PDI Material Flashcards
1
Q
Twaves:
What does it mean is a T wave is peaked?
A
Hyperkalemia
2
Q
Twaves:
What does it mean is a T wave is flattened?
A
Hypokalemia
3
Q
QRS:
What does a higher amplitude QRS mean?
A
Left ventricular hypertrophy
4
Q
QRS:
What does a fast, fat, & irregular QRS mean?
A
Ventricular fibrillation
5
Q
QRS:
What does a fast, fat, & regular rhythmed QRS mean?
A
Ventricular tachycardia
6
Q
QRS:
What does a wide QRS mean?
A
Conduction issue
7
Q
What is the normal width & height of a QRS complex
A
Height up to 5 big squares
Width ~3 small squares
8
Q
ST segment:
What does a flat ST segment mean?
A
normal
9
Q
ST segment:
What does a depressed ST segment mean?
A
Angina/ischemia
10
Q
ST segment:
What does a elevated ST segment mean?
A
Prizmetal angina or MI
11
Q
ST segment:
What does a elevated ST segment in leads II, III, & aVF mean?
A
Inferior infarct
12
Q
ST segment:
What does a elevated ST segment in leads V1-V4 mean?
A
Anterior infarct
13
Q
ST segment:
What does a elevated ST segment in leads I, aVL, & V6 mean?
A
Lateral infarct
14
Q
Describe 3rd degree heart block:
pathophysiology?
A
The ventricles will beat independently of each & there’s no relationship between the p wave & the QRS complex
15
Q
The ventricles will beat independently of each & there’s no relationship between the p wave & the QRS complex
A
3rd degree heart block:
16
Q
Describe 2nd degree heart block:
Type 1 pathophysiology?
A
Type 1 or Wenckebach/moblitz type 1) results in progressive prolongation of the PR interval until a QRS complex is dropped or missed (Usually asymptomatic)
17
Q
results in progressive prolongation of the PR interval until a QRS complex is dropped or missed (Usually asymptomatic)
A
Type 1 or Wenckebach/moblitz type 1, 2nd degree HB
18
Q
Describe 2nd degree heart block:
Type 2 pathophysiology?
A
aka moblitz type 2 results in the QRS complex being dropped/missed without any prior PR prolongation (This is pathological!)
19
Q
results in the QRS complex being dropped/missed without any prior PR prolongation (This is pathological!)
A
moblitz type 2, 2nd degree HB
20
Q
Describe 1st degree heart block:
pathophysiology?
A
Results in prolonged PR interval due to a delayed AV conduction
21
Q
Results in prolonged PR interval due to a delayed AV conduction
A
1st degree heart block
22
Q
Describe the features of sinus bradycardia
Bpm
ECG
Etiology
A
HR <60Bpm
Normal ECG
Normal in athletes & plp on B-blockers
23
Q
HR <60Bpm
Normal ECG
Normal in athletes & plp on B-blockers
A
sinus bradycardia
24
Q
Describe a the features of a left bundle branch block:
QRS complex changes
A
QRS in v1 = W shaped
QRS in v6 = M shaped
“WiLLiaM”
25
QRS in v1 = W shaped
QRS in v6 = M shaped
"WiLLiaM"
left bundle branch block:
26
Describe a the features of a right bundle branch block:
QRS complex changes
QRS in v1= M shaped
QRS in v6= W shaped "MaRRoW"
27
QRS in v1= M shaped
QRS in v6= W shaped "MaRRoW"
right bundle branch block
28
Describe the features of sinus tachycardia:
HR
ECG
HR >100Bpm
Normal ECG
Normal response to stress
29
HR >100Bpm
Normal ECG
Normal response to stress
sinus tachycardia
30
Describe the features of ventricular fibrillation:
ECG
Broad QRS & irregular rhythm
31
Broad QRS & irregular rhythm
ventricular fibrillation
32
Describe the features of atrial fibrillation:
ECG
No p waves & irregular rhythm
33
No p waves & irregular rhythm
atrial fibrillation:
ECG
34
Describe the features of supra-ventricular tachycardia:
ECG
Narrow QRS & regular rhythm
35
Narrow QRS & regular rhythm
supra-ventricular tachycardia
36
Describe the features of ventricular tachycardia:
ECG
Broad QRS & regular rhythm
37
Broad QRS & regular rhythm
ventricular tachycardia
38
Describe the pathophysiology of constrictive/restrictive pericarditis:
patho?
Causes?
Symptoms?
