cardiology Flashcards
(128 cards)
1
Q
What is the hallmark ECG finding of a STEMI?
A
ST elevation ≥1 mm in 2 contiguous leads
2
Q
What is the time goal for PCI in STEMI?
A
≤90 minutes from first medical contact
3
Q
What is the first-line reperfusion therapy for STEMI if PCI is unavailable?
A
Fibrinolysis (e.g., tenecteplase)
4
Q
What is the dose of aspirin in suspected ACS?
A
300 mg chewed stat
5
Q
What is the loading dose of clopidogrel in ACS?
A
300-600 mg orally
6
Q
What is the anticoagulant of choice in STEMI undergoing PCI?
A
Heparin (70-100 units/kg IV)
7
Q
What is the classic presentation of ACS?
A
Retrosternal chest pain radiating to the left arm
8
Q
What ECG leads indicate an inferior STEMI?
A
II, III, aVF
9
Q
What is the most common vessel occluded in inferior STEMI?
A
Right coronary artery (RCA)
10
Q
What ECG finding suggests right ventricular infarction?
A
STE in V4R
11
Q
What is the management of RV infarction?
A
Fluid loading (avoid nitrates)
12
Q
What is the dose of tenecteplase for STEMI?
A
0.5 mg/kg IV bolus (max 50 mg)
13
Q
What is the contraindication to fibrinolysis in STEMI?
A
Prior hemorrhagic stroke
14
Q
What is the target door-to-needle time for fibrinolysis?
A
≤30 minutes
15
Q
What is the ECG finding of posterior STEMI?
A
ST depression in V1-V3 with tall R waves
16
Q
What vessel is typically involved in posterior STEMI?
A
Circumflex artery
17
Q
What is the role of nitrates in ACS?
A
Relieve ischemic chest pain (0.4 mg SL)
18
Q
What is the loading dose of ticagrelor in ACS?
A
180 mg orally
19
Q
What is the dose of morphine in ACS?
A
2-5 mg IV titrated
20
Q
What is the definition of unstable angina?
A
New or worsening chest pain without ST elevation
21
Q
What is the biomarker for myocardial injury?
A
Troponin (I or T)
22
Q
What is the time frame for troponin elevation in MI?
A
3-6 hours after symptom onset
23
Q
What is the management of NSTEMI with ongoing pain?
A
Urgent angiography
24
Q
What is the ECG finding of Wellens syndrome?
A
Deeply inverted T waves in V2-V3
25
What does Wellens syndrome indicate?
Critical LAD stenosis
26
What is the rhythm of ventricular tachycardia?
Regular, wide-complex tachycardia
27
What is the initial treatment for unstable VT?
Synchronized cardioversion (100 J biphasic)
28
What is the dose of amiodarone for VT?
150 mg IV over 10 minutes
29
What is the initial energy for defibrillation in pulseless VT?
200 J biphasic
30
What is the treatment for stable monomorphic VT?
Amiodarone or procainamide
31
What is the ECG finding of atrial fibrillation?
Irregularly irregular rhythm, no P waves
32
What is the rate control agent of choice in AF?
Beta-blocker (e.g., metoprolol)
33
What is the dose of metoprolol IV for AF rate control?
2.5-5 mg IV every 5 minutes (max 15 mg)
34
What is the anticoagulation threshold for AF cardioversion?
CHADS-VASc ≥2
35
What is the dose of apixaban in AF?
5 mg BD (2.5 mg BD if criteria met)
36
What is the treatment for AF with hemodynamic instability?
Synchronized cardioversion (100-200 J)
37
What is the ECG finding of SVT?
Narrow-complex tachycardia, rate >150
38
What is the first-line treatment for stable SVT?
Vagal maneuvers (e.g., Valsalva)
39
What is the dose of adenosine for SVT?
6 mg IV rapid push, then 12 mg if needed
40
What is the complication of adenosine?
Transient asystole
41
What is the ECG finding of torsades de pointes?
Polymorphic VT with twisting QRS
42
What is the treatment for torsades de pointes?
Magnesium sulfate 2 g IV
43
What is the ECG finding of complete heart block?
Dissociated P waves and QRS complexes
44
What is the temporary treatment for symptomatic bradycardia?
Atropine 0.5 mg IV (max 3 mg)
45
What is the pacing threshold for bradycardia?
HR <40 or hemodynamic instability
46
What is the dose of adrenaline in bradycardia?
2-10 mcg/min IV infusion
47
What is the classic triad of aortic dissection?
Sudden tearing chest pain, unequal pulses, widened mediastinum
48
What is the imaging of choice for aortic dissection?
CT aortogram
49
What is the BP target in aortic dissection?
SBP 100-120 mmHg
50
What is the first-line antihypertensive in aortic dissection?
Labetalol (10-20 mg IV)
51
What is the surgical indication for aortic dissection?
Type A (ascending aorta involvement)
52
What is the mortality rate of untreated Type A dissection?
1-2% per hour
53
What is the dose of esmolol in aortic dissection?
500 mcg/kg IV bolus, then 50-200 mcg/kg/min
54
What is the ECG finding in aortic dissection with coronary occlusion?
ST elevation (e.g., inferior STEMI)
55
What is the risk factor for aortic dissection?
Hypertension or Marfan syndrome
56
What is the Stanford classification of aortic dissection?
Type A (ascending), Type B (descending)
57
What is the Wells score component for PE?
Clinical symptoms of DVT (3 points)
58
What is the imaging of choice for PE?
CT pulmonary angiogram (CTPA)
59
What is the ECG finding of massive PE?
S1Q3T3 pattern
60
What is the treatment for massive PE?
Thrombolysis (e.g., alteplase 100 mg IV)
61
What is the dose of heparin in PE?
