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Clin Med > Cardio > Flashcards

Cardio Flashcards

1
Q

What is the difference between chronic stable and unstable angina?

A

Stable: chest pain w/same frequency & intensity for 2 months, substernal/exertional chest pain that is relieved w/rest
Unstable: chest pain at rest

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2
Q

What presents with ST elevation during an episode of chest pain?

A

Prinzmetal angina

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3
Q

What tests should be ordered and what is the treatment for suspected/diagnosed Prinzmetal agina?

A

Test: angiography
Tx: CCBs and nitrates

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4
Q

What diagnosis is commonly associated with chest pain at rest and during emotional stress?

A

Microvascular Angina (Syndrome X)

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5
Q

What is caused by a bacterial infection due to things such as IV drug use, indwelling catheters, failed dental prophylaxis, etc?

A

Endocarditis

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6
Q

What condition is most commonly caused by S. viridans from the mouth?

A

Subacute Bacterial Endocarditis

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7
Q

What is commonly caused by staph aureus, presents with dyspnea, cough, chest pain, confusion/AMS, higher fever, splinter hemorrhages, and may be associated with IV drug use?

A

Acute Bacterial Endocarditis

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8
Q

What is the treatment for subacute/acute bacterial endocarditis?

A

Abx for 4-6 weeks
Acute may need valve replacement

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9
Q

If a patient presents with angina >30 minutes that radiates, diaphoresis, N/V, dyspnea, anxious appearing, hypertension, and increased respiratory rate, what is your suspected diagnosis?

A

STEMI

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10
Q

What is the treatment for a patient with suspected/confirmed STEMI?

A

Aspirin, nitro, O2, IV morphine (MONA), thrombolysis (tPA) or PCI

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11
Q

How is hypertension defined?

A

BP > or = 130/80

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12
Q

What are treatment options for hypertension?

A

ACEi/ARB
CCBs
Thiazide diuretics
Beta blockers

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13
Q

What are the differences between malignant, urgent, and emergent hypertension?

A

Malignant: SBP >140 w/papilledema
Urgent: BP > or = 180/110, treat w/Clonidine
Emergent: BP > or = 180/110 w/organ damage, treat w/nitroprusside

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14
Q

What is your suspected diagnosis for a patient who presents with dyspnea, cough, angina, frothy sputum, pulmonary rales, lower extremity edema, and recent weight gain?

A

Congestive Heart Failure

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15
Q

What are the treatment options for CHF?

A

Stage A: control risk factors (HTN, CAD, lipids, lifestyle)
Stage B, C, D: loop diuretics (symptom control), ACEi/ARBs, beta blockers (carvedilol, metoprolol succinate, bisoprolol), spironolactone
Potentially revascularization, valve replacement, mechanical implants, heart transplant

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16
Q

How is atrial fibrillation defined on an EKG?

A

Irregularly irregular w/no P waves

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17
Q

What is the treatment atrial fibrillation?

A

Cardioversion (electrical or w/pharm) or ventricular rate control & prevention of thromboembolism
Anticoagulation for cardioversion (3 weeks before & 4 weeks after)
Rate control w/beta blockers, verapamil or dilt (CCBs), or digoxin
Amiodarone for refractory
Pacemaker possibly

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18
Q

What commonly presents with dyspnea, chest pain, and exertional syncope in teens and young adults?

A

Hypertrophic Obstructive Cardiomyopathy

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19
Q

What is the treatment for hypertrophic obstructive cardiomyopathy?

A

Avoid strenuous exercise, no treatment if asymptomatic
Ff symptomatic: non-DHP CCB (verapamil) & beta blockers (metoprolol)
IDC implant possibly

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20
Q

What condition commonly presents with complaints of paroxysmal nocturnal dyspnea?

A

Restrictive cardiomyopathies

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21
Q

What is the treatment for restrictive cardiomyopathies?

A

Transplant (no other effective treatment)

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22
Q

What is the leading cause of sudden death in young athletes that is characterized by abnormal heart rhythms & sudden death?

A

Arrhythmogenic Right Ventricular Dysplasia (ARVD)

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23
Q

What is defined as a viral infection that causes inflammation of the heart muscle?

A

Myocarditis

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24
Q

What condition presents with a rubbing sound on auscultation of the heart that is relieved w/leaning forward?

A

Pericarditis

25
Q

What is the treatment for pericarditis?

A

Supportive (NSAIDs - indomethacin, possibly steroids)

26
Q

What are the signs/symptoms of peripheral vascular disease (PVD)?

A

5 P’s
Pain
Pallor
Pulselessness
Poikilothermia (cool feeling)
Paresthesias

27
Q

What is the 1st line treatment for PVD?

