CARDIO Flashcards
(143 cards)
1
Q
How to you ensure you’re in the pericardium when doing a pericentesis?
A
blood should NOT clot
2
Q
What is the rise in the jugular pressure that increases with inspiration with pericardial tamponade?
A
kussmauls
3
Q
What are the 3 Ds of pericardial tamponade?
A
Distant heart sounds, distended jugular, decreased arterial pressure
4
Q
What are the different types of aortic dissection?
A
stanford A and B
5
Q
What is the initial dose of plavix/clopidgrel for MI?
A
300mg
6
Q
Can you use heparin with patients with CrCl
A
NO
7
Q
What other diuretics can be used other than furesomide?
A
bumetanide
8
Q
What are the ADRs of amiodarone?
A
pulm HTN, hyper/hypothyroid, elevated LFT, iodine allergy
9
Q
What statins are approved for acute MI treatment?
A
Atrovastatin 80mg OR Rosuvastatin 40mg
10
Q
Patient passes out after standing for too long?
A
neurocardiogenic syncope
11
Q
What is the most likely cause of a child fainting after an argument?
A
cardio - QT prolongation
12
Q
What is the most likely cause of an adult fainting after an argument?
A
cardio - MI
13
Q
What is the most likely cause of fainting after getting up from a chair?
A
orthostatic
14
Q
What is the most likely cause of orthostatic hypotension if the patient does not have a reflex of increasing HR?
A
autonomic dysfxn
15
Q
What is emergency HTN
A
> 180/120 + organ damage
16
Q
What HTN meds are cautioned after MI?
A
Minoxidil and Clonidine
17
Q
What HTN meds are cautioned after cataract surgery?
A
alpha blockers
18
Q
What HTN meds are contraindicated with bradycardia or heart block?
A
beta blockers, clonidine, CCB
19
Q
What HTN meds are contraindicated with asthma and PAD?
A
beta blockers
20
Q
What HTN meds are contraindicated with pregnancy?
A
ACE, ARB, thiazide
21
Q
What HTN meds are contraindicated with renal artery stenosis?
A
ACE, ARB
22
Q
What HTN meds can cause pericardial effusion?
A
minoxidil
23
Q
-asozin?
A
alpha blockers
24
Q
-dipine?
A
CCB
25
-sartan?
ARB
26
What HTN meds can cause hypertrichosis?
minoxidil
27
What HTN meds can cause hyperurecmia?
thiazide
28
What HTN meds can cause peripheral edema?
CCB
29
What HTN meds can cause diarrhea?
direct renin inhibitors
30
What HTN meds can cause hypokalemia?
thiazide
31
What HTN meds can cause constipation?
CCB (Verapamil), clonidine
32
What HTN meds can cause depression?
beta blockers
33
What HTN meds can cause hyperkalemia?
ACE, ARB, spironolactone
34
What are the 5 common causes of restrictive cardiomyopathy?
1) cancer
2) amlyoidosis
3) radiation
4) fibrosis
5) hemachromatosis
6) scleroderma
35
Angina syncope is a child?
child- hypertrophic cardiomyopathy
36
What is the difference between systolic and diastolic HF?
systolic: prob pumping out, no prob filling; diastolic: prob filling, no prob pumping
37
What are the 5 common causes for systolic HF?
radiation/chemo, tako tsubo, MI, cocaine, viral infxn
38
Patient on a ratio of __ can have balloon pump removed?
3:1
39
Acute MI treatment balloon pump ratio?
1:1
40
What will happen to patient's INR when on amiodarone?
increases
41
What is the INR goal for mechanical valve?
2.5-3.5
42
What is thrombophlebitis?
PE + inflammed vessel walls
43
What is tx for thrombophlebitis?
one month of low molecular heparin
44
What test should be ordered for supsicion of pheochromocytoma?
UA for VMA
45
When treating a patient with HTN urgency, __% in __hours should be avoided?
more than 25% in 1-2hrs
46
What are JNC 7 classification?
pre - 140/90; stage 1 - 160/100; stage 2 - >160/100
47
What is the difference between constrictive and restrictive cardiomyopathy?
constrictive - pericardium constricts; restrictive - deposits within the pericardium
48
What causes death in HOCM?
venticular tachycardia --> ventricular fib
49
How to treat diastolic HF?
same as systolic HF: beta blocker, diuretic, ACE
50
What arrythemia can occur with structural changes?
ventricular tachycardia
51
What types of murmurs are associated with a. fib?
