Cardiovascular Flashcards
(229 cards)
1
Q
General cause of dilated cardiomyopathy
A
malfunction of myocardium
2
Q
Most common causes of dilated cardiomyopathy (4)
A
Alcohol abuse (most common)
Idiopathic
Myocarditis
Drugs (doxorubicin)
3
Q
Sequelae of dilated cardiomyopathy
A
right and left systolic dysfunction, congestive heart failure
4
Q
Most common first symptom of dilated cardiomyopathy
A
exertional intolerance
5
Q
In addition to exertional intolerance, other s/sx dilated cardiomyopathy (4)
A
dyspnea
orthopnea
lower extremity edema
chest pain
6
Q
Physical exam in dilated cardiomyopathy (5)
A
S3 heart sound
JVD
crackles on lungs
mitral regurgitation
lower extremity edema
7
Q
EKG in dilated cardiomyopathy (3)
A
nonspecific ST and T wave changes, LBBB
8
Q
CXR in dilated cardiomyopathy (2)
A
cardiomegaly, pulmonary vascular congestion
9
Q
Echo in dilated cardiomyopathy (4)
A
dilated chambers
thin left ventricular wall
poor wall movement
decreased ejection fraction (often less than 30%)
10
Q
Non-druggy treatment of dilated cardiomyopathy (3)
A
withdraw offending agents like booze
sodium restriction
maybe heart transplant
11
Q
druggy treatment of dilated cardiomyopathy (4)
A
Diuretics
maybe digoxin
ACE inhibitors (unless contraindicated)
Beta-blockers in stable heart failure
12
Q
Most common cause of death in young athletes
A
Ventricular tachyarrhythmias due to hypertrophic cardiomyopathy
13
Q
Most common cause of hypertrophic cardiomyopathy
A
Autosomal dominant genetic cause
14
Q
Pathogenesis of hypertrophic cardiomyopathy
A
Hypertrophy of cardiac septum leads to LV outflow obstruction, impaired diastolic filling, this leads to pulmonary congestion.
15
Q
Most patients with hypertrophic cardiomyopathy have these symptoms:
A
None. Ha. Got you good.
16
Q
Most common presenting symptoms in hypertrophic cardiomyopathy (3)
A
Dyspnea on exertion (most common)
angina
syncope
17
Q
Physical exam, hypertrophic cardiomyopathy (3)
A
Mitral regurgitation (increases with valsalva, decreases with handgrip and leg elevation)
S4 sound
Prominent left ventricular impulse
18
Q
Primary diagnostic test for hypertrophic cardiomyopathy (results)
A
Echocardiogram (septal wall thickness, ejection fraction usually greater than 60%)
19
Q
EKG in hypertrophic cardiomyopathy
A
LVH
20
Q
Treatment of symptomatic hypertrophic cardiomyopathy (3)
A
Beta-blockers (propanolol)
Calcium channel blockers (verapamil)
Diuretics for fluid overload
21
Q
Common causes of restrictive cardiomyopathy (5)
A
Amyloidosis
Sarcoidosis
Hemochromatosis
Post-radiation
Post open-heart surgery
22
Q
Restrictive cardiomyopathy pathogenesis
A
Myocardial changes lead to diastolic noncompliance with elevated filling pressures, this leads to pulmonary congestion
23
Q
Most common symptoms in restrictive cardiomyopathy (2)
A
Exertional intolerance
fluid retention
24
Q
Restrictive cardiomyopathy physical exam
A
elevated JVD
pronounced S4 sound
mitral regurgitation
tricuspid regurgitation
25
Echocardiogram in restrictive cardiomyopathy (3)
ejection fraction between 25% and 50%
Normal LV thickness
Increased atrial size
26
EKG in restrictive cardiomyopathy (3)
Low voltage QRS
Nonspecific ST and T wave changes
27
Definitive / specific diagnostic test for restrictive cardiomyopathy
tissue biopsy
28
Treatment for restrictive cardiomyopathy (2)
Treat underlying cause
Diuretics
29
Name this rhythm
Atrial fibrillation
30
Most common sustained arrhythmia in adults
Atrial fibrillation
31
Major risk with atrial fibrillation
Risk of intra atrial clot formation
32
QRS rhythm in atrial fibrillation
irregularly irregular
33
3 major goals in a-fib treatment
Rate control
Anticoagulation
Rhythm control
34
Rate control agents in a-fib (3)
Beta blockers (metoprolol)
Calcium channel blockers (verapamil, diltiazem)
digoxin
35
Anticoagulation agents in a-fib (2)
heparin acutely
warfarin long term
36
Rhythm control agents in a-fib (2)
Amiodarone is most effective, but side effects are common
Cardioversion may be attempted if no sign of atrial clots
37
Name this rhythm
atrial flutter
38
Atrial flutter symptoms (4)
Dizziness
Palpitations
Chest pain
Dyspnea
39
Best leads to recognize pattern in a-flutter
sawtooth pattern in II, III, aVF
40
Common ventricular rate in atrial flutter
75-150
41
Common atrial rate in atrial flutter
250 to 400
42
Primary treatment of atrial flutter
cardioversion
43
Acute medication treatments of atrial flutter (2)
Beta blockers (metoprolol, esmolol)
Calcium channel blockers (verapamil, diltiazem)
44
Long-term medication treatments for atrial flutter (4)
Amiodarone, sotalol, quinidine or procainamide
45
Definitive treatment of atrial flutter if reentrant site is known
catheter ablation
46
What the heck is going on here? (ignore those lame arrows)
multifocal atrial tachycardia
47
Common patients that get multifocal atrial tachycardia (2)
COPD
severe systemic illness
48
EKG findings in multifocal atrial tachycardia
polymorphic p waves
differing PR intervals
49
Treatment of multifocal atrial tachycardia (one druggy, one non-druggy)
Treat underlying cause
Calcium channel blockers
50
What the fuck, yo?
1st degree AV block
51
Some people with AV block do this for fun
pass out (ok, maybe not so fun)
52
Definition of first degree AV block
PR greater than 200 milliseconds
53
Name that rhythm
Second degree, type 1, Wenckebach
54
Definition of Wenckebach rhythm
progressive increase in PR interval until a P wave is blocked, then the cycle is repeated
55
What it is?
Second degree AV block, type 2
56
Definition of second degree AV block type 2
sudden block of a P wave with no change in PR interval
57
Whaddaya call this?
3rd degree AV block
58
Third degree AV block definition
Atria and ventricles are controlled by different pacemakers, they fire independently
59
Look at this table
because I say so
60
Three non-druggy considerations for treatment of AV block
Asymptomatic patients do not require treatment
Correct any reversible causes
Permanent pacing may be needed
61
Druggy treatment for symptomatic AV blocks (2)
Atropene or isoproterenol
62
What's this all about?
Right bundle branch block
63
How bout this one?
Left bundle branch block
64
List some causes for bundle branch blocks (5ish)
Acute MI
Cardiomyopathy
Big PE
Aortic stenosis
being a dork
65
If a bundle branch block gets conduction across an accessory pathway, it's called ___________ and it can put the patient at risk of \_\_\_\_\_\_\_\_\_\_
Wolff-Parkinson-White Syndrome
Other cardiac arrhythmias
66
What EKG finding will suggest WPW?
Delta waves
67
What duration defines a wide QRS
Greater than 120 milliseconds
68
A wide QRS without other signs of BBB is called
Intraventricular conduction delay
69
These 2 medications are contraindicated in WPW
Digoxin and CCB's
70
Possible presenting symptoms of paroxysmal supraventricular tachycardia
palpitations or anxiety
71
another name for paroxysmal supraventricular tachycardia
AV nodal reentry tachycardia
72
PSVT EKG findings
Rate between 150 and 250
Regular rhythm
Typically no atrial activity seen
73
PSVT treatment (3-6)
Vagal maneuver
Antianxiety meds
Drug of choice is adenosine
Other rate slowing meds like CCB, beta-blockers, digoxin, may be helpful
74
Normal rhythm, then interrupted by a narrow QRS, out-of-rhythm beat
Premature atrial contraction
75
Normal rhythm interrupted by wide-complex QRS
premature ventricular contraction
76
PVC treatment
Treat underlying caue
may use antiarrhythmics
use of beta-blockers is common
77
Class Ia antiarrhytmics (3)
Sodium channel blockers like
