Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Internal Med > OME - Cardio and Pulm > Flashcards

OME - Cardio and Pulm Flashcards

(109 cards)

Start Studying
1
Q

What is Beck’s Triad?

What makes the diagnosis?

Indicates what pathology?

Tx?

A

JVD, HoTN, distant heart sounds

Clear lungs, pulsus paradoxus > 10 mmHg

Pericardial tamponade

Pericardiocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When diagnosing a pleural effusion, after you get the CXR, what do you need next? To assess what?

What else can be used?

Then do what?

A

Recumbent Xray to assess if the fluid is free moving (not loculated) and in sufficient quantity (1cm)

CT scan or bedside US

Thoracentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of ARDS?

CXR post ARDS can show what?

A

Intubate, oxygenate, Give PEEP

Pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Severe persistent asthma:
Day time sx?

Nocturnal sx?

PFTs?

Tx?

A

> /= 1 / day

Frequent

< 60%

SABA + High dose ICS + LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the algorithm for arrhythmia syncope diagnosis?

Presentation?

A

ECG
24-hr Halter
Event recorder

Sudden onset syncope w/NO prodrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pt with refractory severe asthma, add what treatment?

A

PO steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pt that has SVT is treated how?

A

IV Adenosine 6mg
Then 12mg more
Then 12mg more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Opening snap followed by a decrescendo murmur in diastole is what?

What symptoms?

Treatment?

A

MS

CHF/SOB and AFib

Balloon valvotomy or valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some causes of exudate in pleural effusion?

Due to what physiologic etiology?

A

Malignancy, PNA, TB

Inflammation —> increased oncotic pressure of interstitium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What determines how severe a PE is?

A

Response of CV system - HoTN, right heart strain, elevated BNP, elevated troponin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What symptoms are common for pleural effusion?

What makes the Dx?

A

SOB, pleuritic chest pain

CXR shows blunting of the CVAs (req. at least 250cc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is typical chest pain?

Atypical?

A

Substernal, exertional, relieved w/nitroglycerin

2/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CHADS2 score stands for what?

A 
CHF
HTN
Age > 75
DM
Stroke
Stroke

1 point for each

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the goal BP for pts > 60?

Everyone else?

1st line tx?

Who does not Get an ace-I/ARB to start?
Unless what?

A

150/90

140/90

Thiazides, CCB, Ace-I

> 75 or AAs
Unless have CKD, then you do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Main features of bronchitis pts?

A

RHF
JVD
Edema
HSM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the hallmarks of vasovagal syncope?

A

Situational, reproducible, anticipated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

1st step in w/u of pulmonary nodule?

Stable when?

If unstable do what?

A

Compare old films

No change in 2 years

Follow w/serial CTs or biopsy or CXRs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What defines bronchitis?

What physiologic changes occur?

A

Productive cough for more than 3 months in 2 consecutive years

Inc pulmonary vascular resistance and pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mod persistent asthma:
Day time sx?

Nocturnal sx?

PFTs?

Tx?

A

> /= 1 / day

> 1 / week

60-80%

SABA + low dose ICS + LABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

For a pt with new onset AFib, how do you treat?

What classifies as new onset?

A

Cardioversion

< 48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Rumbling Decrescendo murmur is what?

Path?

Tx?

A

AI

ischemia or infarction

replace the valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pt w/old (> 48 hours) AFib, how do you treat and work up?

A

1) warfarin 4 weeks
2) then do TEE
3) if no clot, then cardioversion and warfarin 4 more weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When are NSAIDs contraindicated in treatment of pericarditis?

A

CKD
Low platelets
Peptic Ulcer Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How do you treat CHF exacerbation?

