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Residency > Cardio > Flashcards

Cardio Flashcards

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1
Q

defribrillator shock dosages

A

2J/kg then 4J/kg max 10J/kg for peds)

resume CPR after shock

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2
Q

epi doses during code

A

1mg IV/IO (0.01mg/kg) Q3-5min

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3
Q

amio doses during code

A

1) 300mg

2) 150mg

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4
Q

reversible causes of Cardiac arrest H’s

A 
Hypovolemia 
hypoxia
hyperkalemia
hydrogen ion(acidosis) 
hypoglycemia 
hypothermia
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5
Q

reversible causes of cardiac arrest T’s

A

tension pneumo
tamponade
thrombosis (PE,MI)
toxins

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6
Q

range for therapeutic hypothermia

A

32-36degrees celsius for >24hrs

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7
Q

post arrest managment

A

therapeutic hypothermia
bolus fluids
vasopressors/inotropes to maintain MAP>65
electrolyte goals K>4 and Mg >2

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8
Q

brugada syndrome

A

inherited myocardial ion channel disorder –> malignant ventricular arrhythmias and sudden cardiac death

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9
Q

dx of brugada syndrome

A

ekg ST segment elevation in V1-V3 followed by negative T wave

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10
Q

management of brugada syndrome

A

ICD

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11
Q

congenital long QT syndrome

A

inherited mutations in myocardial ion channels –> prolonged QT

increased risk of torsades de pointes and sudden cardiac death

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12
Q

presentation of congenital long QT syndrome

A

syncope
torsades de pointes
sudden cardiac death
risk of dysrhythmias highest when QTc >500

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13
Q

management of WPW

A

procainamide or synchronized electrical cardioversion

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14
Q

management of AVRT (narrow complex tachy)

can also be wide at times

A

vagal maneuvers
adenosine
CCBs or BBs
DC cardioversion if unstable

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15
Q

VSD

A

mc congenital heart dz
L–> R shunt
holosystolic murmur 2-6wks og age

poor feeding, failure to thrive, hepatomegaly

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16
Q

ASD

A

fixed split S2

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17
Q

PDA

A

continuous machine like murmur
L –> R shunt

tx indomethacin or sx

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18
Q

left sided ductal dependent lesions

A

prostaglandin E1 to increased flow thru ductus arteriosus

ADR: apnea

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19
Q

TOF

A

VSD
overriding aorta
pulm stenosis
RVH

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20
Q

management of ruptured AAA

A

permissive hypotension 80-100

emergent Sx consult

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21
Q

types of aortic dissections

A

standford A: ascending aorta, emergent sx

standford B: descending aorta (less severe)

esmolol HR 60s BP 100-120

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22
Q

ABI for thromboembolism

A

<0.9 indicates impaired blood flow

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23
Q

management of mesenteric ischemia

A 
broad spec (metro, etc) 
emegenct sux resection of necrotic bowel
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24
Q

