in the heart.

Analyze the ECG for signs of enlargement of the heart's chambers (Left Atrial Enlargement - LAA, Right Atrial Enlargement - RAA, Left Ventricular Hypertrophy - LVH, Right Ventricular Hypertrophy - RVH).

Focus on the QRS complex and ST segment to check for any abnormal changes that may indicate a heart attack or other problems.

A systematic approach is key to interpreting an ECG. It involves carefully observing the various components of the ECG to identify abnormalities and make a diagnosis.

Tracheostomy can help reduce the duration of mechanical ventilation and shorten ICU stays in patients expected to require more than 14 days of mechanical ventilation.

Early enteral nutrition is safe for critically ill patients but not necessarily required. Bolus feeding may increase the risk of ventilator-associated pneumonia and C. difficile infection.

Parenteral nutrition should be delayed until after day 8 to reduce the risk of infections, cholestasis, renal replacement therapy, and ventilator days.

Benzodiazepines and polypharmacy are risk factors for oversedation and delirium. Propofol can cause hypotension and propofol infusion syndrome (PRIS) especially with high and prolonged infusions.

Dexmedetomidine doesn't provide clear benefit on vent-free days but can spare the use of other sedatives.

Acute Respiratory Distress Syndrome (ARDS) is a severe lung injury characterized by hypoxemia, bilateral infiltrates on chest imaging, and non-cardiogenic pulmonary edema.

The Berlin definition of ARDS categorizes the severity of the condition based on PaO2/FiO2 ratio, ranging from mild to moderate to severe.

Shock is a state of inadequate tissue perfusion leading to tissue hypoxia. It is characterized by hypotension, tachycardia, oliguria, and altered mental status.

Inotropic agents are used to enhance cardiac contractility in heart failure patients who are not responding to diuretics and afterload reduction. Dopamine, dobutamine, and milrinone are commonly used inotropes.

Cardiogenic shock is a life-threatening condition where the heart is unable to effectively pump blood, leading to inadequate tissue perfusion. It often occurs after a heart attack and is associated with a mortality rate of approximately 7%.

An intra-aortic balloon pump (IABP) is a mechanical circulatory support device that assists the heart in pumping blood. It provides temporary support by increasing coronary blood flow and assisting in left ventricular ejection.

Impella is a percutaneous axial flow pump that provides temporary circulatory support by increasing cardiac output. It is often used in patients with cardiogenic shock.

Atrioventricular (AV) block is a common complication of acute myocardial infarction (MI). It occurs because the right coronary artery (RCA) usually supplies the AV node.

Right ventricular infarction (RVI) is a heart attack that affects the right ventricle. Though angiographically present in many MI patients, only half have clinically significant RVI.

Preload is the amount of blood in the ventricle at the end of diastole (filling). Optimizing preload in acute MI aims to ensure adequate filling and ejection.

Afterload is the resistance the heart faces during ejection. Optimizing afterload in acute MI aims to reduce resistance and improve blood flow.

Upper gastrointestinal bleeding with blood loss rate ≥0.04 mL/min, identified by a tagged RBC scan, can pinpoint the general location of bleeding within the gastrointestinal tract.

A faster imaging technique compared to a tagged RBC scan, CT angiography can detect bleeding ≥0.3 mL/min and provides anatomical details of the bleeding site.

Arteriography allows for precise localization of bleeding vessels, with a detection threshold of ≥0.5 mL/min, and enables interventional radiology procedures to control the bleeding.

The most common cause of upper gastrointestinal bleeding, affecting 20-67% of cases. It can be treated with proton pump inhibitors (PPIs), endoscopic therapy, and, in severe cases, arteriography or surgery.

Erosive gastropathy, characterized by damage to the stomach lining, can be triggered by various factors including NSAIDs, alcohol, and stress. Treatment typically involves high-dose proton pump inhibitors (PPIs).

Erosive esophagitis, affecting the lining of the esophagus, is often associated with cirrhosis, anticoagulation, and critical illness. Treatment includes addressing the underlying cause and high-dose proton pump inhibitors (PPIs).

Esophageal or gastric varices, enlarged blood vessels in the esophagus or stomach, are a result of portal hypertension. They are often associated with liver disease and require specialized treatment.

An emergency procedure reserved for life-threatening upper gastrointestinal bleeding when the bleeding source cannot be localized or treated otherwise. It involves surgically opening the abdomen to control bleeding.