General Flashcards
(24 cards)
most common sx in myocarditis
tachycardia out of proportion to fever -only 50% of patients have viral-related URI/GI symptoms
treatment for inferior MI vs non-inferior MI
non-inferior MI->MONABASH inferior (RV MI)–>avoid MONA (morphine, nitrates) bc these are preload dependent MI’s and these drugs will dec preload worsening hypotension
pt with an inferior MI is hypotensive, next step…
Give fluid bolus -inferior MIs are preload dependent -avoid pressors unless not fluid reponsive
What drug should be added first for aortic dissection BP and HR control
Beta blocker then other afterload reducing agents -BB both dec BP and blocks reflex tachycardia. Other afterload agents cause reflex tachycardia, which is why BB should be given first
Goals for aortic dissection
SBP 100-120 HR<60
Calculate the rate on EKG
300-150-100-75-60-50-43-37 or Count #QRS in 10sec strip*6
which drugs are used in pericarditis
nsaids-dec sx but do not reduce reccurence colchicine-shown to reduce duration of sx AND dec recurrence rate
Most common reason for LVAD failure
Suction event -dec preload causes inc negative LV pressure causing the inflow cannula to be sucked down into the LV–>dec CO rx: IVF, screen for arrhythia
who gets antibiotic ppx for infective endocarditis?
-hx of endocarditis -hx of cardiac surgery+valve pathology -undergoing dental procedures -prosthetic valve (for 1st 6 months)
EPI dosing in -anaphylaxis -cardiac arrest
-anaphylaxis: 0.1 mg -cardiac arrest: 1 mg IV/IM q3-5 min (acls)
EKG reading step by step rule of 4s
- 4 initial features: History, rate, rhythm, axis
- 4 waves: P, QRS, T, U
- 4 intervals: PR, QRS, ST, QT
- 4 initial features: History, rate, rhythm, axis details
History-name, CC, history, lead placement
rate- 300/R-R(# large squares)
rhythm-reg or irreg (look at QRS complexes)
axis-normal, LAD, RAD
Axis
- 4 waves: P, QRS, T, U
P wave:present, monophasic in II, biphasic in V1. 2.5 mm in II (p pulmonale)
- 4 waves: P, QRS, T, U
QRS complex
- <0.12 sec (3 sm boxes)
- any Q waves? septal q waves are normal (I, AVL, V, VI)
- q waves in V1-V3 are abnormal
- 4 waves: P, QRS, T, U
T wave:
- upright in all leads except AVR and V1
- look for peaked, hyperacute, flattened, biphasic T waves
- Broad, peaked, hyperacute T waves seen in early MI and often precedes STE and Q waves
- 4 waves: P, QRS, T, U
U wave (V2, V3)
- unknown what causes U wave
- should be upright
- inversely proportional to HR, assoc with long QT syndrome
- abnormalities
- prominent U waves: >1-2 mm, seen in bradycardia, severe hypokalemia
- inverted U waves: very specific for heart disease.
- U wave + CP–>specific for myocardial ischemia. possibly the earliest sign of UA and MI
Categories of fetal tracings
category I
category III
category II
category I: FHR 110-160, +/-accelerations and early decels. NO variable or late decels
category III: absent baseline variability, recurrent variable/late decels, bradycardia
category II: whatever isn’t I or III
Options to dec risk of pre-term delivery
Cervical cerclage
hydroxyprogesterone
-progesterone (-)fetal membrane apoptosis,
what is the only medication proved to dec risk of preeclampsia
asa
- mech of preeclampsia: inc plt aggregation and inc vasocontriction leading to placental ischemia and infarct. ASA dec both reducing risk
- give to pts with chronic htn, ckd, dm, autoimmune disease, prior preeclampsia, multiparity
Syndesmoses joint
joint where two bones areseparated by ligaments or connective tissue (interosseus membrane)–>tibia/fibula and radius/ulna
what is the first step in an infertility eval?
Eliminate the man–>semen analysis
