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MEDICINE - step up to medicine/pretest/lange/uworld/MKSAP4 study guide solved

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MEDICINE - step up to medicine/pretest/lange/uworld/MKSAP4 study guide solved -major risk factors for atherosclerotic heart disease {{Ans- DM Hyperlipidemia hypertension cigarette smoking Age >... 45 M, >55 F family history of MI at young age high LDL level -CAD prognostic factors {{Ans- LVF EF<50% left main two or three vessel diseases -1. clinical presentation of stable angina 2. dx: 3. what to do with patients with positive stress or echo {{Ans- 1. gradual onset chest or substernal pain brought on by inc. myocardial demand* (exertion/emotion) relieved with rest or nitroglycerin NO CHEST WALL TENDERNESS NO CHANGE WITH POSITION 2. normal PE/ECG *stress test- (HR to 85% max (220-age))-->subendocardial ischemia (ST depression on ECG) *stress echocardiography- shows wall motion abnormalities- akinesis or dyskinesis 3. cardiac catheterization -what is the advantage of stress echo vs stress ECG {{Ans- LV size/function dx. valvular disease identifies CAD * if positive -->cardiac cath -what is a positive stress test {{Ans- If during a stress test the patient experiences: ST depression chest pain hypotension arrhythmias -metabolic syndrome X {{Ans- 3 INSULIN RESISTANCE 2/2 OBESITY --> hypercholesterolemia/low HDL hypertriglyceridemia - >150 impaired glucose tolerance >110 diabetes hyperuricemiaHTN [Show More]

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