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Flashcards in Cardiology Deck (206):
1

What is the most common cause of CHF

Coronary Artery Disease (CAD)

2

What are the 3 forms of CHF

1. Left vs. Right Sided
2. Systolic vs. Diastolic
3. High vs. Low Outlet

3

What are common causes of left and right sided heart failure

Left sided: CAD and HTN
Right sided: Left HF, pulmonary disease

4

What are the 3 compensatory mechanisms for HF

Increased preload
Increased afterload
Decreased contractility

5

What happens to the kidneys in CHF

Decreased renal perfusion so they compensate

6

How do the kidneys compensate with CHF and why

The kidneys aren't getting enough blood, so they think the body is dehydrated
They stimulate the renin-angiotensin-aldosterone and ADH system
That results in fluid and sodium retention and fluid overload (central and peripheral) EDEMA

7

What happens to the ventricles when preload increases (volume overload)

Ventricles dilate (leads to increase in BNP)

8

List the steps in cycle resulting from poor cardiac function and fluid accumulation in the lung with hypoxemia

Acute LV systolic Dysfunction
Decreased myocardial contractility and CO
Catecholamine production (increases HR and BP)
Increase in SVR (Afterload) and BP
Increased myocardial wall tension and O2 demands
Leads to diastolic dysfunction, increased pulmonary artery and capillary hydrostatic pressures, hypoxia, and increases myocardial ischemia

9

What disease processes are associated with low output HF

CAD
Severe HTN
Valvular disease
Cardiomyopathy
Dysrhythmias
Massive PE

10

What disease process are associated with high output HF

Increased metabolic demands
Thyroxicosis, severe anemia, AV fistula, Beriberi (thiamine deficiency), Paget's Disease

11

What symptoms are noted with Left HF

*Think about things that would result from fluid buildup in lungs due to increased pulmonary venous pressure**
Dyspnea, Orthopnea, paroxysmal nocturnal dyspnea, weakness, fatigue, tachycardia, basilar rales, Cheyne Stoke's breathing

12

What symptoms are noted with Right HF

JVSD, Peripheral edema, RUQ pain, Ascites, Hepatomegaly

13

What is the most useful diagnostic test for CHF. What do you see?

Echo
Systolic and diastolic function, ventricular hypertrophy, wall motion abnormalities, valvular disorders

14

What is the most important determinant in prognosis for CHF and how do you measure it.

Ejection Fraction, measured by Echo
Normal EF is 55-60
EF

15

What are two other methods to Dx HF

CXR: Cardiomegaly, Cephalization, Kerley B lines, pleural effusions

BNP: Released due to volume overload

16

What should all patients with CHF be placed on. Why?

Ace-I and Diuretic

17

What two therapies have proven to improve OUTCOMES in CHF

Ace-I and Beta-Blocker

18

What two therapies improve Sx in CHF

Nitrates and diuretics (loop or thiazide)

19

What do Nitrates and diuretics do?

Decrease preload

20

What do Ace-I do?

Decrease afterload and improve CO and improve renal perfusion
Decrease aldosterone production and potentiate other vasodilators

21

What do Beta-Blockers do?

Decrease catecholamines

22

What are examples of Positive Inotropes or Sympathomimetics

Digoxin, Dobutamine, Dopamine

23

Management of CHF
*think LMNOP*

Lasix (Ace-I)
Morphine
Nitrates
Oxygen
Position (place upright to decrease venous return)

Also, Nesiritide which is a synthetic BNP and decreases RAAS activation which leads to sodium excretion

24

What is the most common type of Cardiomyopathy

Dilated Cardiomyopathy

25

What results with dilated cardiomyopathy

Systolic dysfunction
Ventricles can't contract well so there is poor EF
Heart compensates by dilating

26

What are some causes of dilated cardiomyopathy

Idiopathic
Viral (Enterovirus like Coxsackie and Echovirus), Parvovirus
Alcohol abuse, Cocain
Pregnancy

27

What are some sx of dilated cardiomyopathy

HF sx: Weakness, SOB, peripheral edema, Crackles, S3, JVD

28

Dx of dilated cardiomyopathy

Echo: See LV dilation, reduced EF, regional or global LV hypokinesis
CXR: Cardiomegaly, curly B-lines

29

Tx of dilated cardiomyopathy

Think CHF
Ace-I, Diuretics, Digoxin, Beta-Blockers

30

What do you do in dilated cardiomyopathy if EF

Add implantable defibrillator

31

What results in Restrictive Cardiomyopathy

Diastolic Dysfunction
Problem with filling
Fibrosis or infiltration of heart muscle, stiff, inflexible

