cardiology Flashcards

(71 cards)

1
Q

most frequent cause of diastolic heart failure

A

LVH

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2
Q

NYHA class 1 HF

A

asymptomatic

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3
Q

NYHA class 2 HF

A

symptomatic with mod activity

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4
Q

NYHA class 3 HF

A

symptomatic with mild activity

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5
Q

NYHA class 4 HF

A

symptomatic at rest

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6
Q

most predominant symptoms of L HF

A

dyspnea

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7
Q

most predominant symptoms of R HF

A

signs of fluid retention (edema, hepatic congestion, ascites, loss of appetite)

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8
Q

labs to order for HF

A

CBC, BNP, CXR, ECG, echo

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9
Q

initial pharm treatment of HF

A

diuretic and ACE (mild use HCTZ, severe use lasix. remember GFR must be above 30 to use HCTZ)

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10
Q

side effects of ACE

A

cough, dizziness, hypotension

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11
Q

what do beta blockers do to EF?

A

decrease due to decreasing catecholemines

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12
Q

when is digitalis used for HF?

A

in patients who remain symptomatic when taking diuretics and ACE or in HF and Afib and need rate control

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13
Q

signs of digitalis toxicity

A

anorexia, nausea, HA, blurring or yellowing of vision

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14
Q

what HTN med can accelerate CHF progression?

A

CCB–if have to use one, amplodipine DOC

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15
Q

causes of acute pulmonary edema

A

acute MI, valvular regurg, mitral stenosis, noncardiac causes such as opioids, increased ICP, sepsis, shock, DIC

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16
Q

sxs of pulmonary edema

A

severe dyspnea, pink frothy sputum, diaphoresis, cyanosis. wheezing rales and rhonchi

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17
Q

butterfly pattern of alveolar edema

A

acute pulmonary edema

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18
Q

tx pulmonary edema

A

put in sitting position, oxygen, may need to intubate…morphine 2-8mg IV, IV lasix,

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19
Q

symptoms of paroxysmal SVT

A

may be asymptomatic. rapid heart beat, mild chest pain or SOB.
EKG findings? HR 140-240, regular, P wave can be buried in QRS

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20
Q

causes of Afib

A

pericarditis, chest trauma, cardiac surgery, thyroid disorders, acute alcohol withdrawal, older age

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21
Q

tx of Afib

A

if stable, rate control with BB and anticoagulation. if unstable (shock, hypotension), cardioversion. if fails, give IV ibutilide and try again

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22
Q

BB unsuccessful at rate control for Afib. now what?

A

try CCB (diltiazem)

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23
Q

sawtooth baseline on EKG

A

a flutter

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24
Q

tx a flutter

A

rate control. Amiodarone and dofetilide DOC

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25
premature ventricular beats
isolated beats originating from ventricular tissue, sudden death occurs when these are in presence of organic heart disease
26
tx premature ventricular beats
no tx if asymptomatic. bb for symptomatic
27
v tach
defined as run of 3 or more consecutive ventricular premature beats
28
lab findings in torsades
hypokalemia and hypomagnesmia
29
tx v tach
synchronized cardioversion if hypotension, HF, or myocardial ischemia. if patient is tolerating rhythm, use amiodarone or lidocaine
30
V fib treatment
cardiover-defibrillator
31
tx first degree AV block
none
32
2nd degree AV block AKA mobitz 1
progressively lengthening PR interval until beat drops. no tx
33
3rd degree AV block aka mobitz 2
multiple P waves per QRS then bradycardia. tx is pacemaker because can turn in to complete block
34
most common cause of secondary htn
renal parenchymal disease. others are cushings, genetics, kidney diseases, hyperaldosteronism, pheos, renal artery stenosis
35
JNC 7 HTN category 1
bp over 140/90
36
JNC 7 HTN category 2
bp over 160/100
37
action of beta blockers
decrease HR and CO, decrease renin release
38
BB side effects
bronchospasm, AV node depression, raynauds, fatigue, can mask sxs of hypoglycemia
39
CCB action
peripheral vasodilation with less reflex tachycardia and fluid retention
40
who are ccb best for?
blacks and elderly
41
MOA of alpha antagonists (sins)
relax smooth muscle and reduce bp by lowering PVR
42
side effects of alpha antagonists
hypotension, palpitations, HA, nervousness
43
what can hydralazine cause?
lupus
44
what are good drug combos?
Ace and BB, CCB and diuretic. never use CCB and BB together.
45
hypertensive urgencies
bp over 220/110
46
tx HTN emergency
reduce pressure by no more than 25% then to a level of 160/100 over 2-6 hours using labetalol or nicardipine
47
if HTN caused by pheo or cocaine, what HTN drug needs to be avoided?
BB
48
classic sxs of chronic stable angina
lasts less than 3 minutes, brought on by exertion and leaves with rest, can be brought on by heavy meal. tightness, squeezing, burning pressing or aching pain
49
management of coronary artery disease
LDL goal of
50
symptoms of PVD
intermittent claudication (pain on exertion). severe cramping of calf muscles, relieved with rest.
51
workup of PVD
doppler, ABI (less than 1 is abnormal), CT angiography
52
pallor, paresthesia, paralysis, pulses, pain
acute arterial occlusion
53
systolic ejection murmur that ratiates to the carotids
AS
54
AS treatment
INR maintained between 2 and 3
55
aortic insufficiency symptoms
exertional dyspnea and fatigue, PND or pulmonary edema
56
watter hammer pulse, quincke pulses, head bobbing, high pitched decrescendo murmur
aortic regurg
57
AR treatment
serially monitor by echo. surgery indicated when LV dysfunction is less than 55%
58
pansystolic murmur heard best at apex and radiates to axilla
mitral regurg
59
mid systolic click
mitral valve prolapse
60
most likely causative organism of endocarditis
subacute--s viridans. staph aureus. late prosthetic valve usually due to strep
61
physical exam findings of endocarditis
splinter hemorrhages, petechiae, osler nodes (painful), janeway lesions, roth spots on retina
62
duke criteria for endocarditis
2 positive blood cultures, echo showing endocardial involvement, development of murmur
63
complications of endocarditis
stroke, myocardial abscesses, peripheral emboli
64
tx of endocarditis
vanco plus ceftriaxone. replacement may be required, and anticoagulation is contraindicative in native valve endocarditis b/c of increased risk of intracerebral hemorrhage
65
CI of statin
pregnancy, liver disease
66
drug interactions of statins
diltiazem and verapamil
67
what do bile acid sequestrants do to LDL and TG?
decrease LDL, increase TG
68
what is ezetimibe?
cholesterol absorption inhibitor that decreases LDL
69
drugs for hypertriglyceridemia
Niacin and fibric acid
70
side effect of fibric acid
choleylithiasis, myopathy and liver tox
71
side effects of niacin
hyperglycemia and hyperuricemia (avoid in DM and gout) can also cause flushing