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Internal Medicine > Cardiology > Flashcards

Cardiology Flashcards

(51 cards)

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1
Q

Class Ia Anti-arrhythmics

A

Quinidine, Procainamide
Na-channel blocker
prolong action potential

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2
Q

Class Ib Anti-arrhythmics

A

Lidocaine, Tocainide
Na-channel blocker
shorten action potential

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3
Q

Class Ic Anti-arrhythmics

A

Flecainide, Propafenone
Na-channel blockers
no change in action potential

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4
Q

Class II Anti-arrhythmics

A

beta-blockers

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5
Q

Class III Anti-arrhythmics

A

Amiodarone, Sotalol, Bretylium

K-channel blockers

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6
Q

Class IV Anti-arrhythmics

A

Verapamil, Diltiazem

Ca-channel blockers

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7
Q

Posterior MI

A

V1-V2

PDA

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8
Q

Septal MI

A

V1-V3

(septal branch of) LAD

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9
Q

Anterior MI

A

V2-V4

LAD

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10
Q

Inferior MI

A

II/III/aVF

(acute marginal branch of) RCA

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11
Q

Lateral MI

A

I/aVL

Circumflex

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12
Q

Ductus Arteriosus

A

connection between pulmonary trunk and descending aorta so oxygenated blood from placenta can bypass lungs and enter systemic circulation

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13
Q

Foramen Ovale

A

Connection between RA and LA so oxygenated blood from placenta can bypass lungs and enter left heart/systemic circulation

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14
Q

Ductus Venosus

A

Connection between umbilical vein (carrying oxygenated blood from placenta) and IVC

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15
Q

Closure of DA

A

decreased PG-e

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16
Q

Closure of FO

A

decreased IVC/RA pressure after cord-clamping

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17
Q

Closure of DV

A

increased SVR

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18
Q

Familial Hypercholesterolemia

A

defect in LDL receptor
autosomal dominant
homozygous > severe than heterozygous (LDL >600 vs >250)

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19
Q

Familial Combined Hyperlipidemia

A

increased ApoB production

high LDL and TG

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20
Q

Familial Defective AboB-100

A

defect in LDL particle

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21
Q

Physical exam findings in inherited hypercholesterolemia

Study These Flashcards
A

Xanthomas- tendons/skin especially behind knees and ankles
Xanthelasmas- eyelids
Retinal Cholesterol Emboli

22
Q

LDL Target Levels

Study These Flashcards
A

Healthy: <100

23
Q

CAD Risk Factors for LDL Goals

Study These Flashcards
A

Smoking
HTN
HDL 45,
Age (male >45, female >55)

***HDL >60 protective

24
Q

HMG-CoA Reductase Inhibitors

Study These Flashcards
A

Statins
Greatly decrease LDL
decrease TG, increase HDL
SE: myositis, increase LFT’s

25
Cholesterol Absorption Inhibitors
Ezetimibe Decrease LDL SE: myalgias, ? increase LFT's
26
Fibric Acids
``` Gemfibrozil, Fenofibrate (stimulate lipoprotein lipase) Greatly decrease TG decrease LDL SE: myositis, increase LFT's ```
27
Bile Acid Sequestrants
Cholestyramine, Colestipol Decrease LDL ? increase TG SE: bad taste, GI upset
28
Niacin
Increase HDL decrease LDL, TG SE: flushing, nausea, paresthesias, pruritus, increase LFT's, insulin resistance, gout flares
29
TIMI Risk Factors
``` Age >65 3+ CAD risk factors Prior CAD (occlusion >50%) ST change on admission 2+ episodes angina in last 24 hrs Elevated cardiac enzymes Use of ASA in last 7 days ```
30
Adverse Event Rate based on TIMI Score
Score 0-1: 4.7% Score 3: 13.2% Score 5: 26.2% Score 6-7: 40.9%
31
A fib Risk Factors
``` LA enlargement CAD/MI HTN Anemia Valve Dz Pericarditis COPD PE Hyperthyroidism RHD Sepsis EtOH Electrolyte imbalance ```
32
V-tach/V-fib Algorithm
``` Shock w/200, 200-300, 360J Then alternate shock w/ Epi (or vasopressin) Amio Lidocaine Bretylium Magnesium Procainamide Bicarb ```
33
Causes of PEA
``` Hypovolemia Hypokalemia Hyperkalemia Hypomagnesemia Hypoxia Hydrogen (acidosis) Tension ptx Tamponade Thrombus (MI, PE) Tablets (drugs) ```
34
PEA/A systole Algorithm
Epi (1mg IV q3-5min) | Atropine (1mg IV q3-5min)-- max dose 0.04mg/kg (avg 2-3 doses)
35
Causes of CHF Exacerbation
``` Medication non-adherence Diet non-adherence MI Arrhythmia Infection Endo/Peri-carditis Hyper/Hypo-thyroid Anemia ```
36
Aortic Stenosis
Crescendo-Decrescendo Radiates to neck DECREASES with Valsalva
37
Aortic Regurg
``` Early diastolic Austin-Flint (late diastolic rumble) Wide pulse pressure Bounding pulse Quincke Sign ```
38
Mitral Stenosis
Opening snap Diastolic rumble Loud S1
39
Mitral Regurg
Blowing murmur Radiates to axilla widely-split S2
40
HOCM PE Findings
``` S3/4 double/triple apical impulse double carotid pulse mitral regurg (abnl ant leaflet) boot-shaped heart ```
41
HOCM Murmur
``` INCREASED by decreased pre/afterload - Valsalva - vasodilators DECREASED by increased pre/afterload - squatting - clenched fist ```
42
Causes of Restrictive Cardiomyopathy
``` Sarcoidosis Amyloidosis Hemochromatosis Glycogen Storage Dz Radiation Scleroderma ```
43
Cardiac Murmurs: normal inspiration
Increase venous filling >> | • increase rt-sided murmurs
44
Cardiac Murmurs: passive leg raise
Increase venous return/preload >> • increase rt-sided murmurs • decrease HOCM, MVP
45
Cardiac Murmurs: squatting
Increase venous return/preload>> • increase rt-sided murmurs • decrease HOCM, MVP
46
Cardiac Murmurs: Valsalva
Decrease venous return/preload>> • increase HOCM • MVP click sooner (closer to S1) • decrease AS, MVP
47
Cardiac Murmurs: clench fist (isometric hand grip)
Increase afterload>> • decrease HOCM and AS • increase MR, VSD
48
Cardiac Murmurs: amyl nitrate
Decrease afterload>> • decrease MR, VSD • no change in AS
49
Cardiac Murmurs: standing
Decrease venous return/preload>> | • increase HOCM, MVP
50
Cardiac Murmurs: pearls
- HOCM and MVP same except w/Valsalva - only HOCM increases w/Valsalva - MVP decreases w/decreased preload from Valsalva BUT increases w/decreased preload from standing - only MR decreases w/exercise
51
ASD
Fixed splitting of S2 • MR (apex, inc w/exp) • TR (LSB, inc w/insp) •MR/TR holosystolic if cleft in valve (primum, not secundum) • increased flow across pulm valve >> midsystolic murmur

Internal Medicine (3 decks)

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