Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med 1 - Exam 1 > 6-7. Arrythmias 8. Heart Failure + Pulmonary Edema > Flashcards

6-7. Arrythmias 8. Heart Failure + Pulmonary Edema Flashcards

1
Q

Atrial fibrillation cause

A

Irregularly-irregular rhythm

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

Atrial fibrillation risk factor

A

Increases with age

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

Atrial fibrillation diagnosis

A

EKG = No p-waves, irregularly irregular

ALL new A fib dx get ECHOCARDIOGRAM to check for clots

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

Atrial fibrillation treatment of arrythmia/rate

A

Treat arrythmia:
1. AMIODARONE - best to start in hospital
2. Cardioversion - requires anticoagulants for three weeks and TEE
3. Catheter ablation - better than drugs but increased risk of stroke
4. AV Junction ablation - destroys LA-LV link, requires pacemaker

Treat rate:
Beta-blockers and non-dihydropyridines are first line
Less aggressive rate control preferred (<110bpm better than <80bpm)

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

Atrial fibrillation treatment of stroke risk

A

CHADS-VASc determines stroke risk

Congestive heart failure
Hypertension
Age
Diabetes
Stroke history
Vascular disease
Age
Sex category

NOACs (-bans and -trans) better than Warfarin

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

Which is the most common super ventricular tachycardia?

A

AVNRT

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

AVNRT pathophysiology

A

AV sends impulse back up to atria

AV node stimulates atria and ventricles, can beat together causing cannon waves

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

AVNRT diagnostics

A

EKG = retrograde P-waves within or after QRS, pseudo R-waves

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

AVNRT treatment

A

Hemodynamically stable = VALSALVA

Mostly benign, can live with it

If not, Adenosine -> Verapamil -> Ablation if desperate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

AVRT pathophysiology

A

Impulse re-entry via accessory pathway

Wolf-Parkinson White

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

AVRT diagnosis

A

EKG = shortened PR interval, delta waves, Wolf-Parkinson White

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

Young person with syncope, think this arrythmia …

A

AVRT/Wolf-Parkinson White

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

AVRT treatment

A

Hemodynamically unstable = urgent cardioversion

Stable = vagal maneuvers -> adenosine -> verapamil -> ablation

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

Compare and contrast focal atrial tachycardia and multifocal atrial tachycardia

A

FOCAL: Substance caused (meds, caffeine, alcohol)
Incidental, not that important
One atria overrides SA node
Tx = BB or CCB

MULTIFOCAL: Disease caused (respiratory, CHF)
Three of more morphologically distinct p-waves
Treat underlying cause
Otherwise BB or CCB

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

Atrial flutter is uncommon in patients …

A

Without cardiac or pulmonary disease

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

Atrial flutter diagnosis

A

EKG: Sawtooth pattern

Echo always done

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

Atrial flutter treatment

A

Rate control and anticoagulation

Same as A fib (Amiodarone, cardioversion, ablation, beta-blockers, non-dhp CCBs, NOAC)

But ablation works better for this!

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

Ventricular tachyarrhythmias often occur in patients with …

A

Structural heart disease
Post-MI
CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ventricular tachycardia can often degenerate into …

A

V fib

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

Ventricular tachycardia diagnosis

A

Any wide QRS complex tachycardia is assumed to be v. tach until proven otherwise

21
Q

Ventricular tachycardia types

A

Monomorphic: single foci, QRS identical
Polymorphic: several foci, QRS complexes vary

Non-sustained: <30s
Sustained: >30s

22
Q

Ventricular tachycardia treatment

A

Non-sustained, no symptoms = no treatment

Stable sustained = cardioversion or anti-arrhythmics (amiodarone/lidocaine/procainamide)

Pulseless = defibrilation

Prevention = ICD

23
Q

Long QT syndrome causes

A

Congenital or acquired

Sources: Drugs (anti-arrythmics), hypokalemia, hypomagnesemia

24
Q

Long QT syndrome symptoms

A

Syncope is a big clue, especially in children

25
Q

Long QT syndrome prognosis/risks

A

Risk of Torsades (PVC falls in QT)
Risk of sudden death

26
Q

Long QT syndrome treatment

A

Beta blockers
Sympathectomy

27
Q

Torsades de pointes treatment

A

Magnesium short term
B-blockers (propranolol) long term

28
Q

Ventricular fibrillation treatment

A

CPR + defibrillation

29
Q

Ventricular tachycardia drugs to avoid

A

Calcium channel blockers

30
Q

Which premature beat HAS a compensatory pause?

A

PVC

31
Q

Sinus bradycardia treatment

A

IV atropine

32
Q

Drugs that can cause sinus bradycardia

A

Beta-blockers

33
Q

How to treat heart blocks

A

Mobitz type 2 and 3rd degree blocks treat with pacemaker

34
Q

Heart failure left sided presents as … whereas right sided presents as ….

A

Left sided: DYSPNEA
Decreased cardiac output
Increased pulmonary venous pressure

Right sided: PERIPHERAL EDEMA
Fluid retention

35
Q

Systolic vs Diastolic heart failure

A

Systolic: <40% EF, dilated LV

Diastolic: >50% EF, impaired filling

36
Q

Heart failure classifications A, B, C, D

A

A: Increased risk, no abnormality

B: Structural abnormality, no symptoms

C: Structural abnormality with symptoms

D: End-stage, RIP

37
Q

Heart failure etiology

A

CAD (2/3 cases)

HTN

DM

Infiltrative causes:
Amyloidosis
Hemochromatosis
Sarcoidosis

38
Q

Acute decompensated heart failure cause

A

Sudden worsening of new or chronic heart failure

39
Q

Consider acute decompensated heart failure in an older patient with …

A

Shortness of breath

40
Q

Acute decompensated heart failure signs

A

Displaced apical impulse (more lateral)

Worse prognosis if cold, altered mental status, narrow pulse pressure

41
Q

Acute decompensated heart failure diagnosis

A

History most important

BNP is GOLD STANDARD BIOMARKER

EKG = Q-waves, LVH

Echo for EF and wall motion (determines systolic from diastolic)

Chest x-ray (pulm edema, enlarged heart)

42
Q

Acute decompensated heart failure treatment

A

ACE/ARNI

Beta blockers

Spironolactone

SGLT2

Loop diuretics if lots of fluid

Ionotropes if low perfusion (dobutamine/milirinone)

43
Q

CHF with reduced ejection fraction treatment

A

Same meds as acute decompensated HF:
(ACE/ARNI, BB, Spiro, SGLT2)

Can also do:
ICD
Cardiac resync
Heart transplant
LV assisted device

44
Q

CHF with preserved ejection fraction treatment

A

Control risk factors (BP, CAD, DM)

Start with SGLT2 if mild volume overload (diuretics if more severe)

Spironolactone

If stable potassium and creatinine, start ARNI

45
Q

Pulmonary edema causes

A

Increased capillary pressure from left heart failure

46
Q

Pulmonary edema progression

A

Interstitial > alveolar

47
Q

Pulmonary edema risk factor

A

Anything that causes LV to fail

48
Q

Pulmonary edema diagnosis

A

History always most important

CHEST X-RAY BEST INITIAL ASSESSMENT
Cephalization/stag sign -> Kerley B lines -> Butterfly/Bat wings

Echo

BNP

49
Q
A

Clin Med 1 - Exam 1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions