Block 59, 60: Cardio Flashcards
what drugs should be withheld for at least 48 hours prior to cardiac testing? when should you not withhold 48 hours prior?
beta blockers
calcium channel blockers
nitrates
CAD is present
how do you screen for abdominal aortic aneurysm
- male active or former smokes ages 65-75 with one-time US
what has a high sensitivity for diagnosis for CHF
brain natriuretic peptide
BNP
What improves cardiovascular and overall long-term mortality in patients with ST-elevation MI
restoration of coronary blood with primary percutaneous intervention or fibrinolysis
Patients with persistent tachyarrythmia ( narrow - or wide-complex) causing hemodynamic instability should be managed how
immediate synchronized cardioversion
what is a regular-narrow-complex tachycardia called
supraventricular tachycardia
what is cor pulmonale
impaired function of the right ventricle due to pulmonary hypertension, usually due to chronic lung disease
long-term tobacco use, chronic cough, barrel-shaped chest, elevated jugular venous pressure, and enlarged liver
COPD with cor pulmonale
S4 sound indicates
left ventricular hypertrophy from prolonged hypertension
what nonpharmacologic interventions has greatest impact on high blood pressure
DASH diet
when do you use an Holter monitor
oupatient, identify intermittent arrhythmias in patients with symptoms
how are patients with persistent symptomatic PACS be managed
low-dose beta blocker
what is the most common primary cardiac tumor? where is it mostly located
Myxomas
left atrium
3 types of clinical features of cardiac myxoma
- constitutional
- cardiovascular
- embolization
what electrolyte abnormalities in CHF patients parallels the severity of heart failure
Hyponatremia
what heart arrhythmias is specific for digtialis toxcity
atrial tachycardia with AV block
clinical features of cyanide toxicity
- altered mental status
- lactic acidosis
- seizures
- coma
when does seizure occur in alcohol withdrawl
12-48 hours
what can norepinephrine do to the fingers/toes
ischemia of distal fingers and toes secondary to vasospasm
young patient from a developing country, has progressive dyspnea, nocturnal cough, and hemoptysis has
rheumatic
abdominal pain and nausea/vomiting are atypical presentations of what
acute coronary syndrome
who are more likely to have atypical symptoms of acute coronary artery disease
women
elderly
diabetics
what is the mainstay therapy in patients with alcoholic cardiomyopathy
complete cessation of alcohol
main reason for orthostatic hypotension in elderly
decreasing baroreceptors sensitivity and defects in myocardial response to this reflex
patient with muscle weakness, recurrent nephrolithiasis, neuropsychtiatric symptoms, hypercalcemia
primary hyperparathyroidism
significant hypertension with primary hyperparathyroidism suggests a possbile
multiple endocrine neoplasma MEN 2
with pheochromocytoma
what are some studies you can do for venous thrombosis
D-dimer levels
venous doppler study
management of acute limb ischemia after MI with possible arerial embolus from LV thrombus
- anticoagulation
- vascular surgery consultation
- TEE
Cutaneous flushing and intensive generalized pruritus are well known side effects of what? why? antidote?
niacin: prostaglandin-induced peripheral vasodilation
- low dose aspirin
why do you do adrenal veins sampling
differentiates between adrenal hyperplasia and adenoma , both are causes of primary hyperaldosteronism
common cause of secondary hypertension in females
fibromuscular dysplasia
common causes of cardiac chest pain
GERD and esophageal motility
3 clinical features of esophageal origin of chest pain
- prolonged pain lasting more than an hour
- postprandial symptoms
- heartburn or dysphagia
pleuritic chest pain, dyspnea, tachypnea, and tachycardia in long-distance truck driver
PE
statin medications are recommended for primary prevention in patients with
age 40-75
10 year risk of atheroscolertic cardiovasuclar disease equal or greater than 7.5%
define exertional heat stroke
body temp greater than 104
CNS dysfunction
what is a complication that can occur 4 days following an MI
Peri-infarction pericarditis
what causes Wolff-Parkinson White
accessory pathway that bypasses the AV node and directly connects atria to ventricles
EKG finding for wolff-parkinson-white
- short PR interval
- delta wave ( slurred initial upstroke of QRS complex)
- QRS widening
- ST/T wave changes
most effective intervention in overweight patients with hypertension
Loose weight
how does nitroglycerin provide pain relief
decrease left ventricular wall stress
localized pain of the anterior chest that worsens with movement, deep inspiration or coughing. tenderness to palpitation. diagnosis
costochondritis
treatment for costochondritis
reassurance and symptomatic pain management
next step in management with suspected acute arterial occlusion of left lower extremity
arterial doppler study
presents weeks after an MI with chest pain that is improved by leaning forward
Dressler’s syndrome
treatment for Dressler’s sydnrome
NSAID
avoid anticoagulation
PE findings for aortic regurgitaiton
- hyperdynamic pulse
- “water hammer” peripheral pulses
EKG reading for uremic pericarditis
no ST elevation
patient with infected sacral decubitus ulcer, hypotension, tachycardia, tachypnea, and mental status changes has
septic shock
a patient with a drug-eluting stent put in 10 days ago and had another MI? what is the cause
not compliant with drug