32

What happens with EF in Restrictive Cardiomyopathy

Normal or near normal

33

What are causes of Restrictive Cardiomyopathy

Infiltrative Diseases like Amyloidosis, sarcoidosis

34

What are sx of Restrictive Cardiomyopathy

Think CHF
Kussmaul's sign (increased JVP)

35

Dx of Restrictive Cardiomyopathy

Echo: Nondilated ventricles with normal wall thickness, some dilation of atria
CXR: Normal size heart or small

36

Tx of Restrictive Cardiomyopathy

Treat sx: Diuretics and vasodilators

37

What is happening in Hypertrophic Cardiomyopathy

Thickened ventricles (usually left)
Has components of both systolic and diastolic dysfunction

38

Sx of Hypertrophic CArdiomyopathy

Sometimes none! Could result in sudden cardiac death (due to V.fib)
Dyspnea, Angina, Syncope, Arrhythmias

39

How can you increase the sound of a murmur

Valsalva maneuver
It decreases the volume in the LV while creating turbulent flow

40

How can you decrease the sound of a murmur

Squatting, First Clench
Increases peripheral vascular resistance so dilates aorta and creates less turbulent flow

41

Dx of Hypertrophic Cardiomyopathy

Echo: Assymetric wall thickness, especially septal, systolic anterior motion of mitral valve
EKG: LVH
CXR: Cardiomegaly

42

Tx of Hypertrophic Cardiomyopathy

Avoid strenuous exercise
Beta Blockers are 1st line
CCB, Disopyramide (all 3 are negative inotropes)
Surgery: Myomectomy
Alcohol Septal Ablation

43

What is P-Wave

The beat goes through the atrium

44

What is the PR segment

Beat goes through the AV node

45

What is QRS

Rapid contraction through ventricle

46

What is a T wave

Ventricular Repolarization

47

What is a normal sinus rate

>60bpm

48

What is Atrial Fibrillation

Irregularly Irregular Rhythm
No P waves seen

49

Tx for A.Fib

Rate control: Vagal maneuver, CCB or B-Blocker
Cardioversion may be done BUT need to anticoagulate for 3-4 weeks before doing so so they don't throw a clot

50

What are the components of the CHADS2 criteria, and what is it measuring. Tx based on score.

Measuring stroke risk
C: CHF
H: HTN
A: Age>75
D: DM
S2: Stroke, TIA, Thrombus (2points)
High risk: >2 need to place on Warfarin
Moderate risk: 1. Warfarin or ASA
Low Risk: 0. No tx or ASA

51

What are the EKG findings for a 1st degree AV block

1 p for every QRS
PR intervals are prolonged but they are constant

52

Tx for 1st degree AV block

Nothing. They're usually age related, effects of meds, myocarditis, etc.

53

What are the EKG findings for a Type I 2nd degree AV block, and what is another name for this type of block

Mobitz I, Wenkebach
P-waves are constant
PR intervals gradually increase and eventually lead to a dropped QRS complex

54

What causes a Type I 2nd degree AV block

Heightened vagal tone, normal variant, inferior wall ischemia, tends to be transient

55

Tx for Type I 2nd degree AV block

Atropine, Epinephrine, Pacer

56

What are the EKG findings for a Type II 2nd degree AV block, and what is another name for this type of block

Mobitz II
P-waves are constant
PR intervals are constant but there is a dropped QRS complex
Random drop in QRS complex

57

What causes a Type II 2nd degree AV block

MI, usually anterior MI

58

Tx for Type II 2nd degree AV block

Pacer

59

What are the EKG findings for a 3rd degree AV block, and what type of block is this

Complete heart block
P waves are not related to QRS
All P's are not followed by QRS (results in reduced CO)
PR intervals vary - no apparent association with P-waves and QRS complexes

60

What are causes of 3rd degree AV block

MI, usually inferior (narrow QRS), or anterior (wider QRS)

61

What does the QRS complex tell you in the a 3rd degree AV block regarding prognosis

