Cardiology Flashcards
(216 cards)
1
Q
How to calculate rate on ECG (regular)?
A
300/large squares
OR
1500/small squares
2
Q
How to calculate rate on ECG (irregular)?
A
6 x R-R intervals on 10 sec (50 large squares)
3
Q
Hyperkalemia on ECG?
A
Peaked T waves
4
Q
Hypokalemia on ECG?
A
ST depression
U waves
5
Q
Hypercalcemia on ECG?
A
Shortened QT interval
6
Q
Hypocalcemia on ECG?
A
Prolonged QT interval
7
Q
Heart block 1st degree?
A
Prolonged P-R in every complex, but every QRS has its own P
8
Q
Heart block 2nd degree?
A
Mobitz I: gradual prolongation until one P is alone
Mobitz II: fixed P-R with a ratio of P dropped (e.g., 3:1, 4:1)
9
Q
Heart block 3rd degree?
A
P-P and R-R are constant but independent
10
Q
Enzyme to diagnose new MI?
A
Troponins
11
Q
Enzyme to diagnose old MI?
A
CK-mb
12
Q
Medical acute treatment of MI?
A
MONA (morphine, O2, nitrates, ASA) BASH (beta blockers, ACE inhibitors, statins, heparin) and copidogrel (if the probability of CAD is high).
13
Q
Out-patient medical treatment of MI?
A
ABAS (ASA, betablockers, ACE inhibitors, statins)
14
Q
Contraindication of Nitrates (MI context)?
A
Right side STEMI
15
Q
Chest pain + normal ECG + negative troponins. Next step?
A
Stress test:
The goal is to get the patient to target heart rate (85% of their maximum)
16
Q
Diamond classification?
A
(1) Substernal chest pain, (2) Worse with Exertion, and
(3) Better with Nitroglycerin. 3/3 is called typical, 2/3 is called
atypical, and 0-1 is called non-anginal.
17
Q
Indications CABG
A
3 vessel disease or left mainstream disease
18
Q
Indications angioplasty (PCI)
A
1, 2 vessel disease
19
Q
Treatment SVT (stable)
A
Vagal maneuvers. If that doesn’t work Adenosine (6-12-12), if doesn’t work, BB/CCB
20
Q
Causes torsade des pointes
A
Hypokalemia or hypomagnesemia
Prolonged QT
21
Q
Treatment torsade des pointes
A
Magnesium
22
Q
Treatment VTach
A
Amiodarone
23
Q
Treatment A Fib (unstable)
A
Cardiovert
24
Q
Treatment Afib, stable, new (<48h)
A
Rate control (BB/CCB) Cardioversion
25
Treatment Afib, stable, old (>48h)
Anticoagulate -> TEE -> CArdioversion -> Anticoagulate
26
A Fib, valvular clot
Tx?
Warfarin
27
A Fib, non-valvular clot.
Anticoagulation treatment?
NOACs (e.g., dabigatran, apixaban and rivaroxaban)
28
Treatment AFib
RACE (rate control, anticoagulation, cardioversion, etiology)
29
Anticoagulation AFib
CHA2DS2 VASC
o Chronic heart failure: 1 pt
o Hypertension: 1 pt
o Age 65-74: 1 pt
o Age > 75: 2 pt
o Diabetes: 1 pt
o Stroke: 2 pt
o Vascular disease: 1 pt
o Femaie: 1 pt
Results 0: ASA; 1: ASA or anticoagulation; >2: anticoagulation (warfarin aiming for INR of 2-3) or NOAC
30
Door needle time (MI)
60 mins to give tPA
31
Time door balloon (MI)
90 mins
32
Farmaco Tx for 1º AV block
Generally none, but Atropine if Sx
33
Farmaco Tx for 2º AV block type I
Generally none, Atropine if Sx.
Review patient's meds
34
Tx for 2º AV block type II
Peace, even if asx
35
Tx for 3º AV block
Peace
36
Tx Idioventricular rhythym
Peace
37
Defribilable rhythms
VT/VF
38
Farma TX unstable VT/VF
Epinephrine-Amiodarone-Epinephrine-Amiodarone
39
Farma TX PEA/Asystolia
Epinephrine-nothing-Epinephrine-nothing
40
Definition of Hypertensive urgency
> 210/120 NO target-organ damage
41
Hypertensive emergency
dBP > 120 + target-organ damage
42
HTN + CHF/CAD. Ideal tx for HTN?