MITRAL regurg and MITRAL stenosis
52
What murmur RARELY causes sx?
pulm regurg
53
What electrolyte disorder can increase digoxin toxicity?
hypokalemia
54
What med can cause vision to turn blue?
sildenfil
55
What med can cause vision to turn yellow?
digoxin
56
What drug decreases afterload in post MI?
ACE
57
What do V1, 2, 3, 4, 5, 6 leads mean?
1, 2 -posterior? ; 3, 4 - anterior; 5, 6 - lateral
58
Calf pain that is resolved with rest?
peripheral artery disease
59
What is the term for calf pain that is resolved with rest?
claudication
60
What do low ejection fraction and HOCM have in common?
death from VT
61
What mechanical intervention can improve coronary perfusion and work load?
aortic balloon pump
62
What is the best medication for HTN in MI?
dobumatine
63
What meds are recommended with patients with CAD?
ACE and BB
64
What type of adrenal tumor causes HTN?
pheochromocytoma
65
First line HTN with NO DM?
thiazide
66
First line HTN with DM?
ACE
67
Common cause of diastolic HF?
HTN
68
What meds for HF?
ACE, loop diuretic, nitro
69
What meds are recommended with chronic HF?
ACE and BB
70
Vitamin deficiency that causes HF?
thiamine
71
What 2 CCB affects AV node?
verapamil, diltiazem
72
What rash is seen with endocarditis?
petechial
73
Roth spots in a drug user is associated with what bug?
s. aureus
74
How to tell the difference between tricuspid and mitral regrug?
Carvallo's sign - murmur of TRICUSPID regurg increases during held in inspiration
75
What is the physical sign seen with tricuspid stenosis?
JVD
76
Common cause of tricuspid stenosis?
rheumatic fever
77
Rheumatic fever attacks which valve first?
mitral
78
What murmur is heard with pregnancy?
mitral stenosis
79
What are the 3 common causes of mitral and tricuspid regurg?
leaflet degeneration, chordea tendinae rupture, dilation
80
What are the common causes of aortic and pulm regurg?
leaflet degeneration, dilation
81
What is the diff between chronic systolic and diastolic HF?
systolic: ACE, loop diuretic, BB; diastolic: ACE and BB
82
What is gallavardin phenomenon associated with?
aortic stenosis
83
What is austin flint associated with?
aortic regurg: low rumbling murmur
84
What are the 3 symptoms of aortic stenosis?
ASH (Angina, Syncope, Heart failure)
85
What are the 3 symptoms of mitral stenosis?
PHD (Palpitation, Heart failure, Dyspnea on exertion)
86
Machine murmur?
PDA
87
What is pathognomonic for rheumatic fever?
aschoff bodies - subcutaneous nodules
88
What cyanotic heart defect causes right heart failure?
eisenmenger syndrome
89
Pansystolic murmur?
VSD
90
What are the 4 components for tetratology of fallot?
overriding aorta, VSD, RVH, pulmonary valve stenosis
91
Venous ulcer occurs commonly where?
medial mallelous
92
What cardiac abnormality is associated with bicuspid aortic valve?
coarctation of aorta
93
Murmur with pulmonic area ejection murmur and fixed split S2?
ASD
94
What 2 CXR indicates PE?
hamptons hump and westermark sign
95
Imaging study for PE in pregnancy?
VQ scan
96
Patient has a cold L arm d/t arterial clot - what is the valvulopathy?
mitral stenosis
97
What must be r/o'd in marfan sx?
aortic dissection
98
What is first line for varicose veins?
compresison stockings
99
What med for arterial emboli?
heparin
100
What valvulopathy is associated with periperhal arterial emboli?
mitral stenosis
101
What HTN makes peripheral arterial emboli sx worse?
BB
102
Gold standard for peripheral artery?
angiograhy
103
Claudication calls for what first test?
ABI
104
What is associated with giant cell arteritis?
polymyalgia rheumatica
105
30yo male has a syncopal episode after taking abx and EKG shows VT, cause?
QT prolongation from abx
106
70yo male passes out after arguing, what 3 conditions should be r/o'd?
acute coronary syndrome (clot in the heart: MI, unstable angina, angina), ventricular arrhythmia, aortic stenosis
107
What HTN med causes impotence in men?
BB
108
Patient going under radiation is likely to get what type of cardiomyopathy?
constrictive cardiomyopathy
109
Signs of constrictive cardiomyopathy?
JVD, dyspnea on exertion
110
What is affected in HOCM?
sacromere
111
What are causes of HF?
thiamine deficiency, hyperthyroidism, severe anemia, AV shunts
112
Where are the apical impulses located in systolic and diastolic HF?
systolic -downward and L; diastolic: midclavicular and 5th intercostal
113
S4 is associated with?
HOCM, MI, diastolic HF
114
S3 is associated with what HF?
systolic HF
115
What is graham steel murmur?
pulm regurg
116
Opening snap and decrescendo diastolic murmur?
mitral stenosis
117
Crescendo decrescendo systolic murmur?
pulm stenosis
118
Ebstein anomaly?
tricuspid is not formed properly and is not long enough to close the valv resulting to triscupid regurg
119
Why does squatting help kids with tetralogy fallot?
squatting temp closes the shunt so they get more O2 throughout the body
120
What is another word for pansystolic?
holosystolic
121
What is the most common cardiac defect?
VSD
122
12yo male gets leg cramps when running and notice a radial femoral pulse, what to suspect?
coarctation of aorta
123
Common cause of aortic dissection?
HTN
124
Pulmonic area ejection murmur with fixed splitting of S2 , what to expect on CXR?
dilated pulmonary arteries
125
Gold standard for 56yo male with tearing sensation to the back?
aortic angiography
126
Patient presents to ER for CP but cardiac work up is neg. Has many RF for CAD and strong family hx, what work up should he do as out patient?
walking nuclear test
127
Which cardiac enzyme lasts the longest?
troponin
128
Which cardiac enzyme peaks the first?
CKMB
129
How does elderly patient first present when having an ACS?
syncopal event
130
Do a. fib patients have preload?
NO b/c atrium isnt contracting = no blood
131
What is preload vs afterload?
preload: the stretch of the ventricles after the atrium contracts
afterload: the resistance and "push" the ventricles have to do inorder to get the blood through the aortic valve (meaning higher afterload = HTN)
132
Which of the following medications is best avoided when treating a hypertensive patient who has insulin-dependent diabetes mellitus?
Propanolol
133
A 15-year-old boy faints while playing basketball. In the emergency department he is alert and non-cyanotic. Blood pressure 140/90 mm Hg, pulse 72/min/regular and respiratory rate 16/min. Examination shows apical lift, 2/6 ejection murmur at the apex and bisferiens carotid pulse. Which of the following is the preferred initial therapy?
Verapamil
134
A 67-year-old man who has known chronic bronchitis and atherosclerotic heart disease has a 1 week history of increasing exertional dyspnea. Which of the following is the preferred diagnostic test to differentiate pulmonary dyspnea from cardiac dyspnea?
Bnp
135
A 44-year-old woman has an acute ischemic cerebellar stroke. Blood pressure 146/92 mm Hg, pulse 102/min/regular, rectal temperature 102.4 degrees F, and respirations 22/min. Lungs are clear to auscultation. Cardiac examination shows a 2/6 left sternal border diastolic heart murmur. Which of the following is the most likely diagnosis?
Infective endocarditis
136
A 70-year-old man who has a prosthetic aortic valve is to undergo gum surgery. He has no allergies. Which of the following is the preferred agent in endocarditis prophylaxis?
Ampicillin
137
A 70-year-old man has a 2 week history of fatigue and low grade fever. Presence of which of the following would suggest endocarditis as the underlying disease?
Petechiae
138
A 48-year-old man with bipolar disorder is well-controlled on lithium. He recently developed hypertension. Which of the following antihypertensive drugs is most likely to cause lithium toxicity if prescribed to him by your practice?
Hydrochlorothiazide
139
A 56-year-old woman has a 4 month history of poor concentration, forgetfulness, constipation, and dry skin. Hypothyroidism is diagnosed. Which of the following is the most likely electrocardiographic abnormality to be noted?
Low voltage
140
Thirty minutes after using cocaine, an 18-year-old man has agitation, sweating, and restlessness. Blood pressure 220/116 mm Hg, pulse 138/min. Which of the following effects is most likely to be noted if intravenous propranolol is administered?
Further elevation of BP
141
A 67-year-old man has a 2 week history of increasing facial swelling with onset of facial cyanosis. Examination shows elevated jugular venous pressure and dilation of the veins of the anterior chest and both arms. Cardiac examination is normal. Which of the following is the most likely diagnosis?
Superior vena cava syndrome
142
A 33-year-old woman has systolic heart failure related to dilated cardiomyopathy. Which of the following is the least likely cause of the cardiomyopathy?
Prior hx of viral hep
143
Which of the following is the mechanism of action of a thrombolytic medication?
Activates plasminogen
