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ABFM First Aid > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Causes of Wide Split in heart sounds?

A

RBBB, Pulmonic Stenosis, PE or Pulm HTN

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2
Q

Causes of Paradoxical Splitting in heart sounds?

A

AS, LBBB, Pacemaker and LV sys dysfunction

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3
Q

BB overdose tx?

A

Atropine and glucagon

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4
Q

Cause of Fix splitting heart sound?

A

ASD

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5
Q

Left axis deviation will be negative in…

A

lead 2, lead 1 is positive

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6
Q

Right axis deviation will be negative in….

A

lead 1, lead 2 is positive

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7
Q

Most common dysrhythmia in the general population? Most common causes of this?

A

A-fib; HTN & CAD

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8
Q

Which is the preferred method for control of Afib?(rhythm vs rate)

A

Rate control!

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9
Q

CHADS-VAS scoring

A 
CHF +1
HTN +1
Age >75 +2
Diabetes +1
Stroke/TIA +2
Vascular disease +1
Age 65-75 +1
Sex(female) +1

*score 1+ for men or 2+ for women need anticoagulation

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10
Q

When can you use carotid massage/Valsalva for SVT? What medication can you use if this is unsuccessful?

A

if no prior TIA, other serious arrhythmia, MI within the last 6 months or carotid bruit.
- if unsuccessomeone 60+ w/history of CAD or TIA or CKDsful use adenosine, cardioversion if patient unstable

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11
Q

1st line treatment for stable VT?

A

IV amiodarone

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12
Q

HTN goals for: some 35 yo d-bag, diabetic, someone 60+

A
  1. normal person <140/90
  2. DM <130/80
  3. 60+ YOA SBP <150/90
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13
Q

C/I for THZ diuretics

A

gout

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14
Q

C/I for BB’s

A

bronchospasm, heart block, bradycardia

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15
Q

C/I for ACE/ARB

A

Prego, severe/mod renal failure, caution in renal artery stenosis

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16
Q

Indications for BB as 1st line for HTN

A

MI, high risk CAD, rate control for Afib

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17
Q

Indication for ACE/ARB for 1st line for HTN

A

MI, HF, DM, mild CKD

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18
Q

Indications for THZ diuretics for 1st line for HTN

A

Most patients!, Osteoporosis(helps with Ca reabsorption), Kidney stones, recurrent stroke prevention

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19
Q

USPTF recommends screening for HLD in…

A

*Men >35 yoa, women >45 yoa

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20
Q

Who gets a statin?

A
  1. ASCVD >7.5% age 40-75 w/LDL 70+
  2. LDL >190
  3. Ppl w/DM age 40-75 w/LDL 70+
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21
Q

Leading cause of mortality in men and women in the US?

A

CAD

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22
Q

Risk factors for CAD

A

> 65 yoa in women, premature menopause, men >55, 1st degree female relative <55 w/CAD or male<45, smoking, HTN, HDL <40, elevated LDL, Obesity, Physical inactivity, CKD, DM

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23
Q

Goal LDL if on statin? what if Diabetic?

A

Goal LDL <100, if on statin ideally <70 with some recommendations

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24
Q

Drugs that decrease CAD related mortality

A

BB, ACEi, Statin, ASA

25
Q

Spironolactone has mortality benefit in people with CHF class…

A

3-4

26
Q

ACEi have mortality benefit in which class of HF?

A

ALL!

27
Q

BB have mortality benefit in which class of HF?

A

2, 3 & 4

28
Q

How long do you need anticoagulation for mechanical heart valve?

A

Lifetime warfarin someone 60+ w/history of CAD or TIA or CKD

29
Q

How long do you need anticoagulation for bioprosthetic heart valve?

A

3 months warfarin then ASA for life

30
Q

How long MUST you maintain anticoagulation after cardioversion?

A

4 weeks if patient maintains NSR

31
Q

Who needs to be screened for hypertropic cardiomyopathy?

