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Online Med Ed > Cardiology > Flashcards

Cardiology Flashcards

1
Q

pathology of myocardial infarction

A

occlusion of a coronary vessel

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2
Q

patient presentation of myocardial infarction

A

chest pain that is worse with exertion, better with rest, relieved with nitrates in a hypertensive, diabetic, dyslipidemic smoker, who is old

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3
Q

diagnosis of myocardial infarction

A

ST segment changes = STEMI
biomarker elevation = NSTEMI
Stress test = CAD
Coronary angiogram = best test

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4
Q

treatment of myocardial infarction

A

MONA = morphine, oxygen, nitrates, aspirin
BASH = ß blocker, ACE-i, statin, heparin
Coronary angiography with stent (single vessel disease)
CABG (multi-vessel disease)
tPA if no transport available (>60mins)

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5
Q

risk factors and goals for myocardial infarction

A 
HTN = <140/90
Diabetes = A1c < 7.0
Smoking = cessation
dyslipidemia = LDL <100, better <70; HDL > 40, better > 60
age = women >55, men >45
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6
Q

story of MI

A

left-sided/substernal
worse with exertion
better with rest

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7
Q

physical exam of MI

A

nonpositional
nonpleuritic
nontender (not reproducible)

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8
Q

Pain, relief, trops, ST changes in stable angina

A

Pain = exercise
relief = rest + nitrates
trops = negative
ST changes = none

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9
Q

Pain, relief, trops, ST changes in unstable angina

A

pain = @ rest
relief = none
trops = negative
ST changes = none

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10
Q

Pain, relief, trops, ST changes in NSTEMI

A

pain = @ rest
relief = none
trops = elevated
ST changes = none

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11
Q

Pain, relief, trops, ST changes in STEMI

A

pain = @ rest
relief = none
trops = increased
ST changes = elevated

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12
Q

ACUTE treatment options in MI

A

ASA = first drug to give
Nitrates = second
Angioplasty = no clopidogrel needed, only in single-vessel disease
Bare-metal stent = clopidogrel x1mo, only in single-vessel disease
Drug-eluting stent = clopidogrel x1yr, only in single-vessel disease
CABG = left mainstem equivalent or multi-vessel disease
tPA = no PCI is available within 60mins transport time
Door-to-ballon = 90mins

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13
Q

door to balloon time in MI

A

90 mins

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14
Q

chronic treatment options in MI

A 
ß blocker = <140/90, HR <70
ACE-i = BP <140/90
Aspirin = antiplatelet
Clopidogrel = antiplatelet
Statins = LDL < 100 (prefer <70)
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15
Q

imaging in MI

A 
EKG = test of choice, no baseline abnormality
Echo = EKG abnormality, no CABG
Nuclear = CABG, Baseline Wall defects, LBBB
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16
Q

stress test

A

exercise = test of choice, no contraindication to exercise with feet
pharm = any reason why they can’t get on a treadmill of any kind
- dobutamine and adenosine

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17
Q

complications of MI

A

RV failure = right-sided EKG, NO NITRATES
aneurysm = diagnosed by echo
arrhythmia = vtach/vfib - ventricular ectopy from dying cells; Brady/blocks - AV nodal dysfunction

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18
Q

left sided heart failure

A

pulmonary edema, shortness of breath, crackles, dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea
S3

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19
Q

right sided heart failure

A

JVD, peripheral edema, abdominal pain

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20
Q

systolic heart failure

A

floppy (ischemic/chronic), leaky (valves), or dead (ischemic)
depressed ejection fraction
poor forward flow

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21
Q

diastolic heart failure

A

stiff ventricle, unable to fill
pericardium (tamponade, constrictive pericarditis)
restrictive or hypertrophic cardiomyopathy