Patho:
Constriction of heart leads to diastolic dysfunction (poor filling)
Causes:
Amyloidosis
Endocardial fibroelastosis (kids)
Loeffler syndrome (eosinophilia)
Symptoms:
1) CHF
2) Low voltage EKG with diminished QRS amplitude
39
Patho:
Constriction of heart leads to diastolic dysfunction (poor filling)
Causes:
Amyloidosis
Endocardial fibroelastosis (kids)
Loeffler syndrome (eosinophilia)
Symptoms:
1) CHF
2) Low voltage EKG with diminished QRS amplitude
pathophysiology of constrictive/restrictive pericarditis
40
Describe the features of an atrial myxoma:
Signs
Risk
A benign cardiac tumor that is made of mesenchymal made up of ground substance
Symptoms:
1) Syncope
Risk:
Obstruct the mitral valve
41
Describe the features of restrictive/constrictive cardiomyopathy
patho?
Causes?
Signs?
Patho:
Diastolic dysfunction (reduced ventricular filling)
Causes:
Amyloidosis
Endocardial fibroelastosis (children)
Loeffler syndrome
Symptoms:
1) CHF
2) Low voltage EKG with reduced QRS amplitude
42
Patho:
Diastolic dysfunction (reduced ventricular filling)
Causes:
Amyloidosis
Endocardial fibroelastosis (children)
Loeffler syndrome
Symptoms:
1) CHF
2) Low voltage EKG with reduced QRS amplitude
Describe the features of restrictive/constrictive cardiomyopathy
patho?
Causes?
Signs?
43
JVP changes:
a waves represent what?
Absent a waves mean what?
Large a waves mean what?
Cannon a waves mean what?
a waves represent Atrial contraction
absent = a fibrillation
large = pulmonary HTN or stenosis
Cannon = Complete heart block or ventricular arrythmias
44
JVP changes:
C waves represent what?
Contraction of the right ventricle & Closure of the triCuspid
45
JVP changes:
X waves represent what?
relaXation of atria
46
JVP changes:
v waves represent what?
large v wave means what?
v wave represents Venous filling
Large = tricuspid regurgitation
47
JVP changes:
y waves represent what?
emtYing of the right atrium into the right ventricle
48
Pulses:
Describe Pulsus paradoxus
Decrease in pulse during inhalation (10+mmHg) & increase in pulse on exhalation (10mmHg)
49
Decrease in pulse during inhalation (10+mmHg) & increase in pulse on exhalation (10mmHg)
Pulsus paradoxus
50
Pulses:
Describe Corrigan pulse
The pulse is forceful & then it suddenly collapse
ass: aortic regurgitation
51
The pulse is forceful & then it suddenly collapse
ass: aortic regurgitation
Corrigan pulse
52
Pulses:
Describe a Dicrotic pulse
Ass conditions
2 palpable pulses in aortic
Ass:
Decreased cardiac output
Increased resistance 2nd diastole
53
2 palpable pulses in
Ass:
Decreased cardiac output
Increased resistance 2nd diastole
Dicrotic pulse
54
Describe a pulsus bisferiens
2 palpable pulses in systole
ass aortic insufficiency/regurgitation & hypertrophic cardiomyopathy
55
2 palpable pulses in systole
ass aortic insufficiency/regurgitation & hypertrophic cardiomyopathy
pulsus bisferiens
56
Describe parvus et tardus
a low amplitude pulse with delayed up stroke
ass with aortic stenosis
57
a low amplitude pulse with delayed up stroke
ass with aortic stenosis
parvus et tardus
58
Describe Pulsus bigeminus
2 heart beats close together then a longer pause
Ass:
Hypo/hyperkalemia
HYpothyroidism
MI
B-Blocker
59
2 heart beats close together then a longer pause
Ass:
Hypo/hyperkalemia
HYpothyroidism
MI
B-Blocker
Pulsus bigeminus
60
Describe pulsus alternans
A regular alternating pulse amplitude
Ass
Severe left ventricular disease
61
A regular alternating pulse amplitude
Ass
Severe left ventricular disease
pulsus alternans
62
Describe Quincke pulse
pulse in the nail bed
ass aortic regurgitation
63
pulse in the nail bed
ass aortic regurgitation
Quincke pulse
64
Describe a hypokinetic pulse
A low amplitude pulse with low voltage
ass:
MI
Shock
65
A low amplitude pulse with low voltage
ass:
MI
Shock
hypokinetic pulse
66
Heart sounds:
Aortic regurgitation
Sound
Associated conditions
Symptoms
A high-pitched blowing early diastolic decrescendo murmur
Ass:
Acute (endocarditis)
Chronic (Bicuspid aortic valve & CT disease)
Symtoms:
1) Water hammer pulse (wide pulse pressure)
2) deMussets (head bobbing)
67
A high-pitched blowing early diastolic decrescendo murmur
Ass:
Acute (endocarditis)
Chronic (Bicuspid aortic valve & CT disease)
Symtoms:
1) Water hammer pulse (wide pulse pressure)
2) deMussets (head bobbing)
What's the condition?