wells criteria DVT

A 
active cancer (1) 
bedridden or sx <4wks (1) 
calf swelling >3 (1) 
collateral superficial veins (1) 
entire leg swollen (1) 
localized tenderness (1) 
pitting edema (1) 
paralsysis (1) 
previous DVT (1)
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25
wells score interpretation and tx
1-2 mod risk >2 high risk anticoagulation - LMWH or unfractionated heparin or NOAC
26
most common physical exam finding in PE pts
tachycardia tachypnea also common
27
Wells criteria PE
``` clinical signs and symptoms of DVT (3) PE #1 dx (3) HR >100 (1.5) immobilization >3 days or sx w/in 4wks (1.5) previous DVT or PE (1.5) hemoptysis (1) malignancy w/ tx <6mnths (1) ```
28
wells PE Criteria interpretation
<5 = PE unlikely >4 = PE likely
29
PERC def
if no criteria are (+) then < 2% chance of PE so r/o basically
30
PERC criteria
``` age >50 HR >100 SaO on RA <95% unilateral leg swelling hemoptysis recent sx or trauma (w/in wks) Prior DVT or PE hormone use ```
31
most common sign on EKG for PE
sinus tachycardia non specific ST-T changes
32
EKG signs for PE
sinus tachy non specific ST-T changes new RBBB S1Q3T3
33
S1Q3T3
means PE S wave in lead I Q wave in lead III T wave inversion in III
34
CXR of PE patient
mc - NML hamptons hump - wedge shaped density indicated infarcted lung westermakrs - paucity of vessel markings
35
echo findings of a massive PE
RV dilation RV hypokinesis Dilated IVC
36
tx of PE
anticoagulation w/ unfractionated hep or LMWH or NOACs tPA for massive PE embolectomy
37
junctional tachycardia
junctional escape 100-130 nopreceeding p waves
38
SVT (AVnRT)
150-250 regular no discernable pwaves
39
management of SVT (AVnRT)
stable pts = (1)vagal maneuvers --> (2) adenosine 6-12mg bolus IV --> (3) CCBs (dil, verap) or Beta Blockers
40
SVT (WPW, LGL)
narrow = orthodromic wide-complex = antidromic
41
AVnRT vs Afib
AVnRT = regular, very faster Afib = irregular, fast or nml
42
synchronized cardioversion is performed at what voltage
120-200 and can if needed go to 360J
43
causes of atrial flutter
``` idiopathic valvular heart dz cardiomyopathy hyperthyroidism PE chronic lung disease ` ```
44
? aflutter vs SVT next step
use adenosine to block AV node and visualize the saw tooth waves
45
tx of atrial flutter
unstable - synchronized cardioversion (25-50J) sensitive to low voltages stable - diltiazem or beta blockers
46
causes of V tach
``` structural heart dz trauma hypothermia hypoxia severe electrolyte issues brugada congenital long GT QT prolonging meds ```
47
tx of VTach
pulseless - defib CPR unstable - syn cardiovert start at 100J (sedate if time) stable- (1) procainamide 100mg IV over 2min Q5min or continuous infusion (2) amio 150mg IV over 10min then infusion (3) lido 1mg/kg IV over 5min then infusion
48
causes of Pulseless electrical activity
H's and T's tx - CPR, IV epi
49
NIPPV for CHF
decreases preload and afterload improves work of breathing PEEP = most important, decreases preload and stents open airways
50
when should you be weary of CHF without fluid overload
in new onset afib with RVR since patient is not fluid overloaded
51
pressors for CHF with hypotension
NE - reduced risk for arrhythmias but increases afterload Dopamine w/ dobutamine has greater inotropy than NE (but will initially decrease BP so no use if sys <70)
52
initial management of ACS
aspirin (162-324mg) nitro oxygen (only if hypoxemic) pain control (morphine watch BP)
53
wellens syndrome
- biphasic T waves - deep symmetric T wave inversions in anterior precordial leads = proximal LAD occlusion HIGH irsk for progression to anterior MI
54
inferior STEMI
ST elevation in II, III and aVF
55
anterior MI
ST elevation in V2-4
56
septal MI
ST elevation V1-2
57
lateral MI
ST elevation in I, aVL, V5, V6
58
posterior MI
ST depression in V1-V4
59
earliest finding on EKG for STEMI
HYPER acute T waves
60
sgarbossa criteria for STEMI with preexisting LBBB
concordant ST Elevation >1mm in leads with (+) QRS complex (5pts) ST depression >1mm in V1-3 (3pts) Excessive discordant ST elevation >5mm in leads with (-) QRS (2pts)
61
sgarbossa score interpretation
score >2 = 90% specificity for dx of MI
62
complications of STEMI
- cardiogenic shock from LV failure - Heart Block Tachydysrhythmias (Vfib mc complication) LV wall rupture papillary muscle rupture ventricular aneury
63
echo of myocarditis
dilated chambers hypokinesis myocardial biopsy is gold standard
64
tx of refractory pericarditis
steroids
65
physical exam finding of aortic stenosis
crescendo decresendo systolic murmur radiating to carotids
66
aortic stenosis on EKG
LVH with strain | LBBB
67
management of aortic stenosis
- avoid nitrates - give gentle fluids if hypotensive - diuresis if CHF
68
valves affected by infective endocarditis
mitral regurg ---> mitral stenosis with time
69
mcc of chronic mitral regurgitation
afib
70
causes of narrow QRS PEA arrest
- hypovolemia - pericardial effusion leading to tamponade - PE - pneumo
71
management of TOF
- flex knees to chest - morphine/ intranasal fentanyl to decrease pulm vasc resistance - phenylepi/ NE to increase SVR - IVF for volume expansion
72
mc tachydysrthmia in WPW patients
SVT | followed by afib and then atrial flutter 3rd
73
what is targeted temp for post ROSC following cardiac arrest
32-34 | 89.6-96.8

Residency (19 decks)

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