Pathophys

Question 1

prinz metal angina

Answer 1

caused by coronary vessle vasospasm

Question 2

stable angina

Answer 2

sudden onset
3-5 min lasts
releived with rest and nitro

Question 3

unstable angina

Answer 3

sudden onset
initated during rest
lasts longer than 20 min
may not resolve with rest or nitro

Question 4

transmural mi

Answer 4

q wave will be present.

goes through entire thickness of myocardium

Question 5

subedorcardial

Answer 5

q wave not present.

partial thickness

Question 6

1 cause of death from MI

Answer 6

dysrhythmia

Question 7

levine sign

Answer 7

clenched fist over cehst

Question 8

atypical presentation of mi

Answer 8

diabetics
chronic hypertension
elderly
female

Question 9

1 cause of RHF

Answer 9

LHF

Question 10

5 life threats of cp

Answer 10

mi 
pe
aortic dissection 
tamponade 
pneumothorax

Question 11

becks triad

Answer 11

hypotension
jvd
muffled heart tones

Question 12

managment of cardiac tamponade

Answer 12

o2 to 94
fluid 30 ml/kg
dopamine
pericardiocentesis

Question 13

causes of cardiogenic shock

Answer 13

mi 
left sided hf 
tension pneumo 
cardiac tampnoade 
cardiac contusion

Question 14

systolic <80
resp distress 
cp 
weakness 
ams 
tachycardia

Answer 14

cardiogenic shock

Question 15

cardiogenic shock management

Answer 15

treat underlying problem
fluid based on lung sounds
consider positive inotrops

Question 16

hypertensive emergency requirement

Answer 16

uncontrolled hypertension greater than 180

Question 17

tearing sensation on chest or back

Answer 17

dissecting aortica aneurysim (red flag on nremt)

Question 18

syncope 
absent or reduced pulses 
unequal bp 
unequal pulse 
tearing sensation 
flank pain 
scapular pain 
radiation into lungs

Answer 18

dissecting aortic aneurysm

Question 19

normal axis deviation

Answer 19

0-90
vector will point towards hypertrophy
away from infarct

Question 20

right atrial abnormality

Answer 20

dilation of right atrium from elevated venous pressure or high pulmonary pressure
p wave bigger than 2.5mm in lead 2 or 1.5 mmm in lead 1

Question 21

left atrial abnormality

Answer 21

p wave normal height but prolonged duration. means valvular heart disease

Question 22

RVH

Answer 22

caused by pulmonary hypertension.

in v1 R wave taller than s wave

Question 23

LVH

Answer 23

caused by systemic hypertension.

sum of depth of s wave in v1 and r wave in 5 or 6 exceedes 35 mm

Question 24

unstable angina on 12 lead

Answer 24

st depression of .5 mm in 2 contiguous leads

Question 25

benign early repolarization

Answer 25

mimicks st elevation | j or fishook appearance to j point and a concave st segment morphology in v4 v6 and inferior leads

Question 26

``` st elevation (less than 5 mm in multiple leads. depressed or downslopin pr segment. ``` chest pain is positional***

Answer 26

pericarditis- inflammation of pericardial sac positional chest pain

Question 27

s1q3t3 pattern

Answer 27

deep s wave in lead 1 deep narrow q wave in lead 3 t wave inversion in lead 3

Question 28

s1q3t3 new rbbb st depression in 123

Answer 28

PE

Question 29

osborne wave | shivering on 12 lead

Answer 29

hypothermia

Question 30

tall peaked t waves. p waves become flattened and eventually disappear maybe wide qrs

Answer 30

hyperk

Question 31

flat or absent t waves | u wave

Answer 31

hypokalemia

Question 32

u wave

Answer 32

small deflection after t wave

Question 33

shortened qt interval means

Answer 33

hypercalcemia

Question 34

long qt interval means

Answer 34

hypocalcemia

Question 35

dilated cardiomyopathy

Answer 35

heart muscle becomes weak diminishing its ability to pump enough blood through the body

Question 36

hypertrophic cardiomyopathy

Answer 36

myocardial wall becomes thick. usually diagonsed in 30s and 40s

Question 37

brugada syndrome

Answer 37

rare genetic disorder affecting sodium channels in heart

Question 38

long qt syndrome

Answer 38

qt interval longer than .45 | heart is experiencing an extended refractory period.

Question 39

deeply inverted symmetric t waves in precordial leads and prolonged qt interval

Answer 39

intracranial hemorrhage | if ekg shows it then pt has symptoms

Question 40

atherosclerosis

Answer 40

buildup of calcium and cholesterol inside walls of arteries

Question 41

atheroma

Answer 41

mass of fatty tissue that gradually calcifies hardening into atheromatous plaque

Question 42