BB (metropolol, carvedilol) + ACEI
43
HTN + stroke. Ideal tx for HTN?
ACEI + HCTZ
44
HTN + CKD. Ideal tx for HTN?
ACEI
45
HTN + DM. Ideal tx for HTN?
ACEI
46
Secondary effects of dCCB (e.g., amlodipine)
Peripheral edema
47
Secondary effects of ACEI
↑ Cr, ↑ K
| Dry cough, angioedema
48
Secondary effects of ARB
↑ Cr, ↑ K
49
Secondary effects of HCTZ
↓ K, ↓ urinary calcium (used for Kidney stones)
HyperGLUC
50
Secondary effects of BB
↓ HR
51
Secondary effects of Aldosterone antagonists (e.g., spironolactone)
Gynecomastia, ↑ K
52
Secondary effects of Hydralazine
Drug-induced lupus
| Reflex tachycardia
53
Secondary effects of Alpha-antagonists (Doxazosin, Prazosin, Terazosin)
Orthotastisc hypotension
54
Secondary effects of Central (clonidine)
Rebound hypertension
55
Emergency hypertension initial goal of BP reduction
↓MAP 25% in 4-6 hrs then to normal in 24 hours
56
Which anti-hypertensive shouldn't be used with afroamerican patients?
ACEI unless there is a comorbility
57
Most common cause of secondary hypertension
CKD/End-state renal disease (ESRD)
58
Treatment of CHF exacerbation
```
If STEMI/NSTEMI: MONA BASH and cath
Not STEMI/NSTEMI
• L= Lasix (Furosemide) 40-500 mg IV
• M= Morphine 2-4 mg IV
• N= Nitrates
• O= Oxygen
• P= Position
• P= Positive airway pressure (CPAD, BiPAP)
IMPORTANT: Never start or increase a Beta-Blocker during an exacerbation.
```
59
Tx CHF class I
| No limitations of activity; no sx with normal activty
(BB+ACEI)
60
Tx CHF class II
| Slight limitation with activity. Comfortable with rest or mild excertion
(BB+ACEI) + Furosemide
61
Tx CHF class III
| Marked limitation of activty. Comforable only at rest
(BB+ACEI) + Furosemide+ [BiDil (isosorbide /hydralazine)+ Spironolactone]
62
Tx CHF class IV
| Any physicial activity brings disconfort; Sx at rest
(BB+ACEI) + Furosemide + [BiDil (isosorbide /hydralazine) + Spironolactone] + Inotrops (e.g., dobutamine)
63
Causes of CHF
CAD, HTN, valvular, alcohol
64
Dressler syndrome
Pericaditis post MI (2-8 wk)
65
Acute pericarditis triad
Chest pain, friction rub, ECG changes (↓PR, diffuse ↑ST)
66
Causes of pericardial diseases
infectious, autoimmune, trauma, and proximate cancers (breast, lungs, esophagus, lymphoma)
67
Etiology of pericarditis
Viral (coxsackie) or uremia
68
Diagnosis of pericarditis in ECG
ECG: ↓ P-R (Pathognomonic); Diffuse ↑ S-T
| Echo is not used!!!!!
69
Treatment of pericarditis
NSAIDS + Colchicine*
## Footnote
* secondary effect: diarrhea
70
Contraindication of NSAIDs
CKD, thrombocytopenia or peptic ulcer disease (PUD)
71
Treatment of Pericardial effusion
NSAIDS + Colchicine (Tx of pericarditis) but if it doesn’t work, pericardial window is the next step
72
Diagnosis of Pericardial effusion
Echo
73
Sx/sg's of Pericardial tamponade
Beck’s triad
* JVD
* Hypotension
* ↓ heart sounds
Clear lungs
Pulsus paradoxus > 10 mmHg
74
Tx of Pericardial tamponade
pericardiocentesis and bolus of IV fluids
75
Etiology of Constrictive pericarditis
recurrent pericarditis
76
Dyspnea, fatigue
Mimic right CHF (edema, ascites, splenomegaly)
Pericardial knock
Dx and next step?
Constrictive pericarditis
Best step:
- CxR: shows calcifications
- Echo
77
Tx of Constrictive pericarditis
Diuretics and salt retention. If this doesn't work, pericardiotomy
78
Causes of Dilated cardiomyopathy
Viral
Ischemia
Valvular disease
Infectious
Metabolic
Alcoholic (wet beriberi)
Autoinmune
79
Treatment of Dilated cardiomyopathy
Same as CHF (BB, ACEI, diuretics)
80
Etiology of Hypertrophic cardiomyopathy (HCM)
Autosomal dominant mutation
81
Pathofisology of Hypertrophic cardiomyopathy (HCM)
Obstructs the aortic outlet
82
Differences between Hypertrophic cardiomyopathy (HCM) and Aortic Stenosis
Hypertrophic cardiomyopathy is found in young people
| Improves with preload
83
Hypertrophic cardiomyopathy (HCM) is known for...
Sudden death of athletes
84
Treatment of Hypertrophic cardiomyopathy (HCM)
Avoid dehydration (AKA no sports), BB/CCB, myectomy, implantable defibrillator, transplant
85
Causes of Restrictive cardiomyopathy
Sarcoid
Amyloid
Hemochromatosis
Cancer
Fibrosis
86
Cardiomyopathy of wet beriberi
Dilated cardiomyopathy
87
Young patient + aortic systolic murmur + dysnea in excertion + syncope + athlete. Next step? Dx?
Echo; Hypertrophic cardiomyopathy (HCM)
88
Restrictive cardiomyopathy + Pulmonary disease. Dx and next step?
Sarcoidosis.
Cardiac MRI and myocardial Bx
89
Restrictive cardiomyopathy + Cirrhosis/DM. Dx and next step?
Hemochromatosis.
Ferritin and genetic test
90
Restrictive cardiomyopathy + peripheral neuropathy. Dx and next step?
Amyloid.
91
Treatment of Myocarditis
Prevent dehydration
Treat CHF
Anticoagulation
Treat cause
92
Meds to avoid in Hypertrophic cardiomyopathy (HCM)
Avoid *nitrates, ACEI, and diuretics* as they increase left ventricular outflow tract and worsen symptoms. Also avoid *digoxin and hydralazine*
93
Young patient, angina, SOB, systolic murmur at the base that improves with leg raise and worsens with Valsalva
Hypertrophic cardiomyopathy
94
Young patient SOB, diastolic murmur on the apex with rumbling with opening snap. Dx, etiology, and next step?
Mitral stenosis, rheumatic disease, ballon valvulopasty
95
Which murmurs should be treated?
Treat all diastolic murmurs and all greater-than-grade-III systolic murmurs
96
CHF, chest pain, rumbling diastolic murmur at the base that improves with valsalva. Dx?
Aortic insufficiency
97
Old patient, atero sclerosis, CHF, syncope, Systolic murmur crescendo-decrescendo murmur at the base (improves with valsava, worsens with leg raise). Dx? Tx?
Dx: Aortic stenosis
Tx: (Sx replacement + CABG) or TAVR*
## Footnote
* Transcatheter aortic valve replacement
98
Possible tx for aortic Stenosis and their complications
Surgical replacement + CABG
* Complications: Acute kidney injury and fribillation
Transcatheter aortic valve replacement (TAVR)
* Complications: Residual aortic regurgitation and need for pacemaker
99
MI, cardiogenic shock, acute pulmonary edema, Holosystolic murmur at the apex that worsens with leg raise. Dx and pathogenesis?
Acute mitral insufficiency, rupture papillary muscle or chordae tendinae),
100
Young woman, with holosystolic murmur at the apex that worsens with valsava improves with leg raise)
Mitral valve prolapse
101
In addition to common Sx of CHF and SOB, which valvulopathy was
* Hoarness
* Dysphagia
* AFib
* Hemoptysis
Mitral stenosis
102
Cough --> prodome --> syncope. Dx and next step?
Vasovagal syncope, tilt table (tx with BB is controversial)
103
Syncope without prodome.
Most likely dx?