A

IV UFH

28
Q

What can present with symptoms that are described as severe interscapular pain that radiates, and is described as “tearing”?

A

Aortic dissection

29
Q

What can present with the classic triad of abdominal pain, shock, pulsatile mass, but is usually an incidental finding?

A

Abdominal Aortic Aneurysm (AAA)

30
Q

What are the 2 types of aortic dissections?

A

Type A (Ascending) - younger patients, collagen vascular disorders
Type B (Descending) - older patients, hypertensive, atherosclerosis

31
Q

What is the treatment for an aortic dissection?

A

ICU admission, control BP, beta blockade
Surgery on all ascending types
Surgery on descending if rupture, ischemia, or pain

32
Q

What is the suspected diagnosis in a patient who presents with an ulcer over the distal 1/3 of their leg near the medial malleolus that has brawny (wood) edema?

A

Venous insufficiency

33
Q

What are the treatment options for venous insufficiency?

A

Saphenous vein ablation
Vein stripping
Sclerotherapy

34
Q

What are possible signs/symptoms of a pulmonary embolism?

A

Chest pain
SOB
Tachycardia
Anxiety
Hemoptysis
Low O2 sats
Low grade fever

35
Q

What is the gold standard for diagnosing a PE?

A

Pulmonary angiography
Spiral CT

36
Q

What is the treatment for a PE?

A

Heparin
Must be anticoagulated for 3 months

37
Q

What is the suspected diagnosis in a patient who presents with unilateral lower extremity swelling that is painful and warm?

A

Deep Vein Thrombosis

38
Q

What is the gold standard for diagnosing a DVT?

A

Contrast venography
Doppler ultrasound

39
Q

What is the treatment for a DVT?

A

Heparin (esp. LMWH)
Long-term treatment with Warfarin (monitor PTT with heparin for 3 months, PT/INR w/Warfarin)
LE intermittent compression

40
Q

If a patient has a distal DVT and is asymptomatic, how can you manage it?

A

Monitor

41
Q

What are the characteristics of aortic regurg?

A

Backflow into L ventricle
Diastolic murmur at L lower sternal border

42
Q

What might be heard on auscultation of mitral stenosis?

A

Diastolic murmur w/opening snap at apex

43
Q

What are the characteristics of mitral regurg?

A

Backflow into the L atrium
Blowing systolic murmur at apex w/radiation to left axilla

44
Q

What are the characteristics of mitral valve prolapse?

A

Bulging of mitral valve leaflet into L atrium during systole
Mid-systolic click at apex

45
Q

What might be heard during auscultation of tricuspid stenosis?

A

Rumbling diastolic murmur at L lower sternal border

46
Q

What are the characteristics of tricuspid regurg?

A

Backflow into the R atrium
Systolic murmur at L lower sternal border w/radiation to sternum
JVD

47
Q

What might be heard during auscultation of pulmonary stenosis?

A

Harsh systolic murmur at upper L sternal border w/radiation to L shoulder

48
Q

What are the characteristics of pulmonary regurg?

A

Backflow into the R ventricle
Diastolic murmur at L upper sternal border

49
Q

Suspected regurg/stenosis should have what test ordered and are commonly treated with what medications?

A

Test: echo
Tx: ACEi/ARBs, beta blockers, diuretics, or surgery

50
Q

What disorder presents with palpitations, rapid HR >120, and widened QRS and delta waves on EKG?

A

Wolf-Parkinson-White Syndrome

51
Q

What is the treatment for Wolf-Parkinson-White Syndrome?

A

Radiofrequency catheter ablation

52
Q

What is beck’s triad, and what diagnosis do these symptoms commonly present in?

A

Triad: hypotension, JVD, muffled heart sounds
Commonly seen in cardiac tamponade

53
Q

What test should be done for suspected cardiac tamponade and what is the treatment?

A

Test: echo
Tx: pericardiocentesis

54
Q

What commonly presents as QT prolongation due to drugs or alcohol with palpitations, syncope, and dizziness?

A

Torsades des pointes

55
Q

What is the treatment for torsades?

A

IV magnesium

56
Q

If during auscultation you hear a fixed split S2, systolic murmur at L upper sternal border, what is your suspected diagnosis?

A

Atrial septal defect

57
Q

What is the treatment for atrial septal defect?

A

If small, it may close on its own
Larger defects may require surgical closure

58
Q

What presents with a continuous machinery murmur on auscultation?

A

Patent ductus arteriosus

59
Q

What is the treatment for a patent ductus arteriosus?

A

Indomethacin

Clin Med (15 decks)

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