Cardiology Flashcards
(61 cards)
1
Q
LBBB
- describe
A
- Wide QRS > 0.12 sec
- Broad, slurred R V6
- Deep S V1 and V2
2
Q
LBBB
- newly diagnosed, what step is next
A
- Echo
- Cardiac stress test
3
Q
Medication s/p PCI
A
- ASA
- Clopidogrel, prasugrel, ticagrelor (P2Y12 receptor inhibitors)
- BB in stable patients
- Heparin during procedure
4
Q
Length of Dual antiplatelet treatment after PCI
A
Min 6 to 12 months
5
Q
Sick Sinus Syndrome
- sx
A
- dizziness
- fatigue
- dyspnea
- palpitations
- pre- and syncope
6
Q
Sick Sinus Syndrome
- R/O
A
- MI
- AV node dysfunction such as heart blocks
- other causes of syncope
- Hypothyroidism (causes bradycardia)
7
Q
CHF
- pathophys behind edema
A
- CO down = blood backed up = increased venous pressure
- Renal perfusion decreases = compensatory renal sodium retention
8
Q
CHF
- Edema types (left vs. right)
A
- Left HF = pulmonary edema
- Right HF = lower extremity edema/ascites
9
Q
CHF
- mgmt
A
- tx underlying condition
- restrict sodium and fluid intake
- daily monitoring of weight
- lose weight
- ACE i, ARB, BB, diuretics
10
Q
Abdominal aortic aneurysm
- definition
- MC locations
A
- Aorta dilated > 50% normal size
- peri-renal arteries, iliac bifurcation MC locations
11
Q
Abdominal aortic aneurysm
- RF
A
- Smoking (MC preventable factor)
- male
- age
- caucasion
- fam hx
- atherosclerosis
12
Q
Ruptured Abdominal aortic aneurysm
- sx
A
Triad
- abd pain
- hypotension
- palpable pulsatile abdominal mass
13
Q
Abdominal aortic aneurysm
- imaging
A
US
14
Q
Abdominal aortic aneurysm
- Screening
A
- men with smoking history
- One time US between 65 and 75, US f/u based on results
15
Q
Abdominal aortic aneurysm
- mgmt
A
<4.5 cm: annual US
>4.5 cm with expansion: US every 6 months
- >5.5 cm or >0.5 cm growth in 6 months: surgery
16
Q
Aortic dissection
- HTN treatment
A
- correct promptly
- IV esmolol, IV labetalol, IV sodium nitroprusside
17
Q
Ductus arteriosus
- Fetal circulation
A
- Pulmonary artery to aorta
- Kept open via prostaglandins and low O2
18
Q
Ductus arteriosus at birth
A
Fetal changes: increased pulmonary pressure, lung expansion
- changes from right ot left to left to right shunt = closure of ductus arteriosus and foramen ovale
19
Q
Ductus arteriosus
- shunt if doesn’t properly close
A
Left to right shunt from aorta to pulmonary artery bc now aorta is higher pressure
20
Q
PDA
- effects
A
- volume overload
- pulmonary HTN
- right-sided HF
21
Q
PDA
- RF
A
prematurity
low birth weight
22
Q
PDA
- clinical presentation
A
- murmur: harsh, machine-like continuous at pulmonic position
- respiratory sx: tachypnea, apnea, hypercapnia
- heart failure
- bounding peripheral pulses
- widened pulse pressure
23
Q
PDA
- murmur
A
- continuous “machinery-like” murmur
- left second intercostal space
24
Q
PDA
- imaging
A
Echo
25
PDA
| - mgmt
- watchful waiting
- Pharm: indomethacin, ibuprofen
- sx
26
Hypertriglyceridemia
| - mgmt at diff levels
- 150-199: lifestyle
- 200-499: consider pharm for high risk pts
- >500: pharm
27
Dressler Syndrome
- timing
- presentation
- 2-10 weeks s/p MI
| - persistent low-grade fever, pleuritic chest pain, pericarditis
28
Dressler Syndrome
| - mgmt
- ibuprofen/ASA
- steroids
- colchicine
29
Unstable Angina
| - length of chest pain
>20 minutes at rest
30
Varicose Veins
| - mgmt
- Compression stockings and lifestyle (smoking cessation, exercise, elevation of limb) X 3 months
- Sclerotherapy
- Thermal vein ablation
- Surgical excision of veins
31
What tick borne disease is most likely to be associated with AV heart block
Lyme
| - consider Lyme carditis in any patient presenting with new-onset AV block
