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Q2 Clin Med Final (Cardiology, Hyperlip) > Cardiac Diagnosis > Flashcards

Cardiac Diagnosis Flashcards

1
Q

Cardiac Enzymes include? (3)

A

CK
CK-MB
Troponins

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2
Q

CK:

Order why?

A

(Creatine Kinase, general mm enzyme)

suspect acute coronary synd (chest pains, etc)

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3
Q

CK:

Order when?

A 
order serially (every 6 hrs inpatient)
Onset = 3-12hrs

Peak = 18-24hrs

Duration = 36-48hrs

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4
Q

CK:

Results mean?

A

High levels indicate:
cardiac mm injury/exertion,
skeletal mm injury/exertion
NOT conclusive for MI

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5
Q

CK-MB:

Order why?

A

If CK is ↑ and suspect acute coronary synd:

More indicative of heart mm vs skeletal

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6
Q

CK-MB:

Order when?

A

Serially:
Onset = 3-12hrs

Peak = 18-24hrs

Duration = 36-48hrs

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7
Q

Troponins:

Order why?

A

Cardiac regulatory protein for actin/myosin interaction,

levels ↑ w/ heart damage

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8
Q

Troponins:

Order when?

A

suspect ACS

Onset = 3-12hrs

Peak = 18-24hrs

Duration = up to 10 days

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9
Q

Troponins:

Results mean?

A

High sensitivity and specificity for heart damage

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10
Q

Telemetry is?

A

continuous ECG monitoring

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11
Q

Exercise ECG Stress Test:

Order when?

A

Stable pt w/ low risk factors

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12
Q

Stress Tests:

Order why?

A

Eval exert chest pain
Diag CAD in sympt pts
Assess functional capacity (during and after exercise)

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13
Q

Stress Tests:

Results mean?

A

Reveals imbalance b/w myocardial O2 demand and supply to diseased coronary arteries:

ST ↓
↑ HR
sxs develop (chest pain, SOB, etc)

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14
Q

Contraindications to Stress Test? (6)

A 
Acute phase of uncomplicated MI/ACS
Acute myo or pericarditis
Rapid arrhythmias
Severe aortic stenosis, anemia, infection
Hyperthyroidism
Acute aortic dissection
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15
Q

Stress Test does NOT tell me?

A

Site or extent of ischemia
LV fxn
(P) incorrect abnormal results

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16
Q

Nuclear Medicine Imaging is?

A

Radioactive tracers for better imaging,

Obtained at rest and exercise

17
Q

Nuclear Medicine Imaging:

Order when?

A

myocardial ischemia present

18
Q

Nuclear Medicine Imaging:

Order why?

A

Locate injured cardiac mm

Eval effectiveness of vessel surgeries

19
Q

Nuclear Medicine Imaging:

Results mean?

A

Thallium visible in healthy mm w/ adequate blood flow

20
Q

Transthoracic Echocardiogram (TTE) is?

A

US of heart

21
Q

TTE:

Order why?

A 
Eval wall motion at or post MI
Calc EF (65% = normal)
Measure heart chambers
Eval valves
Find masses, infection
22
Q

TTE detractors?

A

Chest wall abnormality
Obesity
Movement
Boobs

23
Q

Transesophageal Echocardiogram (TEE) is?

A

US probe down esophagus, behind heart

24
Q

TEE:

Order when?

A

Need better clarity or access to heart

25
Q

TEE:

Order why?

A 
TTE findings +
Septal defects
Foramen ovale patency
AAA
Aortic Dissection
26
Q

Stress Echocardiogram:

Ordered when?

A

Pt has stenosis

Reg ECG ST undiagnostic

27
Q

Stress Echo:

Ordered why?

A

Preop eval
Conduction/repol abnormalities undiag on ECG ST
Eval valves or EF

28
Q

Stress Echo:

Results mean?

A

Wall motion abnorm w/ stress = ischemia

29
Q

Cardiac Cath/Angiogram is?

A

Gold for CAD diagnosis
Cath and dye threaded into heart
See patency of coronary arteries

30
Q

Cardiac Cath/Angiogram:

Order when?

A

Known or suspected CAD
Atypical chest pain
Pre valve surgery if chest pain or ECG Δs

31
Q

Cardiac Cath/Angiogram:

Order why?

A

locate lesions

Can stent or balloon right then

32
Q

Holter monitor is?

A

ambulatory ECG

33
Q

Holter monitory ordered when/why?

A

Correlate activity and symptoms

Eval syncope, palp
Variable HR
Find silent ischemia (ST seg monitoring)

NOT for infrequent events

34
Q

Event Loop Recorder?

A

Similar to Holter but longer
Pt activates at event
Signal immediately transmitted

35
Q

CT ordered when/why?

A

Detect aortic dissection
Detect coronary artery Ca2+ deposits

NOT good if movement

36
Q

MRI ordered when/why?

A 
Eval of:
Aorta
Pericardium
Myocardium
Valves
Abscess/mass
Myo perfusion

Q2 Clin Med Final (Cardiology, Hyperlip) (8 decks)

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