Cardiology Flashcards
(258 cards)
0
Q
What electrolyte is used in repolarization of the heart?
A
K+
1
Q
What causes fast conduction through the heart?
A
Na+
2
Q
What effect does parasympathetic stimulation have on the heart?
A
Slows heart rate , slows conduction, decreases force of contraction, caused by cholinergic Ach
3
Q
What effect does sympathetic stimulation have on the heart?
A
Norepinephrine -adrenergic causes increase rate, increase force of contraction and increase irritability of foci, constricts arteries causing increase in BP
4
Q
Wandering pacemaker
A
P wave shape varies, atrial rate less than 100, irregular vent rhythm
5
Q
MAT multifocal atrial tachycardia
A
P wave shape varies, rate over 100’ COPD or dig toxicity
6
Q
A fib
A
Continuous rapid firing by many atrial foci, continuous atrial spikes, count vent rate — QRS in 6 sec strip x 10
7
Q
Atrial escape rhythm
A
60-80, atrial foci assumes pacing
8
Q
Junctional escape rhythm
A
40-60, usually no p wave, but may have retrograde atrial polarization causing Inverted p wave
9
Q
Ventricular escape rhythm
A
Looks like PVC’s, 20-40, P and QRS do not match
10
Q
Premature atrial beat
A
Irritable foci, new atrial beat resets the rhythm
11
Q
Preventricular beat
A
Vent irritability caused by low O2, low K+
12
Q
V tac
A
A run of three or more PVC, from epi like substances
13
Q
Paroxysmal atrial tachycardia
A
Different p wave, rate 150-250
14
Q
PAT with AV block
A
More the one P for every QRS, dig excess
15
Q
Paroxysmal junction all tachycardia
A
150-250, May have inverted p waves
16
Q
AV node reentry
A
aVNRT, vicious cycle
17
Q
SVT
A
Any tachycardia that originates above the ventricles
18
Q
Torsades de pointes
A
250-350, low K+, long qt syndrome, looks like a twisted ribbon
19
Q
Atrial flutter
A
250-350, saw tooth,
20
Q
Ventricular flutter
A
250-350, single foci
21
Q
V fib
A
Multiple foci, bag of worms
22
Q
A fib
A
Caused by many irritable parasystolic atrial foci
23
Q
WPW
A
Bundle of Kent, av conduction pathway causing a reentrent SVT
24
1degree AV block
Retards AV node conduction, PR interval greater than .2 sec or one large square, CONSTANT every cycle
25
2 degree AV block Wenkebach
PR interval gets longer than drops the QRS, still PR interval great than .2 sec
26
2 degree AV block Mobit
AV node total block conduction, no progression just a dropped QRS, regular punctual P wave
27
3rd degree AV block
Total conduction block, usually normal P wave with. Junctional QRS, must have pacemaker
28
BBB
Block produces a delay in the depol of that vent, right chest leads V1-V2, left chest leads V5-V6' QRS greater than .12 sec or 3 small blocks
29
How do you determine axis?
If QRS in lead 1 and AVF are positive = two thumbs up sign
30
If QRS in lead one is negative, what is the. Axis?
RAD
31
If the transitional QRS is in V1 or V2 what is the axis?
Right shift
32
If the transitional QRS is in lead V5 or V6, what is the axis?
Left shift
33
How Do you determine atrial hyper trophy in an EKG?
V1- dish aspic P wave = AE. The larger P wave is hypertrophied.
34
How do you determine ventricular hypertrophy in a. EKG?
LVH- mm of S in V1 + mm of R in V5 if greater than 35 then LVH
35
How do you determine ischemia in an EKG?
Diminished blood flow, inverted T waves
36
How do you determine injury in an EKG?
ST elevation, acute or recent injury, earliest sign of infarction
37
What does pericarditis look like on an EKG?
ST segment elevation, flat or concave T wave may be off baseline
38
What is a clue for subendocardial infarction on an EKG?
ST depression, no through entire wall thickness
39
Wat are the signs of necrosis on an EKG?
Q wave, significant small box wide or 1/3 the height of the QRS
40
Which leads would show a lateral infarction?
1 and AVL, circumflex
41
Which leads should show an anterior infarction?
V1-V4 from LAD
42
Which leads would show an inferior infarction?
2,3 and AVF, RCA or LCA
43
Which leads should show a posterior infarction?
V1-V2 large R wave plus ST depression
44
What does a Pulmonary embolism. Look like on EK g?
S1, Q3' inverted T 3..... Large s in lead 1' large Q in 3 and t wave inversion in 3
45
What cases the heart sounds S1?
Mitral and tricuspid closing
46
What causes the heart sound S2?
Atrial and pulmonic valve closing
47
Where is each sound heard the best: mitral, tricuspid, pulmonic, aortic?
Apex, left lower sternal border, left upper sternal border, right upper sternal border
48
What can cause widened splitting of S2?
RBBB pulmonic valve stenosis
49
Fixed splitting of S2 is caused by?
Atrial septal defect
50
Paradoxical splitting of the S2 is caused by?
LBBB
51
After S1, the opening of the aortic or pulmonic valves for stenosis is called an?
Ejection click
52
What are the systolic murmurs?
Aortic stenosis, pulmonic stenosis, mitral regurgitation and tricuspid regurgitation, VSD, MVP
53
What murmur begins after S1, May have an ejection click, high frequency, best heard in the RUSB, and radiates to the neck?
Aortic stenosis
54
What murmur begins after S1, May have a click, and is loudest at the left upper sternal border?
Pulmonic stenosis
55
What holosystolic murmur is heard best at the apex, blows, radiates to the axilla and does not change with respiration?
Mitral valve regurgitation
56
What murmur is holosystolic, heard at the left lower sternal border, radiates to the right of the sternum, is blowing and increases with inspiration?
Tricuspid regurgitation
57
What murmur is holosystolic, high pitched, may have a thrill and does NOT change with inspiration or radiate?
VSD..... Louder = smaller
58
Describe the murmur of MVP.
Midsystolic click, late systolic murmur heard best at the apex.
59
List the diastolic murmurs.
Mitral valve stenosis, tricuspid stenosis, aortic regurgitation,pulmonic regurgitation,
60
What is a blowing murmur in early diastole strongest along the left sternal border heard best siting leaning forward and exhaling.
Aortic valve regurgitation
61
What is an early diastolic murmur heard best in the left upper sternal border?
Pulmonic regurgitation
62
This murmur begins after S2, loudest at first, low pitched, heard at apex and in the left lateral decubidis position.
Mitral valve stenosis
63
This murmur is in early diastole, heard best at lower sternum near xiphoid process?
Tricuspid regurgitation
64
This is the only continuous murmur?
PDA
65
How does digoxin therapy look on EKG?
ST scooped depression, mild PR prolongation
66
How does hyper kalmia look on EKG?
Peaked T wave
67
How does severe hyperkalemia look on EKG?
Flattened P wave, wide QRS
68
How does hypojalemia look on EKG?
ST depression, flattened T, prominent U
69
How does hypercalcemia reflect on the EKG?
Shortened QT interval
70
How does hypocalcemia look on the EKG?
Prolonged QT interval
71
Quinidine
Use for a fib with WPW. Give with BB.
72
Quinidine toxicity?
Diarrhea, cinchonism, vasodilation, TdP
73
Procanamide
a fib with WPW
74
Lidocaine cardio use
Use for PVC
| 2nd choice after amiodarone for V tachs
75
Dilantin
Use for arrthymia due to DIG toxins, causes hyperplasia of the gums
76
Describe what beta blockers do.
Use for SVT and PSVT
Useful in suppressing tackyarrhythmias induced by excessive catecholamines (exercise or emotional stress)
Slow vent rage in a fib or a flutter
May terminate Re entrant SVT. Do not prolong QT
77
Amioderone uses.