32
Primary aldosteronism
| - best initial test
Aldosterone to renin ratio
| * aldosterone is usually elevated and renin suppressed
33
Pulsus bisferiens
- describe
- seen with what heart condition
- two distinct peaks of arterial pulse during systole
| - hypertrophic cardiomyopathy
34
Infective endocarditis
| - empiric abx
vancomycin
| - covers staph (MSSA and MRSA), strep, enterococci
35
Infective endocarditis
abx for
- MSSA
S- trep viridans
- nafcillin or oxacillin
| - penicillin or ceftriaxone
36
Hypertensive emergency
- def
- mgmt
- elevated bp (>180/120) AND signs of end organ damage
- lower bp 10-20% first hour
- then 5-15% over next 23 hours
- Use IV agents (hydralazine, esmolol, nitroprusside, labetalol, nitroglycerine)
37
PEA
| - mgmt
- CPR + epi q 3-5 min
| - manage underlying condition
38
Infective endocarditis
| - MC clinical manifestation
Fever
39
Acute rheumatic fever
| - complication of what
Group A strep infection (about 1%)
40
Acute rheumatic fever
| - patho
- multisystem autoimmune response: ab vs. strep bacteria cross react with host tissue
41
Acute rheumatic fever
| - timing and age
- children 5-15
| - 2-4 weeks after step pharyngitis
42
Acute rheumatic fever
| - sx
- arthritis
- pancarditis
- sydenham chorea
- erythema marginatum
- subcutaneous nodules
- fever
43
Acute rheumatic fever
| - heart issues
carditis
- damages endocardial layer: impacts valves
- Mitral stenosis MC
44
Acute rheumatic fever
| - diagnostic criteria
Jones Criteria
- Joints
- Oh no, carditis
- Nodules
- Erythema marginatum
- Sydenham chorea
45
Acute rheumatic fever
| - labs
evidence of preceding GAS infection:
- throat culture
- rapid antigen detection test
- elevated anti streptococcal ab titer (antistreptolysic O) *most sensitive
46
Acute rheumatic fever
| - mgmt
- NSAIDS for arthritis
| - Abx (PCN or erythromycin) for strep
47
Restrictive Cardiomyopathy
| - patho
- fibrotic processes
- reduced ventricular filling
- increased diastolic pressure / decreased diastolic volume
- restricted ventricular filling
48
Restrictive Cardiomyopathy
| - common casues
- Amyloidosis
- Sarcoidosis
- Hemochromatosis
- Tropical endomyocardial fibrosis
49
Restrictive Cardiomyopathy
| - clinical
- R sided HF symptoms
- Dyspnea, fatigue, LE swelling
- Rales, JVD, hepatomegaly
- Kussmaul's Sign (incr JVP during inspiration)
50
Constrictive Cardiomyopathy
| - pathophys
scarring and loss of elasticity of the pericardial sac (vs. restrictive with is fibrotic process)
51
Constrictive Cardiomyopathy
| - causes
- infection
- post-cardiac surgery
- post-radiation therapy
- connective tissue disorder
- idiopathic
52
Wandering atrial pacemaker
| - overview
atrial dysrhythmia caused by 3+ ectopic atrial foci
53
Wandering atrial pacemaker
| - disease MC at increased risk
COPD
54
Wandering atrial pacemaker
| - EKG
- variable P wave morphology
- variable PR interval duration
- Irregularly irregular rhythm
55
Wandering atrial pacemaker
| - mgmt
- no specific tx required
| - focus on treating underlying condition
56
Coarctation of the aorta
| - MC location
Distal to left subclavian artery, at insertion of ductus arteriosus
57
Coarctation of the aorta
| - RF
- Fam history
| - Turner syndrome
58
Coarctation of the aorta
| - MC sign
HTN
59
Coarctation of the aorta
| - diagnosis
- Systolic HTN in arms
- Delayed or decreased femoral pulses
- low or undecteable arterial BP in legs
- Echo: definitive dx
60
Coarctation of the aorta
| - CXR
- notching of ribs
| - Figure "3" appearance due to indentation of aorta at site of coarctation
61
Coarctation of the aorta
| - mgmt
- sx repair
