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Flashcards in Deck 3 Deck (349)
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1

What antibiotics cover anaerobes

Clindamycin
Metronidazole
Moxifloxacin
Amox-clav
Pip-tazo
Ertapenem

2

What antibiotics cover ESCAPPM bacteria

Cipro
Gentamicin
Ceftazadime
Cefepime
Meropenem

3

What are the ESCAPPM organisms?

Enterobacter
Serratia
Citrobacter
Aeromonas
Proteus
Providencia
Morganella

4

What antibiotics cover pseudomonas?>

Cipro
Gentamicin
Ceftazadime
Cefepime
Meropenem
Pip-tazo

5

What antibiotics cover E. coli, klebsiella and proteus?

Cipro
Gentamicin
Moxifloxacin
Ceftriaxone
Ceftazidime
Cefepime
Pip tazo
Amixicillin-->ecoli and klebsiella only
Amox clav--> ecoli and klebsiella only
Meropenem
Ertapenem

6

What antibiotics cover strep?

Penicillin
Amoxicillin
Cephazolin
Clindamycin
Vanco, linezolid
Cipro
Moxifloxacin
Cefuroxime
Ceftriaxone
Cefepime
Amox clav
Pip tazo
Meropenem

7

Which antibiotics cover MSSA?

Cephazolin
Clindamycin
Rifampin
Vancomycin
Linezolid
Cipro
Cefepime
Amox clav
Piptazo
Meropenem

8

Which antibiotics cover MRSA

Clindamycin
Rifampicin
Vancomycin
Linezolid
Daptomycin

9

What is typical angina

All three of--
1. Substernal chest discomfort or heaviness
2. Provoked by exertion or emotional stress
3. Relieved by rest or nitro

(Atypical angina is two of the above)
(Non cardiac chest pain is none of the above)

10

What helps you call something "non cardiac" chest pain

None of the three features of typical angina

11

What are the CCS classes of angina?

I--chest pain with strenuous exercise
II--chest pain with more than two blocks flat ground or more than 1 flight of stairs
III--chest pain with 1-2 blocks flat ground or 1 flight of stairs
IV--chest pain at rest

12

What causes oxygen demand in the heart

HR
Contractility
Wall stress

13

What determines blood supply to the heart

Coronary vascular resistance
Oxygen carrying capacity
Coronary perfusion pressure

14

What are the 5 types of MI

1. Type 1--spontaneous MI due to primary coronary event (atherosclerotic plaque rupture or erosion with acute embolic event)

2. Type 2--MI secondary to ischemic imbalance (supply demand mismatch)

3. Type 3--MI resulting in death when bio marker values are unavailable (sudden unexpected cardiac death before serum bio markers are collected for measurement)

4. Type 4--MI related to PCI or stent thrombosis

5. Type 5--MI related to CABG

15

What is an ACS

One of unstable angina, NSTEMI, STEMI

16

Define unstable angina

One of:
1. Rest angina lasting more than 20 min
2. New onset angina (angina CCS more than III within two months of initial presentation)
3. Increasing angina (crescendo pattern--increased by at least one CCS class within two months of presentation to at least CCSIII)

17

Define NSTEMI

Any of the features of unstable angina with bio marker elevation (with or without ECG changes)

18

Define STEMI

Defined by ECG changes

19

What are the non modifiable cardiac risk factors

Age
Gender
Family history

20

What are the modifiable cardiac risk factors

Diabetes
HTN
Hyperlipidemia
Smoking

21

Which bio markers are the most specific in ACS?

CKMB and troponin but are typically not elevated until 4-8 hours after the injury and must be repeated at q6h initially

22

What are some other things other than ACS that can cause a rise in troponin

Demand ischemia--> sepsis, LVH
Myocardial ischemia--> coronary vasospasm, stroke
Direct myocardial damage--> cardiac contusion, chemo, pericarditis
Chronic renal insufficiency
Myocardial strain--> CHF, PE

23

What are the ST elevation cut offs in men and women? Where must these elevations be?

Must be in two contiguous leads

Greater than or equal to 0.2 mV for men and 0.15 mV for women in leads V2 and V3, otherwise greater than or equal to 0.1 mV in other leads

24

What are the non invasive cardiac imagining techniques

Echo
MIBI
Cardiac CT angio

25

What are the invasive cardiac imaging techniques

Angiography

26

What test should you do in a low risk UA/NSTEMI

Exercise MIBNI (examines perfusion)

27

What test should you do in a high risk UA/NSTEMI

Early catheterization

28

What should you do in a STEMI?

if in a PCI capable hospital--> catheterization ASAP
Non-PCI hospital--> skip imaging and go straight to fibrinolysis

29

What are the general treatment principles of an MI and how do you achieve them?

1. Increase oxygen supply
--oxygen IF HYPOXIC
--nitrates, morphine (vasodilation)
--anti platelets--> ASA, plavix or alternative
--anti coagulation--> heparin
--relieve obstruction--> PCI, CABG, thrombolytics

2. Decrease demand
--treat underlying cause of the increased demand (I.e sepsis)
--beta blockers

3. Secondary prevention and myocardial recovery
--statins
--ACEi
--MRAs
--lifestyle

30

What is the treatment specifically for STEMI?

1. Anti thrombotic therapy--> ASA, clopidogrel or ticagrelor, heparin or enoxaparin

2. Reperfusion therapy--> PCI, thrombolytics (if STEMI), CABG if indicated

3. Ancillary therapy--> nitro (anti angina), beta blocker, ACEi, MRA, statin, secondary prevention