80 units/kg IV bolus, then 18 units/kg/h
62
What is the target INR for warfarin in PE?
36925
63
What is the risk stratification tool for PE?
PESI score or sPESI
64
What is the thrombolysis indication in PE?
Hemodynamic instability
65
What is the dose of rivaroxaban in PE?
15 mg BD for 21 days, then 20 mg OD
66
What is the ECG finding of right heart strain in PE?
Right axis deviation, RBBB
67
What is the D-dimer threshold to rule out PE?
<500 ng/mL (age-adjusted if >50)
68
What is the treatment for submassive PE with RV dysfunction?
Anticoagulation ± thrombolysis
69
What is the classic presentation of acute heart failure?
Dyspnea, orthopnea, bilateral crackles
70
What is the first-line diuretic in acute heart failure?
Furosemide 20-40 mg IV
71
What is the dose of GTN in acute pulmonary edema?
0.4 mg SL or 5-10 mcg/min IV
72
What is the BP target in acute heart failure with hypertension?
SBP reduction by 25% in first hour
73
What is the role of NIV in acute heart failure?
Reduces intubation rate (CPAP/BiPAP)
74
What is the ECG finding of acute heart failure?
Tachycardia, possible ischemia
75
What is the biomarker for heart failure?
BNP or NT-proBNP
76
What is the NT-proBNP threshold for heart failure?
>300 pg/mL
77
What is the treatment for cardiogenic shock in heart failure?
Inotropes (e.g., dobutamine)
78
What is the dose of dobutamine in cardiogenic shock?
2-20 mcg/kg/min IV
79
What is the complication of excessive diuresis in heart failure?
Hypokalemia
80
What is the ECG finding of pericarditis?
Diffuse ST elevation, PR depression
81
What is the treatment for pericarditis?
NSAIDs (e.g., ibuprofen 600 mg TDS)
82
What is the classic sign of cardiac tamponade?
Beck’s triad (hypotension, muffled heart sounds, JVD)
83
What is the imaging for cardiac tamponade?
Echocardiography (RV collapse)
84
What is the treatment for cardiac tamponade?
Pericardiocentesis
85
What is the ECG finding of tamponade?
Electrical alternans
86
What is the dose of colchicine in pericarditis?
0.5 mg BD
87
What is the risk factor for myopericarditis?
Recent viral infection
88
What is the treatment for hypertensive emergency?
Labetalol or GTN IV
89
What is the BP target in hypertensive emergency?
Reduce by 25% in first hour
90
What is the ECG finding of hyperkalemia?
Peaked T waves
91
What is the treatment for hyperkalemia with ECG changes?
Calcium gluconate 10 mL 10% IV
92
What is the dose of salbutamol for hyperkalemia?
10-20 mg nebulized
93
What is the ECG finding of hypokalemia?
U waves, flattened T waves
94
What is the treatment for severe hypokalemia?
Potassium chloride 10-20 mmol IV
95
What is the classic presentation of endocarditis?
Fever, new murmur, embolic phenomena
96
What is the first-line antibiotic for suspected endocarditis?
Vancomycin + ceftriaxone
97
What is the Duke criteria for endocarditis?
2 major or 1 major + 3 minor
98
What is the imaging for endocarditis?
Transesophageal echo (TEE)
99
What is the surgical indication for endocarditis?
Heart failure or abscess
100
What is the ECG finding of Brugada syndrome?
ST elevation in V1-V3 with RBBB pattern
101
What is the treatment for Brugada syndrome with VT?
ICD placement
102
What is the risk factor for Takotsubo cardiomyopathy?
Emotional stress
103
What is the ECG finding of Takotsubo?
ST elevation mimicking MI
104
What is the echo finding of Takotsubo?
Apical ballooning
105
What is the treatment for Takotsubo cardiomyopathy?
Supportive care, beta-blockers
106
What is the ECG finding of WPW syndrome?
Short PR, delta wave
107
What is the treatment for WPW with AF?
Procainamide or cardioversion
108
What is the contraindication in WPW with AF?
AV nodal blockers (e.g., adenosine)
109
What is the dose of procainamide in WPW?
20 mg/min IV (max 1 g)
110
What is the ECG finding of second-degree AV block Mobitz I?
Progressive PR lengthening, dropped QRS
111
What is the treatment for Mobitz I with symptoms?
Atropine or pacing if unstable
112
What is the ECG finding of Mobitz II?
Constant PR, intermittent dropped QRS
113
What is the treatment for Mobitz II?
Pacemaker
114
What is the definition of cardiogenic shock?
Hypotension (SBP <90) with hypoperfusion
115
What is the first-line inotrope in cardiogenic shock?
Dobutamine
116
What is the dose of milrinone in cardiogenic shock?
0.375-0.75 mcg/kg/min IV
117
What is the complication of inotropes?
Tachyarrhythmias
118
What is the ECG finding of pulmonary edema?
Tachycardia, S3 gallop on exam
119
What is the dose of enalaprilat in heart failure?
1.25 mg IV
120
What is the role of IABP in cardiogenic shock?
Augments coronary perfusion
121
What is the contraindication to nitrates in ACS?
Hypotension (SBP <90)
122
What is the dose of heparin in NSTEMI?
60-70 units/kg IV bolus
123
What is the target aPTT for heparin in ACS?
1.5-2.5 times control
124
What is the ECG finding of ischemic T-wave inversion?
Symmetrical, deep T-wave inversion
125
What is the treatment for Prinzmetal angina?
Calcium channel blockers
126
What is the dose of verapamil in Prinzmetal angina?
40-80 mg orally TDS
127
What is the ECG finding of LV aneurysm?
Persistent ST elevation post-MI
128
What is the complication of LV aneurysm?
Ventricular arrhythmias
