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Card Flashcards

1
Q

HTN

A

Def: blood pressure >= 140/90

SS:
asymptomatic
morning HA
DOE
angina

Eval:
2 readings on 2 different visits

Txt:
Diet
Exercise
Weight
alcohol
Thiazide (chlorthalidone) 12.5 mg qd
Loop (furosemide)
spiranolactone
BB (atenolol) 50 mg qd
ACEI (lisinopril) 10 mg qd
CCB (amlodipine) 5 mg qd
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2
Q

Pericarditis

A

Def: inflammation of pericardial sac

SS:
angina
pericardial friction rub
EKG changes (ST depression)
Beck's triad (blood pressure, neck veins, muffled heart sounds)
Eval:
CBC
troponin
CXR
echocard

Txt:
NSAID
abx
prednisone

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3
Q

Chronic Venus Disease

A

Def: failure of veins to adequately transport blood back to heart

SS:
shallow wet ulcers
pain
edema
tightness
leg aches
Eval:
Virchows (stasis, injury, clotting)
Wells - DVT
duplex US
venogrphy
Txt:
compression stockings
leg elevate
exercise
surgery
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4
Q

Raynaud’s Disease

A

Def: spasm of arteries fingers and toes

SS:
White -> Blue -> Red

Eval:
Clinical

Txt:
avoidance
CCB

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5
Q

Sinus Bradycardia

A

Def: Slow regular heart rate

SS:
Rate

D/t: normal in well conditioned athlete, digoxin, beta blockers, calcium channel blockers, inferior MI, hypothyroidism

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6
Q

Sinus Tachycardia

A

Def: Fast regular heart rate

SS:
Rate 100 - 160

D/t: infants, anxiety, atropine, epinepherine, nicotine, caffeine, cocaine, fever, hypoxia, anemia, pum embolus

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7
Q

Sinus Arrhythmia

A

Def: irregular normal heart rate

SS:
irregular
avg heart rate

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8
Q

Atrial flutter

A

Def: sawtooth flutter waves

SS:
regular
rate 250 - 350
P:Q = 2:1

D/t: ischemic heart disease, acute MI, hypertension, pulmonary embolus, digoxin toxicity, transition to a-fb

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9
Q

Atrial fibrillation

A

Def: irregular shimmering baseline

SS:
irregular
No P waves
No PR interval
Rate 160 -180

D/t: rheumatic heart disease, hypertension, ischemic heart disease, thyrotoxicosis. COPD, pulm embolus, pericarditis, EtOH

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10
Q

Supraventricular tachycardia

A

Def: regular rapid rhythym

SS:
irregular
P waves in T waves
Rate 160 -200

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11
Q

Ventricular tachycardia

A

Def: three or more beats in a row

SS:
Wide QRS > 3 boxes
Rate > 100
3 QRS in row

D/t: ischemic heart disease, acute MI, drugs, cardiomyopathies

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12
Q

Ventricular Fibrillation

A

Def: irregular zigzag pattern

SS:
No P waves
Irregular
No P, PR, QRS, T waves

D/t: severe ischemic heart disease, acute MI, digitalis toxicity, hypothermia, blunt chest trauma, severe electrolyte imbalance

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13
Q

AV block 1st degree

A

Def: wide PR interval

SS:
irregular
PR interval > 5 boxes
normal rate

D/t: digoxin toxicity, inferior MI, myocarditis

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14
Q

AV Block 2 degree type 1

A

Def: increasing PR intervals and then drop

SS:
irregular
PR interval increases and then drops
PR interval restarts

D/t: inferior MI, digitalis toxicity, myocarditis, rheumatic heart disease

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15
Q

AV Block 2 degree type 2

A

Def: regular rate and rhythm with dropped PR interval

SS:
irregular
random P skipped

D/t: acute MI

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16
Q

AV block 3 degree

A

Def: atrial and ventricle contractions out of synch

SS:
irregular
PR interval varies
QRS wide or narrow
P-P constant
R-R constant

D/t: no atrioventricular conduction

17
Q

Premature atrial contractions

A

Def: P node fires early

SS:
P with different shape than other Ps
irregular

18
Q

Premature ventricular contractions

A

Def: QRS occurs without P

SS:
Wide QRS > 3 boxes
P:QRS ratio not 1:1

19
Q

Aortic Stenosis

A

Def: flow across thickened valve

SS:
asymptomatic
angina
syncope
CHF
crescendo-descresendo from S1

Txt:
valve replace

20
Q

Mitral Valve Regurg

A

Def: failure of valve to close properly

SS:
asymptomatic
pansystolic (constant)
palpatations
exercise intolerance
bad news
S3
21
Q