Grand daddy! Decrease SA node firing rate, suppress automaticity, interrupt reentrant circuits, preserves CO,
USE: reentrant tachycardia, a fib, a flutter, SVT with bypass tracts
Tachycardia, fibrillation, more effective than lidocaine
78
Amiodarone toxicity.
Pulmonary toxicity, TdP, hyper/hypo thyroid
| Must monitor with EKG, CXR, thyroid, PFT, LFT
79
Verapamil
CCB. DO NOT USE in: wide complex tachycardia, A fib with WPW, SSS, AV block w/o a pacemaker.
80
Medications used in PSVT treatment.
Adenosine 6 mg
Adenosine 12mg
Verapamil
Digoxin
81
Pacemaker indications.
Symptomatic AV node block, mob it's and type 3.
Long QT syndrome. Recurrent VT. SVT.
Cardiomyopathy. Cardiac arrest. Syncope. NSVT w prior MI
82
How do you treat a bradyarrhythmias?
Increase HR by anti cholinergic drugs (atropine), B receptor agonists (isoproterenol) or a pacemaker
83
What is the number one cause of dilated cardio myopathy?
Idiopathic with coxsackie virus mist common viral
84
Causes of dilated cardiomyopathy?
Idiopathic, HTN, doxorubicin, beri beri, coxsackie virus
85
Clinical presentation of dilated cardiomyopathy?
Exertional intolerance, atypical cp, dyspnea, orhtopnea, edema, crackles on pulm exam
86
What does the echo show in dilated cardiomyopathy?
Dilated thin left vent with low EF
87
What cardiomyopathy is the MC cause of heart transplant?
Dilated
88
What is an inherited disorder AND a common cause of sudden cardiac death in young athletes?
Hypertrophic cardiomyopathy.
89
What happens in the heart during hypertrophic cardiomyopathy?
Hypertrophy leads to left vent outflow obstruction and impaired filling which leads to pulmonary congestion
90
What does the echo show in HOCM?
Septal wall thickness increased and EF of 80-90 %
91
How to treat hypertrophic cardiomyopathy?
No sports, beta blocker to decrease heart rate and improve filling time
CCB to improve ventricle compliance
92
If you hear an S3 think?
CHF
93
If you hear an S4 think?
MI
94
What causes restrictive cardiomyopathy?
An infiltration process like amyloidosis or sarcoidosis . Damage to muscle wall leads to diastolic noncompliance with elevated filling pressure leading to pulmonary congestion
95
Clinical presentation and dx of restrictive cardiomyopathy?
Exertion intolerance, fluid retention, right heart failure with JVD, s3,s4,
Diagnose with echo showing decreased EF 25-50% and normal LV thickness
96
Treatment for restrictive cardiomyopathy?
Diuretics, ACEI, BB or transplant
97
What is the number one cause of CHF?
Ischemic heart disease
98
What is ventricle volume before contraction?
Preload
99
What is the pressure then ventricle pushing against called?
Afterload
100
Clinical presentation and PE of a patient with CHF?
Dyspnea, orthopnea, PND, fatigue, edema, exercise intolerance
JVD, rales, edema, asities
101
What are the signs of right sided heart failure?
Systemic issues like JVD, asities
102
What are the signs of left sided heart failure?
Think pulmonary like orthopnea, dyspnea, rales, PND
103
What are signs of CHF on X-ray?
Cardiomegaly, increased pulmonary vasculature, pleural effusions, kerley b lines
104
What is normal EF?
50-70%, below 35 is failure
105
Treatment for CHF?
Low sodium diet, loop diuretics #1, ACEI use early to decrease hypertrophy, ARB as needed,
106
What Meds do you avoid in patients with CHF?
Steroids, NSAIDs, CCB
107
Normal BP?
120/80
108
Stage 1 BP?
140-159/90-99
109
Goal for BP treatment? In diabetics and renal failure?
Less than 140/90, DM and renal less than 130/80
110
Work up for BP should include?
Optic fundi, carotids, heart, renal mass, renal artery bruit, pulses, skin
UA, glucose, cholesterol, potassium, EKG
111
What is the first line medication for HTN treatment?
Thiazide s
| Lifestyle modifications
112
When should you suspect secondary HTN?
Onset less than 30 or greater than 50, worsening of controlled HTN, failure to respond to treatment, hypokalemia, liable HTN, headache palpitations and sweating, renal failure after ACEI.
113
Headaches, palpitations and sweating with HTN think?
Pheochromocytoma
114
Number one treatment for HTN emergency!
IV nitroprusside
115
Clinical dx of cardio genie shock from hypotension.
SBP less than 90 or a decrease from baseline from 30
116
Treatment for carcinogenic shock (hypotension)?
Dopamine increased cardiac output and BP
| Dobutamine increases cardiac output
117
Definition of Orthostatic hypotension?
Decrease in SBP of 20 or DBP of 10 when recumbent to standing
118
Etiology eps of Orthostatic hypotension?
Antipsychotic Meds, diuretics, alpha blockers, ACEI, ETOH, vasodilators
Parkinson's disease
Polyneuropathies
119
Modifiable risk factors for MI?
Dyslipidemia, smoking, HTN, activity level, obesity, DM
120
Non modifiable mi risk factors.
Age, gender, family hx
121
Describe clinical presentation of MI.
Pain severe and intolerable, retro sternal may radiate to shoulder or jaw, greater than 20 min, crushing constricting in nature, this is caused by ischemia not infarct
122
Who may have a painless MI?
Elderly and women
123
Describe process of creatine kinase in an MI.
Increases at 3-6 hrs
Normal at day 2-4
Peaks at 24 hrs
Check every 8 hrs
124
Describe troponin process during MI.
Increases at 2/4 hrs.
Peaks at 10-24 hrs.
Persist 5/12 days
Test of choice for people who present late
125
Classic patter of EKG for MI?
ST elevation and q waves
126
ST elevation describes what type of injury pattern!
Transmural events
127
Injury pattern showing ST depression.
Subendocardial ischemia
128
Treatment of MI?
M- morphine (pain control, decrease BP)
O- o2
N- nitrates (dilate arteries, improve pre/afterload)
A-ASA
H-heparin
B-bets blockers (control BP and decrease risk of sudden death)
129
Bets blockers contraindicated in whom?
2nd and 3rd degree heart block
130
Absolute contraindications for thrombolytics?
```
Active bleeding
Aortic dissection
Recent head trauma or neoplasm
Hx of CVA
Major surgery or trauma in last 2 wks
```
131
Define angina.
Chest pain that builds rapidly in 30 sec, disappears 5-15 min, produced by activity and relieved by rest
132
Patient presentation of angina?
Achy dull, mid sternal discomfort with radiation to left shoulder, neck or arm
133
Diagnostic test for angina?
Positive stress test or perfusion test
134
Treatment for angina?
Improve risk factors, manage lipids, b blockers, control sx, revascularization with PTCA or CABG
135
What is unstable angina?
New onset angina, increasing angina, onset at rest
136
Treatment for unstable angina?
ASA, b blocker, ACEI, revascularization
137
Classic triad for acute pericarditis?
Chest pain, pericardial friction rub, EKG abnormalities
138
Most common etiology of acute pericarditis?
Viral from coxsackie virus
139
Patient presents with retro sternal CP with radiation to left back and trap, coughing and deep breathing increases pain, leaning forward decreases pain.
Acute pericarditis.
140
Acute pericarditis on EKG?
ST elevation with upright T waves in MOST leads
141
Treatment of acute pericarditis?
NSAIDs, steroids, symptomatic tx
142
This is fluid In the pericardial sac and inability to fill chambers in diastole which leads to decreased stroke volume and decreased cardiac output
Cardiac tamponade
143
Classic triad of cardiac tamponade?
JVD, muffled heart sounds, pulsus paradoxus
144
Treatment of cardiac tamponade?
Drain fluid
145
What is a pericardial effusion?
Prolonged or severs inflammation leading to fluid accumulation around heart
146
A large pericardial effusion can turn into?
Cardiac tamponade.
147
Treatment for pericardial effusion or cardiac tamponade?
Pericardialcentesis
148
What is the stretch of myocardial fibers before contraction?
Preload, the more fibers are stretched the greater the force of the contraction
149
Symptoms of left sided heart failure are?
Dyspnea, orthopnea, PND, fatigue, diaphoresis, rales
150
Sx of right sided heart failure are?
Peripheral edema, JVD, RUQ pain
151
What is acute pulmonary edema?
Severe acute form of left sided heart failure when elevated capillary pressure pushes fluid into the lungs
152
Tachycardic patient with tachypnea and frothy sputum and rales think?
Acute pulmonary edema
153
How does an ACEI work?
Blocks the conversion of angiotensin 1 to angiotensin 2 and therefore decreases blood pressure
154
What is the most common cause of heart failure in the first week of life?
Hypo plastic left heart syndrome
155
What is hypo plastic left heart syndrome?
Underdevelopment of the left side of heart and aorta. Blood from lungs uses PDA and foramen ovale to mix on right side and right vent pushes blood to body.
156
What is transposition of the great vessels?
When the aorta comes from the right vent and the pulmonary artery for the left vent
157
X-ray shows absence of pulmonary artery with narrow mediastinum and narrow heart base. What is the disease?
Transposition of the great vessels
158
IV med for treatment of HTN emergency?
IV nitroprusside
159
Presentation of patient with aortic stenosis?
Dyspnea with exertion or syncope
160
Systolic ejection murmur with crescendo de crescendo and radiation to the carotids is?
Aortic stenosis
161
Mitral stenosis is common in whom?
Adults that had rheumatic fever as a child
162
Harsh mid diastolic murmur heard best at apex is?
Mitral stenosis
163
When stimulated this nerve provides blockage in conduction through the AV node and puts the breaks on, can help in PSVT.
Vagus nerve
164
Cholesterol panel abnormal... Who do you treat with Meds?
Patient t with 2 or more risk factors or LDL over 160.
165
What causes acute rheumatic fever.
Inflammatory dz due to group A strep infection
166
Jones criteria for RF... What are major criteria?
Carditis, polyarthritis, chorea (rapid purposeless movements), erythema marginatum (macules with central clearing) subcutaneous nodules
167
Jones criteria minor criteria?
Arthralgia, fever, increased ESR, increased CRP
168
What is jones criteria to diagnose acute rheumatic fever?
Mist have 2 major or 1 major and 2 minor for diagnosis.
169
What is an aortic aneurysm?
Dilation of the aorta..... May pop
170
Most common location for aortic aneurysm?
Abdominal aorta, 90% below the renal artery
171
Risk factors for aortic aneurysm?
Smoking, HTN, age, hyperlipidemia
172
Presentation of hypo gastric or lower back pain, steady gnawing with pulsatile abdominal mass?
Aortic aneurysm
173
Screening for AAA?
One time ultrasound for men 65-75 who have smoked. If found screen every 4 months if less than 4cm and surgery of greater than 5 cm
174
Most common location for aortic dissection?
Ascending aorta #1
| Descending sorts distal to left subclavian artery #2
175
Patient presents with severe chest pain with sudden onset, with ripping or tearing pain, difference of BP between arms and decreased loc?
Aortic dissection
176
CXR for aortic dissection?
Widened mediastinum
177
Gold standard test for aortic dissection?
MRI
178
Treatment for aortic dissection?
Monitor BP, central line, bets blocker, morphine, surgery consult
179
Arterial embolism causes?
A fib/flutter
Mitral stenosis
Infarct
Post one placements
180
What are the 5 P's of arterial embolism?
```
Pain
Pallor
Pulseless
Paresthesias
Paralysis
```
181
How do you diagnose an arterial embolism?
Echo or arteriogram
182
Treatment of arterial embolism?
Heparin and embolectomy
183
Chronic arterial occlusion is more commen where? What are the risk factors?
Lower extremities,
| Atherosclerosis #1, smoking, cholesterol, DM, HTN
184
PE of arterial occlusion?
Decreased pulse, bruits, ischemic skin changes and ulcers.
185
Arterial insufficiency with foot claudication think?
Buergers dz
186
How to diagnose arterial occlusion?
Ankle/brachial index
Doppler
Arteriography
187
Treatment for arterial occlusion?
Stop smoking!
| Decrease cholesterol, ASA or clopidogril, angioplasty
188
What is giant cell arteritis?
Granulomatosis vasculitis of the temporal artery
189
A patient presents with headache, jaw claudication, vision loss, fever and fatigue with a painful temporal artery. How do you diagnose and treat?
Artery biopsy
| And corticosteroids
190
Describe polyarteritis nodosa?
Multi system vasculitis of medium sized arteries. Patient presents with fever, malaise, wt loss, anorexia, abdominal pain. Dx by biopsy. Treat with high dose steroids or cyclophosphamide.
191
Describe churg Strauss syndrome.
Multi system vasculitis of medium arteries. Typical presentation of asthma, eosinophilia, lung involvement. Middle aged patient with new onset asthma. Dx with biopsy. Tx with high dose steroids or cyclophosphamide.
192
What is thrombophlebitis?
Inflammatory thrombosis involving superficial veins of LE. Vein is palpable, tender and red. Dx on clinical findings but must rule out DVT. Tx with warm compress, NSAIDs, LMWH or IV abx if drug user.
193
What is a venous thrombosis?
Clot in deep vein of extremities.
194
What is virchows triad?
Venous stasis
Vascular damage
Activation of coag system
195
What are the risk factors for venous thrombosis?
Immobilization, hyper coag state, post op, trauma, BCP, cancer, obesity, pregnancy, smoking
196
Sx of venous thrombosis?
Pain and swelling at site and distal to site
197
How can you diagnose venous thrombosis?
Ultrasound, venogram, positive d dimer
198
Who should get DVT prophylaxis?
All high risk.
LMWH
Stockings,
Pneumatic leg compression
199
How do you treat venous thrombosis?
Heparin
Warfarin 3-6 months
Vena cave filter for recurrent episodes
200
What is a varicose vein?
Swelling and pain in superficial veins of the LE from incompetence of the saphenous vein. Treat conservatively, vein striping, sclerosing agent
201
What is endocarditis and what are some predisposing conditions?
Infection of valve leaflet
| MVP, valvular dz, prosthetic valve, congenital abnormalities, IV drug user
202
MC bacteria in acute endocarditis?
Staph aureus, fatal less than 6 wks
203
MC bacteria in subacute endocarditis?
Strep viridans, fatal 6 wks to 1 yr
204
In early onset prosthetic valve endocarditis what is the most common pathogen?
Less than 60 days post op-staphylococci
205
Late onset prosthetic endocarditis most common pathogen?
Greater than 60 days - strep
206
Common presentation of patient with endocarditis?
Fever, chills, new onset murmur, janeway lesion, Osler nodes, Roth spots, splinter hemorrhages
207
What is a janeway lesion?
Small erythematosus lesions on palms and soles, sign of endocarditis
208
What is an Osler node?
Small tender nodules on pulp of digits, common in endocarditis
209
What is a Roth spot?
Lesion on retina on one with endocarditis.
210
Dx tool of choice for endocarditis?
Transesophageal echo #1
Transthoracic echo #2
If patient has prosthetic valve MUST do TEE
211
How do you treat endocarditis?
Abx 4-6 wks minimum
212
Who should get endocarditis prophylaxis?
