Cardio To Know Flashcards
(155 cards)
1
Q
Large VSD left uncorrected leads to
A
Aortic Regurg - increased heart volume and LV dilation
2
Q
Classic findings in MIs (3)
A
Chest pain, >1mm ST cnahes, Increased cardiac enzymes
3
Q
If IVs cant be places, what is alternative route?
A
Intraosseous cannulation. In emergencies, use the extremitites.
4
Q
Chronic angina with ischemia occurs with what valve disease murmur?
A
Mitral regurg murmur = papillary ischemia
5
Q
Long standing MS is a ssociated with that EKG and heart condition?
A
A Fib
6
Q
Most important risk factor for PAD is?
A
Smoking
7
Q
Most important risk factor for CAD is?
A
Diabetes
8
Q
Pulsus Paradoxus & JVD is
A
tamp, echo, pericardiocentesis
9
Q
What medication do you give a HTN with DM?
A
Ace-I
10
Q
What CAD testing is used in the presence of a LBBB?
and Why?
A
LBBB are hard to see so you use an Adenosine radionuclear scan.
11
Q
What psych medication can cause HTN?
A
MAOIs
12
Q
When do you suspect a Pheo? How do you Diag? How do you treat it?
A
Palp, HA, Diaphoresis, and long standing HTN.Diag = uring metaneph & vallinic acid. Tx is with a Pheo
13
Q
What meds decrease VLDL?
A
Fenofibrates (and trigs).
14
Q
What is contraindicated in an Inferior wall MI? and why?
A
Nitro. preload dependent. Inferior wall MI = weak right ventricle. Nitro decreases preload.
15
Q
When do people get Printzmetal Angina
A
AM
16
Q
What do you do for a patient with STEMIs in II, III, AvF?
A
IV fluids. Fluid dependant RV
17
Q
angina new in onset that occurs at rest or with minimal exertion
A
UA
18
Q
Name and hours of Cardiac Markers
A
1) Myoglobin 1 hr, 8 hrs, 1 day
2) CK-MB 2 hrs, 1 day, 3 days
3) TropC 1 hr, 1 day, 1 week
19
Q
What do you give after PCl for an MI?
A
abciximab, eptifibatide or tirofiban to stop platelets
20
Q
What is Infliximab used for?
A
Anti-tumor necrosis factor alpha
21
Q
What is the TIMI score used for? Whats the levels
A
Anticoagulation. 1 = safe to Dc, 3 = Serial Troponin + ASA + Clop. 5 = Antithrobo and PCl
22
Q
What med proven mortality benefit in ST-elevation myocardial infarction?
A
Aspirin
23
Q
What are the leads to the 4 wall MIs?
A
Anterior wall ST elevation in leads V1 through V4
Inferior wall ST elevation in leads II, III, and AVF
Lateral wall ST elevation in leads I, AVL, V5, and V6
Posterior wall ST depressions V1 through V3 and elevations in V8 and V9
24
Q
What EKG finding is a ssociated with myocardial ischemia?
A
ST segment downsloping,
25
What is the equation for the target heart rate used for an exercise stress test?
Target heat rate = 85 % (220 - age (in years)).
26
What anti-angina med do yo ugive once BB and CCB have been tried?
Ranolazine
27
What is contraindicated in NSTEMI treatment?
tPa, there is no thrombus
28
What is contraindicated with severe COPD, asthma, atrioventricular block, hypotension or bradycardia
metoprolol
29
Men determined to be at low risk (lilidemia) screening for lipid abnormalities at age
35 and every 5 years if normal.
30
Timi score components? (7)
>65, (CAD, Lipids, DM, Smoke), Known CAD, ASA w/n 7 days, Severe angina, EKG 0.5mm, + troponins
65 CACA, 0.5 Trop
31
contraindication to fibrinolytic therapy?
Intracranial hemorrage, Masses, Ischemia <3 months, Trauma, Aortic dissection, Active bleeding disorders, Untrontrolled HTN.
32
relative contraindication to fibrinolytic therapy?
Pregnancy, >180/110, internal bleed, ischemia <3 months.
33
What is Eisenbergs syndrome? What is the underlysing cause caused by?
Right to left shunt VSD, caused by Fetal Etoh, ToF
34
EKG of LBBB and RBBB?
LBBB" RR at Lead I, S wave at V1: Treat like stemi or HCM
35
How do you tx SSS and Brady?
Pace and Atropine
36
What is Weinchibach associated with?
Inferia wall MI
37
What EKG findings of Hypothermia?
Osborn (J point), A fib - Extracorporeal heating.
38
Lside CHF sxs?
Dyspnea, Fatigue, S3, Crackles
39
Tx for Kawasaki?
ASA and IVIG
40
Aortic Regurg has
Bounding Pulses, Water hammer, LSB, 2nd ICS,
41
Aortic Stenosis has
Narrow pulses, Decrease with Valsa, Increase with Squat. Pulsus Parvus and Tardus
42
MCC Restrictive MC & what are signs
Amyloids (shinny) then Sarcoidies (HyperCal, ICS)
| Signs = JVD, kussmaul, Rales, Biatrial enlargment
43
How do you treat high trigs?
