Cardio 1 Flashcards by Kelsey Johnson | Brainscape

Q

Hamman’s Sign

A

Diangosis- Spontagnous Pneumomediastium

crunching sound heard on auscultation of the mediastinum with each heartbeat

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Q

Treatment for Spontagnous Pneumomediastium

A

Self limiting
on CXR will show air around heart
* painful neck area and crunching heard

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Q

PPD what size of induration to be postitive

HIV

A

<5mm

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Q

PPD what size of induration to be postitive

Health Care worker

A

> 10mm

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Q

PPD what size of induration to be postitive

IV drug user

A

> 10mm

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Q

PPD what size of induration to be postitive

Child

A

> 10mm

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Q

PPD what size of induration to be postitive

know risk factor for TB

A

> 15 mm

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Q

which of the following findings is most suggestive of Pneumocystis jiroveci pneumonia

A

Serum Lactate dehydrogenase

the higher the value the worse prognosis

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Q

Sarcodosis will have what main buzz words

A

cough, fever
uveitis
bilateral adenopathy
Subcutanous nodules - erythema nodosom

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Q

Causes of Trasudative pleural effusion

A

CHF
Cirrohsis
PE
Nephrotic

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Q

Causes of Exudative pleural effusion

A

Maligancy
TB 
Bacterial or viral PNA 
pancreatitis 
Collagen disorders 
Esophagus rupture
lupus *

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Q

Age 55-80 history of 30 years Smoking what is the screening test

A

low dose CT scan

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Q

What lab value is elevated in Scarcodosis

A

ACE
serum angiotensin converting enzyme *
ESR
Hypercalcemia

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Q

most common cause of restrive cardiomyopathy

A

amlyodosis

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Q

what is the most common cardiomyopathy

A

dilated - “Fat heart”

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Q

Systolic or diastolic

Dilated

A

Systolic

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Q

Systolic or diastolic

Restricitive

A

Diastolic

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Q

Systolic or diastolic

Hypertrophic

A

Diastolic

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Q

Most common cause of Dilated cardiomyopathy

A

*Virus- young healthy
Genetic
*Alcoholism 
postpartum 
chem
heroin

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Q

Key terms- CHF, weakness, SOB, periperal edema
on exam- crackles, S3, JVD
xray- fluffy inflitrates, increased cardiac sillouette

A

Dilated cardiomyopathy

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Q

Best diagnostic tool for cardiomyopathies

A

ECHO-> either
TTE
TEE

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Q

Most common cause of restricitive cardiomyopathy

A

*Amyloidosis
Sarcoidosis
radiaion
Diabetes

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Q

What is the diagnosis-

TTE shows marked biatrial enlargment with non-dialted ventricles

A

Restrictive cardiomyopathy

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Q

Best diagnostic test for Restrictive cardiomyopathy

A

TTE & definitive Biopsy

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Q

Key terms- heart murmur

middiastolic crecendo-decredo increases with valsalva and decreases with squatting

A

Hypertrophic cardiomyopathy

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Q

Treatment for HOCM

what do you want to avoid?

A

BBlockers, impant defib

avoid postitive ionotropes - epi

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Q

Rate is 50 P waves in II, III, AVF

A

Sinus bradycardia

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Q

Rate 50 No P waves in II, III AVF, QRS narrow

A

Junctional Rhythm

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Q

Rate 20-40 wide QRS

A

Ventricular rhythm

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Q

1 P wave for every QRS, PR prolonged >0.2 constant

A

1 degree AV block

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Q

P waves upright, QRS narrow, PR progessively increasing and one dropped QRS not followed by a P wave

A

2 degree, Type I AV block

Wenckebach

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Q

P waves upright, QRS narrow, PR is contant, dropped QRS not followed by a P wave

A

2 degree, Type II AV block

PACE THEM

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Q

P waves upright, QRS regular, but irregular PR intervals

P waves and QRS waves are unrelated

A

3 degree AV block

PACE THEM

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Q

Rate >100, P wave for every QRS

A

Sinus Tachycardia

P wave can be attached to T wave - camel hump

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Q

Rate >150, P waves can be hidden or followed by a QRS

A

Superaventricular Tachycardia

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Q

Rate >300, sawtooth waves

A

Atrial flutter

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Q

Treatment for Atrial Flutter

A

AV node blockers
amiodarone
cardioverision
anticoagulation

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Q

No distinct P waves, regular artial activity but irregularly irregular

A

Atrial Fibrillation- A fib

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Q

Treatment for A fib

A

AV node blockers
amiodarone
cardioverision
anticoagulation

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Q

3 or more P wave Morphology

A

Multifocal artial tachycardia
caused by:
COPD
Theophyllin

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Q

How do you figure out someones max heart rate?

A

Their age - 220

Q

Rate >120, Wide QRS complex, no clear P waves

A

Ventricular Tachycardia

Q

Treatment of V tachycardia

A

Liocaine
Procainamide
Amiodarone
Cardioversion

Q

Polymorphic V- Tach

A

Torsades de pointes

Q

Prolonged QT >500msec

A

Polymorphic V- Tach

Torsades de pointes

Q

Causes of Polymorphic V- Tach

A

Torsades de pointes : 
Hypo K 
Hypo mag
Hypo Calcium
sodium channel blockers
increase intracrainal pressure
Hypothermia

Q

What drugs do you need to avoid in WPW

A

AV node blockers 
-> bblockers
-> calcium channel blockers
-> digoxin 
-> amirodarone
YOU WILL KILL THEM

Q

Exteme rapid rate, disorganized ventricular activity, No pulse, patient is unresponsive
what is diagnosis & treatment

A

Ventricular Fibrillation

DEFIBRILLATION

Q

What are the two Tachycardias that you DO NOT SHOCK

A

Sinus tachy and Multifocal atrial tachy

Q

Treatment for SVT

A

Vagal - ice pack on face
Bolus of saline
Adenosine- type IA
Bblockers
Amidrodrone

Q

How do you administer
Adenosine?
what are some side effects to warn the patient?

A

PUSH ! half life of 10sec
Then follow by saline
and elevate arm
warn the patient they will feel super flushed and feel pressure in their chest

Q

What is the most effective medication for cardioversion

A

Procainimide

Q

Drug category:
Pheneizine
Tranylcypromine
Selegiline

A

Monoamine Oxidase Inhibitors- MAOI’s

Q

MOA: inhitibts MAO which breaks down catecholamines

A

Monoamine Oxidase Inhibitors- MAOI’s
Pheneizine
Tranylcypromine
Selegiline

Q

Side effect: Hypertensive crisis with tyramine containing foods like cheese, wine.

A

Monoamine Oxidase Inhibitors- MAOI’s
Pheneizine
Tranylcypromine
Selegiline

Q

Drug category:
Amitriptyline
Imipramine
Doxepin

A

Ticyclics

Q

MOA: inhibits reuptake of serotonin, norepinephrine and dopamine

A

Ticyclics
Amitriptyline
Imipramine
Doxepin

Q

Side effects: Dry mouth, urinary retention, blurred vision, sedation, orthostatic hypotension, setotonin syndrome

A

Ticyclics
Amitriptyline
Imipramine
Doxepin

Q

Drug category: 
Fluoxetine
paroxetine
Sertaline
Citalopram
Escitalopram

A

Selective serotonin reuptake inhibitors- SSRI’s

Q

MOA: Inhibitis reuptake of serotonin

A

Selective serotonin reuptake inhibitors- SSRI’s

Q

Side effects of this drug:
Loss of libido
weight gain
serotonin syndrome

A

Selective serotonin reuptake inhibitors- SSRI’s

Q

Drug category:
Venlafaxine
Desvenlafaxine
Duloxetine

A

Serotonin Norepinephrine reuptake inhibitors - SNRI

Q

MOA: inhbits reuptake of serotonin and norepinephrine

A

Serotonin Norepinephrine reuptake inhibitors - SNRI

Q

Side effects of this drug: Loss of libido, increased blood pressure, serotonin syndrome