A 
LMNOP
Lasix
Morphine
Nitrates
Oxygen
Position (HOB)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Pt in cardiac arrest, give the algorithm for VT/VF:
Epi —> shock —> Amiodarone —> Shock —> repeat
27
How do you Dx proximal lesions of the lung? Peripheral lesion? Centrally located in lung lesions?
Bronchoscopy / EBUS Percutaneous CT guided VATS
28
What is HTN urgency? Emergency? Treated how?
> 180/110 W/End organ damage IV nitrates or CCBs to get MAP down 25% w/in first 2-6 hours, then normal w/PO meds in 24 hours
28
Pt that has restrictive lung pattern w/B/L symmetrical Arthralgia may have what? Work up how?
Caplan syndrome Rheumatoid Arthritis —> anti-CCP Ab
30
When do cardiac enzymes peak? When can a test be considered Negative?
18 hours 2 sets are negative when separated by 6 hours
31
Light’s criteria used for what? What are the 3 criteria?
Transudate v Exudate LDH > 2/3 upper limit normal (200) LDH effusion / LDH serum > 0.6 Total protein effusion / total protein serum > 0.5
32
Pt with an arrhythmia, what constitutes as “unstable symptoms”? Treat how?
SYS BP < 90 Chest pain SOB AMS Electricity
33
What baselines values should you get before starting a statin?
Lipids A1c LFT CK
33
INR < 5, do what?? 5-9? > 9? Any bleeding ?
Hold dose Hold dose, give Vit K Hold dose, give Vit K, LOWER dose FFP, Vit K
34
What ECG changes may show in bronchitis pts? What sx?
RV strain (RVH), RAD Hypoxia (blue, cyanosis) Pulm HTN, edema
35
What is a symptom that indicates lung cancer may be incurable due to METS?
Hoarseness
35
What are the main SEs of corticosteroids?
Hyperglycemia HTN Osteopenia
36
Massive PE that causes HoTN, treatment? Otherwise?
tPA Heparin to warfarin bridge
37
What is a normal rhythm w/a constantly prolonging PR interval until a QRS complex is dropped? Tx?
2nd degree Wemckebach Atropine, PACE
38
What has AV node dissociation where the Ps march out and the QRSs march out resulting in a dropped P wave?
3 degree AV block
38
What is the pt presentation of someone w/ARDS? Sx? Imaging?
Septic shock, Burns, TRALI, near-drowning SOB, cough, crackles B/L white out
40
Dilated cardiomyopathy causes what major path? Tx?
Systolic HF BB, ACEI, diuretics
41
Pt that has AFib and CHF exacerbation what is contraindicated? Why? Give what instead?
CCBs Drop the EF Digoxin or Amiodarone
42
What PCWP means it is noncardiogenic origin? Find out this info how?
< 12 Right heart CATH
43
What are the acute causes of AI? Chronic?
Cardiogenic shock, pulmonary edema Dilated HF, CHF
43
Doubling the TV of a pt on a vent can cause what? ARDS has what PaO2/FiO2 ratio?
Tension pneumothorax < 200
44
Class IV NYHA is treated with what additionally? Class III and EF < 35%?
Dobutamine AICD
44
ABG in COPD pt shows what? CBC?
Hypoxic hypercapnic respiratory acidosis Erythrocytosis
45
What types of pathology causes demand ischemia?
Stable angina Unstable angina NSTEMI
46
When is a pulmonary nodule suspicious for cancer?
> 2cm Spiculated > 30 yr pack history > 70 y/o
49
How do you increase venous return? Does this increase or decrease the intensity of the 4 MC murmurs?
Squatting, leg lift INCREASE
50
What causes Dilated cardiomyopathy?
``` Ischemia Valve disease Infectious Alcoholic Autoimmune Idiopathic ```
51
How to diagnose CHF? What kinds are there?
Echo Diastolic —> restrictive type Systolic —> EF < 55%
51
Mild persistent asthma: Day time sx? Nocturnal sx? PFTs? Tx?