Mitral Stenosis

A

Def: thickening of bicuspid valve

SS:
exercise intolerance
papitations
CHF
hoarseness
low-pitch mid-diastolic

Txt:
valve replacement

22
Q

Aortic regurgitation

A

Def: failure of valve to close properly

SS:
exercise intolerance
dyspnea
CHF
high pitch, decrescendo diastolic
23
Q

Patent Ductus Arteriosus

A

Def: Failure of shunt to close between pulmonary artery and aorta

SS:
continuous murmur through systole-diastole

24
Q

Inferior leads

A

II, III, AVF

RCA

25
Q

Anterior leads

A

V1 - V4

LAD

26
Q

Lateral leads

A

I, V5, V6, AVL

left circumflex

27
Q

Left or Right axis deviation

A 
\+ = R > S
- = S > R
Normal = I and AVF both +
LAD = I + and AVF - 
RAD = I - and AVF +
ERAD = I - and AVF -

LAD d/t: left ant. hemiblock, emphysema, hyperkalemia, Wolff-Parkinson-White syndrome
RAD d/t: normal in infant and children, RVH, chronic lung disease, left post. hemiblock, PE, Wolff-Parkinson-White syndrome, ASD, VSD

28
Q

RBBB

A

Def: block of bundle of HIS to right ventricle

SS:
V1 and V2
RSR’ (rabbit ears)
Wide QRS > 3 boxes

D/t coronary disease, rheumatic heart disease, trauma, cardiomyopathy

29
Q

LBBB

A

Def: block of bundle of HIS to left ventricle

SS:
V5, V6, I, AVL
R has step
Wide QRS > 3 boxes

D/t coronary disease, rheumatic heart disease, trauma, cardiomyopathy

30
Q

LVH EKG

A 
SS:
Any of the following:
I R > 14
AVL R > 13
V5 & V6 R + V1 & V2 S > 35

D/t mitral insufficiency, systemic HTN, acute MI, aortic stenosis, aortic insufficiency

31
Q

RVH EKG

A 
SS:
RAD
and
V1 R >S
OR
V6 S > R

D/t pulmonary valve stenosis, COPD, status asthmaticus, PE, mitral valve stenosis or mitral valve insufficiency

32
Q

Hyperlipidemia

A

Def: Excessive accumulation of lipids in blood

SS:
asymptomatic
chest pain
sweating
SOB
TC > 200
LDL > 100
HDL 150
Metabolic syndrome

Eval:
cholesterol screen
framingham score

Txt:
Diet
Exercise
Weight
Statins (atorvastatin) 80 mg qd
Fibric acid (fenofibrate)
33
Q

Metabolic syndrome

A 
Waist size
TG > 150
HDL  
130/85
glucose > 110
34
Q

Hypertrophic cardiomyopathy

A

Def: thickening of ventricle wall and septum

SS:
ejection fraction > 60
DOE
chest pain
sudden death
S4

Eval:
EKG
echocard

Txt:
BB/CCB
anti-arrhytmic
defibrillators

35
Q

Obstructive Sleep Apnea

A

Def: cessation of breathing while sleeping

SS:
snore
excessive tiredness
epworth score

Eval:
sleep study

Txt:
CPAP
weight loss
avoid drugs
surgery
36
Q

Heart Failure

A

Def: inability of the heart to pump blood

SS:
Dyspnea
Cough
Fatigue
Edema
wheezes, rhonchi
Eval:
CBC
BNP
EKG
CXR
echocard

Txt:
Diuretics/ACEI/ARB - reduce load
BB - reduce rate and remodeling reversal
Digoxin - increase Cardiac output

37
Q

Stable angina

A

Def: chest pain that are acute reversible and ischemic

SS:
relieved NTG/rest
ST depression/ T wave invert
Prinzmetal - ST elevate, same time every day
normal troponin

Eval:
EKG

Txt:
nitroglycerin 0.3 mg q5 min x 3
aspirin
BB
CCB
38
Q

Cholesterol guidelines

A
  1. Lipoprotein
  2. Rule out DM, hypothyroid, liver/renal disease
  3. CHD risks: AAA, DM, PAD, DAD
  4. risk factors: smoke, HTN, HDL, Fhx, age
  5. Framingham score
  6. lifestyle changes
  7. metabolic syndrome
  8. after 12 weeks pharm changes

SAPE (15 decks)

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