Which of the following is NOT a preferred anti-hypertensive parenteral drug for aortic dissection?

Table 247-9 Preferred Parenteral Drugs for Selective Hypertensive Emergencies
Hypertensive EncephalopathyNitroprusside, nicardipine, labetalol
Malignant HypertensionLabetalol, Nicardipine, Nitroprusside, Enalaprilat
StrokeNicardipine, Labetalol, Nitroprusside
Myocardial InfarctionNitroglycerine, Nicardipine, Labetalol, Esmolol
Acute LV failureNitroglycerine, Enalaprilat, Loop diuretics
Aortic dissectionNitroprusside, Esmolol, Labetalol
Adrenergic crisisPhentolamine, Nitroprusside
Post operative hypertensionNitroglycerine, Nicardipine, Labetalol, Nitroprusside
Pre eclampsia/EclampsiaHydralazine, Labetalol, Nicardipine

The most common cause of death in hypertensive patients is:

Hypertensive heart disease is the result of structural and functional adaptations leading to LVH, CHF, abnormalities of blood flow due to atherosclerotic CAD and microvascular disease, and cardiac arrhythmias.

The most common etiology of secondary hypertension is:

Mechanisms of kidney-related hypertension include a diminished capacity to excrete sodium, excessive renin secretion in relation to volume status, and sympathetic nervous system overactivity

The primary cause of in hospital death from STEMI is:

  • The extent of infarction correlates well with the degree of pump failure and with mortality, both early and later; the most common clinical signs being pulmonary rales and S3 and S4 gallop sounds.
  • Other complications include recurrent chest discomfort, pericarditis, thromboembolism, arrhythmias and LV aneurysm

The following are Class 1 recommedations for use of an early invasive strategy in patients with NSTEMI and unstable angina pectoris except

  • In this strategy, following treatment with anti-ischemic and anti-thrombotic agents, coronary arteriography is carried out within 48hrs of admission, followed by coronary revascularization (PCI or CABG), depending on the coronary anatomy
  • Table 244-3 Class 1 Recommendations for Use of an Early Invasive stragtegy Class 1 (Level of Evidence: A) Indications
    • Recurrent angina at rest/low-level activity despite Rx
    • Elevated TnT or TnI
    • New ST segment depression
    • Recurrent angina/ischemia with CHF symptoms, rales, MR
    • Positive stress test
    • EF < 0.40
    • Decreased BP
    • Sustained VT
    • PCI < 6months, prior CABG

The main agents used to treat acute episodes and abolish recurrent episodes of Prinzmetal Variant Angina (PVA) are:

  • In 1959, Prinzmetal et. al. described a syndrome of severe ischemic pain that occurs at rest but not usually with exertion and is associated with transient ST segment elevation; due to focal spasm of an epicardial coronary artery leading to severe myocardial ischemia.
  • Aspirin may actually increase the severity of ischemic episodes, possibly as a result of the exquisite sensitivity of coronary tone to modest changes in the synthesis of prostacyclin. The response to beta blockers is variable. Coronary revascularization may be helpful in patients who also have discrete, proximal fixed obstructive lesions.

The most accepted and unifying hypothesis to describe the pathophysiology of the metabolic syndrome is:

NCEP/ATP III 2001 Criteria for the Metabolic Syndrome (Table 242-1) 3 or more of the following

  • Central obesity (waist circumference >102cm in M, >88cm in F)
  • Hypertriglyceridemia (TGL >= 150mg/dl, or specific medication)
  • Low HDL cholesterol (<40mg/dL in M and 50mg/dL in F, or specific medication)
  • Hypertension (BP >= 130mm Hg systolic or >= 85mm Hg diastolic, or specific medication)
  • Fasting plasma glucose >=100 mg/dL or specific medication or previously diagnosed Type 2 DM

The most common type of primary cardiac tumor in all age groups are:

  • Primary tumors of the heart are rare. Myxomas are the most common; but sarcomas account for almost all of the MALIGNANT tumors
  • Tumors metastatic to the heart are much more common than primary tumors; metastases may occur via hematogenous or lymphangitic spread or by direct tumor invasion

On diseases of the myocardium, which of the following is NOT TRUE

Chemotherapeutic agents are the most common drugs implicated in cardiomyopathy.

The treatment of choice for severe aortic regurgitation is:

Patients with severe AR may respond to IV diuretics and vasodilators, but stabilization is usually short-lived and operation is indicated urgently. Intra aortic balloon counterpulsation is contraindicated and beta blockers are also best avoided so as not to reduce the cardiac output further. Surgery is the treatment of choice and is usually necessary within 24hrs of diagnosis.

The most common congenital valvular heart defect is:

In venous thrombosis, Virchow’s triad includes all of the following, EXCEPT

In vascular diseases of the extremities, the following are TRUE except:

The most common type of fibromuscular dysplasia is medial hyperplasia.

The “3” sign seen on chest radiography is pathognomonic of:

In Congenital Heart Diseases of adults, the most common form of ASD is:

The most common symptom of chronic cor pulmonale is :

The cardinal symptoms of heart failure are:

In the diagnosis of cardiovascular disease, the following are TRUE, EXCEPT:

A positive abdominojugular reflex, elicited with firm and consistent pressure over the right upper quadrant of the abdomen, is defined by a sustained raise of more than 3cm in jugular venous pressure for at least 5seconds after release of the hand.

In non-invasive cardiac imaging, which of the following is regarded as the gold standard technique for the assessment of myocardial viability?

  • 2D Echo is the gold standard for imaging valve morphology and motion; and is also the imaging modality of choice for the detection of pericardial effusion, assessment of LV cavity size, systolic function and wall thickness.
  • Both CT scanning and MRI are the imaging modalities of choice for the evaluation of the stable patient with suspected aortic aneurysm or aortic dissection.

In sinoatrial (SA)node dysfunction, the following are TRUE, EXCEPT:

In patients with tachycardia-bradycardia variant of sisk-sinus syndrome (SSS) who are at greatest risk for thromboembolism, ie., patients > 65 yo, and with a prior history of stroke, VHD, LV dysfunction or atrial enlargement, anticoagulants should be given.