Narrow QRS: Good prognosis
Wide QRS: Worse prognosis

62

Tx for a 3rd degree AV block

Pacer

63

Summarize 1st, 2nd, and 3rd degree heart blocks

1st degree: A p-wave is being conducted but slower than we would want. This is ok because every signal is making it through at a predictable manner, so no tx.
2nd degree: Most P-waves are being conducted
2nd degree Type I: QRS is dropped due to progressive elongation of PR intervals. This is in a predictable manner, so not as concerning. Tx is Atropine and Pacer
2nd degree Type II: QRS is dropped randomly, PR intervals are all the same size. Random pacing means poor perfusion. This needs to be tx with a pacer
3rd degree heart block: No p-waves are making it through, meaning conduction system is relying on AV node or ventricles, which is too slow to perfuse appropriately. Tx is pacer

64

What is the risk with Atrial Fibrilliation

The atrial are not contracting, so blood is stagnant there and CLOTS can form

65

What is the definitive tx for A.Fib

Catheter ablation to get rid of the accessory pathways

66

What is Ventricular Fibrillation

Ventricles are not contracting
No QRS
This is incompatible with life

67

Tx for V.Fib

Shock, Cardiovert

68

What is Torsades de Pointes and how do you treat.

Sin curve seen on EKG
Precursor to V.Fib if not tx
Tx: IV magnesium

69

What can you see with Torsades de Pointes on EKG

QT Prolongation
Sin-curve

70

What is Atrial Flutter. What do you see on EKG

When the atrium is contracting too quickly
Both Atrium and Ventricle contract
EKG: Saw-tooth waves, no P-waves

71

What is a risk with Atrial Flutter

Clots

72

TX for Atrial Flutter. Definitive Tx

Vagal maneuvers, CCB, Beta-Blockers
Definitive: Ablation

73

What is Wolff-Parkinson-White

Accessory signal present that is not allowing appropriate repolarization before the next depolarization signal comes through

74

What do you see on EKG with WPW

Delta Waves

75

What is a risk with WPW

Arrhythmia

76

What is happening in Supraventricular Tachycardia

A signal is coming from above the ventricles, so could be the AV node or the Atria

77

What do you see in SVT

Narrow QRS

78

Tx for SVT

Valsalva
Drugs: Beta-Blockers or CCB
They shut down the parasympatehtic conduction at AV node

79

What is the difference between ischemia and infarct and how do each look on an EKG

Ischemia: Tissue Obstruction. ST depressions
Infarct: Tissue Death. ST Elevation

80

What is a RBBB and what do you see on EKG

Delay in electrical signal at right side of bundle branch
See Wide Positive QRS in Leads V1, V2

81

What is LBBB and what do you see on EKG

Delay in electrical signal at left side of bundle branch
See Wide Negative QRS in leads V4-V6. Also see a notch or "fork" at the top of the QRS complex in V6

82

What do you see on EKG with LVH

Large QRS Complex (tall peaks)

83

What is a murmur

An extra sound during the cardiac cycle associated with TURBULENT FLOW

84

What is happening in Aortic Stenosis and what are some problems associated with it

LV outflow obstruction
Can lead to LVH

85

Describe the murmur heard

Systolic Ejection Crescendo-Decrescendo at the Right Upper Sternal Border

86

Where does an aortic stenosis murmur radiate to

Carotid Arteries

87

What are sx associated with Aortic Stenosis

Angina, Syncope, CHF

88

Tx for Aortic Stenosis

Surveillance if no sx
If sx, aortic valve replacement

89

What is Mitral Regurgitation and what are complications

Backflow from the LV to LA
Can lead to LV volume overload, so decreased CO

90

What type of murmur is heard with Mitral Regurgitation

Blowing holosystolic Murmur heard best at the Apex

91

Where does a Mitral Regurgitation murmur radiate to

Axilla

92

Sx with Mitral Regurgitation

Acute: Pulmonary Edema, Dyspnea
Chronic: A.Fib, CHF

93

What are maneuvers to increase/decrease the sound of a murmur associated with Mitral Regurgitation

Increase: Handgrip
Decrease: Amyl Nitrate

94

Tx for Mitral Regurgitation

Meds: Ace-I (vasodilators that decrease afterload and can increase forward flow)
Surgery: Valve repair

95

What is happening in Mitral Valve Prolapse

Degeneration of the mitral valve which makes it floppy

96

What type of murmur is heard with a Mitral Valve Prolapse

Missystolic Ejection Click at the Apex

97

How can you increase/decrease the sound of a murmur with Mitral Valve Prolapse

Decrease Venous Return via Valsalva, Standing, or Inspiration causes longer murmur duration

98

Sx with Mitral Valve Prolapse

Most are asymptomatic
Autonomic Dysfxn: Chest pain, Panic Attacks, Arrhythmias
If Progresses: Fatigue, dyspnea, CHF

99

What happens in Mitral Stenosis

Obstruction from LA to LV
Leads to LA Enlargement and increases LA pressure, results in Pulmonary HTN

100

What type of murmur is heard with Mitral Stenosis

Diastolic Rumble at the Apex, may be preceded by opening snap

101

Sx with Mitral Stenosis

R-sided HF, Pulmonary HTN, A.Fib, Mitral Facies

102

Tx with Mitral Stenosis

Valvotomy in young people if rheumatic heart disease is cause
Valve repair in adults

103

What is happening with Aortic Regurgitation

Backflow from the aorta to LV
Leads to LV volume overload

104

What murmur is heard with Aortic Regurgitation

Diastolic Decrescendo Blowing at Left Upper Sternal Border

105

What do you decrease/increase the sounds of a murmur in Aortic Regurgitation

Increase the murmur with handgrip
Decrease the murmur with Amyl Nitrate

106

Where does an Aortic Regurgitation murmur radiate to

Left Sternal Border

107

Sx of Aortic Regurgitation

Left Sided HF (Pulmonary HTN)

108

Tx of Aortic Regurgitation

Vasodilators that will decrease afterload and increase forward flow (Ace-I)
Surgery

109

What is happening with Atrial Septal Defect

Hole in the atrial septum

110

What shunt results in ASD, is there cyanosis

Left to right shunt
No Cyanosis

111

What type of murmur is heard with ASD

Systolic ejection crescendo-decrescendo flow at Pulmonic area (LUSB)

112

Sx of ASD

Asymptomatic until adulthood usually
Kids: Recurrent URI
Adults: Exertional dyspnea, easy fatigability, palpitations, syncope, HF

113

Tx of ASD

Surgical Correction
Spontaneous Closure

114

Where is the area of infarct with ST elevations in V1-V4. What artery is involved

Anterior
Left Anterior Descending

115

Where is the area of infarct with ST elevations in I, aVL, V5 and V6. What artery is involved

Lateral
Circumflex

116

Where is the area of infarct with ST elevations in I, aVL, V4, V5, V6. What artery is involved

Anterolateral
Mid LAD or Circumflex

117

Where is the area of infarct with ST elevations in II, III, aVF. What artery is involved

Inferior
Right Coronary Artery

118

Where is the area of infarct with ST DEPRESSIONS in V1-V2. What artery is involved

Posterior
RCA, Circumflex

119

What causes atherosclerosis

Lipid deposition, calcification, plaque formation in vessels

120

What are modifiable risk factors with atherosclerosis

Diabetes
Cigarette Smoking
HTN
Hyperlipidemia

121

What constitute a dx for Metabolic syndrome

3 or more
Abdominal obesity
Trg>150
HDL110
HTN

122

What falls under Acute Coronary Syndromes

Unstable Angina
NSTEMI
STEMI

123

What is Angina

Imbalance between myocardial oxygen demand and myocardial oxygen delivery

124

Sx of Angina

Subseternal chest pain, Chest tightness, Radiation to neck or Jaw, Dyspnea, Nausea/Vomiting, Diaphoresis, Levine's Sign

125

What is Stable Angina

Regular pattern of angina exacerbated by physical or emotional stress
Relieved with rest within minutes
Relieved with NTG within minutes

126

Dx of Stable Angina

History

127

Tx of Stable Angina

Modify RF, low fat low cholesterol diet
Meds: Nitrates, Beta-Blockers, CCB

128

What is first line acute management for Stable Angina

NTG

129

What is first line chronic management for Stable Angina

Beta-Blockers

130

What is the classic regimen for someone with Angina

Daily ASA, Sublingual NTG as needed for pain, Daily Beta-Blockers, and Statin if LDL is increased

131

What causes Acute Coronary Syndrome

Ruptured coronary plaques that lead to bleeding, platelet aggregation, and thrombus formation
May slo be caused by cocain-induced or prinzmetal's variant angina

132

What is Unstable Angina

New onset of angina symptoms
Increased intensity of stable angina
Increased frequency of angina
Subtotal occlusion of vessels that lead to severe sx without infarction

133

What is an MI

Complete occlusions of vessels
NSTEMI and STEMI

134

Sx of an MI

Pain is more prolonged, not relieved with rest or NTG
Note that 1/3 of pts don't have pain, instead only come in with dyspnea, diaphoresis, nausea, weakness (Diabetics, women, obses pts)
Tachycardia, bradycardia, CHF, Hypotension, new murmur
Post-MI Pericarditis with friction rub may occur after 24 hours

135

What are some common EKG findings with an MI

T-Wave Abnormalities
ST-segment depression:Ischemia
ST-Segment elevation:Infarction
Q-waves: Infarction
V1-V2: Septal or Posterior
V3-V4: Anterior
V5-V6, I, aVL: Lateral
II, III, aVF: Inferior
V1-V2 with depressions:Posterior

136

What are common biomarkers seen in MI

Myglobin
CPK-MB
Troponin, Troponin, Troponin!

137

When does Troponin rise, peak, and normalize

Rise: 4-6 hours
Peak: 18-24 hours
Normalizes: 7-10 days

138

What is the gold standard for an MI workup

Coronary Angiography

139

What other dx modalities can be used in MI

CXR, Echo, Stress testing

140

TX of Unstable Angina and NSTEMI

1. Antithrombotic Therapy
2. Adjunctive Therapy

141

Tx for STEMI

1. Reperfusion Therapy
2. Antithrombotic Therapy
3. Adjunctive Therapy

142

What is part of Antithrombotic Therapy

These PREVENT clots
ASA: prevents platelet aggregation
Heparine
Clopidogrel:
Glycoprotein (for people going cath lab)

143

What are common Adjunctive Therapies

Beta Blockers: Metoprolol
Nitrates
Morphine
CCB

144

What is a common Reperfusion Therapy in STEMI. And how soon should they be started

Primary Percutaneous Coronary Intervention - do it if it's within 90 minutes
Fibrinolytics - Do within 30 minutes

145

What are common Thrombolytic Therapies (Fibrinolytic)

These DISSOLVE clots
Tissue Plasminogen Activators: Alteplase (rTPA)
Streptokinase

146

What is common Adjunctive Therapy in STEMI

Beta-Blockers
Ace-I
Nitrates
Morphine
Statin therapy if high LDL

147

What is a complication of MI

Heart Failure
Ventricular Fibrillation
Dressler's Syndrome: Post-MI pericarditis (1-2 months after) associated with fever and pulmonary infiltrates

148

What is an anuerysm

Abnormal dilation of the aorta

149

What is the most common cause for an aneurysm

Atherosclerosis

150

What are 2 common RF for Anuerysms

Smoking and COPD

151

Sx of Anuerysm

Asymptomatic until large or rupture
Scenario: Older male with severe back pain or abdominal pain who presents with syncope or hypotension with tender pulsatile abdominal mass
Flank Ecchymosis

152

Dx of Aneurysms

Abdominal ultrasound
CT scan for thoracic
Angiography

153

What is the gold standard for dx of Anuerysms

Angiography

154

Tx of Aneurysms. What is definitive tx.

Definitive: Surgery
3-4cm: monitor every year with ultrasound
4-4.5cm: Monitor every 6 months
>4.5: Vascular surgeon referral
>5.5 or expansion in 6 months: Immediate surgery

155

What is an Aortic Dissection

Tear in the innermost layer of aorta

156

What is RF for aortic dissection

HTN, Age, Connective Tissue Disease (Marfans)

157

Sx of Aortic Dissection

Acute onset
Severe tearing ripping pain in upper chest or back
Decreased peripheral pulses: Variation in pulses between left and right arm

158

Dx of Aortic Dissection. What is the gold standard

Gold Standard: MRI Angiography
CXR, CT with contrast

159

Tx for Type A vs. Type B

Type A: Tear in ascending and descending. Tx: Surgery
Type B: Tear in descending only. Tx: Meds with Beta Blockers (Labetalol) with sodium nitropurisside if needed

160

What causes Peripheral Artery Disease

Atherosclerosis

161

Sx of Peripheral Artery Disease

Pain with exertion (walking), intermittent claudication, Ulcerations

162

What happens with an arterial embolism/thrombosis

Acute occlusion of an artery

163

What are common sources for emobli or thrombi

Heart and Aorta

164

Tx for emboli/thrombosis

Revascularize

165

What are sx for Acute Occlusion (6 P's)

Pain, Pallor, Pulselessness, Paresthesias, Poikilothermia, Paralysis

166

Dx for Acute Occlusion

Arterial Duplex, MRA, CTA, ABI, Angiography

167

What is Giant Cell Arteritis

Vessel Inflammation of medium/larger arteries

168

What is Giant Cell Arteritis commonly associated with

Polymyalgia Rheumatica

169

What is another name for Giant Cell Arteritis

Temporal ARteritis

170

Sx with Giant Cell Arteritis

Headache, scalp tendernes, jaw claudication, sore throat, visual loss

171

Dx of Giant Cell Arteritis

Elevated ESR/CRP
Temporal Artery Biopsy: see mononuclear lymphocyte infiltration, multinucleated giant cells
Clinical DX!