Quinidine
Procainamide
disopyramide
78
Class Ib antiarrhythmics (2)
Sodium channel blockers like
Lidocaine
mexiletine
79
Class Ic antiarrhythmics (2)
Sodium channel blockers like
Flecainide
propafenone
80
Class II antiarrhythmics (2)
Beta blockers like
Propanolol
Metoprolol
81
Class III antiarrhythmics (2)
Prolonged action potential duration drugs like
Amiodarone
sotalol
82
Class IV antiarrhythmics (2)
Calcium channel blockers like
Verapamil
diltiazem
83
Class Ia antiarrhytmic side effects
Nausea, vomiting
Quinidine: hemolytic anemia, thrombocytopenia, tinnitus
Procainamide: drug induced lupus
84
Class Ib antiarrhythmic side effects
Lidocaine: dizziness, confusion, seizures, coma
Mexiletine: tremor, ataxia, rash
85
Class Ic antiarrhythmic side effects
Flecainide: nausea, dizziness
86
Class II antiarrhytmic side effects
CHF, bronchospasm, bradycardia, hypotension
87
Class III antiarhythmic side effects
Amiodarone: hepatitis, pulmonary toxicity, thyroid disease, peripheral neuropathy
Sotalol: bronchospasm
88
Class IV antiarrhythmic side effects
AV block, hypotension, bradycardia, constipation
89
Precipitating causes of V-tach (5)
electrolyte imbalance
acid-base problems
hypoxemia
MI
drugs
90
Long QT can lead to this dangerous rhythm
Torsades de pointes
91
Drugs associated with torsades de pointes (9)
Tricyclic antidepressants
Erythromycin
Ketoconazole
haloperidol
cisapride
disopyramide
pentamidine
sotalol
Class I antiarrhythmics
92
Some things that can lead to heart failure (6)
Valvular heart disease
Coronary artery disease
arrhythmia
hypothyroidism
High cardiac output syndromes
hypertension
93
Conditions that can precipitate heart failure (6)
Reduction of medication
discontinuing medication
increased sodium intake
anemia
infection
PE
94
Presenting symptoms of heart failure (6)
dyspnea
orthopnea
paroxysmal nocturnal dyspnea
fatigue
exercise intolerance
edema
95
Physical exam in heart failure (9)
restless
dyspnea
JVD
Rales
tachycardia
S3 / S4 heart sounds
displaced PMI
RUQ tenderness / ascites
Peripheral edema
96
Labs in heart failure
Elevated LFT's
Elevated BNP
Check CBC and thyroid to rule out anemia and thyroid disease
97
Imaging in heart failure
CXR: cardiomegaly, increase in pulmonary vasculature, pleural effusion, Kerley B lines
Echocardiogram is diagnostic, signs of systolic or diastolic dysfunction, decreased ejection fraction
98
What's weird here
Kerley B lines, suggestive of heart failure
99
EKG in heart failure
LVH
100
Class I heart failure
No cardiac symptoms with ordinary activity
101
Class II heart failure
Cardiac symptoms with marked activity, but asymptomatic at rest
102
Class III heart failure
Cardiac symptoms with mild activity, but asymptomatic at rest
103
Class IV heart failure
Cardiac symptoms at rest
104
Non-druggy therapy for heart failure
Low sodium diet
Quit smoking, idiot
other obvious things for heart: exercise and weight loss, controlling other comorbidities
105
Drugs that should be avoided in heart failure
Aspirin, NSAID's, CCB's
106
Goals of druggy therapy for heart failure
control fluid retention
control neurohormonal activation
control symptoms
107
Big 2 drugs for heart failure (especially with left ventricular dysfunction and if not contraindicated)
ACE and Beta
108
This drug can improve symptoms and exercise tolerance in heart failure by increasing cardiac contractility
Digitalis
109
If a patient can't use an ACE in heart failure, what are some other options
Vasodilators, like hydralazine and nitrates
110
Some possible end organ damage from hypertension (7)
LVH
Angina
Heart failure
Stroke
Chronic Kidney Disease
Peripheral artery disease
Retinopathy
111
6 lifestyle modifications for hypertension
Weight loss
Limit alcohol intake
Regular aerobic exercise
Quit smoking, dummy
