Cardiovascular Disorders Flashcards Preview

USMLE Step Two > Cardiovascular Disorders > Flashcards

Flashcards in Cardiovascular Disorders Deck (150)
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61

CHADS2 score

congestive heart failure - 1
hypertension - 1
age > 75 - 1
diabetes mellitus - 1
stroke - 2

62

causes of pulsus paradoxus

cardiac tamponade, tension pneumothorax, and severe asthma

63

treatment of unstable patient with Afib

immediate cardioversion

64

treatment of stable patient with Afib

< 48 hours: cardioversion
> 48 hours: 3-4 weeks of rate control and antiocogulation prior to cardioversion

65

mechanism of dipyramidole infused myocardial perfusion scanning

dipyramidole is a vasodilator, diseased vessels are already maximally dilated, so dipyramidole vasodilates non-disease vessels and draws even more blood away from diseased vessels

66

treatment for aortic regurgitation

afterload reduction with ACE-inhibitor or nifedipine, severe cases should undergo valve replacement

67

ranking of lifestyle modifications for high blood pressure

weight loss
DASH diet
dietary sodium
exercise
alcohol intake

smoking has little effect on hypertension but does contribute to heart disease

68

treatment of cocaine-induced STEMI

PTCA or thrombolysis
aspirin, nitrates appropriate, avoid beta-blockers which will allow unopposed alpha-activity and further vasoconstriction

69

pulsus parvus et tardus

decreased pulse amplitude and delayed pulse upstroke seen in aortic stenosis

70

mechanism of decreased preload in cardiac tamponade

pericardial fluid pressure exceeds ventricular pressure and inhibits ventricles from expanding and filling properly

71

drug of choice in patient with stable angina and hypertension

beta-blocker

72

mixed venous oxygen concentration in hypovolemic shock

decreased from increased oxygen extraction by hypoperfused tissue

73

mixed venous oxygen concentration in septic shock

normal from hyperdynamic circulation and improper distribution of the cardiac output

74

mechanism by which nitroglycerin relieves angina

dilaiton of veins decreases preload and stretching of myocardial muscle

it is actually unclear if nitroglycerin increases coronary blood flow in diseased patients although it performs this function in healthy coronary vessels, so this is not the major way angina is relieved

75

metabolic abnormalities found in hyperaldosteronism (conn's syndrome)

low renin, high aldosterone
high sodium, low potassium, high bicarbonate (metabolic alkalosis)

76

pansystolic murmur at the apex with radiation to the axilla days to months after a myocardial infarction

ventricular aneurysm

papillary muscle rupture occurs 3-7 days after

77

normal right atrial pressure

4-6 mmHg

78

normal pulmonary artery pressure

25/15 mmHg

79

normal PCWP

6-12 mmHg

80

right atrial pressure > 10 mmHg
pulmonary artery systolic pressure > 40 mmHg

diagnostic criteria for massive pulmonary embolism

81

unstable angina pharmacotherapy if no percutaneous intervention is planned

aspirin, clopidogrel

82

unstable angina pharmacotherapy if percutaneous intervention is planned

gp IIb/IIIa inhibitor

83

intranodal or bundle of His conduction problem

second degree mobitz I heart block

84

infranodal conduction problem

second degree mobitz II heart block

85

absence of conduction between atria and ventricles

third degree heart block

86

AV nodal reentry anomaly

PSVT
treatment: adenosine, carotid massage, valsalva maneuver

87

AV reentry (not through the node, through accessory pathway)

wolff-parkinson-white
treatment: amiodarone, procainamide

88

treatment of hemodynamically stable ventricular tachycardia

amiodarone

89

complication of esophageal dilation

esophageal rupture, penumomediastinum, and mediastinitis

90

causes of mediastinitis

iatraogenic procedure, boerrhave tear