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Cardiovascular System 2 Flashcards

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1
Q

What should be performed after 6-8 weeks in patients with suspected Kawasaki disease?

A

Echo (to check for coronary artery aneurysms)

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2
Q

How does the measles rash spread?

A

From head to toe

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3
Q

What does squatting do during Tet spells?

A

Increases the systemic vascular resistance

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4
Q

What happens in Tetralogy of Fallot when the pulmonary vascular resistance exceeds the systemic vascular resistance?

A

Cyanosis (R to L shunt)

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5
Q

What’s the tx for Vfib?

A

Defibrillation

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6
Q

When do you give Epinephrine?

A

Vtach

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7
Q

How does the cardiac contour look with acute tamponade (rather than subacute)?

A

Acute has a normal cardiac contour

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8
Q

Is anticoagulation needed in lone paroxysmal Afib?

A

No

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9
Q

What does increased QRS voltage indicate?

A

LVH

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10
Q

Tet spells are due to what VOT?

A

RVOT

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11
Q

What would you check first before performing a renal US?

A

Serum creatinine and urinalysis

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12
Q

What should be suspected in young patients with unexplained AV block?

A

Sarcoidosis

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13
Q

How does B-blocker toxicity present?

A

Bradycardia, hypotension, hypoglycemia, delirium, seizures, cardiogenic shock

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14
Q

How do you treat B-blocker toxicity?

A

Glucagon

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15
Q

How does digoxin toxicity present?

A

Fatigue, nausea, blurred vision, disturbed color perception, cardiac arrhythmias

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16
Q

What does wide splitting indicate (causes a delayed pulmonic sound)?

A

Pulmonic stenosis
RBBB

“Drinking PBR makes you wide”

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17
Q

What does paradoxical splitting indicate (eliminates the split sound)?

A

AS

LBBB

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18
Q

What does increasing hand grip increase?

A

Afterload

“Jerking off the afterload”

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19
Q

What murmurs are increased by hand grip?

A

MR, AR, and VSD

“Mr Arvsd loves jerking off”

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20
Q

What does valsalva decrease?

A

Preload

“To reduce pre-cum, bear down during sex”

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21
Q

What murmurs are increased by valsalva?

A

HOCM

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22
Q

What does rapid squatting increase? (3)

A
  1. Venous return
  2. Preload
  3. Afterload
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23
Q

What murmurs are increased by rapid squatting?

A

MR, AS, and VSD

“Mr ASSvsd loves squats”

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24
Q

Diastolic _____?

A

ARMS &

PRTS

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25
The machine is a ____?
PDA
26
What are the 3 signs of LHF?
1. Orthopnea 2. Paroxysmal nocturnal dyspnea 3. Pulmonary edema
27
What are the 3 signs of RHF?
1. Hepatomegaly 2. JVD 3. Peripheral edema
28
Are the following levels increased or decreased in hypovolemic shock? PCWP (preload) CO SVR (afterload)
PCWP: Decreased CO: Decreased SVR: Increased
29
What protozoan can cause megacolon and cardiac disease?
T cruzi (Chagas disease)
30
Remember, the question stem might include a JVD but it might be a normal value! What is the normal range for JVD?
Less than 4cm above sternal angle
31
T/F: Turner's syndrome can predispose to aortic dissection?
True
32
What is sick sinus syndrome?
Age-related degeneration of the cardiac conduction system, leading to bradycardia/tachycardia, pauses, etc
33
Which EKG reading has irregularly irregular beats with no P waves?
Afib
34
Which EKG reading has a sawtooth-like appearance?
Aflutter
35
Which EKG reading has completely random, drawn-appearing waves?
Vfib
36
Which EKG reading has a prolonged (>200ms) PR interval?
First degree AV block
37
Which EKG reading has a progressively longer PR interval with an eventual dropped QRS?
Second degree AV block: Mobitz type I
38
Which EKG reading has randomly dropped QRS?
Second degree AV block: Mobitz type II
39
Which EKG reading has complete dissociation of P and QRS wave?
Third degree (complete) AV block
40
What conditions have wide splitting?
Pulmonic stenosis RBBB "Many right wingers are very wide"
41
Which conditions have "paradoxical" aka no splitting?
AS LBBB "The left has some paradoxical beliefs"
42
Which condition has fixed splitting?
ASD
43
Are the following levels increased or decreased in cardiogenic and obstructive shock? PCWP (preload) CO SVR (afterload)
PCWP: Increased or decreased CO: Decreased SVR: Increased
44
Are the following levels increased or decreased in distributive shock? PCWP (preload) CO SVR (afterload)
PCWP: Decreased CO: Increased (sepsis, anaphylaxis) or decreased (CNS injury) Decreased
45
What are the 6 main causes of JVD?
1. Pulmonary HTN 2. Pericardial effusion/cardiac tamponade 3. Tricuspid stenosis 4. RHF 5. SVC syndrome 6. Constrictive pericarditis
46
What's a complication of cardiac cath within the first 12 hours that results in sudden onset of hypotension and back pain?
Retroperitoneal hematoma
47
What imaging study do you do to check for retroperitoneal hematoma?
CT scan of abdomen/pelvis without contrast
48
What type of heart defect causes a holosystolic murmur at the left lower sternal border?
VSD
49
Can bradyarrhythmias have a widened QRS?
Yes
50
What's the most common heart complication of rheumatic fever?
Mitral stenosis
51
What heart chamber can get dilated due to severe MS?
L atrium, and this can lead to Afib
52
If you're having trouble determining whether or not it's decompensated HF vs tamponade/effusion, what should you check?
BP-- if it's high then it's HF, if it's low then it's tamponade/effusion
53
Where is the MI if there is ST elevation in leads II, III, & aVF?
Inferior MI | "inFerior"
54
Where is the MI if there is ST elevation or depression in leads I & aVL?
Posterior MI
55
Where is the MI if leads V1-V6 are involved?
Anterior MI
56
Where is the MI if leads I, aVL, V5&V6 or II, III, & aVF are involved?
Lateral MI
57
Which vessel is involved in an anterior MI (leads V1-V6)?
LAD
58
Which vessel is involved in an inferior MI (leads II, III, & aVF)?
RCA or LCX
59
Which vessel is involved in a posterior MI (leads V1-V3, I or aVL)?
LCX or RCA
60
Which vessel is involved in a lateral MI (I, aVL, V5 & V6, or II, III, & aVF)?
LCX
61
Which MI shows ST elevation in V4-V6?
R ventricle
62
Which vessel is involved in a R ventricle MI (ST elevation in leads V4-V6)?
RCA
63
What might cause chest pain in a young adult and shows prolonged QRS on EKG?
First degree AV block
64
Is peripheral edema or S3 more specific to HF?
S3
65
Which 2 mineralocorticoid receptor antagonists improve overall survival for HF in symptomatic patients with LV systolic dysfunction?
1. Spironolactone | 2. Eplerenone
66
What kind of pulses go along with AR?
Bounding "water hammer"
67
What type of drug is clopidogrel?
P2y12 receptor blocker
68
What type of drug is apixaban?
Factor Xa inhibitor
69
At what diameter of occlusion to AS symptoms become severe?
<1cm
70
What's the best imaging study for patients with suspected aortic dissection?
CT angiography
71
What is a TTE used to look for?
Valvular abnormalities
72
T/F: renal artery stenosis can results in an upper abdominal systolic/diastolic bruit?
True
73
Would an AAA cause HTN?
No; it would likely just be an asymptomatic pulsatile mass
74
What is a common cause of LV hypertrophy?
Prolonged HTN
75
What's the anti-anginal mechanism of nitrates?
Systemic vasodilation and decrease in cardiac preload, resulting in a decrease in LV end-diastolic and end-systolic volume, leading to a reduction in LV systolic wall stress which reflects afterload (and therefore a decreased O2 need)
76
Does aortic root dilation in Marfan's cause an early diastolic murmur, due to AR?
Yes
77
What are the symptoms of digoxin toxicity?
Nausea, vomiting, diarrhea, vision changes, arrhythmia
78
What do urine metanephrines test for?
Pheochromocytoma
79
What does a 24-hour urine cortisol excretion test for?
Cushing syndrome
80
What does a high plasma aldosterone/renin ratio indicate?
Primary aldosteronism (Conn syndrome)
81
What's the first step in diagnosing bilateral abdominal masses with HTN?
Renal US
82
How does acute pericarditis appear on EKG?
Diffuse ST elevations (more sloping than STEMI)
83
Why does Tetralogy of Fallot present with a harsh, systolic ejection murmur over the LUSB?
Due to pulmonary stenosis

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