Reduce sodium intake
Reduce saturated fat and cholesterol intake
112
Drug choices for hypertension with angina
Beta blockers and CCBs
113
Drug choices for hypertension with diabeetus or hyperlipidemia
ACE inhibitors
CCBs
114
Drug choices for hypertension with CHF
Diuretics and ACE inhibitors
115
Drug choice for hypertension with previous MI
ACE and Beta
116
Drug choice for hypertension with chronic renal failure, or asthma/COPD
Diuretics and CCB's, maybe also ACEi
117
7 common causes for secondary hypertension
Renovascular disease
Coarctation of the aorta
Primary aldosteronism
Cushing's Syndrome
Pheochromocytoma
Obstructive Sleep Apnea
Renal parenchymal hypertension
118
Diagnosing renovascular disease
Elevated Cr
MRI of renal arteries
Renogram
119
Diagnosing coarctation of aorta
Unequal pulses
Rib notching
Claudication
MRI
120
Diagnosing primary aldosteronism
Hypokalemia
Metabolic acidosis
Renin / aldosterone
121
Diagnosing Cushing's syndrome
truncal obesity
cortisol
dexamethasone suppression test
122
Diagnosing pheochromocytoma
Tachycardia
Polyuria
Headache
Diaphoresis
Plasma metanephrine and normetanephrine
123
Diagnosing sleep apnea
Snoring
Obesity
Sleep study
124
Diagnosing renal parenchymal hypertension
Elevated Cr
abnormal UA
24 hour urine for protein
Renal ultrasound
125
Avoid this drug in patients with bilateral renal artery stenosis
ACE inhibitors
126
7 etiologies for malignant hypertension
Aortic dissection
Post CABG
Acute MI
unstable angina
Eclampsia
Head trauma
Severe burns
127
Some defining symptoms of malignant hypertension (other than elevated blood pressure)
headache
confusion
blurry vision
nausea and vomiting
seizures
oliguria
128
Target blood pressure in malignant hypertension
170/110 over first 12 or so hours
Normal after that
129
3 meds in malignant hypertension
nitroprusside in hypertensive encephalopathy, intracranial bleeding and heart failure
Use nitroprusside with propanolol for dissecting aneurysm
Oral clonidine for hypertensive urgency
130
3 causes of hypovolemic shock
Hemorrhage
Volume depletion
Extravascular spacing
131
2 causes of cardiogenic shock
Myocardial dysfunction
Valvular defects
132
4 causes of obstructive noncardiogenic shock
Pericardial tamponade
Tension pneumothorax
Severe pulmonary embolism
Left ventricular outflow obstruction
133
Symptoms of cardiogenic shock
Altered mental status
cyanosis
oliguria
cool clammy extremities
134
Vasopressor agents used in cardiogenic shock
Dopamine can increase systemic pressure and cardiac output
Dobutamine can increase cardiac output, but not systemic blood pressure
135
Definition of orthostatic hypotension
Fall in systolic of 30 mm Hg or more
Fall in diastolic of 10 mm Hg or more
between recumbent and upright
136
10 causes of orthostatic hypotension
Antipsychotics
Diuretics
Alpha blockers
ACE inhibitors
Alcohol
Tranquilizers
Vasodilators
Methyldopa
Neuropathies
Parkinson's
137
Most MI deaths occur within ________ of onset of symptoms
1 hour
138
10 Risk factors for coronary atherosclerosis
Hyperlipidemia
Hypertension
Oldness
Fatness
Family history
Stress
Diabeetus
Having a penis
Being lazy
Smoking like a goddamn idiot
139
Who tends to have painless MI's?
Old folk
Diabeetuses
140
In addition to chest pain, list some other associated symptoms of MI
Nausea
Vomiting
Diaphoresis
Dyspnea
Weakness
141
How long does troponin stay elevated after an MI?
How about CKMb?
Myoglobin?
troponin 5-10 days
CKMb 2-4 days
Myoglobin less than 1 day
142
How long after the start of an MI is Troponin elevated?
CKMb?
Myoglobin?
Troponin 2-6 hours
CKMb 3-6 hours
Myoglobin 1-2 hours
143
ST elevation in II, III, aVF
Location?
Artery?
Inferior
RCA
144
STE in I, aVL, V5, V6
Location?
Artery?
Lateral
Circumflex
145
STE in V1-V4, I, aVL
Location?
Artery?
