Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPR Exam 1 > Cardiac Clinical Med 4 (Miller) > Flashcards

Cardiac Clinical Med 4 (Miller) Flashcards

1
Q

What is syncope?

A
  • A transient, self-limited loss of consciousness due to cerebral hypoperfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three categories of syncope?

A
  • Neurally mediated syncope
  • Cardiac syncope
  • Orthostatic hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is neurally mediated syncope?

A
  • Transient
  • Vasovagal syncope
  • Carotid sinus syndrome
  • Situation syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is cardiac syncope?

A
  • Due to arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is orthostatic hypotension?

A 
- Chronic
Subtypes
- Initial 
- Classic
- Delayed
- Neurogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some syncope mimics?

A
  • Seizures
  • Sleep disturbance
  • Trauma
  • Metabolic/toxic disorders
  • Psychogenic/pseudo-syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the clinical presentation of neurally mediated syncope?

A
  • Orthostatic intolerance
  • Autonomic activation
  • Eyes remain open and deviate upward, pupils dilated
  • Urinary incontinence may occur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the autonomic activation in neurally mediated syncope?

A
  • Diaphoresis
  • Pallor
  • Palpitations
  • Nausea
  • Hyperventilation
  • Yawning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the clinical presentation of orthostatic hypotension?

A
  • Reduction in systolic BP of > 30 mmHg or diastolic BP > 10 mmHg within 3 min of standing
  • Will have lightheadedness, dizziness, and presyncope with postural change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the clinical presentation of cardiac syncope?

A
  • Will occur suddenly and with few warning symptoms

- Often while supine or during exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is syncope diagnosed?

A
  • Need a detailed history
  • Look for key elements like: history of CV disease
  • Medication reconciliation (some meds could be causing)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What testing can be done to help diagnose syncope?

A
  • EKG to look for abnormalities
  • CBC w/ electrolytes
  • BNP and troponin if suspicious of cardiac cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some different monitors to help track episodes of syncope?

A
  • Holter
  • Event monitor
  • External loop recorder
  • Internal monitor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would constitute an outpatient stay with syncope?

A
  • Presumed neurally mediated syncope

- Cardiac syncope with no serious condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would constitute observation with syncope?

A
  • Age >50
  • h/o cardiac disease
  • Functioning cardiac disease
  • Abnormal ECG
  • FH sudden cardiac death
  • Symptoms do not point towards neurally mediated syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What would constitute admission with syncope?

A
  • Major cardiac arrhythmias
  • Serious CV condition
  • Noncardiac conditions (severe anemia, major trauma, persistent abnormal VS)
17
Q

What is the treatment for neurally mediated syncope?

A
  • Increase central blood volume and cardiac output
  • Reassurance, avoid triggers and plasma volume expansion with fluid and salt
  • Physical counterpressure maneuvers of the limbs
18
Q

What is the treatment of orthostatic hypotension?

A
  • Remove reversible causes like meds
  • Teach patient about moving properly from supine to upright
  • Compression stockings and counterpressure maneuvers
  • Midodrine or fludrocortisone
19
Q

What is the treatment of cardiac syncope?

A
  • EPS

- Treat underlying cardiac disorder

20
Q

What are the modifiable risks of hypertension?

A
  • Smoking
  • DM
  • Dyslipidemia/hypercholesterolemia
  • Obesity
  • Inactivity
  • Unhealthy diet
21
Q

What are some relatively fixed risk factors of hypertension?

A
  • CKD
  • Family history
  • Age
  • Socioeconomic status
  • Male sex
  • Obstructive sleep apnea
  • Psychosocial stress
22
Q

What are some pathological consequences of hypertension on the heart?

A
  • Structural adaptations like:
  • LVH
  • HF
  • Atherosclerotic CAD and microvascular disease
  • Cardiac arrhythmias including a fib
23
Q

What are some pathological consequences of hypertension on the brain?

A
  • CVA
  • Impaired cognition/dementia
  • HTN encephalopathy
24
Q

What are some pathological consequences of hypertension on the kidney?

A
  • Renal injury

- ESRD

25
Q

What are some pathological consequences of hypertension on the peripheral arteries?

A
  • PAD
26
Q

What is defined as primary HTN?

A
  • Elevated BP with no specific underlying disorder
27
Q

What is defined as secondary HTN?

A
  • Elevated BP with a specific underlying disorder
28
Q

What is asymptomatic severe HTN?

A
  • Severe BP elevation (180/110) WITHOUT end organ damage
29
Q

What is a hypertensive emergency?

A
  • Severe BP elevation (180/110) WITH symptoms of end organ damage
30
Q

What is defined as normal BP?

A
  • < 120/80
31
Q

What is defined as elevated BP?

A
  • 120-129/<80
32
Q

What is defined as stage 1 HTN?

A
  • 130-139/80-89
33
Q

What is defined as stage 2 HTN?

A
  • > 140/90
34
Q

What can patients do to help treat and prevent HTN?

A
  • Reduce weight and salt intake
  • Adapt to a DASH diet
  • Moderation of alcohol consumption
  • Physical activity
35
Q

How do we choose which medications to use in the treatment of HTN?

A
  • Choose based on safety and individual efficacy
  • Blacks do better on CCBs or diuretics
  • Whites do better on ACEi or ARBs
36
Q

What should you include in the reassessment of hypertension?

A
  • Detection of orthostasis
  • ID white coat effect
  • Document adherence
  • Monitor response
  • Reinforce importance of treatment and assistance in achieving BP target
37
Q

What is the clinical presentation of someone with HTN emergency?

A
  • Agitation, delirium, stupor, seizures, nausea/vomiting
  • Focal weakness, numbness, dysarthria, aphasia
  • Visual disturbance, fresh flame hemorrhages, exudates, papilledema
  • Chest discomfort, palpitations
  • Acute severe back pain
  • Dyspnea
38
Q

What do you do when someone has a HTN emergency?

A
  • Need EKG, CXR, UA, serum electrolytes and creatinine

CPR Exam 1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions