Cardiac

Question 1

Mechanism of dobutamine

Answer 1

Increasing contractility and promoting vasodilation along with increasing renal perfusion and UOP

Question 2

Cardiac tamponade physiology

Answer 2

Beck triad- hypotension distended jugular veins and miffled heart tones
Narrowed pulse pressure, altered neuro status, pericardial rub, shock, tachycardia, and tachypnea

Question 3

Beck triad

Answer 3

Beck triad- hypotension, from low CO, distended jugular veins, from heart compression, and muffled heart tones from fluid in the pericardial space

Question 4

Pericarditis

Answer 4

Inflammation of the pericardium often caused by bacterial or viral infections, metabolic disorders, medication reactions, kawasaki and some others
S/S- chest pain, fever, pericardial friction rub

Question 5

B1 adrenergic stimulation

Answer 5

Increased myocardial contractility and increased heart rate

Question 6

B2 adrenergic stimulation

Answer 6

Vasodilation

Question 7

Alpha adrenergic stimulation

Answer 7

Increased SVR through smooth muscle contraction

Question 8

Dopaminergic stimulation

Answer 8

Dilation of renal and mesenteric vasculature

Question 9

1st line anti rejection medication

Answer 9

Methylprednisolone

Question 10

Exercise stress testing goal HR formula

Answer 10

Peak HR= 220 - age in years

Question 11

Stills murmur

Answer 11

*most common

Mid left sternal border grade 2-3 vibratory, quieter or disappears when upright

Question 12

Pulmonary ejection murmur

Answer 12

8-14 y/o
Left upper sternal border
Grating, no radiating, grade 1

Question 13

Venous hum

Answer 13

Innocent murmur
Continuous where diastolic is louder than systolic
Can only be heard when upright

Question 14

Peripheral pulmonic stenosis murmur

Answer 14

Innocent
Newborns and preterm
Transmits to axilla and back
Disappears around 3-6 months

Question 15

Carotid bruit

Answer 15

Supraclavicular

Innocent

Question 16

Jones criteria for acute rheumatic fever

Major

Answer 16

Migratory arthritis
Carditis and valvulitis
CNS involvement-chorea
Erythema marginatum
Subq nodules

Question 17

Jones criteria for acute rheumatic fever

Minor

Answer 17

Argralgia
Fever
Elevated inflammatory markers
Prolonged PR

Question 18

Main infectious agent of rheumatic fever

Answer 18

Group a strep

Question 19

Most deadly cardiomyopathy

Answer 19

Restrictive because of the stiff heart walls

Question 20

Acute rheumatic fever management

Answer 20

Penicillin
Aspirin
Cards and ID consult

Question 21

Long qt syndrome tx

Answer 21

Beta blockers

May need an ICD or pacemaker

Question 22

S/sx of cardiomyopathy

Answer 22

Sob fatigue lethargy chf decreased appetite

Question 23

3 types of cardiomyopathies

Answer 23

Dilated hypertrophic and restrictive

Question 24

Cardiomyopathy management

Answer 24

Stable- ACE inhibitors or beta blockers

Acute- increase CO with inotropes vasodilators and diuretics

May need antivirals, IVIG, VAD ECMO or heart transplant

Question 25

Myocarditis

Answer 25

Serious acute infection of myocardium, usually viral | Very ill appearing with murmur, sinus tach at rest and sudden heart failure

Question 26

Gold standard myocarditis diagnostic

Answer 26

Biopsy ;EMB)

Question 27

Pericarditis symptoms

Answer 27

Fever tachypnea tachycardia friction rub and tamponade

Question 28

Myocarditis management

Answer 28

Ace dig diuretics ivig

Question 29

Pericarditis tx

Answer 29

Emergent pericardiocentesis | Abx for 3-4 weeks for presumed staff and hflu

Question 30

Endocarditis symptoms

Answer 30

Fever murmur embolus phenomenon myalgias malaise Pete his vasculitis and osler nodes

Question 31

Which way to acyanotic lesions shunt

Answer 31

Left to right

Question 32

Hallmark vsd murmur

Answer 32

Regurgitant systolic murmur at llsb | Usually holosystolic

Question 33

Hallmark signs of ASD

Answer 33

Female and slender Widely split fixed S2 grade 2/3 at LUSB often asymptomatic and spontaneously close

Question 34

3 components of AV canal

Answer 34

ASD, inlet VSD, abnormal formation of AV valves resulting in l to r shunting

Question 35

Coarc symptoms

Answer 35

Upper extremity hypertension absent of weak LE pulses, pulmonary edema in neonates with LV failure, risk for intracranial hemorrhage

Question 36

Vascular ring

Answer 36

Trachea and esophagus surrounded by vascular structures or the aorta causing compression

Question 37

Vascular sling

Answer 37

Pulmonary artery is between trachea and esophagus causing trachea compression

Question 38

4 defects in TOF

Answer 38

Vsd Rvot obstruction Overriding aorta Rvh

Question 39

How to treat a tet spell

Answer 39

``` Oxygen Morphine Knee to chest Bicarb *try to keep calm to prevent ```

Question 40

Pulmonary atresia tx

Answer 40

PGE at birth then BT shunt

Question 41

BT shunt

Answer 41

Used to increase pulmonary blood flow in ductal dependent lesions Basically making a PDA Connection between PA and carotid

Question 42

Cardiac complication of RF

Answer 42

Mitral stenosis

Question 43

Complications/sx of mitral stenosis

Answer 43

Fatigue SOB hemoptysis LA enlargement, a fib, blood clots, pulmonary edema, pulmonary htn Grade 1-4 apical murmur

Question 44

Treatment for unstable SVT

Answer 44

Synchronized cardioversion 0.5-1j