CVS Exam 5 Final Time Flashcards by Daddy Pig

Definition

Answer

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Infective Endocarditis (IE) Major Signs

FROM JANE: Fever; Roth’s spots; Osler’s nodes; Murmur (new/changing)/ Janeway lesions/ Anemia/ Nail hemorrhages (splinter)/ Emboli

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Modified Duke’s Criteria for IE Major Criteria

Blood culture positive (typical organisms); Endocardial involvement (echo: vegetation abscess dehiscence)

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Modified Duke’s Criteria for IE Minor Criteria

Fever (>38°C); Immunologic phenomena (Osler’s Roth’s glomerulonephritis RF)/ Vascular phenomena (emboli infarcts aneurysm Janeway)/ Echocardiographic findings (suggestive)/ Predisposition (heart condition/IVDU)/ Microbiologic evidence (positive culture not major)

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Rheumatic Fever (RF) Major Signs

JONES Criteria: Joints (migratory polyarthritis); O-shaped heart (carditis valve involvement)/ Nodules (subcutaneous)/ Erythema marginatum/ Sydenham’s chorea

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Rheumatic Fever (RF) Minor Criteria

Fever arthralgia elevated ESR/CRP prolonged PR interval

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Rheumatic Fever Histology

Aschoff bodies (granulomatous nodules)

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Deep Vein Thrombosis (DVT) Risk Factors

Virchow’s Triad (SHE): Stasis of blood flow; Hypercoagulability; Endothelial injury

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Pericarditis Signs

PERIC: Pulsus paradoxus; ECG changes (diffuse ST elevation PR depression)/ Rub (pericardial friction rub)/ Increased JVP (if tamponade)/ Chest pain (sharp pleuritic relieved by leaning forward)

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Common Viral Cause of Pericarditis

Coxsackie B virus

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Pericarditis Treatment (First-line)

Colchicine (inhibits neutrophil migration)

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Pericarditis Treatment (Severe Effusion)

Pericardiocentesis

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Pericarditis Treatment (Constrictive/Tamponade)

Pericardiectomy

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Kawasaki Disease Signs

CRASH & Burn: Conjunctivitis (non-purulent bilateral); Rash (polymorphous)/ Adenopathy (cervical)/ Strawberry tongue/ Hands & feet (erythema swelling desquamation)/ Fever lasting ≥5 days

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Cardiac Tamponade Beck’s Triad

3 D’s: Distant heart sounds (muffled); Distended jugular veins (JVD); Decreased arterial pressure (hypotension)

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Other Sign of Cardiac Tamponade

Pulsus paradoxus

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Diuretics Use in Acute LVF

First-line treatment to rapidly reduce preload and alleviate pulmonary congestion (e.g. IV Furosemide)

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Digoxin Mechanism of Action

Increases force of contraction by inhibiting the sodium (Na+) pump

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Digoxin Indication

Rate control in atrial fibrillation with left ventricular systolic dysfunction (Class I)

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Ramipril (ACE Inhibitor) Use

First-line therapy for heart failure

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Ramipril (ACE Inhibitor) Electrolyte Risk

Hyperkalemia

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Thiazide Diuretics Side Effect

Risk of hyperglycemia (impacts diabetes)

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Amiodarone Drug Class

Antiarrhythmic (Class III)

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Amiodarone Mechanism of Action

Prolongs action potential duration and refractory period by acting at potassium channels

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Antiarrhythmics Safe in LV Systolic Dysfunction

Amiodarone and Dofetilide

Atropine Drug Class

Muscarinic receptor antagonist

Atropine Effect on Heart Rate

Initial bradycardia due to central stimulation followed by tachycardia (blocks vagal effects allowing unopposed sympathetic effect)/ increases HR in sinus rhythm

Phenylephrine Drug Class

Selective α1-adrenergic receptor agonist

Phenylephrine Contraindication in MR

Increases afterload worsening mitral regurgitation

Examples of Calcium Channel Blockers

Verapamil Diltiazem

Beta-Blocker for Stanford Type B Dissections

Esmolol

Reasonable Choices for Anticoagulation

Low molecular weight heparin or unfractionated heparin

Medication for Supraventricular Tachycardia (SVT)

Adenosine 6 mg intravenously followed by a saline flush

Medication for Wide Complex Tachycardia (WCT)

Intravenous procainamide

Medications for Rate Control (Example)

Carvedilol and Digoxin

Life-Saving Procedure for Unstable Tachyarrhythmias

Emergent direct current (DC) cardioversion

Myocardial Infarction (MI) Medications (Examples)

Antiplatelets (aspirin) Anticoagulants (heparin) Nitrates Beta Blockers Pain medication Statins

Nitrates Use for Chest Pain

Given for chest pain in the ER; relax coronary arteries/lower preload

Takayasu Arteritis Characteristics

Vasculitis affects Asian <40 affects aortic arch similar to Giant Cell Arteritis

Medication for Giant Cell Arteritis

Corticosteroids

Medication for Stable Angina

Glyceryl trinitrate (GTN)