Aortic regurgitation
68
Heart sounds:
VSD
Sound
Associated conditions
A HARSH holosystolic murmur
Ass:
Down syndrome (ostium primum)
69
A HARSH holosystolic murmur
Ass:
Down syndrome (ostium)
VSD
70
Heart sounds:
MVP
Sound
Associated symptoms
Complications
Late systolic crescendo-decrescendo murmur & midsystolic click.
Ass:
Elher-Danlos
Marfans
Rheumatic heart disease
Infect endocarditis (s.viridians)
Comp:
Severe mitral regurgitation
"MVP click"
71
Late systolic crescendo-decrescendo murmur & midsystolic click.
Ass:
Elher-Danlos
Marfans
Rheumatic heart disease
Infect endocarditis (s.viridians)
Comp:
Severe mitral regurgitation
MVP
72
Heart sounds:
Mitral regurgitation
sounds
associated condition
location
Holocystolic high-pitched blowing murmur
Ass:
Post MI syndrome
rheumatic heart disease
endocarditis (s. viridians)
IHD
location: apex radial to axilla
73
Holocystolic high-pitched blowing murmur
Ass:
Post MI syndrome
rheumatic heart disease
endocarditis (s. viridians)
IHD
location: apex radial to axilla
Mitral regurgitation
74
Heart sounds:
Tricuspid regurgitation
Ass conditions/risks
location
Holosystolic high-pitched blowing murmur
ass:
IV drug abuse (s. aureus endocarditis)
Marfans
EDS
Pulmonary HTN
Location:
tricuspis
75
Heart sounds:
Aortic stenosis
Ass conditions
Symptoms
Causes
Systolic crescendo-decrescendo murmur ejection murmur (louder -> softer)
Ass:
Pulsus parvus et tardus (weak & delayed carotid upstroke)
Ass:
1) Syncope
2) Angina
3) Dsypnea
Causes
Aortic valve sclerosis
Bicuspid aortic valve (ass with turners)
Rheumatic fever
76
Systolic crescendo-decrescendo murmur ejection murmur (louder -> softer)
Ass:
Pulsus parvus et tardus (weak & delayed carotid upstroke)
Ass:
1) Syncope
2) Angina
3) Dsypnea
Causes
Aortic valve sclerosis
Bicuspid aortic valve (ass with turners)
Rheumatic fever
Aortic stenosis
77
Heart sounds:
S1/S2 Splitting
Heart sounds
S1 Mitral & tricuspid valves closing
S2 Aortic pulmonic valves closing
78
Heart sounds:
Wide split s2
ass conditions
Pulmonic stenosis
RBBB
79
Heart sounds:
Fixed splitting S2
ass conditions
Ass with left-right shunt (ASD)
80
Heart sounds:
Paradoxical splitting S2
Delayed aortic valve closure
ASS:
Aortic stenosis
LBBB
81
Heart sounds:
Mitral stenosis
Sound
Ass condition
What mimics it
Diastolic open-snap followed by a delayed diastolic rumbling
Ass:
Rheumatic fever
SLE
RA
Mimicers:
L. atria myxoma
Bacterial endocarditis
82
Diastolic open-snap followed by a delayed diastolic rumbling
Ass:
Rheumatic fever
SLE
RA
Mimicers:
L. atria myxoma
Bacterial endocarditis
Mitral stenosis
83
Heart sounds:
PDA
Sound
Ass condition
Treatment
Continuous machine-like murmur
Ass:
Congenital rubella
FAS
Fetal hytoin syndrome (phenytoin)
Rx:
Prostaglandins (open if sugery later)
Indomethacin (close)
84
Continuous machine-like murmur
Ass:
Congenital rubella
FAS
Fetal hytoin syndrome (phenytoin)
Rx:
Prostaglandins (open if sugery later)
Indomethacin (close)
PDA
85
Key words:
LOC
Feeling unwell
Drinks alot
Recovers quickly
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
Orthostatic hypotension
Differentials:
Hypovolemia
Medication side effects
Hypoglycemia
Tests:
Electrolytes
Blood glucose
ECG
Rx:
Glucose replacement
Fluid & electrolyte replacement
86
Differentials:
Hypovolemia
Medication side effects
Hypoglycemia
Tests:
Electrolytes
Blood glucose
ECG
Rx:
Glucose replacement
Fluid & electrolyte replacement
What's the diagnosis
Diagnosis:
Orthostatic hypotension
87
Key words:
Dizzy
Chest hurts
Swollen legs
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
CHF (due to aortic stenosis)
Differentials:
Valvular disease
Atrial myxoma
MVP
Tests:
CBC
Electrolytes
Kidney function test
BNP/ANP
ECG
ECHO
Chest x RAY
Rx:
lifestyle changes (WL, diet, exercise)
Diuretics
ACE inhibitors
Restrict fluid
B-blockers
88
Differentials:
Valvular disease
Atrial myxoma
MVP
Tests:
CBC
Electrolytes
Kidney function test
BNP/ANP
ECG
ECHO
Chest x RAY
Rx:
lifestyle changes (WL, diet, exercise)
Diuretics
ACE inhibitors
Restrict fluid
B-blockers
What's the condition?