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22
Q

NYHA classifications of heart failure

A 
I = no symptoms, unlimited exertional capacity
II = slight limitation: comfortable with exertion and rest, but without unlimited capacity (ok ADLs)
III = moderate limitation: comfortable at rest only (no ADLs)
IV = severe limitations, patient is dyspneic at rest
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23
Q

diagnostic choices for heart failure

A 
cxr
ekg
bnp
2d echo
nuclear
angiogram, LV gram
angiogram, coronaries
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24
Q

cxr in heart failure

A

large heart, generally useless

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25
Q

ekg in heart failure

A

old ischemia, generally useless

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26
Q

bnp in heart failure

A

if elevated, likely heart failure, but cannot discern left/right, diastolic/systolic

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27
Q

2d echo in heart failure

A

test of choice

gives much information including EF and diastolic failure, valve lesions

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28
Q

nuclear imaging in heart failure

A

gives EF and reversible ischemia

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29
Q

angiogram, LV gram in heart failure

A

gold standard, invasive, generally not needed

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30
Q

angiogram, coronaries

A

determine CAD state: ischemic cardiomyopathy vs. not

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31
Q

treatments everyone in heart failure gets

A

ß-blocker, ACE-i
salt restriction <2g NaCl
fluid restrict <2L H2O

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32
Q

treatments in ischemic heart failure

A

add aspirin, add statin

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33
Q

treatment if EF <35%

A

must be >/= NYHA III

AICD

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34
Q

treatment in NYHA stage I

A

ß blocker + ACE-i

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35
Q

treatment in NYHA stage II

A

BB + ACE-i

loop diuretics

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36
Q

treatment in NYHA stage III

A

BB + ACE
loop diuretics
hydralazine/isosorbide dinitrate, spironolactone

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37
Q

treatment in NYHA stage IV

A

BB + ACE
loop diuretics
hydralazine/isosorbide dinitrate, spironolactone
pressors

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38
Q

path of congestive heart failure

A

systolic vs diastolic
right vs left
ischemic vs non-ischemic

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39
Q

patient in congestive heart failure

A

dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, peripheral edema, crackles, jvd

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40
Q

diagnosis in CHF

A

1st: BNP
then: 2D echo = trans thoracic echo
Best: LV ventriculogram

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41
Q

treatment in CHF

A

systolic: NYHA stage
Diastolic: control BB

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42
Q

grade I murmur

A

S1, S2 > murmur (murmur is softer)

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43
Q

grade II murmur

A

S1, S2 = murmur (murmur is equal)

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44
Q

grade III murmur

A

S1, S2 < murmur (murmur is louder)

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45
Q

grade IV murmur

A

palpable thrill

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46
Q

grade V murmur

A

1/2 stethoscope off chest, still audible

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47
Q

grade VI murmur

A

no stethoscope is needed

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48
Q

when to investigate a murmur

A

any diastolic murmur

any systolic murmur >/= 3/6 (more than II)

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49
Q

how to investigate murmur

A

2D echo to evaluate all murmurs

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50
Q

path of mitral stenosis

A

rheumatic heart disease, stenosis of valve
decreased forward flow during DIASTOLE
atrial stretch

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51
Q

patient with mitral stenosis

A

Afib with CHF symptoms
opening snap
diastolic decrescendo murmur

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52
Q

diagnosis of mitral stenosis

A

echo

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53
Q

treatment of mitral stenosis

A

balloon valvotomy

valve replacement

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54
Q

path of aortic stenosis

A

calcification, sclerosis of outflow from ventricle

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55
Q

patient with aortic stenosis

A

old men with atherosclerosis
shortness of breath, syncope, chest pain
crescendo-decrescendo murmur
2nd ICS, R sternal border

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56
Q

diagnosis of aortic stenosis

A

echo

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57
Q

treatment of aortic stenosis

A

valve replacement

balloon doesn’t work

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58
Q

follow up for aortic stenosis

A

CABG assessment if replacing valves

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59
Q

what to think if young person with aortic stenosis

A

bicuspid aortic valve

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60
Q

path of MVP

A

congenital defect

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61
Q

patient with MVP

A

women, especially pregnant

sounds like mitral regard, opening snap

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62
Q

diagnosis of MVP

A

echo

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63
Q

treatment of MVP

A

valve replacement

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64
Q

path of mitral regurgitation

A 
acute = infarction, infection, ruptured papillary muscle, chordae tendinae
chronic = prolapse, ischemia
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65
Q

patient with mitral regurg

A 
acute = fulminant CHF, hypoxemia, hypotension
Chronic = AFib, exertional dyspnea, HOLOSYSTOLIC murmur, radiating to the axilla
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66
Q

diagnosis of mitral regurg

A

echo

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67
Q

treatment of mitral regurg

A

valve replacement

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68
Q

path of aortic regurg/insufficiency

A

ischemia, infection, dissection

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69
Q

patient with aortic regurg

A 
usually sick, hypotension, CHF
decrescendo murmur at aortic valve
wide pulse pressure
water-hammer pulse (bounding)
quincke's pulse (nail beds)
head bobbing
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70
Q

diagnosis of aortic regurg

A

echo

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71
Q

treatment of aortic regurg

A

valve replacement

intra-aortic balloon pump

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72
Q

path of hypertrophic cardiomyopathy

A

sarcomere defect

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73
Q

pt with HOCM

A

sudden cardiac death
dyspnea, syncope with exertion
young patient

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74
Q

diagnosis of HCOM

A

echo

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75
Q

treatment of HOCM

A

avoid exercise/dehydration
ß-blockade
myotomy

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76
Q

path of dilated cardiomyopathy

A

decrease contractility

virus, EtOH, ischemia, chemo

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77
Q

pt with dilated cardiomyopathy

A

systolic CHF: orthopnea, PND, DOE, crackles, dyspnea, JVD

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78
Q

dx of dilated cardiomyopathy

A

echo = dilated

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79
Q

tx of dilated cardiomyopathy

A

CHF: BB, ACE-i, diuretics
avoid/stop etoh
avoid/stop chemo
transplant

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80
Q

path of HOCM

A

genetics, sarcomeres

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81
Q

pt with HOCM

A

murmur = aortic stenosis

young athletes - sudden cardiac death, syncope, dyspnea on exertion

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82
Q

what increases most murmurs?

A

leg raise/squat

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83
Q

what decreases most murmurs?

A

valsalva

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84
Q

what increase HOCM and MVP murmurs?

A

valsalva

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85
Q

what decreases HOCM and MVP murmurs?

A

leg raise/squat

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86
Q

why is the mech of murmur different in HOCM and MVP?

A

increased blood = fill heart more = less obstruction from hypertrophy or valve

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87
Q

dx of HOCM

A

echo = asymmetric hypertrophy

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88
Q

tx of HOCM

A 
avoid dehydration
avoid exercise
BB = CCB (rate control)
etoh ablation, myectomy
AICD if increased risk of death
transplant
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89
Q

path of concentric hypertrophic cardiomyopathy

A

HTN

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90
Q

pt with concentric hypertrophic cardiomyopathy

A

diastolic CHF

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91
Q

dx of concentric hypertrophic cardiomyopathy

A

echo = concentric hypertrophy

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92
Q

tx of concentric hypertrophic cardiomyopathy

A 
DIA CHF
- avoid dehydration
- BB = CCB (Rate)
- control BP
transplant
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93
Q

path of restrictive cardiomyopathy

A

amyloid, sarcoid, hemachromatosis, cancer, and fibrosis

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94
Q

pt with restrictive cardiomyopathy

A

DIA CHF
amyloid -> neuropathy
sarcoid -> pulmonary disease
hema -> cirrhosis, bronze diabetes, CHF

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95
Q

dx of restrictive cardiomyopathy

A

echo = restrictive
amyloid -> fat pad biopsy
sarcoid -> cardiac MRI -> biopsy
hema -> ferritin -> genetics