``` heavy crushing pain radiates to left arm also goes neck jaw upper back epigastrium not affected by breathing or movement may show levine sign ```

Answer 42

acs

Question 43

plasmin

Answer 43

activates plasminogen which dissolves clot

Question 44

cor pulmonale

Answer 44

heart disease that develops because of chronic lung disease. usually secondary to copd

Question 45

``` tachycardia pulsus alternan(strong and weak beats) crackles cough with frothy sputum third heart sound paroxysmal nocturnal dyspna orthopnea (positional dyspnea) pulsus parodoxus ```

Answer 45

lvf

Question 46

``` weight gain ascites swelling jvd liver enlargment spleen enlargment nausea ```

Answer 46

RVF

Question 47

causes of cardiac tamponade

Answer 47

``` aortic dissection blunt trauma mi heart surgery hypothyroidism renal disease ``` pt will often be to ill to answer questions

Question 48

cardiac tamponade treatment

Answer 48

if no signs of hf give fluid | pericardiocentesis

Question 49

cardiogenic shock ss

Answer 49

``` compensated: crackles jvd peripheral pulse weak and rapid skin pale and mottled, cool and moist narrow pulse pressure ``` decompensated is same but with altered mental status

Question 50

cardiogenic shock treatment

Answer 50

1-200 ml of fluid stop if crackles appear | dopamine, epi, norepi titrated to 90 sys

Question 51

hypertensive emergency

Answer 51

acute elevation of bp with end organ damage

Question 52

hypertensive encephalopathy

Answer 52

acute hypertensive crisis. sudden escalation to above 200/130

Question 53

when map gets dangerous

Answer 53

150 can breach blood brain barrier 1/3rd difference of sbs and dbp added to dbp first sign nv and headache then seizures blindness or aphasia

Question 54

endocarditis

Answer 54

infection of lining of heart | can damage heart valves

Question 55

fever and chills loss of apetite weight loss joint ache sob cough red and blue lesions on palms and soles

Answer 55

endocarditis

Question 56

valvular stenoissi

Answer 56

heart must work harder to pump through narrowed vavles

Question 57

pericarditis causes

Answer 57

viral, bacterial, fungal heart surgery heart attack

Question 58

flu like symptoms stabbing pain made worse by deep breathing coughing, laying flat. made better when sitting up fever, tachycardia, tachypnea, jvd

Answer 58

pericarditis

Question 59

myocarditis

Answer 59

inflammation of myocardium | caused by viral infection, rheumatic fever, chemical poisons, alchoholism

Question 60

rheumatic fever

Answer 60

causes stenosis of mitral valve and aortic valve

Question 61

scarlet fever

Answer 61

caused by same bacteria as strep throat. strawberry tongue | dangerous to infants

Question 62

``` sudden onset pain. sense of impending doom tearing ripping sensation max pain immediatly does not stop bp discrepency ```

Answer 62

aortic aneurysm

Question 63

acute arterial occlusion

Answer 63

sudden onset and disruption of blood flow because of thrombus or trauma to artery

Question 64

pale mottled skin on limb when raised turns red when lowered below heart sensory issue in limb

Answer 64

acute arterial occlusion

Question 65

claudication

Answer 65

pain or cramping in legs during activity

Question 66

dvt

Answer 66

blood clot in vein.

Question 67

risk factors for dvt

Answer 67

pregnant or immobile for long periods of time. damage to inner lining of vessle dehydration, oral contraceptives hormone replacement therapy