Diagnosis:
CHF (due to aortic stenosis)
89
Key words:
Hard to breath
High fever
IV user
Diagnosis?
Differentials?
Tests?
Rx?
Tricuspid regurgitation (bacterial endocarditis via s. aureus)
Diff:
Pulmonary HTN
Pulmonary stenosis
Pulmonary emboli
Tests:
CBC
ESR
CRP
ECHO
Rx:
Antibiotics
Monitoring
Diuretics
Antiarrhythmics
Eventual valve replacement
90
Diff:
Pulmonary HTN
Pulmonary stenosis
Pulmonary emboli
Tests:
CBC
ESR
CRP
ECHO
Rx:
Antibiotics
Monitoring
Diuretics
Antiarrhythmics
Eventual valve replacement
Diagnosis?
Tricuspid regurgitation (bacterial endocarditis via s. aureus)
91
Key words:
Weight loss
Poor sleep
Fast heart rate
Swollen neck
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
Hyperthyroidism
Diff:
Arrythmia
Pheochromocytoma
Tests:
Thyroid functions & Ultrasound
Urine test
ECG
Holter/monitor
Rx:
Antithyroid drugs (methimazole or PTU)
92
Diff:
Arrythmia
Pheochromocytoma
Tests:
Thyroid functions & Ultrasound
Urine test
ECG
Holter/monitor
Rx:
Antithyroid drugs (methimazole or PTU)
Diagnosis?
Diagnosis:
Hyperthyroidism
93
Key words:
Chest pain rad from front to back
Hard to breath
Dizzy
Light headedness
Abnormal sweating
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
Aortic dissection
Diff:
MI
Pericarditis
Tests:
Cardiac enzymes
ECG
CT
Chest X ray
ECHO
Rx
Surgery
Nitrates
B-blockers
ACE inhibitors
Sup O2
Aspirin & HEPARIN
94
Diff:
MI
Pericarditis
Tests:
Cardiac enzymes
ECG
CT
Chest X ray
ECHO
Rx
Surgery
Nitrates
B-blockers
ACE inhibitors
Sup O2
Aspirin & HEPARIN
Which condition?
Diagnosis:
Aortic dissection
95
Key words:
Lots of stress
Dizzy
poor sleep
Chest pain
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
Stable angina
Diff:
MI
Anxiety
Tests:
Cardiac enzymes
Lipid profile
ECG
Cardiac stress test
Rx:
Lifestyle changes
B-blockers
Nitrates
96
Diff:
MI
Anxiety
Tests:
Cardiac enzymes
Lipid profile
ECG
Cardiac stress test
Rx:
Lifestyle changes
B-blockers
Nitrates
What's the condition?
Diagnosis:
Stable angina
97
Key words:
Cold-intolerant
Losing hair
Weight gain
No appetite
Constipation
Fatigue
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
Hypothyroidism
Diff:
Iron deficiency anemia
Depression
Tests:
CBC
Thyroid pannel & ultrasound
Iron studies
Rx:
L-Thyroxine replacement (thyroid replacement)
Follow up at regular intervals
98
Diff:
Iron deficiency anemia
Depression
Tests:
CBC
Thyroid pannel & ultrasound
Iron studies
Rx:
L-Thyroxine replacement (thyroid replacement)
Follow up at regular intervals
What's the condition?
Diagnosis:
Hypothyroidism
99
Key words:
Splitting headache
Jaw pain
Blurry vision
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
GC temporal arteritis
Diff:
Migraine
Transient ischemic attack
Tests:
Elevated ESR
Elevated CRP
Segmental biopsy
CT/MRI
Rx: Glucocorticoids
100
Diff:
Migraine
Transient ischemic attack
Tests:
Elevated ESR
Elevated CRP
Segmental biopsy
CT/MRI
Rx: Glucocorticoids
What's the condition?
Diagnosis:
GC temporal arteritis
101
Key words:
Calf pain when active
Foot goes numb
Chest pain
Discolored leg
Diagnosis?
Differentials?
Tests?
Rx?
Diagnosis:
Acute limb ischemia
Diff:
Buegers disease
Compartment syndrome
Tests:
ABI (ANKLE BRACHIAL INDEX)
Angiography
Rx:
Anticoagulants
Angiography
102
Diff:
Buegers disease
Compartment syndrome
Tests:
ABI (ANKLE BRACHIAL INDEX)
Angiography
Rx:
Anticoagulants
Angiography
What's the diagnosis
Diagnosis:
Acute limb ischemia
103
