(Test Bank) Mayo Clinic Cardiology Board Review Questions And Answers

Margaret,Murphy,

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Test Bank for Mayo Clinic Cardiology Board Review Questions And Answers, The downloadable file consists of 328 pages, and the total size of the file is 6.09 MB. Purchase now only for highly discounted price.

Author(s): Margaret, Murphy

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Mayo Clinic Cardiology Board Review Questions and AnswersLloyds-FM.qxd 29/10/2007 9:50 PM Page iLloyds-FM.qxd 29/10/2007 9:50 PM Page iiMayo Clinic Cardiology Board Review Questions and Answers Written by Mayo Clinic Cardiovascular Fellows Editors Margaret A. Lloyd, MD Joseph G. Murphy, MD MAYO CLINIC SCIENTIFIC PRESS AND INFORMA HEALTHCARE USA, INC. Lloyds-FM.qxd 29/10/2007 9:50 PM Page iiiISBN 1-4200-6746-X / 978-1-4200-6746-0 The triple-shield Mayo logo and the words MAYO, MAYO CLINIC, and MAYO CLINIC SCIENTIFIC PRESS are marks of Mayo Foundation for Medical Education and Research. ©2008 by Mayo Foundation for Medical Education and Research.All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means—electronic, mechanical, photocopying,recording, or otherwise—without the prior written consent of the copyright holder, except for briefquotations embodied in critical articles and reviews. Inquiries should be addressed to ScientificPublications, Plummer 10, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. For order inquiries, contact Informa Healthcare, Kentucky Distribution Center, 7625 Empire Drive, Florence, KY 41042 USA. E-mail: orders@taylorandfrancis.com www.informahealthcare.com Library of Congress Cataloging-in-Publication Data Mayo Clinic cardiology: board review questions and answers / edited by Margaret A. Lloyd, Joseph G. Murphy. p. ; cm. ISBN-13: 978-1-4200-6746-0 (pb : alk. paper)ISBN-10: 1-4200-6746-X (pb : alk. paper) 1. Cardiology—Examinations, questions, etc. 2. Heart— Diseases—Examinations, questions, etc. I. Lloyd, Margaret A. II. Murphy, Joseph G. III. Mayo Clinic.IV. Title: Cardiology. [DNLM: 1. Heart Diseases—Examination Questions. WG 18.2 M4725 2007] RC669.2.M37 2007 616.1'20076–dc22 2007035216 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors oromissions or for any consequences from application of the information in this book and make nowarranty, express or implied, with respect to the contents of the publication. This book should not berelied on apart from the advice of a qualified health care provider. The authors, editors, and publisher have exerted efforts to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time ofpublication. However, in view of ongoing research, changes in government regulations, and the constantflow of information relating to drug therapy and drug reactions, the reader is urged to check the packageinsert for each drug for any change in indications and dosage and for added warnings and precautions.This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health careproviders to ascertain the FDA status of each drug or device planned for use in their clinical practice. Printed in Canada 10 9 8 7 6 5 4 3 2 1 Lloyds-FM.qxd 29/10/2007 9:50 PM Page ivPREFACE This publication, organized in a question-and-answer multiple-choice format, is a companion to Mayo Clinic Cardiology: Concise T extbook , 3rd edition. It was written by cardiology fellows, primarily for fellows in training, and focuses on hot topics in cardiology and likely board examination areas. It will also be useful for practicing cardiologists preparing for recertification in cardio logy. It was an honor for us to edit the work of five talented cardiovascular fellows training at Mayo Clinic in Rochester, Minnesota . They are the heart and soul of this project, and this book would not have been successfully completed without them. Busy clinical demands mean that preparation time for the certification examination in cardiology be used judiciously. The topic s and question format were developed to help trainees and recertifying physicians focus their preparation for the American Board of Internal Medicine cardiology examination. The book is designed to allow readers to self-test before the examination and to iden