< 1 / day > 2 / month >/= 80% SABA + Low dose ICS
52
ST changes in leads II, III, aVF mean what? What is contraindicated? 1st step is to give what?
Inferior MI/Right sided infarct Morphine, Nitro IVF
53
Pt that has CAD or CHF, give what 1st line meds?
BB + Ace-I
54
How do you know there is VTac? Treat how?
No P Waves Wide QRS complexes Amiodarone or lidocaine
55
What are the acute sx of MR? Chronic?
Cardiogenic shock, pulmonary edema CHF, AFib
55
Head bobbing and, hyper dynamic pulse, and WIDE pulse pressure = ? Described how?
AI/AR Blowing diastolic decrescendo murmur
57
What are the 3 main causes of vasovagal syncope? Diagnose how?
Visceral organ stim - cough/defecation, etc Overactive carotid sinus Psychotropic Tilt-table
58
When is the only time you use an IVC filter in setting of PE?
DVT and they have an ACTIVE bleed (GI)
59
What rhythm only has the ventricles contracting and will not show any p waves?
Idioventricular rhythm
59
PEA/Asystole cardiac arrest what do you do?
Epi —> Nothing —> repeat
59
COPD exacerbation w/out signs of infection treated with what? What can you check? Will look how?
Doxycycline Procalcitonin levels Decreased if viral
60
What does hand grip due to to SVR? How does affect the intensity of HCOM and AS? MVP?
Increases Afterload Decreases later onset in MVP
64
What diseases qualify pts for a statin?
StarCraft on your PC Stroke CAD PVD Carotid Stenosis
65
Pt has a pericardial KNOCK, means what? Dx? Tx?
Constrictive pericarditis —> diastolic CHF Echo Pericardiectomy
65
Intermittent asthma: Day time sx? Nocturnal sx? PFTs? Tx?
= 2 / wk < 2 / month >/= 80% SABA
66
Sx of pericarditis? | Treatment of pericarditis?
Pleuritic and positional chest pain w/multiphasic friction rub NSAID + colchicine
67
Sinus bradycardia that is stable treat how? If unstable?
Atropine Pace
68
What indicates Orthostatic HoTN?
DEC systolic BP of 20 DEC diastolic BP of 10 INC HR of 10 Or symptoms going from laying to standing
68
What qualifies a pt to get a statin no matter what?
LDL > 190
73
What does the MVP murmur sound like?
Holosystolic murmur
74
What is the PATH behind ortho HoTN?
``` Volume down (Diarrhea, dehydrated, diuresis, hemorrhage) OR Dysfunctional ANS - DM, Parkinson’s, advanced age ```
74
What is the screening recommendation for lung cancer?
Annual low dose CT scan of chest | 30 yr pack hx, quit < 15 yr ago, bw 55-80 yrs old
75
What sx seen in hemochromatosis HF? Dx how?
Cirrhosis, DM Ferritin, genetic testing, cardiac MRI
76
Pt w/LDL 70-189 gets statin if they have what else?
Age 40-75 + DM Or Age + Calculated risk (DM, HTN, smoke, Dyslipidemia)
76
What levels can be increased in sarcoidosis? Treat how?
ACE, calcium, Vit D Methotrexate and cyclophosphamide
78
Holosystolic murmur radiating to the axilla heard at apex is what? Pathology? Tx?
MR Ruptured papillary m. Or chordae tendinae (d/t MI) acutely Ischemia or MVP chronically BB/CCB
78
HCOM and MVP, what makes the murmur LOUDER? Quieter?
Dec venous return —> Valsalva Inc venous return —> squat
78
What sx seen in sarcoidosis HF? Dx how?
Pulm disease Cardiac MRI 1st, then endomyocardial biopsy
79
What is the path behind restrictive cardiomyopathy? Is also what? Tx?
Sarcoidosis, amyloid, hemochrom, cancer, fibrosis Diastolic HF Diuresis and RATE control
80
Confirmed STEMI goes where? Dx how? NSTEMI? + stress test?