Anterior
LCA
146
ST Depression v1, v2
Location
Artery
Posterior
RCA circumflex
147
STE v3-v6
Location
Artery
Apical
LAD / RCA
148
STE I, aVL, v4-v6
Location
Artery
Anterolateral
LAD / circumflex
149
STE V1-V3
Location
Artery
Anteroseptal
LAD
150
4 absolute contraindications to thrombolytic therapy in MI
Active bleeding / bleeding disorder
Prior hemorrhagic stroke / other stroke within 1 year
Intracranial or spinal cord cancer
Suspected / known aortic dissection
151
4 relative contraindications to thrombolysis in MI
Severe / uncontrolled hypertension
Anticoagulation: therapeutic or elevated INR
Old ischemic stroke
Recent major surgery / trauma / pregnancy
152
Only way to exclude coronary artery disease with certainty. (used in angina)
Coronary angiography
153
4 general treatment considerations for angina
Quit smoking
control BP
control diabeetus
exercise
154
3 major meds for angina
ACE
Beta
Nitrates
155
3 things that would make angina unstable
New onset
Worsening
Occurs at rest
156
Treatment of unstable angina (5)
ACE
Beta
Aspirin / heparin / clopidogrel
Nitro
Revascularization (CABG / angioplasty)
157
2 other conditions that may be associated with Prinzmetal angina
Raynaud
Migraines
158
Treatment of Prinzmetal angina
nitrates
CCB's
NO Beta Blockers!
159
5 Major Jones Criteria of acute Rheumatic Fever
Carditis
Polyarthritis
Chorea
Erythema Marginatum
Subcutaneous nodules
160
4 minor Jones Criteria for Rheumatic Fever
Arthralgia
Fever
Long PR
Lab (ESR, CRP)
161
Rheumatic fever treatment
Bed rest
Antibiotics to prevent, but they don't help once you have RF
Anti-inflammatories can help (aspirin up to steroids)
162
AAA screening, how and who
Ultrasound, males 65-75 who have ever smoked
163
AAA treatment
Beta blockers
Imaging q6mo
surgery if greater than 5.5cm or rapidly changing
164
Definitive treatment for aortic dissection
surgery, duh
165
Embolus / thrombus physical exam
5 P's
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
166
What's the awesome name for temporary loss of vision in one eye, frequently due to ophthalmic artery occlusion
amaurosis fugax
167
3 methods for diagnosis of peripheral arterial occlusion
Ankle/brachial index
Ultrasound doppler
Arteriography
168
5 treatments for peripheral arterial occlusion
Pentoxifylline (decreases blood viscosity)
Aspirin
Ticlopidine (inhibits platelet aggregation)
Thromboendarterectomy
Stop Fucking Smoking
169
Most common symptom of giant cell arteritis
New onset of temporal headache
170
Definitive diagnosis of giant cell arteritis
biopsy
171
Giant cell arteritis treatment
Corticosteroids
172
Phlebitis treatment
Warm moist compresses
NSAIDS
Abx to cover staph if septic thrombophlebitis
173
9 risk factors for DVT
Prolonged immobilization
Postoperative
Pelvic or extremity trauma
Birth control pills
Cancer
Hypercoagulable state
Preggers
Obesity
Smoking
174
DVT diagnosis
ultrasound
D-dimer may be useful to rule out in low probability patients
175
DVT treatment
Bridge heparin to warfarin
Warfarin, INR 2-3
IVC filter
176
Aortic stenosis symptoms
angina, syncope, CHF
177
Physical exam in Aortic stenosis
Delayed carotid upstroke
Strong apical impulse
Narrowing pulse pressure
Loud, rough, diamond-shaped systolic murmur with ejection click (best heard at base of heart, with radiation to neck)
178
Imaging in aortic stenosis
CXR: dilatation of ascending aorta, pulmonary congestion, boot shaped heart
Echo shows thickening of LV wall, valvular calcifications
179
Aortic stenosis treatment
Avoid strenuous activity
Treat CHF with diuretics and sodium restriction
Valve replacement
180
This awesome drug is contraindicated in aortic stenosis
ACEi
181
6 causes of aortic regurgitation
Rheumatic fever
Infectious endocarditis
Hypertension
Syphilis
Collagen vascular disease
Marfan
182
Symptoms of aortic regurgitation (4)
Dyspnea on exertion
syncope
chest pain
CHF
183
Physical exam in aortic regurgitation (6)
Wide pulse pressure
Bounding pulses
S3 heart sound
Displaced apical impulse
Decrescendo, blowing diastolic murmur on left sternal border
Low-pitched apical diastolic murmur (austin-flint murmur)
184
Imaging in aortic regurgitation
CXR: LVH
Echo: left ventricular enlargement
185
Druggy treatment for aortic regurgitation
Cover CHF sith digoxin, diuretics, ACEi, salt restriction
186