tify areas that need further review. We strongly encourage trainees to read beyond the multiple-choice answers and develop a deeperunderstanding of the science that underpins cardiovascular medicine. As always, thanks are due to the many persons involved in the production of this book. Rick A. Nishimura, MD, and Steve R. Ommen, MD, directors of the annual Mayo Clinic Cardiovascular Review Course, provided encouragement for this book and Mayo Clinic Cardiology: Concise T extbook . Patra A. Baker assisted with typing the manuscripts. Roberta J. Schwartz (production editor), T raci J. H. Post (scientific publications specialist), and LeAnn M. Stee and Randall J. Fritz, DVM (editors), all staff in Mayo Clinic Scientific Publications, were of tremendous assistance. Karen Barrie (art director) provided guidance on the design. SandraBeberman, Vice President, Informa Healthcare, provided valuable advice. Every effort was made to ensure that the answers and discussion are timely and accurate. If errors are noted, please contact us so that corrections can be made in future editions. We are also interested in additional topics you would like to have included in future editions of this review book. Margaret A. Lloyd, MD Joseph G. Murphy, MD Consultant, Division of Cardiovascular Diseases, Consultant, Division of Cardiovascular Mayo Clinic, Rochester, Minnesota Diseases, and Chair, Section of Scientific Assistant Professor of Medicine, Publications, Mayo Clinic, College of Medicine, Mayo Clinic Rochester, Minnesota lloyd.margaret@mayo.edu Professor of Medicine, College of Medicine, Mayo Clinic vLloyds-FM.qxd 29/10/2007 9:50 PM Page vLloyds-FM.qxd 29/10/2007 9:50 PM Page viAFFILIATIONS EDITORS Margaret A. Lloyd, MD, Consultant, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Medicine, College of Medicine, Mayo Clinic Joseph G. Murphy, MD, Consultant, Division of Cardiovascular Diseases, and Chair, Section of Scientific Publications, Mayo Clinic, Rochester, Minnesota; Professor of Medicine, College of Medicine, Mayo Clinic AUTHORS T. Jared Bunch, MD, is from Logan, Utah. He graduated from Utah State University with undergraduate degrees in chemistry, liberal arts, and sciences. He received his MD from the University of Utah. He completed a residency in internal medicine and a fellowship in car diovascular diseases and is currently a fellow in electrophysiology at Mayo School of Graduate Medical Education, College of Medicine, Mayo Clinic. Garvan C. Kane, MD, PhD, is from Dublin, Ireland, and received his MD and PhD from University College Dublin, Ireland. He completed his internal medicine residency and clinical pharmacology and cardiovascular diseases fellowships at Mayo School of Graduate Me dical Education, College of Medicine, Mayo Clinic. He is completing his cardiovascular fellowship, and he is an Assistant Professor of Medicine, College of Medicine, Mayo Clinic. His clinical focus will include echocardiography and pulmonary vascular diseases. Charles X. Kim, MD, is from Chicago, Illinois. He received dual BS degrees in cellular biology and chemistry from the University of Illinois, Urbana-Champaign, and his MD from the University of Chicago. He completed his residency in internal medicine at Northwestern Un iversity in Chicago. He is a fellow in cardiovascular diseases at Mayo School of Graduate Medical Education, College of Medicine, Mayo C linic, and his areas of expertise are coronary care and interventional cardiology. Matthew W. Martinez, MD, is from Wading River, New York. He attended Longwood University in Farmville, Virginia, and received his BS in biological sciences from Wright State University in Dayton, Ohio. He received his MD at Mayo Medical School and completed his r esidency in internal medicine at Mayo School of Graduate Medical Education, College of Medicine, Mayo Clinic. He is a fellow in cardiovascu lar diseases at Mayo School of Graduate Medical Education and an Instructor in Medicine, College of Medicine, Mayo Clinic. His area of expertis e is advanced cardiac imaging in MRI, CT, echocardiography, and nuclear cardiology. His clinical interests include cardiomyopathies and cardi ac assessment in athletes. Brian P . Shapiro, MD, is from