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96
Q

tx of restrictive cardiomyopathy

A 
DIA CHF
- BB = CHF
gentle diuresis
transplant
underlying disease
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97
Q

etiologies of pericardial disease

A

infection - viral, bacterial, fungal, TB
autoimmune - rheumatoid arthritis, lupus, Dressler’s, uremia
trauma - penetrating, blunt, aortic dissection
cancer - breast, lung, esophageal, lymphoma

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98
Q

path of pericarditis

A

viral, uremia

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99
Q

pt with pericarditis

A

chest pain = pleuritic and positional

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100
Q

dx of pericarditis

A

1st: EKG shows PR depressions, diffuse ST elevations
best: MRI

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101
Q

tx of pericarditis

A

NSAIDs + colchicine
NSAIDs - c/I CKD, thrombocytopenia, PUD
colchicine - c/I diarrhea
no longer use steroids

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102
Q

f/u of pericarditis

A

increase recurrence after steroids

hemodialysis for uremia

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103
Q

path of pericardial effusion

A

pericarditis

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104
Q

pt with pericardial effusion

A

pericarditis

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105
Q

dx of pericardial effusion

A

echo = effusion

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106
Q

tx of pericardial effusion

A

pericardial window

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107
Q

path of pericardial tamponade

A

RV cannot fill

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108
Q

pt with pericardial tamponade

A

JVD + hypotension + decrease heart sounds (Beck’s triad)
clear lungs
pluses paradoxus > 10mmHg

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109
Q

dx of pericardial tamponade

A

echo

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110
Q

tx of pericardial tamponade

A

pericardiocentesis

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111
Q

f/u of pericardial tamponade

A

IVF in real life

112
Q

path of constrictive pericarditis

A

pericarditis

113
Q

pt with constrictive pericarditis

A

diastolic CHF

pericardial knock

114
Q

dx of constrictive pericarditis

A

echo

115
Q

tx of constrictive pericarditis

A

pericardiectomy

116
Q

hypertension medications

A 
CCB
ACE
ARB
thiazide
loop
BB
art-dilator
veno-dilator
spironolactone
clonidine
117
Q

side effect of CCB

A

peripheral edema

118
Q

indication for CCB

A

JNC8, angina

119
Q

side effect of ACE

A

increase K, cough, angioedema

120
Q

indication for ACE

A

JNC8

121
Q

side effect of ARB

A

increase K, no cough, no angioedema

122
Q

indication for ARB

A

ACE-i intolerance

123
Q

side effect of thiazide

A

decrease K, urinary symptoms, inc gout

124
Q

indications of thiazide

A

GFR > 60

125
Q

side effect of loop

A

decrease K, urinary symptoms

126
Q

indication of loop

A

GFR < 60

127
Q

BB side effect

A

decrease HR, hypertriglyceridemia, hyperglycemia

128
Q

bb indications

A

CAD, CHF

129
Q

art-dilator side effects

A

reflex tachycardia

130
Q

art-dilator indications

A

CHF

131
Q

veno-dilator side effects

A

c/I sildenafil = hypotension

132
Q

veno-dilator indications

A

CHF

133
Q

spironolactone side effects

A

increase K, gynecomastia

134
Q

indications of spironolactone

A

CHF

135
Q

clonidine side effect

A

rebound HTN

136
Q

clonidine indications

A

never

137
Q

normal BP

A

<120/80

138
Q

stage I hypertension

A

140/90

139
Q

stage II hypertension

A

160/100

140
Q

diagnosis of hypertension

A

screen everyone
2 readings, 2 weeks, 2 visits
best: ambulatory monitoring

141
Q

treatment for pre-hypertension

A

lifestyle modifications

142
Q

treatment for stage I HTN

A

1 med

143
Q

tx for stage II HTN

A

2 med

144
Q

tx for HTN urgency

A

orals

145
Q

HTN urgency

A

180/110

146
Q

hypertensive emergency treatment

A

IV

147
Q

hypertensive emergency

A

end organ damage

148
Q

JNC-8 tx guidelines

A 
>60, no disease = 150/90
everyone else = 140/90
CCB, thiazide, ACE/ARB are ok
old and black = no ACE/ARB
CKD = ACE/ARB
no ßblockers (4th line)
149
Q

path of cholesterol

A

need enough to make cells
too much makes plaques
plaques make atherosclerosis

150
Q

pt with cholesterol

A

HDL is good
LDL is bad
Non-HDL cholesterol is what matters

151
Q

dx of cholesterol

A

lipid panel

152
Q

tx of cholesterol

A

diet and exercise

adherence

153
Q

f/u cholesterol

A

statins, others

154
Q

who gets a statin?

