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CEN2 > CARDIOVASCULAR > Flashcards

CARDIOVASCULAR Flashcards

1
Q

CP at rest >20 minutes, transient ST or T-wave changes. Trop normal.

A

Unstable Angina

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2
Q

What might a new LBBB be?

A

STEMI

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3
Q

Easy EKG HR identification

A

300/150/100/75/60

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4
Q

Lateral MI leads

A

I, aVL, V5, V6

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5
Q

I, aVL, V5, V6

A

LATERAL MI

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6
Q

Inferior MI leads

A

II, III, aVF

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7
Q

II, III, aVF

A

INFERIOR MI

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8
Q

Septal MI leads

A

V1, V2

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9
Q

V1, V2

A

SEPTAL MI

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10
Q

Anterior MI leads

A

V1, V2, V3, V4

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11
Q

V1-V4

A

ANTERIOR MI

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12
Q

Troponin elevation times

A

elevation at 4-6 hours, peak at 24-36 hours, normal 5-12 days

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13
Q

When should we consider a fibrinolytic for a STEMI?

A

If unable to get PCI within 90 minutes (TPA within 30 minutes, still send to cath lab)

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14
Q

When do we give oxygen for CP?

A

Only if hypoxic

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15
Q

Thrombolytic 1 time dose

A

Tenecteplase (TNKase)

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16
Q

30% of interior infarcts also involve what?

A

Right ventricle

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17
Q

What must we do on all inferior infarcts?

A

Right side EKG b/c 30% of inferior MIs also involve right ventricle. Right side EKG is MIRROR IMAGE

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18
Q

What is the right ventricle critical to?

A

cardiac output - preload/strech/filling

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19
Q

What is the most specific lead to determine a right side MI?

A

V4’ / V4r

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20
Q

Good ventricular wall stretch (filling) is needed for maximal ejection. Increased filling (preload) too much will decrease cardiac output.

A

Sterling’s Law

21
Q

3 characteristics of PRELOAD

3 characteristics of AFTERLOAD

A

Preload: right side of heart, managed by fluid, venous system

Afterload: left side of heart, BP/resistance dependent, arterial system

22
Q

What does increasing afterload also increase?

A

Heart workload

23
Q

What 3 meds decrease preload?

A

Lasix, morphine, nitro

24
Q

What meds decrease afterload?

A

Any vasodilator (nipride, ntg)

25
Q

Symptoms of left sided HF? Right sided HF?

A

Left = pulmonary edema + dependent edema

Right = venous congestion + anasarca

26
Q

What BP med is used for eclampsia?

A

Hydralyzine

27
Q

-Vaso-dilators that decrease afterload

-Veno-dilators that decrease preload

-Arterilar-dilators that decrease afterload

A

-Vaso-dilators = alpha-blockers (catapres, clonodine)

-Veno-dilators = morphine, nitro, lasix

-Arterilar-dilators = hydralyzine, CCB

28
Q

What is the treatment goal for hypertensive crisis?

A

Decrease BP by 20-30% over 2-3 hours, treat until relief of symptoms

29
Q

This affects endocardium and valves; symptoms are Janeway lesions and Roth’s spots. Check sed rate for diagnosis.

A

Endocarditis

30
Q

What are Janeway lesions? When do we see them?

A

Micro-emboli causing lesions to hands/fingers seen in endocarditis

31
Q

What are Roth’s spots? When do we see them?

A

Micro-hemorrhages on retina seen in endocarditis

32
Q

Inflammatory, CP relieved by leaning forward, EKG shows ST changes in all leads

A

Pericarditis

33
Q

Beck’s Triad

A

-JVD
-Muffled heart sounds
-low BP

34
Q

This causes Beck’s triad; associated with pulsus paradoxus; treat with pericardiocentesis

A

Cardiac Tamponade

35
Q

What is pulsus paradoxus?

A

SBP increases by 10mmHg or more during inspiration

36
Q

Where on the heart does a blunt cardiac injury cause damage?

A

Anterior (sometimes inferior)

37
Q

This causes vasospasm of vessels esp in fingers

A

Raynaud’s

38
Q

This causes thrombi of vessels esp in fingers

A

Buergers

39
Q

What is pain like in PVD?

A

Pain increases with use and is relieved with rest

40
Q

Non-obstructing clot on vessel wall waiting to break off and travel downstream

A

Thrombus in situ

41
Q

Virchow’s Triad (DVT)

A

-venous stasis
-hypercoagulability
-endothelial injury

42
Q

What do we see on CXR in an aortic aneurysm?

A

Widened mediastinum

43
Q

Allen’s Test procedure

A

-examiner grasps the patient’s wrist and applies finger pressure to block the vascular supply from the radial and ulnar arteries.
-The patient then makes a fist three to four times so as to force the venous blood out of the hand via the posterior veins.
-After 1 minute, the patient lets the arm hang down and opens the now pale hand.
The examiner now releases compression, first from one artery then from the other.
-This procedure is repeated with the radial artery released and compression on the ulnar artery maintained.

44
Q

What is the phlebostatic axis?

A

MAL, 4th ICS

45
Q

What 3 things does a good arterial wave have?

A

-rapid upstroke
-clear dicrotic notch
-definite end diastole

46
Q

Complications of an a-line

A

-dislodgement
-bleeding
-infection
-etc

47
Q

1st degree AV block

A

PR >0.2 (1 large box)

48
Q

Heart block Wenckeback

A

2nd degree type ONE

49
Q

Associated with endocarditis: tender, purple-pink nodules found on the distal fingers and toes, pain usually proceeds nodule development, and they disappear in hours to days, leaving no sequelae.

A

Osler Nodes

CEN2 (12 decks)

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