Cardiology Flashcards
(32 cards)
What is the most common cardiac complication in Hemachromatosis?
arrhythmia; paroxysmal A fib
Carcinoid syndrome affects which heart valve?
pulmonic; pulmonary stenosis
Pts with a subclavian or jugular CRBSI MUST be treated w/ what AB(s)?
VANCOMYCIN (MRSA protective)
Pts with a femoral CRBSI MUST be treated w/ what AB(s)?
- VANC
- cefepime (pseudomonas)
- caspofungin (candida)
Methadone, Ondasteron, and Amiodarone cause what change in the EKG> deadly arrhythmia?
== QT prolongation»_space; torsades de pointes (TdP)
- norm = <440
Citrate toxicity from recurrent blood transfusions depletes what 2 electrolytes?
Calcium & Magnesium
what is the most common post-op arrhythmia?
how is it identified on EKG?
premature ventricular complex
EKG = bigeminy = finding in which every normal complex is followed by a premature complex
**also see trigeminy
what are some causes of post op arrhythmias (PVCs) ??
high levels of catecholamines (endogenously due to the perioperative stress state; exogenous in the case of cardiovascular support)
***electrolyte or acid-base imbalances (e.g., hypokalemia, hypomagnesemia)
reduced ventilation
certain drugs
what treatment reduces the risk of SCD in pts with HOCM?
SCD is caused by Vfib / Vtach
SOOO
Placement of an automated, implantable cardioverter defibrillator (AICD) is the best method to prevent sudden cardiac death (SCD) in patients with HOCM
AICD averts fibrillation = no death
what kind of murmur continuously radiates to the neck but disappears when pt flexes the neck?
venous hum (veins are easy to compress)
how can pts on hemodialysis with a created AV fistula end up with HFpEF?
AV fistulas send blood from systemic circulation to pulm circulation > dec in SVR> increased HR w/ decreased filling pressures triggers RAAS activation
what dx test is performed prior to anticoag therapy or cardioversion in a pt with AFib?
why?
alway visualize the heart w/ TEE prior to giving anticoags/cardioversion bc you want to see if there is an active thrombus sitting in the heart waiting to be thrown around
(anticoags & cardioversion will loosen a thrombus from a heart wall/valve)
what is the difference between synchronized cardioversion and defibrillation?
synchronized cardioversion waits for a R wave before admin a shock === SOOO there must be a PULSE in order to shock!
defibrillation is given when there is NO PULSE & you are trying to bring pt back
which arrhythmias receive synchronized cardioversion?
arrhythmias with a PULSE:
- A fib
- A flutter
- AVNRT
- Pulsing Vtach
which arrhythmias receive defibrillation?
arrhythmias with NO PULSE:
- ventricular fibrillation
- Pulseless VTach
BP for hypertensive emergency?
> 180 / >120
either one is an emergency
which patients are recommended evaluation/screening for AAA?
65-75 yo w/ PMHx smoking & ATHEROSCLEROTIC diseases (claudication/PAD/HLD/HTN)
Afib is almost always likely to occur in pts with what
- arrhythmia
- valve disease
pre-excitation WPW > Afib in 20% of pts
Mitral stenosis; hx of rheumatic fever enlarges the L.atria> excites the Pulm VEIN > Afib in 2/3 of pts
Pts with new onset Afib should always be evaluated for what valve disease?
Mitral valve stenosis!
Pts with UNSTABLE Afib/AFib w/ RVR need to be treated with what ASAP (aka this takes priority over any med!!)
EMERGENCY synchronized cardioversion (controls RHYTHM)!!
what are the 2 complications of AFib?
- Afib w/ RVR
2. emboli
Dx criteria for AFib w/ RVR
drug Management of AFib w/ RVR
AFib w/ HR >100 pt can be stable or unstable
1st= Bblockers
2nd= CCB Nondihydropyridines (verapamil & diltiazem)
3rd (if cant tolerate above)= Digoxin or Amiodarone
what is the PARASITE mnemonic for the etiology of AFib ?
THIS IS VERY IMPORTANT
P- Pulm dx (COPD, PE, PNA) A- Anemia R- Rheumatic heart disease/Mitral Stenosis A- Atrial Myxoma S- Sepsis or Hypovolemia (dehydration) I- Ischemia T- Thyroid dx (Hyperthyroidism or Thyrotoxicosis) E- Ethanol
when is the ONLY time SVR is decreased?
when shock is SEPTIC/distributive or NEUROGENIC shock!