Arrhythmia
104
Indications of statins
o Vascular disease (MI, carotid stenosis, peripheral vascular disease, cerebrovascular disease)
o LDL > 190 mg/dL (10 mmol/L)
o LDL 70 mg/dL (4 mmol/L)-190 mg/dL (10 mmol/L) + age 40-75 + DM
o LDL 70 mg/dL (4 mmol/L)-190 mg/dL (10 mmol/L) + cardiovascular risk factors (HTN, smoking, obesity, family Hx, XY > 45 y-o/XX > 55 y-o
105
Secondary effects of statins
↑ LFTs (most common), rhabdomyolysis
106
Secondary effects of Fibrates
myositis and ↑ LFTs (don’t give with statins)
107
Secondary effects of Ezetimibe:
diarrhea
108
Secondary effects of Bile acid sequestrants:
diarrhea
109
Secondary effects of Niacin:
flushing (treat with ASA)
110
Definition of metabolic syndrome
Central obesity: men waist circumference > 94; women waist circumference > 80
2 of the following:
* TG > 1.7 mmol (150 mg)
* HDL < 1 mmol (40 mg) in XY, 1.3 mmol (50 mg) in XX
* BP > 130/85
* Fasting glucose > 5.6 mmol (100 mg)
111
Does hypertriglyceridemia increase the risk of cardiovascular disease?
No. However, when severe (10 mmol – 885 mg) associated with pancreatitis
112
Classic ECG finding in atrial flutter.
“Sawtooth” P waves.
113
Definition of unstable angina.
Angina is new, is worsening, or occurs at rest.
114
Antihypertensive for a diabetic patient with proteinuria.
ACEI.
115
Beck’s triad for cardiac tamponade.
Hypotension, distant heart sounds, and JVD.
116
Drugs that slow AV node transmission.
β-blockers, digoxin, calcium channel blockers.
117
Hypercholesterolemia treatment that leads to flushing and pruritus.
Niacin.
118
Murmur—hypertrophic obstructive cardiomyopathy (HOCM).
Systolic ejection murmur heard along the lateral sternal border
↑ with Valsalva maneuver and standing.
119
Murmur—aortic insufficiency.
Diastolic, decrescendo, high-pitched, blowing murmur
that is best heard sitting up; ↑ leg rise with ↓ preload (handgrip
maneuver) and valsava.
120
Murmur—aortic stenosis.
Systolic crescendo/decrescendo murmur that radiates to the neck; ↑ with ↑ leg raise
121
Murmur—mitral regurgitation.
Holosystolic murmur that obscure S1 and S2 that radiates to the axillae or carotids.
122
Murmur—mitral stenosis.
Diastolic, opening snap, mid- to late, low-pitched murmur.
123
Treatment for atrial fibrillation and atrial flutter.
If unstable, cardiovert. If stable or chronic, rate control with
calcium channel blockers or β-blockers.
124
Treatment for ventricular fibrillation.
Immediate cardioversion.
125
Autoimmune complication occurring 2–4 weeks post-MI.
Dressler’s syndrome: fever, pericarditis, ↑ ESR.
126
JVD and holosystolic murmur at the left sternal border, 5th intercostal space.
Treatment?
Treat existing heart failure and replace the tricuspid valve.
127
Diagnostic test for hypertrophic cardiomyopathy.
Echocardiogram (showing thickened left ventricular wall and outfl ow obstruction).
128
A fall in systolic BP of > 10 mmHg with inspiration.
Pulsus paradoxus (seen in cardiac tamponade).
129
Classic ECG findings in pericarditis.
Low-voltage, diffuse ST-segment elevation.
130
Definition of hypertension.
BP > 140/90 on three separate occasions two weeks apart.
131
Eight surgically correctable causes of hypertension.
Renal artery stenosis, coarctation of the aorta,
pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism.
132
Diagnostic tests for a pulsatile abdominal mass and bruit.
Abdominal ultrasound and CT.
133
Indications for surgical repair of abdominal aortic aneurysm.
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured.
134
Treatment for acute coronary syndrome.
Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers,
| heparin.
135
What is metabolic syndrome?
Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or
proinflammatory states.
136
Appropriate diagnostic test?
| ■ A 50-year-old man with angina can exercise to 85% of maximum predicted heart rate.
Exercise stress treadmill with ECG.
137
Appropriate diagnostic test?
| ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
Pharmacologic stress test (e.g., dobutamine echo).
138
Target LDL in a patient with diabetes.
< 70.
139
Signs of active ischemia during stress testing.
Angina, ST-segment changes on ECG, or ↓ BP.
140
ECG findings suggesting MI.
ST-segment elevation (depression means ischemia),
| flattened T waves, and Q waves.
141
Coronary territories in MI.
Anterior wall (LAD/diagonal)
Inferior (PDA)
Posterior (left circumflex/oblique, RCA/marginal)
Septum (LAD/diagonal).
142
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.
Dx?