Miami, Florida. He received his undergraduate degree from the University of Florida in history, and his MD from the University of Miami. He completed his residency in internal medicine and a clinical investigator research fellowship (in he art failure) and he is currently a cardiovascular fellow at Mayo School of Graduate Medical Education, College of Medicine, Mayo Clinic, with exper tise in imaging (MRI, CT, echocardiography, nuclear cardiology). viiLloyds-FM.qxd 29/10/2007 9:50 PM Page viiLloyds-FM.qxd 29/10/2007 9:50 PM Page viiiTABLE OF CONTENTS I. Cardiac Electrophysiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 T. Jared Bunch, MD II. Coronary Artery Disease Risk Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Charles X. Kim, MD III. Cardiac Catheterization and Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Charles X. Kim, MD IV. Myocardial Infarction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Charles X. Kim, MD V. Congestive Heart Failure and Cardiac Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Brian P . Shapiro, MD VI. Valvular Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Matthew W. Martinez, MD VII. Noninvasive Cardiac Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Garvan C. Kane, MD, PhD VIII. Cardiac Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 Garvan C. Kane, MD, PhD ixLloyds-FM.qxd 29/10/2007 9:50 PM Page ixLloyds-FM.qxd 29/10/2007 9:50 PM Page xABBREVIATIONS 5-HIAA 5-Hydroxyindoleacetic acid AAA Abdominal aortic aneurysmACC American College of CardiologyACE Angiotensin-converting enzymeACS Acute coronary syndromeACUITY Acute Catheterization and Urgent Intervention T riage StrategyADMIRAL Abciximab Before Direct Angioplasty and Stenting in Myocardial Infarction Regarding Acute and Long-Term Follow-up AF Atrial fibrillationAFFIRM Atrial Fibrillation Follow-up Investigation of RhythmAHA American Heart AssociationAMI Acute myocardial infarctionANP Atrial natriuretic peptidesAo AortaAR Aortic regurgitationARB Angiotensin receptor blockerARDS Acute respiratory distress syndromeAS Aortic stenosisASA Aminosalicylic acidASD Atrial septal defectAV Aortic valveAVA Aortic valve areaAVNRT Atrioventricular node reentry tachycardiaAVR Aortic valve replacementAVRT Atrioventricular reentrant tachycardiaBARI Bypass Angioplasty Revascularization InvestigationBARI 2D Bypass Angioplasty Revascularization 2—DiabetesBENESTENT Belgium Netherlands Stent Study GroupBID T wice dailyBIV-ICD Biventricular implantable cardioverter defibrillatorBMI Body mass indexBNP Brain natriuretic peptideBP Blood pressurebpm Beats per minuteBSA Body surface areaCABG Coronary artery bypass graft/Coronary artery bypass graftingCAD Coronary artery diseaseCARE-HF Cardiac Resynchronization in Heart FailureCASS Coronary Artery Surgery StudyCBC Complete blood countCCS Canadian Cardiovascular SocietyCCU Critical care unitCHF Congestive heart failureCK Creatine kinaseCK-MB Creatine kinase myocardial fractionCNS Central nervous systemCO Cardiac output xiLloyds-FM.qxd 29/10/2007 9:50 PM Page xiCOMPANION Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure COPD Chronic obstructive pulmonary diseaseCOURAGE Clinical Outcomes Utilizing Revascularization and Aggressive Drug EvaluationCPR Cardiopulmonary resuscitationCREDO Clopidogrel For Reduction of Events During ObservationCRP C-reactive proteinCRT Cardiac resynchronization therapyCS Coronary sinusCT Computed tomographyCURE Clopidogrel in Unstable Angina to Prevent Recurrent EventsCV CardiovascularCVA Cerebrovascular accidentDANAMI Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction DC Direct currentDES Drug-eluting stentDINAMIT Defibrillator in Acute Myocardial Infarction T rialDM Diabetes mellitusDOE Dyspnea on exertionE/A E:A wave ratioEBCT Electron beam computed tomographyECG Electrocardiographic/Electrocardiogram/ElectrocardiographyECSS European Cooperative Surgery StudyED Emergency department/Emergency roomEECP Enhanced external counterpulsationEF Ejection fractionEOA Effective orifice areaEP ElectrophysiologyERASER Evaluation of ReoPro and Stenting to Eliminate RestenosisET-A Endothelin-AET-B Endothelin-BFA Femoral arteryFAA Federal Aviation AdministrationFDA Food and Drug AdministrationFDG