Prosthetic valve or heart transplant, hx of endocarditis, heart defect, mouth procedures, soft tissue, abdominal infections
213
What medications are given for endocarditis prophylaxis?
Amoxicillin/ampicillin
| If allergy clindamycin
214
Describe aortic stenosis.
Due to left vent outflow obstruction, leads to increase left vent pressure and hypertrophy.
215
A systolic murmur that radiates to neck and increased when leaning foreword?
Aortic stenosis
216
A cardiac stress test is contraindicated ins patient with a symptomatic murmur of?
Aortic stenosis
217
What is aortic insufficiency and the acute and chronic causes?
Due to abnormal leaflets or proximal aortic root
Acute -endocarditis or dissection
Chronic-HTN, marfans
218
What has a diastolic blowing murmur on LSB? With weakens pulse pressure and hammer pulses?
Aortic insufficiency
219
What med is give given to a patient with symptomatic bradycardia post MI?
Atropine 0.5mg every 5 min up to 3 mg total
220
IV drug user with pleuritic chest pain, fever, Roth spots, janeway lesion and Osler nodes?
Endocarditis caused by staph aureus.
221
Valve affected by IV drug users?
Tricuspid
222
Oval, pale retinal lesion surrounded by hemorrhages?
Roth spot. Infective endocarditis
223
Hemorrhagic painless macular plaques on palms and soles?
Janeway lesions
224
Small painful modular lesions on pads of fingers?
Osler nodes
225
Renal arteries emerge from?
Abdominal aorta
226
Blood supply to the colon?
Celiac trunk
227
What supplies blood to the lower extremities?
Common iliac artery to the internal and external iliac arteries
228
Occlusion to this can cause acute bowel ischemia.
Inferior mesenteric artery
229
No beta blockers in a patient with?
Peripheral vascular disease, reactive airway dz or heart block!
230
Four findings in tetralogy of fallot?
Pulmonary stenosis, VSD, overriding aorta, RVH. Blue squatting smurf
231
Best med for HTN with heart failure?
BB, ACEI
232
Best med for HTN with post MI?
BB, then ACEI
233
Best HTN med for diabetes?
ACEI, ARB
234
Best HTN med for renal dz?
ACEI, ARB
235
Best HTN med for recurrent stroke?
Thiazides, ACEI
236
Contraindications to thiazides?
Gout
237
Contraindications to potassium sparing diuretics?
Hyperkalemia
238
Contraindications to ACEI/ARB?
Prego, renal artery stenosis, hyperkalemia
239
Contraindications to nondihydropine CCB?
Heart block, heart failure
240
Contraindications to BB?
Heart block, asthma, depression, cocaine abuse
241
Contraindications to. Alpha blocker?
Orthostatic hypotension, heart failure
242
Sharp chest pain, worse lying down, better sitting up
Pericarditis
243
Systolic ejection murmur in LUS border
Aortic stenosis
244
Troponin appearance and duration?
2-4 hrs, 5-10 days good for late presenters
245
CK-MB appearance and duration?
3-6 hrs 2-4 days peaks at 24 hrs
246
ST depression?
Subendocardial ischemia
247
ST elevation?
Transmural ischemia
248
EKG change in II, III, aVF?
Inferior, RCA
249
EKG changes in I, aVL, V5, V6?
Lateral, circumflex
250
EKG changes in V2-V4
Anterior, LCA
251
EKG changes in V1-V2?
Posterior, RCA or circumflex
252
EKG changes in V3-V6?
Apical,
| LAD or circumflex
253
EKG changes in I, aVL, V4-V6?
Anteriolateral, LAD or circumflex
254
EKG changes in V1-V3?
Anterioseptal, LAD
255
Pericardial friction rub?
Acute pericarditis
256
What causes diffuse ST elevation and upright T waves on EKG?
Acute pericarditis
257
Foot drop is from compression of what nerve?
Paroneal