172

Tx of Giant Cell Arteritis

Steroids and referral to ENT

173

What is a complication of Giant Cell Arteritis

Blindness

174

What is Phlebitis/Thrombophlebitis

Inflammation of the superficial vein and venous occlusion/inflmmation

175

What is Phlebitis associated with

IV cath, Trauma, Pregnancy

176

Sx of Phlebitis

Pain, Tenderness, Edema, Redness, Induration, Palpable Cord

177

Dx of Phlebitis

Venous Duplex Ultrasound

178

Tx of Phelbitis

Supportive: Elevation, warm compress, NSAIDS, Compression stocking
If Septic: Abx
Vein Ligation/Excision

179

What are Varicose Veins

Dilated, Tortuous superficial veins seen with increased estrogen like OCP or pregnancy

180

Sx of Varicose Veins

Asymptomatic or mild ache

181

Tx of Varicose Veins

Stockings, Elevation, Intervention techniques

182

What is Chronic Venous Insufficiency

Vascular incompetency of either deep and/or superficial veins

183

When does Chronic Venous Insufficiency usually occur

DVT or Trauma

184

Sx of Chronic Venous Insufficiency

Leg pain worse with prolonged sitting, improved with leg elevation or walking
Edema, Stasis, Dermatitis
VENOUS STASIS ULCER: usually at MEDIAL malleolus
Atrophic Blanche

185

Dx of Chronic Venous Insufficiency

Ankle/Brachial Index
Trendelenburg Test, Ultrasound

186

Tx of Chronic Venous Insufficiency

Compression: Leg elevation, stockings, exercise, Una boot
If ulcers: wet to dry dressings, skin grafting, hyperbaric O2
Venous valve transplant

187

What is a Venous Thrombus

DVT

188

What are RF for DVT

Virchow's Triad: Venous stasis, endothelial damage, hypercoagulability

189

Sx of DVT

Unilateral swelling/edema of lower extremity
Calf Tenderness, Phlebitis (local warmth, erythema, palpable cord)

190

Dx of DVT

Venous Duplex Ultrasound is #1
D-Dimer
Venograph is Gold Standard

191

RF of DVT

Surgery, Travel, Genetics, Pregnancy

192

Tx of DVT

Anticoagulation Therapy: Heparin, LMWH, Warfarin for 3-6 months

193

What is a TIA

Sudden onset focal neurologic deficits, usually due to emobuls

194

Sx of TIA

Short interval of vision, speech, weakness, sensory abnormalities
Internal Carotid: Monocular visual loss, temporary "lamp shade" over one eye, weakness in contralateral hand

195

Dx of TIA

CT
Carotid Doppler, CT Angiography, Serum Glucose

196

Tx of TIA

ASA Plavix (antiplatelet therapy), No Thrombolytics, Place supine to increase cerebral perfusion

197

What is a Stroke

Neruologic deficits due to ischemia or hemorrhage

198

Sx of Ischemic Stroke

Correlate with vessel involved (anterior vs. posterior circulation)

199

Dx of Ischemic Stroke

Noncontrast CT
MRA/MRI
CT Perfusion/CTA
CBC, Coag studies, EKG

200

Tx of Ischemic Stroke

Reverse Ischemia/Salvage brain tissue
Thrombolytic therapy (tPA) within 3 hours
Antiplatelet Therapy (ASA, Plavix)

201

Most common cuase for Hemorrhagic stroke

HTN

202

Dx of Hemorrhagic Stroke

Noncontrast CT

203

Tx of Hemorrhagic Stroke

Supportive, BP control

204

Sx of Subarachnoid Hemorrhage

Acute onset "worst headache of my life", syncope, nausea/vomiting, nuchal rigidity

205

Dx of Subarachnoid Hemorrhage

CT
If CT negative but high suspicion do LP

206

Tx of Subarachnoid Hemorrhage

Supportive (no exertion, stool softener, anti-anxiety meds)