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From Flashcardlet > MKSAP: Cardio > Flashcards

MKSAP: Cardio Flashcards

0
Q

Ankle-brachial index for pts with peripheral vascular dz? For severe cases? For vascular calcification?

A
  • ABI < 0.9 = peripheral vascular dz
  • severe < 0.4
  • calcification > 1.3
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1
Q

Peripheral ischemia after an arterial catheterization?

A

-think: cholesterol embolism syndrome

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2
Q

Pt with prosthetic heart valve and unexplained fever?

A

-think: bacterial endocarditis

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3
Q

Lack of pericardial effusion on echo?

A
  • does not exclude pericarditis

- 40% of pts w/ pericarditis lack effusion

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4
Q

Initial tx of acute viral pericarditis?

A

-high-dose NSAID, such as indomethacin or ibuprofen

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5
Q

Atrial tachycardia with variable block?

A

-think: digitalis toxicity

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6
Q

EKG finding of digitalis toxicity?

A

-atrial tachy with variable block

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7
Q

Tx for life threatening Dig toxicity?

A

-digitoxin-specific antibody fragments

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8
Q

Which pts does CABG improve the survival in?

A
  • w/ obstructive left main and/or 3-vessel CAD

- reduced EF

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9
Q

What is the most important determinant of survival in cardiac arrests? Why?

A
  • time to defibrillation

- most adults go into cardiac arrest bc of a ventricular arrhythmia

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10
Q

What is pathognomonic for acute pericarditis on EKG?

A

-PR-segment depression

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11
Q

Pulmonary capillary wedge pressure and CO in cardiogenic shock?

A
  • PCWP = elevated

- CO = low

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12
Q

Short term and long term tx of coronary artery vasospasm?

A
  • short term = nitrates

- long term = CCBs

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13
Q

Most common artery to be involved with ascending aortic dissection?

A

-right coronary artery

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14
Q

What 2 things can an ascending aortic dissection lead to?

A
  1. Aortic regurg

2. Obstruction of right coronary a.

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15
Q

What are the 4 main benefits of using a Beta-blocker post MI?

A
  1. Reduces size of infarct
  2. Reduces frequency of recurrent MI
  3. Improves short-term survival
  4. Improves long-term survival
16
Q

What 3 cardiac problems can give you an ST elevation?

A
  1. MI
  2. Variant angina
  3. Acute pericarditis
17
Q

What 3 leads are inferior?

A
  1. Lead II
  2. Lead III
  3. Lead aVF
18
Q

How to determine which pts with afib should be on warfarin v aspirin?

A
  • determine the CHADS2 score:
    1. CHF –> 1 pt
    2. HTN –> 1 pt
    3. Age >/= 75 –> 1 pt
    4. Diabetes –> 1 pt
    5. Stroke or TIA hx –> 2 pts
  • score of >/= 3 –> give warfarin
  • score of 1 or 2 –> give aspirin
19
Q

Inferior leads

A

Leads II, III, and aVF

20
Q

Anteroseptal leads?

A

-leads V1-3

21
Q

Lateral and apical leads?

A

-V4-6

22
Q

What is pathognomonic for acute pericarditis on EKG?

A

-PR-segment depression

23
Q

For an acute MI, if fibrinolytics are indicated, when should they be given?

A
  • within 30min of arrival to hospital

- not after 12 hrs of sx!

24
Q

Alcoholic cardiomyopathy: describe changes in heart? Tx?

A
  • both ventricles are dilated and globally hypokinetic

- tx: abstaining from alcohol may reverse the cardiomyopathy in pts with less advanced dz + tx for heart failure

25
Q

Cardiac amyloidosis: describe changes in heart? How dies it typically present?

A
  • changes: left ventricular wall thickness increased –> due to amyloid deposition
  • presentation: restrictive cardiomyopathy w/ diastolic dysfunction (rather than systolic dysfunction)
26
Q

How to dx diastolic heart failure?

A

-made when the ssx of systolic heart failure are present, but there is normal left ventricular ejection fraction and an absence of significant valvular abnormalities

27
Q

What is the one drug that is indicated for all pts with systolic heart failure, regaurdless of ejection feaction?

A

-ACEi

28
Q

What 3 things are seen on EKG for a Wolff-Parkinson-White syndrome pt?

A
  1. Short PR segment
  2. Delta wave
  3. Tachycardia
29
Q

What 2 medications are indicated in all pts with systolic heart failure?

A
  1. ACEi

2. Beta-blocker

30
Q

Tx for tachycardic pts who are unstable?

A

-immediate direct-current cardioversion

31
Q

Dosage of beta-blockers in pt with systolic HF?

A

-should be titrated to pts heart rate

32
Q

Tx for ventricular fibrillation or sustained ventricular tachy?

A

-implantable cardioverter-defibrillator

33
Q

What hypertensive medication should be avoided in pregnancy? Why?

A

-ACEi –> can cause fetal renal agenesis

34
Q

Tx of monophasic ventricular tachy in a hemodynamically stable pt? Unstable pt?

A
  • stable: IV
    1. Lidocaine
    2. Procainamide
    3. Amioderone
  • unstable: direct-current cardioversion
35
Q

What is one physical exam finding that can help exclude the dx of severe aortic stenosis? Why?

A
  • a physiologically split S2

- with severe stenosis the valve leaflets do not “snap” shut, so the aortic component will be absent

36
Q

List 4 physical findings of severe aortic stenosis?

A
  1. Small and late carotid pulses
  2. Late peaking systolic murmur
  3. Absence of splitting of S2
  4. Sustained apical pulse
37
Q

What increases the murmur of hypertrophic cardiomyopathy? What decreases it?

A
  • increases w/ valsalva maneuver

- decreases w/ squatting from standing

38
Q

Which heart condition can go undiagnosed until pregnancy and why?

A
  • mitral stenosis

- can be asymptomatic until the body is hemodynamically stressed, as in pregnancy

From Flashcardlet (79 decks)

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