ESR Levels in Vasculitis

Elevated

Medication to Close Patent Ductus Arteriosus (PDA)

Indomethacin (inhibits Prostaglandin E2)

Dofetilide Drug Class

Class III antiarrhythmic drug

Dofetilide Mechanism of Action

Blocks potassium channels prolonging action potential

Sign of Acute Mitral Valve Regurgitation

Large V wave in the pulmonary capillary wedge pressure

Sign of Acute Ventricular Septal Defect

Normal V wave

Diagnosis for Patient with Progressive Respiratory Distress Exertional Dyspnea Orthopnea PND Tachycardia Hypertension Hypoxemia Elevated JVP S3 Rales Pulsatile Liver Edema AKI Elevated BNP Cardiomegaly Diffuse Bilateral Infiltrates Small Bilateral Pleural Effusions (given NSAID use)

Acute decompensated heart failure (ADHF)

Diagnosis for Patient with 3-day history of Palpitations Fatigue Shortness of Breath Irregularly Irregular Heart Rate (with obesity hypertension obstructive sleep apnea excessive alcohol consumption)

Paroxysmal atrial fibrillation

Next Diagnostic Step for Paroxysmal AFib

Electrocardiogram

Next Therapeutic Step for Paroxysmal AFib

Anticoagulation and rate control

Diagnosis for Patient with Progressive Exertional Dyspnea Exercise Intolerance Orthopnea "Water Hammer" Peripheral Pulses Hyperdynamic

Laterally Displaced Apical Impulse Soft S1 S3 Early Diastolic Decrescendo Murmur at Left Upper Sternal Border Mild Pitting Edema/Chronic aortic regurgitation

Next Diagnostic Step for Chronic Aortic Regurgitation

Electrocardiogram and echocardiography

Next Therapeutic Step for Chronic Aortic Regurgitation

Surgical evaluation if the regurgitation is severe

Common Causes of Chronic Aortic Regurgitation

Abnormalities in valve leaflets (bicuspid aortic valves rheumatic heart disease endocarditis) or aortic root disease (longstanding hypertension)

Imaging Findings in Chronic Aortic Regurgitation

ECG may show left-axis deviation; Chest radiograph may reveal cardiomegaly dilated aortic knob and root

Associated with Coarctation of the Aorta/Turner Syndrome

Least Common Cardiomyopathy

Restrictive Cardiomyopathies

Lab Findings Supporting Endocarditis Diagnosis

ESR and CRP anemia leukocytosis

Most Common Valve Affected in Infective Endocarditis

Mitral Valve (especially with Mitral Valve Prolapse)

Complications of Acute Heart Failure

Pulmonary edema cardiogenic shock arrhythmias renal dysfunction

Complications of Chronic Heart Failure

Declining ejection fraction thromboembolism cardiac cirrhosis cachexia hyponatremia

Pathophysiology of Hypertension Complications (Examples)

Atherosclerosis/plaque LV hypertrophy/workload heart failure/pump failure stroke/ischemia

Risk Factors for Heart Failure (Examples)

Hypertension diabetes valvular disease obesity smoking and sedentary lifestyle

Definition of Signs (Medical)

Measurable clinical findings observed by a healthcare provider (Objective)

Definition of Symptoms (Medical)

Experiences reported by the patient (Subjective)

Anti-Atherosclerotic Therapies (Examples)

Lifestyle (diet exercise smoking cessation) medications (statins antihypertensives antidiabetics)

Complications (General Examples in Cardiology)

Chest pain dyspnea palpitations syncope

Symptoms (General Examples in Cardiology)

Dyspnea syncope chest pain palpitations

DVT Diagnosis

Compression ultrasound; D-dimer to rule out

Varicose Veins Diagnosis

Duplex ultrasound

Chronic Venous Insufficiency Diagnosis

Duplex ultrasound

Acute Limb Ischemia Cause

Embolism/thrombosis

Acute Limb Ischemia Symptoms

Pain Pallor Pulselessness Paresthesia Paralysis Poikilothermia (6 P's)

Acute Limb Ischemia Diagnosis

Doppler ultrasound

Chronic Limb Ischemia Cause

Atherosclerosis

Chronic Limb Ischemia Symptoms

Claudication rest pain non-healing ulcers gangrene

Chronic Limb Ischemia Diagnosis

ABI Doppler ultrasound

Hypertension Risk Factors (Examples)

Obesity inactivity high salt intake stress genetics

Hypertension Symptoms (Examples)

Headache dizziness vision changes chest pain

Hypertension Pathophysiology Factors (Examples)

Increased vascular resistance due to endothelial dysfunction and increased sympathetic tone

Hypertension Diagnosis (Examples)

Repeated BP measurements ambulatory monitoring end-organ damage assessment

First-Line Anti-Hypertensives (Examples)

ACE Inhibitors ARBs Beta-Blockers CCBs thiazide diuretics

CVS Exam 5 Final Time Flashcards

(83 cards)