EORs > FM 2 > Flashcards

FM 2 Flashcards

(93 cards)

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1
Q

define cardiac chest pain that that occurs at rest and usually happens at night or early morning hours

A

printzmetal or vasospastic

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2
Q

gold standard to diagnose printzmetal angina

A

coronary angiography with the injection of provocative agents into the coronary artery.

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3
Q

tx for prinzmetal angina

A

nitro and CCB***

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4
Q

what medication is contraindicated for printzmetal angina

A

BB

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5
Q

Early wide “bizarre” QRS, no p wave seen

A

PVC

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6
Q

NSTEMI

A

ECG changes such as ST-segment depression, T-wave inversion, or both may be present, cardiac markers will be elevated

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7
Q

pericarditis cp is relieved with?

A

sitting and/or leaning forward

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8
Q

best initial test for PE

A

spiral CT

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9
Q

triangular or rounded pleural-based infiltrate usually located adjacent to the hilum

A

estermark sign or Hampton hump

**PE

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10
Q

gold standard definitive test for diagnosis of PE

A

Pulmonary angiography

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11
Q

S4 heart sounds

A

Diastolic HF (ejection fraction is usually normal)

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12
Q

S3 heart sound

A

Systolic HF (reduced EF) with volume overload - tachycardia, tachypnea. (Rapid ventricular filling during early diastole is the mechanism responsible for the S3)

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13
Q

best test to diagnose CHF

A

echo

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14
Q

Systolic left heart failure tx

A

ACEI + loop diuretic + BB

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15
Q

Diastolic heart failure tx

A

Ace inhibitor + β-blocker or CCB

(**(do not use diuretics in stable chronic diastolic failure)

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16
Q

what murmur do you MC hear with CAD

A

mitral regurg an S4

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17
Q

BP under what for prevention of CAD

A

<140/90

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18
Q

want LDL levels under?

A

<70

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19
Q

ASA allergy.. waht to prescribe for MI Prevention

A

clopidogrel

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20
Q

dental or medical procedures in the mouth, intestinal tract or urinary tract

want to think?

A

endocarditis

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21
Q

fever + new onset murmur

A

endocarditis

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22
Q

MCC of ndocarditis with intravenous drug users

A

staph aureus

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23
Q

MCC Of Endocarditis with prosthetic valve

A

staph epidermitis

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24
Q

emperic tx for endocarditis

-what if they have prosthetic vavle?