FluorodeoxyglucoseFFV Forward flow volumeFMD Fibromuscular dysplasiaFREEDOM Future Revascularization Evaluation in Patients with DiabetesGISSI Gruppo Italiano per lo Studio della Streptochinasi nell’Infarto MiocardicoGUSTO-I Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Artery Hgb HemoglobinHCM Hypertrophic cardiomyopathy/Hypertrophic obstructive cardiomyopathyHCTZ HydrochlorothiazideHDL High-density lipoproteinHIT Heparin-induced thrombocytopeniaHR Heart rateHRA High right atriumHTN HypertensionICD Implantable cardioverter defibrillatorICH Intracerebral hemorrhage xiiLloyds-FM.qxd 29/10/2007 9:50 PM Page xiiICU Intensive care unit IE Infective endocarditisINR International normalization ratioISHLT International Society for Heart and Lung T ransplantationIU International unitsIV IntravenousIVC Inferior vena cavaIVUS Intravascular ultrasoundJVD Jugular venous distentionJVP Jugular venous pressureLA Left atriumLAD Left anterior descendingLAO Left anterior obliqueLBBB Left bundle branch blockLCA Left coronary arteryLCX Left circumflexLDL Low-density lipoprotienLIMA Left internal mammary arteryLp(a) Lipoprotein aLSB Left sternal borderL-TGA Levo transposition of the great arteriesLV Left ventricle/Left ventricularLVAD Left ventricular assist deviceLVEDP Left ventricular end diastolic pressureLVH Left ventricular hypertrophyLVOT Left ventricular outflow tractMACE Major adverse cardiac eventMADIT-II Multicenter Automatic Defibrillator Implantation T rial IIMASS Medicine, Angioplasty, or Surgery StudyMCA Middle cerebral arterymCi milli CuriesMELLITUS Optimal Management of Multivessel DiseaseMET Metabolic equivalentMI Myocardial infarctionMIRACLE Multicenter InSync Randomized Clinical EvaluationMPI Myocardial perfusion imagingMR Mitral regurgitationMRI Magnetic resonance imagingMS Mitral stenosisMUGA Multiple gated acquisition/Multigated image acquisition analysisMUSTT Multicenter Unsustained Tachycardia T rialMV Mixed venousMVA Mitral valve areaMVR Mitral valve replacementNCEP National Cholesterol Education PanelNO Nitrous oxide/Nitric oxideNOS Nitric oxide synthetaseNPH Neutral Protamine HagedornNRAF National Registry of Atrial FibrillationNSAID Nonsteroidal anti-inflammatory medicationNSTEMI Non-ST elevation myocardial infarction xiiiLloyds-FM.qxd 29/10/2007 9:50 PM Page xiiiNTG Nitroglycerine NYHA New York Heart AssociationOM Obtuse marginalPA Pulmonary arteryPABV Percutaneous aortic balloon valvulotomyPAF Paroxysmal atrial fibrillationPAH Pulmonary artery hypertensionPAI-1 Plasminogen activator inhibitor 1PAP Pulmonary artery pressurePCI Percutaneous coronary interventionPCWP Pulmonary capillary wedge pressurePET Positron emission tomographyPFO Patent foramen ovalePMBV Percutaneous mitral balloon valvotomyPTCA Percutaneous transluminal coronary balloon angioplasty/Percutaneous transluminal coronary angioplasty PVC Premature ventricular contractionQTc Corrected QT intervalRA Right atriumRAO Right anterior obliqueRCA Right coronary arteryREACT Rescue Angioplasty Versus Conservative T reatment or Repeat ThrombolysisREM Rapid eye movement sleepRF Regurgitant fractionRV Right ventricle/Right ventricularRVOT Right ventricular outflow tractRVSP Right ventricular systolic pressureSCD-HeFT Sudden Cardiac Death in Heart Failure T rialSEM Systolic ejection murmurSEP Systolic ejection periodSHOCK Should We Emergently Revascularize Occluded Coronaries for Cardiogenic ShockSIRIUS Sirolimus-coated stent in treatment of de novo coronary artery lesionsSISR Sirolimus Eluting Stents Versus Vascular Brachy Therapy for In-Stent RestenosisSL NTG Sublingual nitroglycerineSR Sarcoplasmic reticulumSTEMI ST elevation myocardial infarctionSV Stroke volumeSVC Superior vena cavaSVT Supraventricular TachycardiaTD CO Thermodilution cardiac outputTEE T ransesophageal echocardiogram/T ransesophageal echocardiographyTGA T ransposition of the great arteriesTICM Tachycardia-induced cardiomyopathyTID Three times dailyTIMI Thrombolysis in myocardial infarctionTMET T readmill exercise testTnI T roponin ITnT T roponin TtPA Tissue plasminogen activatorTR T ricuspid regurgitationTTE T ransthoracic echocardiogram/T ransthoracic echocardiography xivLloyds-FM.qxd 29/10/2007 9:50 PM Page xiv