Emergent CATH, ST elevation or NEW LBBB Urgent CATH Elective CATH
81
What presents w/worsening dyspnea (on exertion), orthopnea, PND? Dx how? Treat?
Pericardial effusion Echo Pericardial window
82
What is the treatment for acute presentation of chest pain?
``` MONA BASH Morphine Oxygen Nitrates ASA ``` BB ACEI Statin Heparin
85
What has a normal PR interval but drops QRSs randomly? Treatment?
Type II Mobitz AV block PACE
86
How do you decrease venous return? Does this increase or decrease the intensity of the 4 MC murmurs?
Valsalva Decrease
87
Treatment for HIT?
Draw HIT panel Stop heparin Give Argatroban
88
What kind of lung cancer do NON-smokers get? Located where?
Adenocarcinoma Periphery
90
How do you know there is SVT? Treat how?
Narrow, fast, HR > 150 No P waves Adenosine
91
WOMAN PE mnemonic = what?
``` Syncope Diff Dx W --> Vasovagal O —> Ortho HoTN M —> Mechanical valve A —> Arrhythmia N —> Neuro P —> PE E —> Electrolyes (glucose, TSH) ```
92
What has a regularly prolonged PR interval? Treat how?
1st degree AV block Atropine, Pace
92
Pt w/suspected ILD 1st step in w/u? Will show what? Do what next? Will show what? What to continue to w/u?
CXR Patchy infiltrates High Res CT Ground glass opacities Serology or Bx
93
What sx most often present in amlyloid HF? Dx how? What random disease can cause it?
Neuropathy Fat pad biopsy Multiple myeloma
95
Pt with COPD what inhalers do you give them in order?
``` SABA + LAMA (tiotropium) + LABA + ICS + PDE4-i + Steroids ```
96
MC causes of pericarditis? Dx how? Best test?
Viral (coxsackie) and uremia ECG —> PR depression and Diffuse ST elevation MRI
96
CHADS2 score of 0 do what? 1? 2?
ASA ASA or anticoagulation ONLY anticoagulate
97
What murmurs require a workup? How do you start working it up?
3 or higher Any diastolic murmur 1st: TTE, then TEE
101
What is a wide QRS? Means what? Narrow? Means what?
> .12 ms, ventricular rhythm < .12 ms, atrial rhythm
103
What are the SEs of BBs?
Bradycardia | Maybe syncope
107
Excessive ventilation in an intubated COPD pt can cause what?
Hypoventilation
108
Neurogenic syncope is d/t what? Presents how? Dx?
Dec blood flow to posterior circulation —> vertebrobasilar insuff. Post-octal state, FND CTA
109
Crescendo-decrescendo systolic murmur is what? Sx? Tx?
AS SAD ``` Preload reduction (BB/CCB) Valve replacement which leads to Ostia being lost —> CABG ```
111
ARDS is a _____ that results from ______? Results in what?
Noncardiogenic pulmonary edema Increased permeability of the capillaries Hypoxemia
112
When can you start home O2 in a COPD pt?
PO2 < 55 on ABG OR SpO2 < 88% on a pulse ox at rest
119
How do small emboli cause dyspnea? Mechanism?
Platelet-derived mediators —> inflammation RR increases, CO2 blown off and O2 canNOT get in
129
What is the treatment for a loculated effusion? What can parapneumonic effusions form? Treatment? Repeat effusions treated with what?
Thoracostomy (chest tube) Empyema, Thoracotomy Pleurodesis
132
Staging of lung cancer is done with what? Before making a treatment plan, must do what?
PET-CT PFTs
140
What is the best test to detect a PE? What if there is CKD or AKI? What also must be present?
CT Angio / Spiral CT V/Q scan, Clear lungs
146
PE causes what physiologically? (2 things)
1 - limitation of gas exchange 2 - INC in pulmonary vascular resistance, causes Right heart strain

Internal Med (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions