IM cardio Flashcards
(59 cards)
1
Q
endocarditis prophylaxis if high risk - when
A
- gingival manipulation or resp track incision
- GU or GI track procedure if active infection
- surgery of infected skin or muscle
- surgical placement of prosthetic cardiac material
2
Q
high risk for endocarditis
A
- prosthetic valve
- previous infective endocarditis
- structural valve abn in transpl
- Certain CHD subtypes
3
Q
constrictive pericarditis - etiology
A
- idiopathic or viral
- cardiac surgery
- radiation
- TB
4
Q
most specific symptom for decompenstated heart failure
A
S3
5
Q
prefered treatment for AF
A
- No other heart disease: flecainide or propanenone
- LVH: Dronedarone, amiodarone
- CAD without HF: sotalol, droneadrone
- HF: amiodarone, dofetilide
- refractory: radioablation
6
Q
pulm hypertension treatment
A
combination of phosphodiestarase type 5 inh + endothelin receptor antagonist
7
Q
hypertrophic cardiomyopathy - treatment
A
b-blockers
anternative: CCB
8
Q
Non stemi treatment
A
- dual antiplatelet
- nitrates
- beta blockers
- statins
- anti-coagulants
9
Q
when to put implantable cardioverter in hypertrophic cardiomyoparthy
A
if 1 or more RFs
- family history of sudden death in younger than 50
- personal history of Ven arrhythmia
- syncope due to vent arr
- Massive thickness
- LV fraction less than 50%
10
Q
S3 vs S4 caused by
A
s3: flow sound
s4: atrial contraction
11
Q
S4 - assoviated conditions
A
- LV hypertrophy
- restrictive cardiom
- Acute MI
12
Q
Treatment of DVT or pe
A
MORE THAN 3 MONTHS ANTICOAGULATION WITH ORAL Xa INH (rivaroxaban)
13
Q
post menop patients with flashes but history of DVT - treamtent
A
SSRI
14
Q
pre-operative management of AF patients
A
- stable and asympt: continue rhythm control and surgery after addressing coagulation
- stable but uncontrol rhythm: rhythm control and surgery after addressing coagulation
- unstable: electrical cardioversion and delay surgery
Stop DOAC 1-3 days before
15
Q
general management of pulm Hypertension
A
- normoxia, euvolemia, sinus rhythm
- contraceptive
- immunization
- if refractory: transplantation
16
Q
how to reduce HF hospitalization
A
- in-person monitoring and medication management
17
Q
Sex in post-MI patients
A
- low risk: can perform light intensity exercise without symptoms: start sex
- high risk: refractory angina: wait until detailed assessment
- intermediate: wait until the stress test
18
Q
sudde death in young people without murmur
A
anomalous coronary artery
19
Q
TCA oversodose
A
CNS: mental statys, seizures, resp depression
Cardio: hypotensionm arrhythmia, prolonged intervals
Anticholinergics
20
Q
TCA toxicity treatment
A
- o2, intubation
- IV fluids
- charcoal (within 2 hours)
- IV sodium biocarbonate for QRS intereval widening or
- Ventri arrhyth
21
Q
treatment of cocaine induced cardio
A
- benzo+nitro
- never b blockers
- CCBs
- phentolamine for persisent
- PCI for myoc infraction
22
Q
role of HTN in AAA
A
not related
23
Q
BNP - falsely low and falsely elevated
A
- low in obesity
- elevated in entresto use
24
Q
start amiodarone in patient on Warfarin
A
decrease warfarin by 25%
25
indications of Aortic valve replacement
1. onset of symptoms (angina, syncope)
2. EF less tham 50
3. undergoing other cardiac surgery
26
Severe AS criteria
1. velocity more than 4
2. gradient more than 40
3. valve area less than 1cm2 (not required)`
27
aortic dissection treatment
IV b blockers (esmolol)
| + sodium nitropruside if SBP more than 120
28
cyanide poisoning - common etiologies
1. structure fires
2. occupational exposure
3. cyanide-containing medications (nitroprusside)
29
cyanide poisoning - management
1. decontamination
2. supportive care
3, empiric treatment with hydroxycobolamin + sodium thiosulfate
30
what is cardiac index
pump function
| cardiac output value based on the patient's size.
31
sick sinus syncope - clues for diagnosis
1. preceding fatigue or dizziness
| 2. sinus pauses on ECG
32
antithrombotic therapy in mechanical valves
1. warfarin 2-3 in aortic if no risk factors (AFib, systolic dysfunction, prior PE etc)
2. warfarin 2.5-3.5 in mitral valve or aortic valve with RFs
3. low dose aspirin if strong indication (CAD)
33
Bicuspid aortic valve - diagnosis
screen ech for patients and1st degree relatives
34
Bicuspid aortic valve - complications
1. infective endoc
2. severe regurgitation or stenosis
3. Aortic root or ascending aortic dilation
4. dissectioon
35
Bicuspid aortic valve - management
1. echo every 1-2 years
| 2. balloon valvuloplasty or surgery
36
beta blocker toxicity
1. iv fluids for hypotension + atropine if bradycardia
2. glucagon for directly counteract toxicity
3. calcium gluconate sometimes to augment BP
37
apixaban in mechanical valves
does not work
38
indications for implantable cardioverted-deffibrillator placement in HCM
1. family history of scd
2. syncope
3. NSVT
4. Hypotension during exercise
5. LVH more than 3cm
6. 2ry prevention: survivors of cardiac arrest or sustained spont ventric arrhythmuas
39
ST elevation criteria
New ST elevation at J point in 2 or more contagious leads with :
- more than 1 mm in all leads except V2 and V3
- 1.5 or more mm in women and 2 or more in men age more than 40 and 2.5 or more in men age less 40 in V2+V3
40
ST depression MI - TREATMENT
1. Dual therapy
2. nitrates
3. b-blockers
4. statis
5. anticoagulation
41
Current guidlines recomend biventricular pacing devices for patients in sinus rhythm who meet all the following criteria:
1. EF less 35
2. NYHA 2-4
3. LBB with QRS more than 150
42
Warfarin mechanism of action
vit K antagonist
43
Warfarin - disadvantages
1. therapeuitc onset 7 days
2. requires bridging
3. lab monitoring
44
patient with DVT or PE are typically treated with
3 or more months anticoagulation with oral factor Xa inh (rivaroxaban)
45
PE or DVT when on menopauseal hormone therapy
stop them and start SSRI
46
when to do immediate coronary angiography in unstable angina or NSTEMI
1. hemodynamic instability
2. HF with new MR
3. Recurrent chest pain
4. Ventricular arrhythmua
47
MR in MI
papillary muscle rupture
48
MR in connective tissue disease
rupture of chordae tendineae
49
Elhers-Danlos vs MARFAN - cardiac manifestations
Elhers: MVP
Marfan: MVP, aortic root dilation
50
Elhers-Danlos vs MARFAN - skin
Elhers: transpartent + hyperextensible, easy bruising, atrophy
Marfan: nothing
51
Elhers-Danlos vs MARFAN - musculoskeletal
both hypermobility, pectus excavatum, scoliosis
Elhers: arched palate
Marfan: Tall with long extr
52
anti-heprtensive medications that cause periph edema (how to solve it)
alodipine, nifedipine
| CCB with ACEi reduce it
53
Afib - when to give anticoag
Chadvasscore
men 2 or more
women 3 or more
54
CHA2 DS2 VASc
```
CHF
HTN
Age 75
DM
STROKE
VASCU DISEASE
AGE 65-74
SEX female
```
55
statin causes myopathy - next step
wait, recheck creatinine and if back to normal restart statin
56
wolf parkinson white - treatment
ablation
57
causes of aquired long QT syndrome
1. medication
2. metabolic disorders (electrolytes, starvation, hypothyr)
3. BRADYARRHYTHMUAS
4. OTHER (HIV, MI, hypothermia, Intracranial disease
58
revised cardiac index (cardiovasc risk of non-cardiac surgery)
```
6 risk predictors:
1. high risk surgery (vasc, intrathoracic)
2. ischemic heart diease
3. CHF
4, Cerebrov disease
DM treated with insulin
6. Cr more than 2
O-1 LOW RISK
2 OR MORE ELEVATED RISK
```
59
pericarditis treatment
ASPIRIN