A

vascular disease (CVA, PVD, CAD)
LDL >/= 190
LDL 70-189 + age 40-75 + diabetes
LDL 70-189 + age 40-75 + calculated (risk factors)

155
Q

high intensity statin

A

atorva 40, 80

rosuva 20, 40

156
Q

moderate intensity statin

A 
atorva 10, 20
rosuva 5, 10
simva 20, 40
prava 40, 80
lova 40
157
Q

low intensity statin

A

simva 5, 10
prava 10, 20
lova 20

158
Q

check lipids

A

q1y

159
Q

check A1c

A

DM = q3mo

160
Q

check CK

A

muscle soreness/myalgias

161
Q

check LFTs

A

hepatitis

162
Q

good effect of statin

A

decrease LDL, TG

163
Q

bad effect of statin

A

myositis, increase LFT

164
Q

good effect fibrates

A

decrease Tchol, increase HDL

165
Q

bad effect of fibrates

A

myositis, increase LFT

166
Q

good effect of ezetimibe

A

decrease LDL

167
Q

bad effect of ezetimibe

A

diarrhea

168
Q

good effect of bile acid resins

A

decrease LDL

169
Q

bad effect of bile acid resins

A

diarrhea

170
Q

good effect of niacins

A

increase HDL, decrease LDL

171
Q

bad effect of niacins

A

flushing, pre-tx with aspirin to avoid

172
Q

tx vfib

A

amiodarone

shock

173
Q

tx vtach

A

amiodarone

shock

174
Q

tx torsades

A

magnesium

shock

175
Q

tx SVT

A

adenosine

shock

176
Q

tx 1deg block

A

atropine

pace

177
Q

tx 2deg block type 1

A

atropine

pace

178
Q

tx 2deg block type 2

A

pace

179
Q

tx 3deg block

A

pace

180
Q

codes - no pulse

A

CPR

181
Q

codes - shock delivered

A

CPR

182
Q

codes - anything

A

CPR

183
Q

all codes

A

epi

184
Q

VT/VF codes

A

epi, amio

185
Q

PEA, asystole

A

epi

186
Q

path of afib with RVR

A

underlying stressor

ischemia, infection, structural heart

187
Q

pt with afib with RVR

A

palpitations, asymptomatic

188
Q

dx of afib with RVR

A

EKG

189
Q

tx of afib with RVR

A

no heart failure: BB or CCB
heart failure: dig, amio
shock: shock

190
Q

path of afib

A

PIRATES =

ischemia, infarction, structural heart

191
Q

pt with afib

A

palpitations, asymptomatic

192
Q

dx of afib

A

ekg

193
Q

tx of afib

A

rate control = rhythm control

rhythm: cardiovert after TTE, TEE, one month of anticoagulation
rate: BB, CCB
rate: anticoagulant with CHADS2

194
Q

what is CHADS2

A 
C - CHF
H - HTN
A - age >75
D - Diabetes
S - stroke
S - stroke
score 0 = aspirin
score 1 = rivaroxaban, apixaban
score 2+ = warfarin or -axabans
195
Q

path of vasovagal syncope

A

visceral stimulation: micturition, coughing, sneezing
carotid stimulation: turning head, tight tie, boxer blow
psychogenic: sight of blood
cardioinhibitory surge = hypotension, bradycardia

