Cardio

Question 1

LAD, LCx, RCA vascular territories?

Answer 1

LAD: anterior and septum
LCx: lateral
RCA: inferior and right ventricle

Question 2

Unstable angina, NSTEMI, STEMI are what kind of coronary syndromes?

Answer 2

acute

Question 3

Risk factor for athero syndromes? (5)

Answer 3

Age (M>45, F>55)
Hypertension
Hyperlipidemia
Diabetes
Tobacco
Family history (M

Question 4

If pt gets chest pain during procedure and some risk factors what steps to take?

Answer 4

1. stop procedure
2. sublingual nitroglycerin
3. aspirin
4. emergency dept

Question 5

place what with catheterization?

Answer 5

stents

Question 6

Difference between bare metal and drug-eluting stents?

Answer 6

Drug eluting stents last longer, have to give dual anti- platelet therapy for 1 month with bare metal, 1 year for drug-eluting.

Question 7

If pt has stent, what considerations for tooth extraction?

Answer 7

Postpone for amt time theyre on antiplatelet therapy

Question 8

Aspirin or other drugs with “grel” are?

Answer 8

antiplatelet

Question 9

type of drugs are..
statins?
"olol"
"pril/sartan"
nitro

Answer 9

lipid-lowering
beta blockers
Ace-inhibitors
nitrates

Question 10

Cardiomyopathies defined as due to what? Manifest as what?

Answer 10

Abnormal muscle function, abnormal contraction/relaxation, CHF

Question 11

Etiology of Ischemic cardiomyopathy?

Answer 11

coronary disease

Question 12

Etiology of non-ischemic cardiomyopathy?

Answer 12

Htn
Valve Disease
Infiltrative disease
Arrythmia

ALcohol
Chemo
Viral infection

Question 13

Treatment for cardiomyopathy:
symptoms?
prevent remodeling?
devices?

Answer 13

diuretics for symptoms
beta-blockers, ace inhibitors for remodeling
defibrillators, “resynch” therapy

Question 14

Patients in decompensated heart failure should get procedures?

Answer 14

Should not undergo nonemergent procedures

Question 15

Conduction system components?

Answer 15

SA, AV, His, bundles

Question 16

P, QRS, T waves are?

Answer 16

P - atria activation
QRS - ventricle activation
T - recovery

Question 17

Tachycardia BPM?

Answer 17

> 100

Question 18

Bradycardia BPM?

Question 19

Rate = ?

Answer 19

60/R-R interval

Question 20

Normal sinus rhythm means?

Answer 20

Each P followed by one QRS

Question 21

Atrial Fib rhythm?

Answer 21

no P wave, ventricle contracts at random intervals

Question 22

Atrial flutter rhythm?

Answer 22

saw-tooth P wave, QRS after several flutter waves

Question 23

narrow vs wide complex tachycardia

Answer 23

wide has big smooth QRS, suspect ventricular

Question 24

QRS interval should be how long?

Question 25

Syncope in young athlete can mean...

Answer 25

underlying cardiac condition, avoid epinephrine

Question 26

Sinus pause sinus arrest will cause patient to?

Answer 26

black out

Question 27

If any pauses are greater than what or HR less than what, stop procedure? This could be?

Answer 27

pauses > 3seconds | HR

Question 28

Implantable Cardioverter Defibrillators need Abx prophylaxis?

Answer 28

nooo

Question 29

What can affect ICDs programming?

Answer 29

electrocautery

Question 30

Magnet does what to ICD? How strong is safe?

Answer 30

disables ICD shocks, >30s disables 10 Gauss/1mTelsa

Question 31

Lub and Dub sounds are wut?

Answer 31

``` lub = atrioventricular valves close dub = semilunar valves close ```

Question 32

Cardiac murmur from?

Answer 32

turbulent blood flow from stenotic or regurgitant valve

Question 33

Mechanical and bioprosthetic pros cons

Answer 33

Mechanical: lasts longer but needs lifelong anticoagulation Bioprosthetic: doesn't last as long but doesn't need lifelong anticoag

Question 34

Prosthetic valve complications?

Answer 34

thrombosis Endocarditis Leak Hemolysis

Question 35

INR goal for all mechanical valves is?

Answer 35

2.5 - 3.5 (0r 2.0 if bileaflet/mechanical aortic valve with no history of stroke, afib, left ventricular dysfunction, or hypercoag state)

Question 36

Low risk valve patients?

Answer 36

Bi-leaflet aortic valve AND no history of stroke, atrial fibrillation, left ventricular dysfunction or hypercoagulable state

Question 37

High Risk valve patients?

Answer 37

Mitral or tricuspid valve Multiple valves Older valves History of previous event Left ventricular dysfunction Atrial fibrillation Hypercoagulable state

Question 38

Treatment considerations for low risk patients?

Answer 38

Warfarin withheld 48-72h before procedure so INR can fall below 1.5 Warfarin started 24h after Heparin not cessary

Question 39

High risk patients treatment procedure?

Answer 39

"Heparin Bridge" 1. stop warfarin >72h before 2. IV unfractionated herparin started when INR below 2 (usually 48h prior) 3. Heparin stopped 6h before 4. Heparin/Warfarin restarted after surgery/bleeding stops 5. Heparin discontinued when INR reaches therapeutic levels

Question 40

Endocarditis risk factors?

Answer 40

``` Structural Heart DiseaseTypic Prosthetic heart valves IV drug abuse HIV+ Hospital-Acquired Hemodialysis Pacemakers Poor dental hygiene Prior history of endocarditis ```

Question 41

Typical Endocarditis organisms

Answer 41

``` Staph. aureus Strep. viridans Strep. bovis Enterococcus HACEK group ```

Question 42

Endocarditis Major criteria

Answer 42

Positive blood culture with common microorganism | Evidence of Endocardial envolvement (vegetation/murmur)

Question 43

Endocarditis Minor criteria

Answer 43

``` Fever Single positive blood culture Predisposing condition (IV drug use, cardiac abnormality) Embolic event (embolic stroke, pulmonary infarcts, renal infacts, conjuctival hemorrhages, Janeway lesions) Immunologic phenomenon (Glomerulonephritis, Osler’s node, Roth’s spot) ```

Question 44

Dental prophylaxis needed when? (4)

Answer 44

Prosthetic valve Previous infective endocarditis CHD (unrepaired, repaired within 6mo, repaired but defects) Cardiac transplant with valvulopathy

Question 45

What kind of dental procedures require prophylaxis?

Answer 45

minupulation of gingival tissue, periapical region, perforation of oral mucosa (but not anesthetic)

Question 46

Abx Chart

Answer 46

yeah