Cardiology-IM Flashcards by Jennifer Dutton

(RoshReview)

dyspnea, fatigue, and signs of right-sided heart failure, such as peripheral edema are signs of _________

signs of constrictive pericarditis

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(RoshReview)

what electrocardiogram findings suggest acute pericarditis?

diffuse ST elevation and PR depression

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(RoshReview)
physical exam findings:
pericardial knock on cardiac auscultation, 
Kussmaul sign
pulsus paradoxus
indicate....?

constrictive pericarditis

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(PPP 8)

MC type of cardiomyopathy

DILATED CARDIOMYOPATHY

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(PPP 8)

What usually causes DILATED CARDIOMYOPATHY?

SYSTOLIC DYSFUNCTION, leading to a dilated, weak heart

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(PPP 8)

what is the most common etiology of dilated cardiomyopathy?

IDIOPATHIC, most common cause

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(PPP 8)

what is the most common infectious cause of dilated cardiomyopathy

VIRAL most common

esp enteroviruses like Coxsackievirus B, echovirus

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(PPP 8)

what are the most common TOXIC causes of dilated cardiomyopathy

ETOH ABUSE, COCAINE, anthracyclines (eg DOXORUBICIN), radiation

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(PPP 8)

what is the most common metabolic reason for DILATED CARDIOMYOPATHY?

Vit B1 (thiamine) deficiency
thyroid disorders

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(PPP 8)

echocardiogram findings of dilated cardiomyopathy

LEFT VENTRICULAR DILATION (LARGE CHAMBER)
thin ventricular walls
DECREASED EJECTION FRACTION
(similar findings to systolic heart failure)

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(PPP 8)

what is the diagnostic test of choice for dilated cardiomyopathy

echocardiogram

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(PPP 8)

management of dilated cardiomyopathy is the same as….

…standard systolic heart failure treatment

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(PPP 8)

how do we manage/reduce mortality for dilated cardiomyopathy?

ACEi/ARBs
BB (metoprolol or carvedilol)
SYMPTOM CONTROL WITH DIURETICS
digoxin
Spironolactone

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(PPP 8)

what is a key finding on physical exam for dilated cardiomyopathy?

S3 gallop hallmark (due to filling of a dilated ventricle)

mitral or tricuspid regurgitation too.

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(PPP 19)
dysfunction of the sinus node that leads to a combination of SINUS ARREST WITH ALTERNATING PAROXYSMS OF ATRIAL TACHYARRHYTHMIAS AND BRADYARRHTHMIAS

sick sinus syndrome

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(PPP 19)

sick sinus syndrome - dysfunction of the _________

sinus node

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(PPP 19)

brady-tachy syndrome

sick sinus syndrome

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(PPP 19)

define sick sinus syndrome

dysfunction of the SINUS NODE that leads to a combination of
SINUS ARREST with
ALTERNATING PAROXYSMS of ATRIAL TACHYARRHYTHMIAS and BRADYARRHYTHMIAS

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(PPP 19)

management of stable sick sinus syndrome

symptoms are transient, no urgent therapy required

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(PPP 19)

management of hemodynamically unstable sick sinus syndrome

ATROPINE first line

dopamine, epinephrine

transcutaneous pacing

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(PPP 19)

long-term management of sick sinus syndrome

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permanent pacemaker definitive

addition of an automatic implantable cardioverter defibrillator if alternating between tachy and brady

(PPP 22)

EKG manifestations of 3rd Degree Heart Block

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regular P-P intervals
regular R-R intervals
BUT THEY ARE NOT RELATED TO EACH OTHER
(pt often bradycardic)

(PPP 22)

management of complete heart block

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acute or symptomatic: transcutaneous pacing

…often followed by permanent pacemaker placement

(PPP 85)

almost always the cause of mitral stenosis

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rheumatic heart disease

(PPP 85) | MC symptom of mitral stenosis

dyspnea

(PPP 85) | the sounds of mitral stenosis (list three), and where it's best heard

``` PROMINENT S1 OPENING SNAP low pitched MID-DIASTOLIC RUMBLING MUMUR best heard at apex ```

(PPP 85) | four positions that increase the murmur intensity of mitral stenosis

left lateral decubitus position squatting leg raise lying supine

(PPP 84) | two features of the sounds of aortic regurgitation, and the best place to hear them

diastolic blowing decrescendo murmur best heard at the left upper sternal border

(PPP 84) | how do you increase the murmur intensity of aortic regurgitation murmur?

