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Cardio <3 > 7: Syncope, PVD, Drugs (Quiz W8) > Flashcards

7: Syncope, PVD, Drugs (Quiz W8) Flashcards

1
Q

PVD RFs

A 
ateriosclerosis
HTN
smoking
trauma
copper def/zinc excess
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2
Q

Abdominal Aortic Aneurysm

A

early sxs: bloating, gas, GI upset

sxs late/about to dissect: boring, visceral, lumbosacral pain

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3
Q

AAA Dx

A

US then CT

D-dimer positive if dissection

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4
Q

AAA Tx

A 
surgery
stop smoking
control HTN/dyslipidemia
ASA, Beta blocker
zinc/copper balance
Proanthocyanidins, flavonoids, Vit C, B complex
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5
Q

Intermittent claudication

A

induced by exercise, reduced by rest

dt peripheral arteriosclerosis

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6
Q

PAD Tx

A 
bypass surgery
angioplasty
control HTN/dyslipidemia
stop smoking
statins
fibrates (to lower TGs and increase HDL)
BB
ACEi
Clopidogrel
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7
Q

PAD ND Tx

A 
arginine + vit E
quercitin
rutin (Ruscus, Aesculus)
ginkgo biloba
blood thinning (nattokinase, fish oil, bromelain)
chelation tx
high folate
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8
Q

Polyarteritis Nodosa

A

inflammation and necrosis of medium sized muscular arteries–> ischemia

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9
Q

Polyarteritis Nodosa Dx

A

fever, ab pain, renal failure, HTN

nephritis–> arthralgia, muscle tenderness, weakness, nodules

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10
Q

Polyarteritis Nodosa Tx

A

prednisone- titrate up

check DHEA

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11
Q

Prednisone and Hydrocortisone

A

10mg Preg= 40mg Hydro

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12
Q

Temporal Arteritis

A

Chronic inflammation of large arteries-carotids, cranials, aorta, coronaries

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13
Q

Temporal Arteritis sxs

A

HAs, diplopia, scotoma, ptosis, pain with chewing, blindness, polymylagia rheumatica, CTS, FUO, fatigue, wt loss

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14
Q

Temporal Arteritis labs

A

elevated ESR, anemia, elev alk phos

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15
Q

Thromboangitis Obliterans

Buerger’s

A

smokers, male
HLA-A9, HLA-B5
coronary a not involved!

Dx: arteriogram

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16
Q

Thromboangitis Obliterans Sxs

A

ischemia–>gangrene/ulcers, thrombophlebitis, cold, sweating, pain

17
Q

Thromboangitis Obliterans Tx

A

stop smoking, avoid cold
walk 2x/day
unna boot, chelation, treat PAD

18
Q

Raynaud’s Dz

A

spasm of arterioles, BL

Dx: Allen’s test

19
Q

Raynaud’s Tx

A 
avoid cold, exercise
stop smoking
Magnesium + Mag Phos
EFAs
Niacin
Arginine + vit E
20
Q

Well’s Score DVT

<2 unlikely
2 or > likely

A 
active cancer/TX +1
calf swelling > 3cm UL +1
sup veins +1
pitting edema UL +1
previous DVT +1
swelling of entire leg +1
pain along deep v +1
recent immobilization +1
recent bedridden +1
alt dx as likely -2
21
Q

DVT Tx

A 
heparin + warfarin [INR target=2-3 mins, bleeding time 8-12 mins]
pressure hose stockings
nattokinase
fish oil
ginseng, bromelain, gingko, ASA
22
Q

SVT

A

if deep bifurcation, tx as DVT

if small SVT: NSAIDs, pressure hose, witch hazel + massage

23
Q

Aesculus hippocastanum

A

TX for PVD/CVI
reduces cap permeability/edema
improves circ
improves venous tone

24
Q

Hamamelis Virginiana

A

anti-inflamm, astringent, hemostat
tx for venous congestion
reduces cap permeability

25
Q

Syncope

A

actue decrease in cerebral blood flow secondary to limited CO

26
Q

Neurally Mediated Syncope

A

most common cause!

  • vasovagal: Ach release at vagus n –> decreased SA node rate–> decreased CO –>LOC
  • cough, post mic, post defecation
  • carotid sinus syndrome by massage
27
Q

CV Syncope

A 
bradycardia, tachycardia
obstructive cardiomyopathy
valve dz
carotid sinus (plaques)
exertional/aortic stenosis-chest pain, DOE, syncope
28
Q

Non Cardiac Syncope

A 
hyperventilation/hypocapnea/low CO2 in blood
hypoglycemia
pulmonary HTN
orthostatic HTN (decrease > 20/10 usu dt hypovolemia)
unexplained
neurologic dz
electrolyte imbalance (K)
Peripheral Venous Insuff
29
Q

confusion and syncope

A

post event confusion = seizure!

30
Q

Red flags sxs with syncope

A 
chest pain
dyspnea
low back pain
palpitations
severe HA
focal neuro deficits
diplopia
ataxia
dysarthria
31
Q

PE syncope

A 
vitals, ortho BP
rapid glucose
cardio exam
abdomen-pulsatile mass
neuro
trauma
guiac- anemia dt GI blood loss
32
Q

Labs Syncope

A 
serum glucose
CBC (anemia)
CMP (electrolyes)
cardiac enzymes esp if cardiac sxs
UA (UTI in elderly)
CXR (pneumonia, CHF)
Echo/Holter
Stress test
HUTT (head up tilt testing)
head CT (stroke)
33
Q

Vasovagal Tx

A

avoid trigger!
oxygen 2-6L
supine, rest, vitals

Cardio <3 (9 decks)

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