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IM MedEd > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Best drug to lower LDL?

Side fx?

A

STATIN —| HMG CoA Reductase

Fx: hepatotoxicity,myositis

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2
Q

Drug to lower LDL & Raise HDL but causes flushing…

How do you prevent this side fx?

A

Niacin –| HSL in fat, decreasing FFA transport

Fx: flushing!, hepatotoxicity
Prevent flushing with asprin!

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3
Q

Best drug to lower total cholesterol? Side fx?

A

Fibrates –> PPAR-a agonist = increases lipolysis, raising HDL & lowering TC

Fx: gallstones, myositis

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4
Q

Lipid drug that causes diarrhea, constipation, gallstones & bloating? Mechanism of action?

A

Resins –> increases secretion of bile acids in GI resutling in decreased LDL

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5
Q

Drug that blocks the absorption of cholesterol in the intestines? Fx?

A

Ezetimibe = decreases LDL

Fx: myositis, contipation, bloating, diarrhea

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6
Q

Who gets a statin?

A
  1. Vascular disease
  2. LDL >/= 190
  3. LDL 70-189 + 40-75yoa +DM or 10yr risk
  4. LDL 70-189 + 40-76 w/calculated risk
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7
Q

How often do you check lipids in a person on a statin or w/hypercholesteremia?

A

ANNUALLY!

*dont need to check liver shit unless symptoms

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8
Q

SIRs Criteria requires 2+ of….

A
  1. Temp >38 or <34
  2. HR >90
  3. RR>20 or PaCO2 <32
  4. WBC >12000 or <4000 or >10% bands
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9
Q

How often do you screen for cholesterol levels?

A

35q5

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10
Q

Screening for osteoporosis?

A

> 65

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11
Q

Breast cancer screening?

A

50q2 till 75

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12
Q

Cervical cancer screening?

A

21q3 till 75

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13
Q

HTN screening?

A

18q2

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14
Q

Tx of SIRs?

A
  1. Give 30cc/kg bolus IVF
  2. Remove sources of infection
  3. O2 as needed
  4. Pressers of bolus fails
  5. Empiric abx
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15
Q

Treatment fo HF for EVERYBODY?

A

<2g of salt per day, <2L H2O per day, ACE/ARB, BB

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16
Q

Tx for reducing preload in HF pt…which type needs a reduced preload?

A

Diuretics(furosemide), Nitrates, Dietary modifications.

*usually diastolic needs this

17
Q

Diastolic heart failure etiology

A

FILLING FAILURE due to Pericardium(tamponade, constrivie pericarditis) or Cardiomyopathy(restritive or hypertrophic)

18
Q

Systolic HF etiology

A

FORWARD failure due to Leaky valves(regurge), Dead heart(ischemia/infarct), floppy muscles(HTN, EtOH, Drugs)

19
Q

NYHA classifications of HF…

A

1: no limitations, no sx
2: slight limitation, comfortable at rest and walking
3: Moderate, comfortable at rest only
4: bed bound, sxs at rest

20
Q

Tx for reducing afterload in HF pt….who needs this?

A

usually needed by systolic failure

- ACE/ARB, Hydralazine, Spironolactone

21
Q

When do you use inotropes like dobutamine in HF?

A

once they reach class 4 = bed bound w/sxs at rest

22
Q

Who gets anticoagulated?

A

Ppl with a score of 2 on CHAD2(CHF, HTN, age>/=75, DM or previous stroke or TIA(2pts)). A fib with out these RF = no anticoagulant

CHAD = 1 use ASA only

23
Q

40 yo male w/2 wks fever, malaise, wknes, weight loss, L sided chest pain + ab pain. decrease lung sounds + dullness in L lower. 2/6 systolic murmer. L sided pleural effusions, splenomegaly w/splenic fluid. dx?

A

Infectivie endocarditis causing splenic abscess

Prob due to staph or strep

24
Q

Drug user who now has Fever, cough + some endocarditis. MC endocardiits? what murmer would you hear?

A

Tricupid due to Staph Aureus = triscupid regurge = holosytolic murmer that increases with inspiration

25
Q

What heart shit is atropine used for?

A

Bradycardia and 1 degree av block

26
Q

What heart shit is adenosine used for?

A

SVT >150

27
Q

What heart shit is mg used for?

A

Torsades

28
Q

What heart shit is amiodarone used for?

A

Torsades and vtach *can also use lidocaine

29
Q

What heart shit is used for stable afib?

A

CCB(diltiazam), BB, digoxin = rate control

30
Q

Which heart shit gets worse with leg raise/squat and better with valsalva/standing ?

A

Mitral stenosis, aortic stenosis, mitral regurg and aortic regurg

31
Q

How do you treat hypertrophic cardio myopathy

A

Avoid dehydration and give beta blockers

32
Q

How do you treat restrictive cardiomyopathy? What would you see on echo?

A

Look for dilated atrium and hypertrophic ventricles. Treat with gentle diuresis

33
Q

How do you treat heart failure?

A

LMNOP = Lasix, morphine, oxygen, nitro, position

34
Q

What heart defect will remain a fever cause? What can this lead you down the road?

A

Mitral stenosis which can eventually present as atrial fib you Laois and’s and should be treated with rate controlled via calcium channel blocker‘s beta blockers or digoxin

35
Q

Respiratory variation in systolic bp(pulses paradoxus), hypotension, tachycardia, jvd + widener mediastinum. Dx?

A

Cardiac tamponad = pericardial fluid accumulation

IM MedEd (24 decks)

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