A

IV vancomycin or ampicillin/sulbactam PLUS aminoglycoside

prosthetic valve—– add rifampin

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25
High-Risk patients endocarditis prophylaxis for procedures give?
Amoxicillin - 2 g 30-60 minutes before the procedure
26
SPSTF recommends screening for patients for hyperlipidemia with NO evidence of CVD and NO other risk factors should begin at _______years of age
35
27
NCEP recommends screening all adults for hyperlipidemia at age _____years regardless of risk factors
20
28
FOUR GROUPS MOST LIKELY TO BENEFIT FROM STATIN THERAPY
1. Patients with any form of clinical atherosclerotic cardiovascular disease (ASCVD) 2. Patients with primary LDL-C levels of 190 mg per dL or greater 3. Patients WITH diabetes mellitus, 40 to 75 years of age, with LDL-C levels of 70 to 189 mg per dL 4. patients WITHOUT diabetes, 40 to 75 years of age, with an estimated 10-year ASCVD risk ≥ 7.5%
29
HDL level of ___ is protective
>60
30
list the high intensitty drugs given for hyperlipidemia
Atorvastatin 40-80 mg Rosuvastatin 40 mg
31
Primary hypertension is defined as
resting systolic BP ≥ 130 or diastolic BP ≥ 80 - on at least two readings - on at least two separate visits - with no identifiable cause
32
BP - normal - elevated - stage 1 - stage 2
NORMAL: <120/80 and <80 ELEVATED: 120-129 and <80 STAGE 1: 130-139 OR 8-89 STAGE 2: >140 OR >90
33
target BP
<130/80
34
treatment guidelines for BP of: - normal - elev - stage 1 - stage 2
NORMAL: eveal in 1 year, encourge healthy lifestyle ELEV: Recommend healthy lifestyle changes and reassess in 3-6 months STAGE 1: - assess 10 yr risk * *If risk < 10% start healthy lifestyle management and reassess in 3-6 months * *If risk > 10% or CVD, DM, CKD - lifestyle mod + 1 medication - reassess in 1 month - ---->If goal met after 1 month - reassess in 3-6 months - ----> if goal not met after 1 MO--- diff med or titrate current med STAGE 2: healthy lifestyle + 2 BP meds * *If goal met after 1 month - reassess in 3-6 months * *If goal not met after 1 month, consider different med or titrate
35
HTN | For NON-BLACK patients, including those with diabetes: Initial treatment should be with either:
ACEI Or ARB or Long-acting calcium channel blockers (most often a dihydropyridine such as amlodipine) or a thiazide-like diuretic (chlorthalidone or indapamide)
36
two meds that are most effective for HTN in black pt
thiazides and CCB
37
HTN MEDS FOR THE DISEASE | 1. angina pectoris
1. CCB | 2.
38
tx for acute coronary syndrome
``` M O N A ACEI ```
39
what is malignant HTN | -tx? **********
Diastolic reading > 140 associated with papilledema (stage iv emergency) and either encephalopathy or nephropathy TX 1. hydralazine IV
40
-prils
ACEI
41
-sartans
ARBs
42
Nifedipine
Dihydroperidine CCB
43
Amlodipine
Dihydroperidine CCB
44
-pines
Dihydroperidine CCB
45
Diltiazem
non Dihydroperidine CCB
46
Verapamil
non | Dihydroperidine CCB
47
-zosins
alpha blockers
48
A-M BBs are?
cardioselective--- act only on B1 * atenolol * metoprool * Esmolol * bismolol
49
N-Z BBs are?
``` non cardio selective --act on B1 and B2 *Nadolol *Propranolol *Timolol *Sotalol (pindolol ```
50
list alpha and beta BBs
Labetalol | Carvediolol
51
HTN in pregnancy tx?
Hydralazine* labetalol nicardipine Methyldopa
52
HTN + AFIB tx?
BB or CCB (non dihydroperidne ... verap or diltizame)
53
Angina + HTN tx
BB or CCB
54
POST MI + HTN tx
BB or ACEI
55
Systolic HF + HTN tx
ACEI, BB, ARB, Diuretics
56
DM/CKD + HTN tx
ACEI, ARB
57
Osteoporosis + HTN
thiazides
58
AA + HTN
CCB or diuretics thiazides
59
first line tx for intermittent claudication aka periph arterial disease
smoking cessation
60
other lines of tx for intermttent claudication
graduated exerise---walk to the point of claudication, then rest, then continue etc control HTN DM weight ASA + clopidogrel Cilostazol (vasodilator)
61
tx for asymptomatic PAD
preventative measures: - ASA - lipid lowering agents - bp control
62
tx for PAD
- prevention of atherosclerosis---control HLD, HTN, weight, DM - manage hyperlipidemia---statins, diet, exercise graduated exercise reduce BP stop smoking * ******MEDICAL INTERVENTION MOST IMP 1. ASA + ticlopidine or clopidogrel---- symptomatic relief 2. Cilostazol (PDE inhib aka vasodilator)***************
63
diagnosis for PAD
ABI <0.9 | -definitive=arteriography
64
first line tx for PVD
elevation and use of compression stockings
65
S4, LVH, | young male who passes out during sports
HOCM
66
Medium-pitched, mid-systolic murmur that decreases with squatting and increases with straining or valsalva
HOCM
67
mcc CHF
CAD HTN MI DM
68
left sided HF s/s
pulmonary symps---- dyspna MC, orthopnea (LATE finding), pulm congestion/rales, pink frothy sputum, transudative effusions****
69
right sided HF s/s
``` backs up into periphery *periph edema, pitting edema hepatic congestion, fatigue abd bloating anorexia ```
70
cxr findings for chf
kerley b lines--white markings in periphery butterly or batwing apperance--pulm wedge pressure 12-18 hhmg pulm edema and or plerual effusion--perihilar congestion peri bronchial cuffing cardiomegaly
71
meds that a pt with CAD need to be on/discharged on from hosptial
ASA SL nitro prn dialy BB high intensity statin +/- ACEI (if LV function impaired)
72
what valve is MC invovled in endocarditis
mitral
73
mc bug causing acute bacterial endocarditis with normal valves
streph aureus
74
MC valves invovled in bac endocarditis | in order of mc to least mc
mitral--mc arotic 2nd mc tricuspid 3rd mc pulmonic 4th mc
75
subacute bac endocarditis mc bug
strep viridans--- less virulent why its subacute and is an indolent infection MC from oral infection****
76
IV drug user endocarditis mc bugs
MRSA staph aureus pseudomonas candidida
77
prosthetic valvues endocarditis mc bugs
staph epidermidis
78
mc bug to cause endocarditis after valve surgery
candida
79
MCC OVERALL of endocarditis
streptococcus viridans
80
acute endocarditis with native valve and not IVDU
ampicillin + Nafcillin + gentamicin or Vancomycin + gentamycin for mRSA
81
pt with prosthetic valve who have endocarditis tx
vanco + gentamicin + rifampin
82
IVDU endocarditis
nafcillin or vanco
83
subacute endocarditis with native valve tx
pencillin or ampicillin + gentamycin
84
fungal ednocarditis tx
amphotericin B and usually surgery
85
indications for abx prophylaxis b4 oral procedures and DOC and alternatives
cardiac * prosthetic valve or any prosthetic inserts like stents * prior hx of endocarditis * congen heart dz * cardio valvuloplasty in transplanted heart DOC= 2g amoxicillin 30-60 min b4 Clindamycin is allergic
86
ACEI and pregnancy
CONTRAINDICATED SE: cough, angioedema, hyperK
87
list rate control CCBs
verpamil and diltiazem
88
hydralazine can cause
lupus like syndrome and pericarditis
89
tx - htn emergency - htn urgency - malig htn
emergency= sodium nitroprusside DOC urgency= clonidine DOC malignant=hydralazine
90
tx for isolated hypertriglyceridiemia
Fibrates---- Gemfibrozil and Fenofibrate and Niacin ***statins not used alone for this
91
se of niacin
hyperglycemia--- caution with DM flushing incr in LFTs
92
SE of fibrates
rhabdo--esp with Gemfibrozil + statin combo
93
SE of statins
myopathy rhabdo incr in LFTs

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