Prinzmetal’s angina
143
Common symptoms associated with silent Mls.
CHF, shock, and altered mental status.
144
The diagnostic test for pulmonary embolism.
V/Q scan.
145
An agent that reverses the effects of heparin.
Protamine.
146
The coagulation parameter affected by warfarin.
PT.
147
A young patient with a family history of sudden death
| collapses and dies while exercising.
Hypertrophic cardiomyopathy.
148
Endocarditis prophylaxis regimens.
Oral surgery—amoxicillin for certain situations.
GI or GU procedures— not recommended
149
The 6 P’s of ischemia due to peripheral vascular disease.
Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia.
150
Virchow’s triad.
Stasis, hypercoagulability, endothelial damage.
151
The most common cause of hypertension in young women.
OCPs.
152
The most common cause of hypertension in young men.
Excessive EtOH.
153
Most common non-ichemic cause of chest pain
Gastrointestinal
154
Menstruating woman
Chest pain
Menstruating women almost never have MI
155
Risk fx of CAD
* Dm: worse
* Tobacco: most inmediate benefit if corrected
* HTN: most common
* Hyperlipidemia
* Family Hx: 1st degree + premature (male <55; female <65)
* Age (male >45; women >55)
* Renal disease
156
Woman
Chest pain after stressful event
MI
Ventricular “ballooning” on Echo
| Dx and Tx
Takotsubo cardiomyopathy
Tx: beta blockers and ACE inhibitors
## Footnote
Acute myocardial damage most often occurring in postmenopausal women immediately following an overwhelming, emotionally stressful event (Massive catecholamine discharge). This leads to “ballooning” and left ventricular dyskinesis.
157
Chest pain differential
158
Best initial test for chest pain
ECG
159
Best test when uncertain etiology of chest pain
Stress test
160
Stress test modalities and indications
161
Ttx for CAD
* ASA
* BB: 1st line tx. Don't use in severe asthma, prizmental angina, and cocaine.
* ACE-i: specially if low EF. Cough and low K as 2nd effects
* Statin: goal LDL < 70. Liver dysfunction most common adverse effect
## Footnote
Dihydropyridine CCBs (nifedipine) increase mortality (don't use). Non-Dihydropyridine CCBs may replace BB.
162
Patient with CAD. High LDL despite statin at maximum dose.
| Next step to treat dyslipidemia?
PCSK9 Inhibitors
Evolocumab and alirocumab
163
ACS are associated to what on auscultation?
S4 gallop
164
Decrease of 10 mmHg in BP on inspiration
Pulsus paradoxus: Tamponade
165
Increase in JVD on inspiration
Kussmaul sign: Constrictive pericarditis
166
Triphasic scratchy sound on auscultation
Friction rub: pericarditis
167
Continuous machinery murmur
Shunt: patent ductur (PDA)
168
Point of maximal impulse displaced to axila
LV hyperthrophy
169
Tx of PVCs in ACS?
Should NOT be treated!
170
You Dx a STEMI
| Best initial step in management?
ASA + other antiplatelet
And call cath lab
| Antiplatelet: clopidogrel, prasugrel, ticagrelor
## Footnote
Consultation almost never the right choice
171
Best antiplatelet if patient undergoing angioplasty and stening
Prasugrel
172
Contraindications of thrombolytics
* Major bleeding (bowel or CNS)
* Recent Sx (2 weeks)
* Recent nonhemorrhagic stroke (6 momths)
* Recent trauma/head injury
* Severe HTN
* Bleeding disorder
173
# e
Indications of ACS meds
174
In what ACS is heparine indicated
NSTEMI: as part of initial therapy
STEMI: indicated but after revascularization
175
Tx differences between ACS presentations
176
When to use tPA (thrombolytics) in ACS
STEMI
177
Glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors (antiagregation) are best for
NSTEMI undergoing PCI or stenning
178
# Complication of ACS
Patient with ACS with new murmur and Step-up in O2Sat from RV to LV in ACS
| important difference in SatO2 between RV and LV
Septal rupture
179
# Complication of ACS
Patient with ACS, bradycardia and cannon A waves
3rd degree AV block
180
# Complication of ACS
Patient with ACS, bradycardia and no cannon A waves
Sinus bradycardia
181
# Complication of ACS
Patient with ACS with sudden loss of pulse and JVD
Tamponade vs wall rupture
182
# Complication of ACS
Patient with inferior MI, tachycardia, hypotension with nitro
RV MI
183
# Complication of ACS
Patient with ACS, new murmur, rales/congestion on lungs
Valve rupture
184
Most common cause of CHF.