``` sitting and leaning forward squatting supine leg raise expiration handgrip (these increase venous return) ```

(PPP 84) | how do you decrease the intensity of aortic regurgitation murmur?

``` Valsalva standing inspiration amyl nitrate (these decrease venous return) ```

(PPP 83) | what are the sounds of aortic stenosis? and where do you best hear them?

systolic crescendo-decrescendo murmur best heard at RUSB radiating to the carotid artery

(PPP 83) | how do you increase the murmur intensity of aortic stenosis?

``` sitting while leaning forward expiration squatting supine leg raise (increased venous return) ```

(PPP 83) | How do you decrease the murmur intensity of aortic stenosis?

``` Valsalva standing inspiration hand grip (decreased venous return) ```

(PPP 83) | what is pulsus parvus et tardus? What kind of murmur is it related to?

weak, delayed carotid pulse ``` tardus = late parvus = weak, small ``` aortic stenosis

(PPP 83) | what is the MC etiology of aortic stenosis?

degenerative, calcifications, wear and tear, esp >70 yrs of age

(PPP 673) | 40-60% of acute rheumatic fevers affect _____

heart valves

(PPP 673) | what valves are most commonly affected by acute rheumatic fever?

mitral (75-80%) | aortic (30%)

(PPP 673) | how do we diagnose acute rheumatic fever? What is the name of the criteria?

JONES CRITERIA for Rheumatic Fever 2 major - or - 1 major + 2 minor PLUS supporting evidence of a recent GAS infection!

(PPP 673) | What are the major criteria for Rheumatic Fever diagnosis?

``` JONES J = Joint (migratory polyarthritis) O = Oh my heart (active carditis) N = Nodules (subcutaneous) E = Erythema marginatum S = Sydenham's chorea ``` PLUS supporting evidence of a recent GAS infection!

(PPP 673) | what are the minor criteria for JONES criteria for Rheumatic Fever, clinical and lab?

Clinical --> fever & arthralgia Lab --> increase acute phase reactants (ESR, CRP, leukocytosis) and EKG (prolonged PR interval) PLUS supporting evidence of a recent GAS infection!

(PPP 52) | three categories of anticoagulants for anticoagulant therapy for ACS

unfractionated heparin low molecular weight heparin (enoxaparin, dalteparin) fondaparinux (direct factor Xa inhibitor)

(PPP 83 and EOR score report) | MC etiology for aortic stenosis for pts >70

degenerative, calcifications

(PPP 83 and EOR score report) | MC etiology for aortic stenosis for pt < 70 yrs

congenital reasons or | bicuspid valve

(PPP 83 and EOR score report) | ANGINA is the MC symptom for which valvulopathy?

aortic stenosis

(PPP 83 and EOR score report) | how do you increase the intensity of the murmur of aortic stenosis?

``` you decrease the resistance so that you increase the flow through the valve and make the murmur louder, i.e.: sitting while leaning forward squat lay supine raise a leg ```

(PPP 83 and EOR score report) | how do you decrease the intensity of the murmur of aortic stenosis?

``` you increase the resistance, decrease the flow through the stenotic valve, and lower the volume on the murmur VALSALVA STAND HANDGRIP inspiration ```

(PPP 83 and EOR score report) | what diagnostic study is best test for aortic stenosis?

echo

(PPP 83 and EOR score report) | what are the EKG findings indicative of aortic stenosis?

L ventricular hypertrophy, which is a heightened QRS

(PPP 83 and EOR score report) | primary management for aortic stenosis?

surgery | aortic valve replacement is the only effective treatment

(PPP 83 and EOR score report) | what kind of murmur is aortic stenosis? what are the sounds of aortic stenosis? where is it best heard?

SYSTOLIC crescend-decrescendo RUSB, radiating to carotid artery

(PPP 84 and EOR score report) | what kind of murmur is aortic regurgitation? what are the sounds of aortic regurgitation? where is it best heard?

DIASTOLIC blowing decrescendo LUSB

Cardiology-IM Flashcards

(51 cards)