Fish oil, fenofebrates
44
What tx is contraindicated in pericarditis?
Warfarin (protein C problems)
45
Most common 2nd HTN cause?
Renal stenosis
46
What med is ionotropic, decrease Pul wedge pressure, and has normal BP?
Dobutamine.
47
How do you treat PEA? and Asystole?
CPR and Epi
48
What meds makes CHF worse?
Cilostazil, NSAIDS, Metformine, PDE5
49
What artery is the most turbulent?
Common femoral artery
50
How do you treat vtach?
Sotalol, Amioderone, Lido, Procanimide VS DeFib.
51
Does CKD respond to thiazides?
No
52
What med decreases preload only?
Furosimide
53
What med decreases both preload and afterload w/o being an ionotrope
Ace
54
Does tPA have allergic rnx?
No
55
Large vs small ASD,longstanding?
Large = LVH, Small = RVH, Long = Biventricular Hypertrophy
56
EKG of BRugada?
RBBB, STEMI & T wave inversion in V1-V3
57
goal of STEMI reprofusion ( PCL and Throbolytic)
90 mins and 30 mins
58
What can cause pericarditis?
| How do you tx?
INH, Coxsachie, entero, Procanimide, Dressler.
| NSAID, Colchicine, ASA, Lean forward
59
What is the EKG of Pericarditis?
Diffuse STEMI, PR depression in AVF
60
Dressler time and sxs
1-2 weeks post MI, fever, Leukocytosis.
61
What has BEcks, low volt, Elec Alter, and cardio meg
Tamponade
62
What can cause Myocarditis?
| How do you tx?
Coxsachie, entero, SLE, Rheum, Clonidine.
| Ace, Dobutamine, IVIG
63
What can cause DCM ?
| How do you tx?
Entero/Cox, EtoH, Parvo, Chaga.
| Ace, BB, Diuretic, stop Salt.
64
R-side CHF sxs. Tx
S3, pink forth lungs (transudative effusion) EFr, MI, DCM, weak LV. tx = Ace, BB, Dig, LMNOP
65
L-side CHF sxs
S4, Stiff vent, JVD, Rales, Edema. tx = Ace, BB, Dig, LMNOP
66
High outflow HF causes?
Paget, anemia, Preg, Thyroidtox, beri-beri, AV shunt
67
Low output HF causes?
MI, Ischemia, HTN
68
Diag and what do you see on XRAY for HF
Batwing, Kerley B (25), cephalization, Peribronch cuff, Cardiomegaly
69
HCM sings and sxs?
Autodom, S4, /\ murmur, increase with valv/clenching.
70
Tx for HCM?
BB, Verapamil, Disopyeramid. NO digox or Nitrates. Myomectormy and alcohol ablate.
71
Chronic angina and Ischemia occur due to what?
Mitral papillary mucsle death = regurg.
72
LBBB are hard to diagnose. What test can see CAD with LBBB?
Adenosine Radio scan
73
VLDL and Chylomicrons are treated with
Fenofibrates
74
Decreased murmur with hand grip is associated with
HCM
75
Bruits over the groin with a high pulse (115) is pathonmeumonic for?
Specifically in penetrating trauma
AV Fistula. Bruits or thrills in veins.
76
What are albuterols SE?
Tachy and jittery. NO HTN.
77
TOGA has what kind of S2?
Loud
78
TOF has what kind of S2?
| High or low hematocrit?
Single, High
79
What are the 5 major jones criteria?
Carditis, migratory arthritis, chorea, Erythema marginatum, and subcutaneous nodules.
80
Is the annuloplasty preferred over a mitral valve replacement?
Yes, in Regurg.
81
Transient ST elevations and Morning chest pain is...
Prinzmental- CC, no BB
82
How do you treat Rheum Fever?
ASA, ICS, and PCN.
83
What are the major Jones criteria for Rheum?
Migratory joint, Carditis, Nodules, Erythema Marginatum, Sydhamns Corea
84
What valvular murmurs increase with hand grips?
AR and MR
85
what are Aortic stenosis complications?
Angina, syncope, chest pain
86
Chronic AS leads to ..
LVH
87
What is the murmur of AS and how do you best hear it
/\ systolic dereased with vel, increased with squat. radiates to carotids. lean forward
88
What type of pulse pressure does AS have? And what pulses are they?
Narrow pulse pressure. Pulsus tardus and parvus
89
What is the AS murmur and where is it heard best? What kind of pulse?
blowing\ diastolic leaning forward. Bounding pulses
90
What increase and decreases the AR murmur
increase with squat and hand grip. decrease with Valsalve (like AR)
91
What kind of pulse pressure does AR have?
Wide pulse pressure
92
Chronic AR can lead to what other condition?
