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P3.2 > Cardiac CIS > Flashcards

Cardiac CIS Flashcards

1
Q

ddx for dyspnea

A
  • medications (B blocker in COPD pt_
  • cardiac
  • metabolic- thyroid dz
  • neuromuscular
  • psychogenic- anxiety, PTSD
  • pulm
  • upper airway
  • other- anemia, obesity
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2
Q

platypnea

A

-diff in breathing when erect

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3
Q

PND (paroxysmal nocturnal dyspnea)

A
  • SOB at night- wakes pt after an 1-2 hrs

- caused by pulm congestion from left HF

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4
Q

hyperpnea

A

-breathing deeper and more rapid

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5
Q

hypopnea

A

-breathing shallower and slower

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6
Q

NYHA classification of Heart Disease/Failure

A
  • 1- no limitation of physical activity
  • 2- slight limitation of physical activity- ordinary physical activity causes symptoms
  • 3- marked limitation of physical activity- less than ordinary activity causes symptoms
  • 4- unable to engage in any physical activity w/o discomfort, can occur at rest
  • 5- atypical symptoms, either at rest or exertion
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7
Q

ACC/AHA classification of Heart Disease/Failure

A
  • A- at high risk, no symptoms
  • B- structural heart dz, no symptoms
  • C- current or prior symptoms
  • D- refractory HF- need device or special intervention
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8
Q

left HF- symptoms

A
  • low cardiac output
  • elevated pulm venous pressure
  • congestion
  • dyspnea!
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9
Q

right HF- symptoms

A

-fluid overload- edema, JVD!

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10
Q

systolic HF

A
  • dec ejection fraction
  • LVEF < 40%
  • CAD/MI, HTN, tachycardia or atrial arrhythmias
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11
Q

diastolic HF

A
  • dec ability of ventricles to fill with blood
  • aging and myocardial stiffening
  • LVH from HTN
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12
Q

management of chronic HF

A
  • ACEI
  • aldosterone antagonist
  • B blockers
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13
Q

Hydrochlorothiazide- can lead to what electrolyte abnormalities

A
  • low K, Na, Cl, Mg

- high Ca, uremic acid

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14
Q

ACEIs- adverse reactions

A
  • dry cough
  • angioedema
  • hyperkalemia in setting of AKI
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15
Q

Delirium tremens (DTs)

A
  • severe alcohol withdrawal
  • hallucinations, disorientation, agitation, tachycardia, HTN, etc
  • 48-96 hrs after last drink, can last up to 7 days
  • hyperventilate-> resp alkalosis
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16
Q

DTs- why give thiamine and glucose?

A

-prevent Wernicke’s encephalopathy

17
Q

what is a banana bag

A
  • IV infusion of thiamine, folate, multivitamin in isotonic saline with 5% dextrose
  • treats DTs
18
Q

causes of black colored stools

A
  • iron supplements
  • beets
  • pepto-bismol
  • upper-GI bleed
19
Q

treatment for sinus tachycardia

A

-treat underlying cause

20
Q

cause of absent pedal pulses

A

-peripheral vascular dz

21
Q

rheumatic fever

A
  • group A streptococcal infection

- rash- erythema marginalization

22
Q

acute coronary syndrome- presentation

A
  • chest pain
  • radiation
  • palpitations
  • nausea- from vagal stimulation
  • diaphoresis
  • dyspnea
23
Q

acute coronary syndrome- most commonly presents as?

A

pressure-type chest pain- occurs at rest or minimal exertion, >10 min

  • radiate to arms, neck, jaw
  • inc exertional dyspnea
24
Q

atypical presentation of acute coronary syndrome

A
  • older pts, women
  • diabetes mellitus, impaired renal fxn, dementia
  • epigastric pain, indigestion, inc dyspnea
25
Q

immediate treatment for ACS

A

MONA-B

-morphine, O2, nitroglycerine, ASA, B blocker

26
Q

ACS- labs

A
  • cardiac markers- Troponin- Q6h x3
  • CXR
  • EKG
  • lipid panel- fasting in am
  • urine drug screen
27
Q

STAT cath lab- when?

A

uncontrollable chest pain, new left BBB, STEMI

28
Q

nitroglycerine- contraindicated when?

A

-when pt is taking phosphodiesterase inhibitors (sildenafil- viagra)

29
Q

pericarditis- DDX

A
  • idiopathic
  • infectious- viral!!
  • autoimmune
  • neoplasm
  • cardiac
  • trauma
  • radiation
30
Q

history for pericarditis

A
  • autoimmune disorders
  • viral infection
  • trauma
  • medications
  • TB and HIV
31
Q

pericarditis- major clinical manifestations

A
  • chest pain- pleuritic, sharp, radiation to shoulders
  • pericardial friction rub
  • pain improved by sitting upright, leaning fwd
32
Q

pericarditis- EKG

A
  • diffuse ST segment elevations

- PR depression

33
Q

pericarditis- stages of EKG

A
  • diffuse ST segment elevation with PR depression
  • ST segment returns to isoelectric line
  • T wave inversions
  • EKG becomes normalized
34
Q

pericarditis- used to monitor treatment progression

A

-CRP (acute phase reactant)

35
Q

pericarditis- treatment

A
  • ASA 650-1000 mg PO TID for 1-2 wks

- Colchicine 0.5-0.6 mg PO BI for 3-6 months

36
Q

refractory pericarditis

A

-use corticosteroids

37
Q

contraindicated in pericarditis

A

-anticoagulation- risk for cardiac tamponade

P3.2 (11 decks)

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