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Lab Medicine > Cardiac Workup > Flashcards

Cardiac Workup Flashcards

1
Q

what does an elongated Q wave indicate?

A

Possible previous MI

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2
Q

what are the descending numbers for the lines for rate?

A 
300
150
100
75
60
50
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3
Q

for rhythm what should you look for?

A

each QRS complex is preceded by a P wave and each P wave is followed by a QRD complex

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4
Q

2 indicators of ischemia

A

T-wave inversion

ST depression

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5
Q

infarction indications

A

ST elevation

new LBBB in setting of CP, presumed STEMI until proven otherwise

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6
Q

What are the lateral leads

A

I and AVL, V5 and V6

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7
Q

is diffuse ST elevation likely a STEMI?

A

no, usually a pericarditis (will also have QRS complex alternanas)

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8
Q

what are the inferior leads?

A

II, III and AVF

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9
Q

What doe the inferior leads correspond to?

A

RCA (right circumflex artery)

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10
Q

What do the lateral leads correspond to?

A

Circumflex vessels

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11
Q

criteria for ST elevation MI

A

abnormalities in 2 continuous leads

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12
Q

can you diagnose cardiomegaly with a AP?

A

No due to magnification

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13
Q

with an aortic dissection what can be widened?

A

mediastinum

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14
Q

why is CMP important?

A

renal function
LFTs
K+

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15
Q

what are troponins meant to do?

A

Diagnose heart attacks, but can be elevated for other reasons

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16
Q

value of other cardiac enzymes?

A

don’t have much role

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17
Q

what is PBNP an indicator for?

A

CHF, but can be chronically elevated with renal dz

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18
Q

what is the most valuable diagnostic tool in cardiology?

A

Echocardiogram

19
Q

what must you send with an arrhythmia to a cardiologist?

A

TSH level

20
Q

why do we care about PTNR?

A

want to know baseline before giving an anticoag

21
Q

why do we care about LFTs?

A

produce clotting factors

22
Q

High AST, High ALT, elevated PTNR- what do they likely have?

A

Liver Dz

23
Q

reasons people will have a murmur that aren’t structural problems?

A

hyperdynamic
sick
dehydrated

24
Q

what problem with the pericardium can echo diagnose?

A

Pericardial effusion (but not pericarditis)

25
Q

What is a more specific test for endocarditis?

A

Trans esophageal echo

26
Q

normal ejection fraction?

A

55-65% (same as gallbladder)

27
Q

what are wall motion abnormalities indicative of?

A

ischemic in that area (not getting good blood supply)

28
Q

what is hypokinesis?

A

part of the heart is barely moving (MI in that area)

29
Q

what is apical ballooning?

A

diagnostic of broken heart syndrome

Takotsubo cardiomyopathy

30
Q

How do you determine is someone has CAD or not

A

risk stratification

31
Q

what are some non-invasive stress stests

A

Exercise treadmill- young men
stress echo- most common
nuclear stress test

32
Q

what do you do a nuclear stress test for?

A

LBBB
CABG
can’t do treadmill
known CAD

33
Q

what is the preferred non-invasive test?

A

Stress echo

34
Q

what is an invasive evaluation for ischemic?

A

left heart catheterization

35
Q

what conditions do we defibrillate?

A

V-tach

V-fib

36
Q

what conditions do you cardiovert for?

A

must put cardiovert on the machine
less energy is used
used for hemodynamically unstable

37
Q

how long does it take to r/o a heart attack?

A

6 hours (takes that long for troponins to reveal themselves)

38
Q

how much ASA do you give for an MI?

A

2 baby aspirins chewed (160 mg)

39
Q

if you give nitroglycerin and chest pain goes away is it cardiac?

A

Not necessarily- possibly esophageal

40
Q

Meds for MI?

A 
ASA
O2
Nitro
Morphine 
anticoags (heparin, lovenox) 
anti-platelets (aspirin, plavix) 
BBs
statins
41
Q

Difference b/w unstable and STEMI

A

Unstable angina- manage like ischemic event but you have objective evidence other than hx (EKG and labs are normal)
NSTEMI- hx and abnormal troponin or ECG

42
Q

what do people with a NSTEMI get?

A 
Aspirin
Lovenox or Heparin
morphine PRN 
statins 
Beta blockers (oral) 
Nitroglycerin PRN 
will eventually get cathed
43
Q

Who goes to the cath lab sooner, STEMI or non-STEMI

A

STEMI

Lab Medicine (12 decks)

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