196
Q

pt with vasovagal syncope

A

prodrome
one of the pathologies
situational

197
Q

dx of vasovagal syncope

A

tilt-table

198
Q

tx of vasovagal syncope

A

ß blockers

199
Q

path of orthostatic syncope

A

volume down = dehydration, diarrhea, diuresis, hemorrhage

autonomic nervous system = age, diabetes, Shy-Drager (Parkinson’s)

200
Q

pt with orthostatic syncope

A

orthostats

201
Q

dx of orthostatic syncope

A

orthostatics

202
Q

tx of orthostatic syncope

A

rehydrate/transfuse
steroids if that fails
cautious standing in elderly

203
Q

path of mechanical cardiac syncope

A

valvular or structural lesion = HCOM, saddle embolus, aortic stenosis, left atrial myxoma

204
Q

pt with mechanical cardiac syncope

A

exertional syncope

205
Q

dx of mechanical cardiac syncope

A

echo

206
Q

tx of mechanical cardiac syncope

A

treat underlying mechanical disease

207
Q

path of arrhythmia syncope

A

arrhythmia, too fast or too slow

208
Q

pt with arrhythmia syncope

A

sudden onset, no prodrome

209
Q

dx with arrhythmia syncope

A

EKG (usually negative)
Holter (24hr EKG)
event recorder (1mo)

210
Q

tx of arrhythmia syncope

A

AICD or arrhythmia meds

211
Q

path of neurogenic syncope

A

poor perfusion to the brain - posterior circulation

212
Q

pt with neurogenic syncope

A

sudden onset, no prodrome

focal neurologic deficit

213
Q

dx of neurogenic syncope

A

CTA

214
Q

tx of neurogenic syncope

A

medically manage

stenting

215
Q

CCB

A

amlodipine, felodipine

216
Q

ACE

A

lisinopril, quinapril, benazepril

217
Q

ARB

A

losartan, valsartan

218
Q

thiazide

A

HCTZ, chlorthalidone

219
Q

loop

A

furosemide

220
Q

ß blocker

A

metoprolol, carvedilol, nebivolol

221
Q

art dilator

A

hydralazine

222
Q

veno-dilator

A

isosorbide dinitrite, mononitrate

223
Q

Aldo antagonists

A

spironolactone

eplerenone

224
Q

secondary causes of HTN

A 
hyperaldosteronism
hyperthyroid
hypercalcemia
aortic coarctation
renovascular
pheochromocytoma
cushing's
OSA
225
Q

history of hyperaldosteronism (HTN)

A

refractory HTN or HTN and HypoK

226
Q

history of hyperthyroid (HTN)

A

weight loss, sweating, heat intolerance, paliptaitons

227
Q

work up for hyperaldosteronism

A

Aldo:renin >20

CT pelvis

228
Q

workup of hyperthyroid

A

TSH, free T4

229
Q

history of aortic coarctation

A 
children = warm arms, cold legs, claudication
adults = rib notching, BP differential in legs and arms
230
Q

workup of aortic coarctation

A

cxr

angiogram, CTA

231
Q

history of renovascular HTN

A

DM or glomerulonephritis
young women = FMD
old guy = RAS
Renal bruit, hypoK

232
Q

workup of renovascular HTN

A

CrCl
BMP
Aldo:renin <10
U/s renal artery

233
Q

history of hypercalcemia

A

polyuria, AMS, moans, groans, bones, kidney stones

234
Q

workup of hypercalcemia

A

free Ca

235
Q

history of pheochromocytoma

A

pallor, palpitations, pain, perspiration, pressure

236
Q

workup of pheochromocytomaa

A

24hr urinary metanephrines

CT

237
Q

history of Cushing’s

A

diabetes, HTN, central obesity, moon facies

238
Q

workup of Cushings’

A

low-dose dexa
ACTH level
high-dose dexa

239
Q

history of OSA

A

obesity, daytime somnolence, improved with CPAP

240
Q

workup of OSA

A

sleep study

241
Q

PIRATES

A

mnemonic for new onset atrial fibrillation
Pulmonary disease - COPD, PE
Ischemia - ACS
Rheumatic heart disease - mitral stenosis
Anemia - high output failure, tachycardia/atrial myxoma
Thyrotoxicosis - tachycardia/Tox - cocaine
Ethanol/endocarditis
Sepsis/sick sinus syndrome