A

1st degree family members every year between 12-18 yoa then every 5 years with ECG +/- Echo

32
Q

Kussmaul sign is indicative of…

A

Kussmaul Sign - lack of JVP decline during inspiration sx of restrictive cardiomyopathy or constrictive pericarditis

33
Q

Pulsus Paradoxus is seen with…

A

Pulsus Paradoxus: SBP decrease by greater than 10 mmHg with inspiration. Seen with cardiac tamponade, constrictive pericarditis, asthma & COPD

34
Q

Electrical alternans is seen with….

A

cardiac tamponade

35
Q

ABI of —- indicates PVD with >50% stenosis. ABI of — indicates ischemia.

A

<0.9 = stenosis; <0.4 = ischemia

36
Q

Pentoxifylline treats PVD by…

A

increasing RBC deformity and decreasing serum viscosity

37
Q

Cilostazol treats PVD by…

A

inhibits platelet aggregation & increases vasodilation

38
Q

How long for anti platelets in scheduled cath with placement of DES and BMS?

A

DES - 6 month

BMS - 1 month

39
Q

Criteria for fibrinolytic therapy in STEMI

A

Symptom onset + transport time < 12 hrs. Or PCI hospital is >2 hrs away

40
Q

Dose of ASA for pericarditis?

A

2-4g/d

41
Q

3 BB that reduce mortality in CHF?

A

Metoprolol succinate, carvedilol & bisoprolol

42
Q

Digoxin and lasix doesn’t decrease mortality in CHF but does decrease…

A

Hospitalization

43
Q

What’s the benefit of adding ivabradine(corlanor) ? Criteria to adding this Med?

A

LVEF <35% with symptomatic NYHA 2-3 who are already on a BB with HR > 70 at rest.

*reduces hospitalization

44
Q

1 cause of secondary HTN

A

Sleep apnea!hyperaldosteronism is now #2

45
Q

Thiazide diuretics are ineffective with GFR…

A

<30-40

**loops still work! And work better with metolazone

46
Q



A
47
Q

When do you need to rapidly decrease BP? What is the ideal rx to use?

A

Dissecting AAA, labetalol or esmolol

*want SBP <110 Idealy between 90-100

48
Q

How often should you repeat echocardiogram for patient with asymptomatic aortic stenosis

A

Every 3 to 5 years for asymptomatic patients per ACA/AHA

49
Q

What antihypertensive medications are contraindicated in first-° AV block?

A

None of this is a benign rhythm you can use any medication

50
Q

Which type of second-degree AV block is a wenckebach?

A

Mobitz type 1 second-° AV block

51
Q

New onset Mobitz type one second° AV block(wenckebach) could be indicative of… How do you treat this for them?

A

Usually a benign rhythm however maybe indicative of inferior wall ischemia if it is new. The rhythm itself does not require any additional treatment however further evaluation into possible RCA ischemia is needed

52
Q

Treatment of Mobitz type two2° AV block

A

Second-degree block by itself is a benign condition however Mobitz type two has a high risk of progressing to 3rddegree AV block and will require referral for possible placement of permanent pacemaker. This is a problem with the distal conduction system below the AV node a.k.a. the his Purkinje system.

53
Q

For a patient who is in a fib who needs to be cardioverted how long do they need to be on anticoagulation before and after cardio version?

A

Ideally at least four weeks before and four weeks after

54
Q

Cut off for a long QT syndrome and men and women?

A

QTC greater than 460 and women or 440 in men

55
Q

When does long QT syndrome require treatment? What is the treatment?

A

QTC greater than 470 needs a beta blocker where is a QTC greater than 500 may need implantable ICD due to risk of torsades de point and sudden cardiac death

56
Q

Which SSRI can cause prolong QT syndrome commonly?

A

Citalopram

57
Q

What size of AAA can you add somebody referred to vascular surgeon?

A

5 to 5 1/2 cm

58
Q

How Do you measure an ABI?

A

SBP in X LE / SBP in X UE = ABI

  • Will need vascular Doppler on PT to get ankle BP
59
Q

Treatment of cocaine induced ACS

A

MONA + benzodiazepines if that doesn’t help then used CCB. Avoid BB bc they can cause spasms when used with cocaine.

ABFM First Aid (22 decks)

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