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MTBs Step 2CK > Cardio > Flashcards

Cardio Flashcards

1
Q

which side of the heart shit increases with…..

inhalation

A

inhale you increase venous return to the right heart

*its venous return increases bc venous = blue & when your blue you inhale

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2
Q

Amyl Nitrate will —–to the heart/

A

decrease afterload

*vasodilator

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3
Q

guy comes in with ST elevation. hes already had MONA what do you do next?

A

Cath

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4
Q

tx of MS

A

diuretics then balloon valvuloplasty

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5
Q

what drug is uniquely used to tx PAD

A

cilostazol

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6
Q

what drug does a person need to be on with a 1. DES & 2. bare metal stent?
how long?

A

Clopidogrel

  1. DES = 12m
  2. Bare metal stent = 1m
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7
Q

tx of WPW

A

procainamide

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8
Q

what murmer?

water-hammer pulse, wide pulse pressure, Quinke Pulse, Hill Sign

A

AR!

quinke = pulse in nail bed
hill = bp in leg 40 more than arm
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9
Q

dx of pericardial tamponade

A

ECG

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10
Q

MVP murmer

increase?

A

midsystolic click murmer

inc: valsalva + standing

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11
Q

Peripheral Arterial disease(PAD) sx

A

claudication, smooth, shiny skin, loss of hair and sweat glands and loss of pulses in the feet

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12
Q

what is the best initial test for pt with CHF

A

echo! = tells you if its systolic dysfunction or diastolic dysfunction

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13
Q

what 2 L sided murmers are increased by standing/valsalva but decreased by squating/leg raise

A

HOCM, MVP

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14
Q

Peripartum Cardiomyopathy

A

prego women makes Ab’s to her own heart. LV dysfunctionis short term and often reversable if not need transplant.

tx: ACE, BB, Diuretic, etc

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15
Q

pathogenesis of CHF?

A

infarction/ valvular heart disease/hypertension —> dilation —> regurgitation —> CHF

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16
Q

S4 means….

A

sound of atrial systole contracting against a stiff or noncompliant LV

well fuck…you

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17
Q

MR dx test?

A

TEE

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18
Q

MR murmer

increase? decrease?

A

pansystolic murmer caused by dilation of the heart that radiates to the axilla
.
inc:leg raise, squat, handgrop
dec: standing, valsalva and amyl nitrate

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19
Q

when do you give biventricular pacemaker?

A

EF <35% + QRS >120ms

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20
Q

tx of MVP

A

BB > valve repair

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21
Q

AS murmer

increases? decreases?

A

crescendo-decrescendo systolic murmer

inc: leg raising, squatting + amyl nitrate
dec: valsalva, standing, handgrip

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22
Q

if you see electrical alternans on ECG you shoudl be thinking….

A

pericardial tamponade, QRS height alternates between leads

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23
Q

causes of pleuritic pain

A

PE, pneumonia, pleuritis, pericarditis, pneumothorax

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24
Q

you do a nuc stress tests & see low uptake. what do you do next?

A

ANGIOGRAPHY to determine what vessels are involved.

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25
Q

how do you differentiate from 3rd degree block vs sinus brady?

A

3rd degree block will have “cannon a-waves” = atrial contracting againsted a closed tricuspid = ventricular diassociation

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26
Q

Squatting will —– to the heart.

A

increase venous return

*pushes blood from legs to heart via M contractions

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27
Q

lifting legs in the air with ——ot the heart.

A

increase venous return

*gravity

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28
Q

tx of bradycardia

A

atropine

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29
Q

MS sx

A

diastolic openign snap, dilated LA pushes on esophagus causing “horseness”, increased risk of Afib, elevates Left mainstem bronchus due to dilated atrium

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30
Q

What meds lower mortality in ACS?

A

BB(only one thats not time sensitive), Aspirin & Nitro

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31
Q

pt post MI, w/oxy sat in RV > RA. dx?

A

septal rupture!

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32
Q

when do you give a implantable cardioverter/defibulator

A

EF <35%

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33
Q

Which RF of CAD can you eliminate that will provide the greatest IMMEDIATE benefit?

A

smoking

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34
Q

Which cardiac marker can be used to assess 2nd MI?

A

CKMB

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35
Q

Constrictive pericarditis sx? path?

A

heart calcifies = can be seen on xray

sx: pericardial knock bc heart cant fill, edema, JVD, hepatosplenomegaly, ascites, kussmauls sign(increased JVD on inhalation)

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36
Q

sx of pericardial tamponade

A

SOB, hypotension, JVD, CLEAR LUNGS, pulsus paradoxus(>10mmhg on inhalation), ELECTRICAL ALTERNANS

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37
Q

What do you give for an NSTEMI?

A

heparin

38
Q

tx of diastolic dysfunction in CHF

A

diastolic - normal EF

basic: ACE, BB(metoprolol, carvedilol), Spironolactone or hydralazine+nitrates

39
Q

what are Rhonci?

A

Rhonci in the Bronchi = wheezing due to constriction/inflammation

40
Q

who gets a statin?

A
  1. anyone with CAD
  2. LDL>190
  3. LDL 70-189 w/DM + 40-75yoa
  4. LDL 70-189 + 40-75 yoa w/calculated risk
41
Q

pt on ACE/ARB develops hyperkalemia. what do you do?

A

switch them to hydralazine + nitrates

42
Q

valsalva will ——to the heart.