242
Q

SVT

A

aberrent reentry that bypasses SA node

243
Q

SVT rhythm

A

narrow (atrial), fast (tachycardia), and distinguished from sinus tachycardia by resting heart rate >150 + loss of p waves

244
Q

tx svt

A

adenosine

245
Q

ventricular tachycardia

A

wide complex and regular tachycardia
“tombstones”
no p waves, just QRS

246
Q

tx v tach

A

Amiodarone or lidocaine

247
Q

atrial fibrillation

A

narrow complex tachycardia, irregularly irregular, absent p waves

248
Q

unstable new a fib treatment

A

shock

249
Q

stable new a fib treatment

A

rate control with CCB or BB

consider cardiovert if <48hrs

250
Q

when to cardiovert a fib

A

<48 hrs OR >48hrs + negative TTE->TEE

251
Q

when to tx a fib with warfarin

A

> 48hrs, positive TTE-> TEE

252
Q

sinus bradycardia

A

slow sinus rhythm

253
Q

tx sinus brady

A

atropine

if really bad, pacing

254
Q

1st deg AV block

A

regularly prolonged PR interval

255
Q

tx 1st deg AV block

A

atropine
pacing
nothing

256
Q

2nd deg AV block type 1

A

constantly prolonging PR interval until QRS is dropped

257
Q

tx 2nd deg AV block type 1

A

atropine
pace
nothing

258
Q

2nd deg AV block type 2

A

normal PR interval but randomly drops QRS

259
Q

tx 2nd deg AV block type 2

A

pace

260
Q

3rd deg AV block

A

total AV node dissociation, p’s march out, QRS march out

261
Q

tx 3rd deg AV block

A

avoid atropine

pace

262
Q

idioventricular rhythm

A

rhythm without atrial activity

looks like 3rd deg block without p waves

263
Q

tx idioventricular rhythm

A

avoid atropine

just pace

264
Q

Cardiac arrest

A

VT/VF -> 2mins CPR + epinephrine -> shock -> 2mins CPR + Amiodarone -> 2mins CPR + epinephrine -> 2mins CPR + Amiodarone

PEA/asystole -> 2mins CPR + epi -> no shock -> 2mins CPR -> no shock -> 2mins CPR + epi -> 2mins CPR

265
Q

ACLS: 1 - identify rhythm

A

1 - determine rate (tachycardia > 100, Brady <60)
2 - determine QRS width (wide >0.12msec & ventricular; narrow <0.12 & atrial)
3 - regular or irregular rhythm

266
Q

ACLS: 2 - are there symptoms with arrhythmia?

A

no symptoms -> IVF, O2, monitor

yes symptoms -> is pt stable?

267
Q

ACLS: 3 - stable vs. unstable?

A

unstable: chest pain, SOB, AMS, or systolic <90 - use electricity

268
Q

ACLS: 4 choose intervention

A

unstable: electricity
stable: medications

269
Q

ACLS tx stable: fast + narrow

A

atrial

adenosine

270
Q

ACLS tx stable: fast + wide

A

ventricular

amiodarone

271
Q

ACLS tx stable: slow

A

atropine

272
Q

ACLS tx stable: a fib/flutter

A

rate control = BB, CCB

273
Q

tachycardia rhythms - atrial narrow

A 
sinus tachycardia
SVT
multifocal atrial tachycardia
Afib
Aflutter
274
Q

tachycardia rhythms - ventricular wide

A

Vtach
Vfib
Torsades

275
Q

Brady rhythms - varying PR intervals

A

sinus Brady
1st deg AV block
2nd deg AV block
3rd deg AV block

276
Q

Brady rhythms

A

junctional

idioventricular

Online Med Ed (18 decks)

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