Definitive treatment for aortic regurgitation
surgical valve replacement should be performed before ejection fraction is less than 55%
187
Symptoms of mitral stenosis (3)
exertional dyspnea
orthopnea
paroxysmal nocturnal dyspnea
188
Mitral stenosis is most common in this population
Women between 25 and 45
189
Mitral stenosis physical exam
Prominent jugular A wave (sure)
Opening snap in early diastole
Soft, low pitched diastolic rumble heard best at apex in left decubitus postition
Palpable right ventricular heave at left sternal border
190
EKG in mitral stenosis
left atrial enlargement, atrial fib
191
CXR in mitral stenosis
left atrial enlargement, prominent pulmonary arteries
192
2 major diagnostic tests for mitral stenosis
echocardiogram
cardiac cath
193
Mitral stenosis treatment
Control a fib and CHF
Valve replacement or percutaneous transvenous mitral valvotomy
194
6 causes of mitral regurgitation
Rheumatic fever
Papillary muscle rupture
Chordae tendineae rupture
Calcification
Mitral valve prolapse
Lupus
195
Mitral regurgitation symptoms
fatigue
dyspnea
orthopnea
CHF
196
Mitral regurgitation physical exam (4)
Left ventricular lift or apical thrill
Holosystolic murmur at apex with radiation to base or left axilla
s3 heart sound
laterally displaced apical impulse
197
EKG with mitral regurgitation
LVH
198
Diagnostic test for mitral regurgitation
echocardiogram
199
Mitral regurgitation treatments
Treat CHF with digoxin, diuretics, ACEi and salt restriction
Valve replacement must be performed early and is the only definite treatment
200
Symptoms of mitral valve prolapse
chest pain
palpitations
201
Physical exam in mitral valve prolapse
mid to late click at apex
crescendo, mid to late systolic murmur
202
diagnostic test for mitral valve prolapse
echocardiogram shows valve leaflets bulging backwards in systole
203
mitral valve prolapse treatment
Avoid stimulants
Maybe some beta blockers
204
2 causes for tricuspid regurg
Pulmonary hypertension
Endocarditis
205
Symptoms of tricuspid regurgitation (3)
Ascites
Edema
RUQ pain
206
Physical exam in tricuspid regurgitation (4)
Hepatic enlargement
JVD
Parasternal lift
Holosystolic murmur, left sternal border
207
Treatment for tricuspid regurg
treat underlying cause (endocarditis, pulmonary hypertension)
208
Pulmonary stenosis physical exam
early systolic opening ejection click
systolic ejection murmur, radiates to base
209
Spend some time with this table
Do it
210
This table is really good too, look at it a bunch
I like looking at tables
211
5 predisposing factors for endocarditis
Mitral valve prolapse
Degenerative valvular disease
IV drug abuse
Prosthetic valve
Congenital abnormalities
212
3 bugs for community acquired endocarditis
Staph aureus
Strep viridans
Enterococcus
213
4 bugs for nosocomial endocarditis
Staph aureus
Staph epidermidis
Enterococcus
Funguses
214
3 bugs for prosthetic valve endocarditis
Staph epidermidis
Staph aureus
Enterococcus
215
6 symptoms for endocarditis
Fever
Fatigue
Malaise
Weight loss
Arthritis
Myalgias
216
7 physical exam findings in endocarditis
Petechiae
Osler's nodes (palmar surface of fingers and toes)
Janeway lesions (palms and soles)
Splinter hemorrhages
Roth's spots (retinal hemorrhage)
Murmur
Splenomegaly
217
Labs in endocarditis
Leukocytosis
ESR elevation
Hematuria
218
2 major and 4 minor Duke criteria for endocarditis
Major: positive blood culture, murmur or echo showing a thing
Minor: predisposing condition, fever, vascular pneumonia, immunologic stuff
219
Empiric abx, community acquired endocarditis
nafcillin, penicillin, gentamicin
220
Empiric abx, hospital acquired endocarditis (or pcn allergy)
vanco, gentamycin
221
Empiric abx, endocarditis with prosthetic valve
vanco, genta, rifampin
may need to replace valve
222
symptoms of pericarditis
chest pain worsens with deep breathing or lying down
pain improved by sitting and leaning forward
223
pericarditis physical exam
friction rub
224
EKG in pericarditis
STE in all precordial leads, with no reciprocal depression
225
cardiac tamponade symptoms
Hypotenson
tachycardia
dyspnea on exertion
226
physical exam in cardiac tamponade (4)
JVD
indistinct heart sounds
narrow pulse pressure
pulsus paradoxus
227
Hey look, another table!
bask in it's tabley goodness
228
pericardial effusion CXR
large water bottle shaped heart
229