A

decrease blood return = increases intrathroasic pressure = flattens IVC = decreasing flow into heart

43
Q

VSD murmer

increases ?

A

holosytolic murmer at the LLstearnal boarder, SOB

inc: exhalation, squat, leg raise

44
Q

pulsus paradoxus is classic for…

A

(>10mmhg on inhalation) = pericardial tamponade

45
Q

guy comes in with ST depression hes has MONA what do you do next?

A

thrombolytics! = depression = he hasnt clotted yet = bust up that clot and save the myocardium

46
Q

AR murmer

increases? decreases?

A

blowing diastolic murmer = diastolic decrescendo murmer @ LLboarder
inc: leg raiseing, squatting, handgrip

47
Q

stent vs bypass

A 
stent = 1-2vessels
bypass = 3 + vessel or main vessel dz
48
Q

causes of postional chest pain

A

pericarditis = worse when lying dwn but better when sitting up

49
Q

tx of SVT

A

adenosine

50
Q

dx of VSD

A

echo then cathe

51
Q

What would you give an asthmatic instead of a BB for CAD?

A

CCB like Vermpamil or Diltalazam

*risk fo reflex tachy

52
Q

RF of Ischemic heart dz?

A

DM, HTN, Tobacco, Hyperlipidemia, PAD, Obesity, Inactivity & family History

53
Q

MS murmer increases with…

A

leg raise, squat and expiration

54
Q

ECG of pericarditis

A

global ST elevation and PR segment depression

55
Q

mechanism of Thallium in stress tests?

A

picked up by NaK ATPase = decrease uptake = dmg myocardium

56
Q

best test for PAD

A

ABI with >10% differ then angiography

57
Q

tx of hypertropic cardiomyopathy

A

BB & diuretics

58
Q

tx of MR?

A

ACE ARB, Nifedipine; if EF<60 then do surgery

59
Q

tx of AS?

A

diuretics > valve replacement

60
Q

screening for AAA

A

65-75 smokers w/U/S

61
Q

tx of pericarditis

A

NSAIDs + Colchicine

62
Q

if a patient cannot get PCI within 90 min what do you need to do for them?

A

thrombolytics

63
Q

tx for aortic dissection

A

1.ence BB 2. Nitroprusside 3. Surgical Consultation

64
Q

whats the single worst/most dangerous factor for CAD?

A

diabetes

65
Q

restrictive cardiomyopathy sx

A

SOB, Kussmauls Sign(increased JVP with inhalation), low voltage ECG

66
Q

tx of PAD

A

ASA, BP control with ACE, exercise, lipid control and CILOSTAZOL(unique)

67
Q

which nuclear stress test should be used wiht obese pt? why?

A

sestamibi bc it has greater ability to penetrate tissue in fattys

68
Q

do u need to ppx pt for dental surgery if they have MVP

A

no

69
Q

MCC of death after MI?

A

Vtach or Vfib

70
Q

tx of restrictive cardiomyopathy

A

diuretics + tx underlying cause +/- pericardiocentesis

71
Q

handgrip will ——to the heart.

A

increases blood in the heart/afterload

  • compressing arteries in arm pushing blood back into heart
72
Q

other not so common causes of CHF

A

alcohol, post viral myocarditis, radiation, adraymycin, doxorubicin, chagus + others, hemochromatosis, thyroid dz, peripartum cardiomyopathy, thiamine deficiency

73
Q

tx of AR

A

ACE, ARB, Nifedipine to decrease afterload = push blood out

then surgery if EF <55

74
Q

takotsubo cardiomyopathy tx

A

ACE, diuretics and BB

75
Q

Tx of dialated cardiomyopathy

A

ACE/ARB, BB, Spironolactone

76
Q

tx of pericardial tamponade

A

pericardiocentesis and if chronic pericardial windown placement

77
Q

what are rales?

A

Rales in the Tails = bubbling/crackling in the aveoli due to fluid

78
Q

ASD auscultation shit

A

fixed splitting of S2

79
Q

which side of the heart shit increases with…..

expiration

A

exhale you evict blood from your lungs & into the LV

80
Q

RV infarction is likely to cause what complication?

A

3rd degree block!

81
Q

Which stress test drug shouldn’t be used in asthmatics?

A

Dipyridamole = can provoke bronchospams

82
Q

Complications of MI

A

shock, valve ruptures, septal rupture, myocardial wall rupture, sinus brady, 3rd degree block, RV infarction

83
Q

S3 means….

A

rapid ventricular filling during diastole

fuck…your screwed

84
Q

what should you NOT do with pericardial tamponade?

A

give diuretics

85
Q

sx of pericarditis

A

pleuritic chest pain that is positional, sharp & breif, friction rub, GLOBAL ST ELEVATION & PR depression

86
Q

what bb do you give for MI? why?

A

metoprolol or esmolol = B1 selective!

87
Q

MS what might you see on ECG?

A

biphasic Pwaves

88
Q

tx of constrictive pericarditis

A

diuretics then surgical removal of the pericardium

89
Q

standing up will ——to the heart.

A

decreases blood return

*gravity!

90
Q

tx of systolic dysfunction in CHF

A

systolic = decreased EF

basic: ACE, BB(metoprolol, carvedilol), Spironolactone or hydralazine+nitrates
unique: DIGOXIN

MTBs Step 2CK (20 decks)

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