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Cardiology Flashcards

(51 cards)

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0
Q

Murmur associated with Atrial Septal Defect

A

Systolic ejection murmur
Fixed split S2
2nd and 3rd intercostal space

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1
Q

Murmur associated with Tetrology of Fallot

A

Crescendo decrescendo holosystolic along left sternal border radiating to back

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2
Q

Murmur of patent Ductus Arteriosus

A

Machine like with a thrill

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3
Q

Murmur associated with Coarctation of the Aorta

A

Harsh systolic murmur heard in the back

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4
Q

Treatment of Patent Ductus Arteriosus in a neonate

A

NSAIDS, by stopping prostaglandin production(prostaglandins keep the shunt open in utero so blood can bypass the lungs)

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5
Q

Coarctation of the Aorta, key physical exam findings

A

Delayed or weak femoral pulses

Hypertension in upper extremities, hypotension in lower

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6
Q

Treatment of coarctation of the aorta

A

Pts < 50 open surgical repair

Pts > 50 stenting

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7
Q

Mitral valve stenosis physical exam findings

A

Opening snap following S2
Low pitched murmur at the apex
Rales secondary to pulmonary congestion
Tachycardia t

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8
Q

Diagnostic test for Mitral Valve Stenosis

A

ECHO with Doppler

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9
Q

Murmur for mitral valve regurgitation

A

Pansystolic blowing murmur at the apex radiates to axilla

Loud S3

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10
Q

Aortic stenosis murmur

A

Harsh crescendo decrescendo systolic murmur along right sternal border
May radiate to carotids

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11
Q

Orthostasis/Postural hypotension definition

A

Greater than 20mm Hg drop in systolic BP or greater than 10mm Hg drop in diastolic BP between supine and standing measurements

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12
Q

Initial treatment for essential hypertension

A 
Thiazide diuretics
( loop diuretics should be used only in those with renal dysfunction, with close electrolyte monitoring)
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13
Q

What is first line therapy for HTN in those with chronic kidney disease and diabetes?

A

ACE inhibitors, they help preserve kidney function

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14
Q

ACE inhibitor mode of action

A

Inhibit bradykinin degradation and stimulate synthesis of vasodilating prostaglandins

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15
Q

Major side effect of ACE inhibitors

A

Cough

Hyperkalemia is another

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16
Q

Calcium channel blockers are a preferred treatment for HTN in what group of people?

A

Blacks and elderly patients

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17
Q

Treatment for aortic dissection

A

Nitroprusside and B-blocker (labetalol Or esmolol) and urgent surgery

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18
Q

Preferred HTN treatment in pregnancy

A

Hydralazine

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19
Q

Side effects of Beta blockers

A 
Asthma exacerbation 
Bradycardia
Hypoglycemia
Nausea/vomiting
Not to be used for cocaine induced acute coronary syndrome
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20
Q

Thiazides diuretics side effects

Study These Flashcards
A 
Decrease in Na
INCREASE in CA 
Decrease in K
Decrease in Mg
Increase in Uric Acid(think gout)
Increase in glucose (pay attention in the diabetic pt)
21
Q

Losartan

Study These Flashcards
A

Angiotensin Receptor Blocker (ARB)
Reduces vasoconstriction
Reduces aldosterone secretion
Side effects: less cough than ACEI, teratogenicity, hyperkalemia

22
Q

Dressler Syndrome

Study These Flashcards
A 
1-2 weeks post MI:
Pericarditis
Fever
Leukocytosis
Pericardial Effusion
Pleural Effusion
23
Q

Treatment of fibromyalgia

Study These Flashcards
A

Pregabalin (lyrica)
SSRIs, sSNRIs, TCAs
NSAIDS Do NOT help

24
Polymyositis treatment
High dose steroids Methotrexate Azathioprine
25
Heart failure and ACE inhibitors both cause this common side effect
Cough
26
What is pulses alternans? | What condition do you see it in?
Alternating strong and weak pulse force | Seen in heart failure
27
What is paradoxical pulse? | What conditions is it seen in?
>10mmHg drop in systolic blood pressure during inspiration | Seen in obstructive lung disease and tamponade
28
What heart conditions cause a reversed split S2 (split during expiration)?
LBBB LVH AS
29
S4 is best heard in what position?
LL decubitus with the bell | It is never heard in a fib
30
Mitral valve prolapse causes what murmur?
Midsystolic click | Heard brst at apex and LLSB with diaphragm
31
Most common holosystolic murmurs?
Mitral and tricuspid regurgitation | VSD
32
Diastolic rumble is heard in?
Mitral stenosis
33
Most common continuous murmur?
Patent ductus Arteriosus | "Machinery like"
34
Meds indicated to prevent recurrent ventricular tachycardia
Sotalol | Amiodarone
35
Med used during a v tach episode to convert the rhythm
Lidocaine
36
Side effects of amiodarone
Sinus bradycardia AV block Increase in defibrillation threshold
37
Recommended INR before cardioversion
1.8 for three weeks
38
Recommended INR for patients with long standing A Fib in which cardioversion has failed?
2.0 to 3.0
39
What are the ECG findings associated with Wenckebach heart block?
(Type 1 second degree AV block) | Progressive lengthening of the PR interval with a dropped beat
40
Risk factors for metabolic syndrome include
Trig >150 BP>130/85 Fasting blood sugar>110 Abdominal girth >35 in women and >40 in men
41
Treatment of unstable bradycardia
Vagolytic (atropine) Positive chronotropic (epinephrine or dopamine) Transcutaneous pacing may be indicated
42
Treatment of unstable tachycardia
Synchronized cardioversion | May also need anti arrhythmic therapy: amiodarone, B Blocker, lidocaine
43
A regular narrow complex tachycardia is usually from AV node (such as PSVT). What is the treatment?
Adenosine via rapid IV push
44
Treatment of A flutter in an unstable patient
Electric cardioversion
45
Treatment of A flutter in a stable patient
First, anticoagulate with heparin, enoxaparin or warfarin Next, control rate with B Blocker, metoprolol or esmolol ( or diltiazem or verapamil) Then, cardioversion
46
What anti arrhythmic drug is first line for chronic A flutter?
Dofetilide
47
What is Brugada syndrome?
A genetic disorder causing syncope, v fib, and sudden death often during sleep. Asian men
48
What are the preferred drugs for acute V tach
Amiodarone Lidocaine Procainamide
49
Treatment of torsades de pointes?
IV magnesium Correct electrolyte abnormalities (hypomagnesemia or hypokalemia) Withdrawal of drugs that may have caused it Isoproterenol infusion and override pacing may then be necessary
50
What is first degree heart block
All atrial beats are conducted to ventricles, but PR interval is greater than .21 seconds

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