HTN resulting in a cardiomyopathy or abnormality of the myocardial muscle
185
SOB
+
Sudden onset, clear lungs
| Dx?
Pulmonary embolus
186
SOB
+
Sudden onset, wheezing, increased expiratory phase
| Dx?
Asthma
187
SOB
+
Slower, fever, sputum, unilateral rales/rhonchi
| Dx?
Pneumonia
188
SOB
+
Decreased breath sounds unilaterally, tracheal deviation
| Dx?
Pneumothorax
189
SOB
+
Circumoral numbness, caffeine use, history of anxiety
| Dx?
Panic attack
190
SOB
+
Pulsus paradoxus, decreased heart sounds, JVD
| Dx?
Tamponade
191
SOB
+
Palpitations, syncope
| Dx?
Arrhythmia
192
SOB
+
Dullness to percussion at bases
| Dx?
Pleural effusion
193
SOB
+
Long smoking history, barrel chest
| Dx?
COPD
194
SOB
+
Burning building or car, wood-burning stove in winter, suicide attempt
| Dx?
Carbon monoxide poisoning
195
Best initial test for CHF in the outpatient context
Transthoracis echo
196
Patient with systolic CHF in outpatient management with ACE-i but hyperkalemia.
Management?
Patiromer
## Footnote
Magement of hyperkalemia if you want to keep using ACE-i or ARBs in any Dx
197
Male patient with systolic CHF in management with spironolactone + gynecomastia
| Management?
Switch spironolactone to **eplerenone**
198
Which systolic CHF medications have proven mortality improvement and which have not
Lower mortality
* ACE-i/ARBs
* BB
* Hydralazine/nitrates (e.g., BiDil) in severe systolic CHF
* Spironolactone
Do NOT lower mortality
* Digoxine
* Furosemide
199
Medications with proven benefits in dyastolic CHF
Spironolactone
Diruetics
| Digoxine and BB have NOT proven benefits
## Footnote
ACE-i and ARBs are uncertain
200
How do loop diuretics and thiazides change Ca++ and K+
Ca++
* Loops loose Calcium (hypoCalcemia)
* Thiazides take it in (hyperCalcemia)
K+: both produce hypoKalemia
## Footnote
Both produce hyperuricemia as well
201
Side effects of thiazides
HyperGLUC (hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia)
HypoKalemia
HypoNatremia
202
S3 vs S4 gallop
An **S3** gallop signifies rapid ventricular filling in the setting of **fluid overload** and is associated with dilated cardiomyopathy.
An **S4** gallop signifies a stiff, **noncompliant ventricle** and ↑ “atrial kick,” and may be associated with hypertrophic cardiomyopathy.
203
Which medications have proven mortality benefit in chronic treatment of angina?
Only ASA and BB
204
Complications of ACS
Death
Arrythmia
Rupture
Tamponade
Heart failure
Valvular disease
Aneurysm
Dressler's syndrome
Emboli
Reinfraction
| DARTH VADER
205
Tx WPW
Acute: Procainamide Or Amiodarone
Chronic: ablation
206
Possible causes of PEA
5H and 5 T
Hypovolemia
Hypoxia
Hydrogen
Hyper or hypo K+
Hypothermia
Tamponade
Trauma
Toxic
Thrombosis
Tension pneumothorax
207
Med to reverse NOACs
| Rivaroxaban, apizaban, edoxaban
Andexanet
208
Med to revert dabigatran
idarucizumab
209
Meds to reverse Warfarin
Prothrombin complex concentrate (PCC)
210
If arrythmia not clear and ECG not clear either
| Next step?
eletro physiology studies
211
Tx of primary HTN in pregnant women
Metildopa
BB
Hydralazine
212
BP in upper limb > BP in lower limb
| Dx?
Coarctation of aorta
213
Episodic HTN
Flushing
| Dx?
Pheochromocytoma
214
Patient with osteoporosis and HTN
| Best initial tx for HTN?
Thiazides
215
Patient with hyperthyroidism and HTN
| Best initial tx for HTN?
BB
216
Echo reporting: Systolic anterior motion of mitral valve
| Dx?
Hyperthrophic obstructive cardiomyopathy (HOCM)