CHF from dilated LV
93
What valve disease causes hemoptysis and ruddy checks
MS, Also Afib
94
What valve is best heard at the LLD and has an open snap murmur
MS
95
This valve disease an lead to LAE and pulm HTN.
MS
96
What is the tx for dilated cardio myopathy? and Diag?
Echo - Stop drinking, Ace, BB, Diuretics--> transplant
97
What is the patho of DCM
Dilated and floppy heart. poor EF
98
What Cardio myopathy has a diastolic dysfunction?
Restrictive CM
99
MCC of Restricitve CM?
Amyloid (bright), radiation, Sarcoids (medisteium)
100
Signs of RCM
JVD, kussmall
101
Signs of HCM
s4, poor EF,
102
Presentation and path of HCM
Big and think septum = blood cant leave the heart. Exercised enduced syncope
103
How do you treat HCM?
Beta blockers. No other ionotrops. Myomectomy. Alcohol ablate.
104
What is the treatment for Bruggada?
BB --> AICD
105
What conduction disorder is associated with Theopheline toxicity? Also with COPD
MAT
106
how long do you antigoag afib
4 weeks
107
what drugs prolong QT
sotolol, aminoderone, hypothermia, erythromycin
108
Which anti-HTN meds are safe in pregs
Beta blockers, methyldopa, labetalol
109
what arrhythmia has a delta slope and a shorter PR?
WPW
110
What has a suppressed PR?
Pericarditis
111
what dysrythmia occurs in long-standing constrictive pericarditis
A-fib
112
Patient has lost aortic knob, has a widened mediastium, and is HoTN. What does the pt have?
Traumatric aortic rupture
113
Common post MI complication with a VSD is
HF
114
What medications are contraindicated in Gout?
Thiazides
115
If the patient has cardio shock, what will happen if an intraaortic ballon is placed?
Systolic BP is normalize, PCWP drops.
| Due to offloading the heart
116
firbrinolytic therapy should be continued from 12 hours of onset of chest pain?
true, 12 hrs
117
MC valvular disease from Rheum Fever is?
MS
118
What med is used in diastolic HF? and in systolic HF?
Diastolic PrEF= Beta
| Systolic, rEF = Aces
119
uncontrolled HTN can lead to?
Chronic HF
120
What is Cannon A waves and what causes it?
3rd AV block. Blood hitting a closed tricuspid.
121
is an idioventrical rythm normal after a STEMI?
Yes
122
what med SE is constipation & gingival hyperplasia?
CCB
123
What chronic condition can lead to absent dorsalis ped pulses and why?
A fib = throw a thrombus
124
What electrolyte abnormality is found with AV blocks?
Hyperkalemia
125
What medication is contraindicated in PAD?
propranolol
126
How do you treat a TIA?
1st ASA 2nd Clopidegrol
127
When do you place a resync Pace?
Wide QRS, has an auto defib
128
Patient has HoTN, and 0 venous pressure. What does the patient have?
Internal bleeding. Tamp would have high venous pressure.
129
How do you calculate mean arterial pressure?
MAP = DBP + 1/3(SBP−DBP)
130
What is the order of meds In a Positive CHA2DS2VaS?
Rivarobaxan
131
If you See STEMI on EKG, what do you do?
PCl within 90 mins
132
What disease has auto dom Fibrillin defect?
Marfans
133
What is the patho difference with Ehlers and Marfans?
Ehlers has reduced lysyl hydroxylas in collagen. Not tall or arachnodactyly.
134
Does Amioderone have CKD?
No
135
Are vasodilators contraindicated in Dissection?
Yes - increase sheer forces do to artificial increase in HR.
136
What med is CI in WPW?
CCB
137
WHat meds have 1st dose syncope as their SE?
Alpha blockers
138
What meds can cause SLE?
Procanimide
139
How do you tx Pulm HTN?
Diuretics
140
Does digox lead to st depression?
Yes
141
Is PSVT's rate 240 and controlled with vagal + Adenosine?
yes
142
ethacrynic acid is a _______ medication
Loop diuretic
143
Tirofiban is a _______med
glycoprotein IIb
144
How does morphine help with an MI?
Pain control and venodilation.
145
What med is an inhibitor to adenosine diphosphate for platelets aggrogation?
Clopidegrol
146
idioventricular rhythm + HoTN needs what?
Atropine
147
what med as a longer duration of action thiazides or loops?
Thiazides.
148
WHats the MOA of Nitroprusside?
arterio and veno dilation
149
Systolic HTN is treated with?
CCB+ Thiazides (AA) patients.
150
Post strep arthitis is treated with?
PCN and ASPIRIN
151
MOA of CCB?
Dilate arteries
152
MOA of nitrates?
Vasodilation of Coronary arteries
153
Unstable angina is due to incomplete occlusion - why are CCB and Fibrinolytics CI?
dont vasodilate - break occlusion and cause a compete block downstream.
154
PACs are treated with?
Beta blockers
155
what beta blockers are used in CHF?
MCB - metoprolol, Carvadolol, Bisoprolol
