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MTBs Step 2CK > Cardio > Flashcards

Cardio Flashcards

(90 cards)

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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
how do you differentiate from 3rd degree block vs sinus brady?
3rd degree block will have "cannon a-waves" = atrial contracting againsted a closed tricuspid = ventricular diassociation
26
Squatting will ----- to the heart.
increase venous return *pushes blood from legs to heart via M contractions
27
lifting legs in the air with ------ot the heart.
increase venous return *gravity
28
tx of bradycardia
atropine
29
MS sx
diastolic openign snap, dilated LA pushes on esophagus causing "horseness", increased risk of Afib, elevates Left mainstem bronchus due to dilated atrium
30
What meds lower mortality in ACS?
BB(only one thats not time sensitive), Aspirin & Nitro
31
pt post MI, w/oxy sat in RV > RA. dx?
septal rupture!
32
when do you give a implantable cardioverter/defibulator
EF <35%
33
Which RF of CAD can you eliminate that will provide the greatest IMMEDIATE benefit?
smoking
34
Which cardiac marker can be used to assess 2nd MI?
CKMB
35
Constrictive pericarditis sx? path?
heart calcifies = can be seen on xray sx: pericardial knock bc heart cant fill, edema, JVD, hepatosplenomegaly, ascites, kussmauls sign(increased JVD on inhalation)
36
sx of pericardial tamponade
SOB, hypotension, JVD, CLEAR LUNGS, pulsus paradoxus(>10mmhg on inhalation), ELECTRICAL ALTERNANS
37
What do you give for an NSTEMI?
heparin
38
tx of diastolic dysfunction in CHF
diastolic - normal EF | basic: ACE, BB(metoprolol, carvedilol), Spironolactone or hydralazine+nitrates
39
what are Rhonci?
Rhonci in the Bronchi = wheezing due to constriction/inflammation
40
who gets a statin?
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
pt on ACE/ARB develops hyperkalemia. what do you do?
switch them to hydralazine + nitrates
42
valsalva will ------to the heart.
decrease blood return = increases intrathroasic pressure = flattens IVC = decreasing flow into heart
43
VSD murmer | increases ?
holosytolic murmer at the LLstearnal boarder, SOB inc: exhalation, squat, leg raise
44
pulsus paradoxus is classic for...
(>10mmhg on inhalation) = pericardial tamponade
45
guy comes in with ST depression hes has MONA what do you do next?
thrombolytics! = depression = he hasnt clotted yet = bust up that clot and save the myocardium
46
AR murmer | increases? decreases?
blowing diastolic murmer = diastolic decrescendo murmer @ LLboarder inc: leg raiseing, squatting, handgrip
47
stent vs bypass
``` stent = 1-2vessels bypass = 3 + vessel or main vessel dz ```
48
causes of postional chest pain
pericarditis = worse when lying dwn but better when sitting up
49
tx of SVT
adenosine
50
dx of VSD
echo then cathe
51
What would you give an asthmatic instead of a BB for CAD?
CCB like Vermpamil or Diltalazam | *risk fo reflex tachy
52
RF of Ischemic heart dz?
DM, HTN, Tobacco, Hyperlipidemia, PAD, Obesity, Inactivity & family History
53
MS murmer increases with...
leg raise, squat and expiration
54
ECG of pericarditis
global ST elevation and PR segment depression
55
mechanism of Thallium in stress tests?
picked up by NaK ATPase = decrease uptake = dmg myocardium
56
best test for PAD
ABI with >10% differ then angiography
57
tx of hypertropic cardiomyopathy
BB & diuretics
58
tx of MR?
ACE ARB, Nifedipine; if EF<60 then do surgery
59
tx of AS?
diuretics > valve replacement
60
screening for AAA
65-75 smokers w/U/S
61
tx of pericarditis
NSAIDs + Colchicine
62
if a patient cannot get PCI within 90 min what do you need to do for them?
thrombolytics
63
tx for aortic dissection
1.ence BB 2. Nitroprusside 3. Surgical Consultation
64
whats the single worst/most dangerous factor for CAD?
diabetes
65
restrictive cardiomyopathy sx
SOB, Kussmauls Sign(increased JVP with inhalation), low voltage ECG
66
tx of PAD
ASA, BP control with ACE, exercise, lipid control and CILOSTAZOL(unique)
67
which nuclear stress test should be used wiht obese pt? why?
sestamibi bc it has greater ability to penetrate tissue in fattys
68
do u need to ppx pt for dental surgery if they have MVP
no
69
MCC of death after MI?
Vtach or Vfib
70
tx of restrictive cardiomyopathy
diuretics + tx underlying cause +/- pericardiocentesis
71
handgrip will ------to the heart.
increases blood in the heart/afterload * compressing arteries in arm pushing blood back into heart
72
other not so common causes of CHF
alcohol, post viral myocarditis, radiation, adraymycin, doxorubicin, chagus + others, hemochromatosis, thyroid dz, peripartum cardiomyopathy, thiamine deficiency
73
tx of AR
ACE, ARB, Nifedipine to decrease afterload = push blood out then surgery if EF <55
74
takotsubo cardiomyopathy tx
ACE, diuretics and BB
75
Tx of dialated cardiomyopathy
ACE/ARB, BB, Spironolactone
76
tx of pericardial tamponade
pericardiocentesis and if chronic pericardial windown placement
77
what are rales?
Rales in the Tails = bubbling/crackling in the aveoli due to fluid
78
ASD auscultation shit
fixed splitting of S2
79
which side of the heart shit increases with..... | expiration
exhale you evict blood from your lungs & into the LV
80
RV infarction is likely to cause what complication?
3rd degree block!
81
Which stress test drug shouldn't be used in asthmatics?
Dipyridamole = can provoke bronchospams
82
Complications of MI
shock, valve ruptures, septal rupture, myocardial wall rupture, sinus brady, 3rd degree block, RV infarction
83
S3 means....
rapid ventricular filling during diastole | fuck...your screwed
84
what should you NOT do with pericardial tamponade?
give diuretics
85
sx of pericarditis
pleuritic chest pain that is positional, sharp & breif, friction rub, GLOBAL ST ELEVATION & PR depression
86
what bb do you give for MI? why?
metoprolol or esmolol = B1 selective!
87
MS what might you see on ECG?
biphasic Pwaves
88
tx of constrictive pericarditis
diuretics then surgical removal of the pericardium
89
standing up will ------to the heart.
decreases blood return *gravity!
90
tx of systolic dysfunction in CHF
systolic = decreased EF basic: ACE, BB(metoprolol, carvedilol), Spironolactone or hydralazine+nitrates unique: DIGOXIN

MTBs Step 2CK (20 decks)

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