A

Serotonin Norepinephrine reuptake inhibitors - SNRI

Q

Drug category: 
Nefazodone
Vortixetine
trazodone
Vilazodone

A

SSRI/ 5HT agonists

Q

MOA: norepinephrine and dopamine retuptake inhibitor

A

Bupropion

Q

Bupropion side effects

A

anxiety
Restlenssness
insomnia
lowers seizure threshold * do not give to anorexic patient

Q

Drug cateogry: 
Diazepam
Lorazepam
Temazepam
Oxazepam

A

Benzodiazepine

Q

MOA: GABA agonist, decreases neuronal excitability

A

Benzodiazepines & Barbiturates

Q

What is the reversal agent to Benzodiazepines

A

Flumazenil

Q

Drug category:
Phenobarbital
Pentobarbital

A

Barbiturates - used for anesthesia and seizures

Q

what drug increases the P450 system

A

Barbiturates:
Phenobarbital
Pentobarbital

Q

what are the two types of heart failure

A

low out put

high out put

Q

What are cause of low-out put heart failure

A

Coronary artery disease
hyptertension
valve disease
cardiomyopathies

Q

EXAM*

What are cause of High-out put heart failure

A

Thyrotoxicosis
Severe anemia
Beriberi - thiamine def
Paget’s disease

Q

What is the most common cause of right heart failure

A

LEFT heart failure

Q

BNP levels are important for what disease state?

A

Heart failure
>500 decompensated CHF
if chronic 100-500

Q

what conditions can cause mild elevation in BNP

EXAM*

A

chronic CHF
eldery women
Pulmonary embolism
COPD
pulmonary hypertension

Q

What will a x-ray of CHF look like

in progression of disease

A

cardiomegaly
cephalization-> fluid in upper lungs
Kerley B lines-> lateral lung fields
Alveolar fluid
Pleural effusions

Q

what two medications have been proven to reduce morality in Heart Failure

A

ACE - reduces afterload

BBlockers

Q

What medications decrease preload?

A

Nitrates

Loop diuretics

Q

What medications decrease afterload ?

A

ACE
high nose nitrates
Nitroprusside

Q

What medication decrease preload and afterload

A

Nitrates

Q

Most common cause of Primary essential hyptertension

A

Alcohol
AA
Smokers 
Lack of exercise 
NSAIDS

Q

Normal BP
Prehypertension
Stage 1
Stage 2

A

<120 / 80
120-139 / 80-90
140-159 / 90-99
>160

Q

What are blood pressure goals for
ALL
>60, DM & CKD

A

< 140 / 90

<150 / 90

Q

If an african amercian is placed on ACE what are they are risk for?

A

Angioedema

Q

Causes of refactory hypertension

A

phenochromocytoma
Renal artery stenosis
coractation of the aorta 
Cushings 
chronic steroid use 
hyperaldosteronism

Q

what are some causes of hypertensive emergencies

A

Aortic dissection
pulmonary edema
MI 
Cerebral hemorrhage
encephalopathy 
preeclampsia/ ecclam

Q

Severe HTN, elevated BUN, optic disc is fuzzy

A

Malignant hypertension

- > paplliedema

Q

What is the BP level of Hypertensive urgency

Hypertensive emergency

A

urgency > 180 / 120
no organ damage

Emergency > 160/120
organ damage

Q

Treatment for urgency

A

Quicker!
24 hour rule
25% within the first few hours
IV drip

Q

Treatment for Emergency

A

Gradually!
24-48 hour rule
less than 25% within the first hour
Goal 2-6 hours get BP 160/100

Q

Hypertensive emergency will have what organs affected?

A

Hypertensive stroke 
seizure
Encepahlopathy 
retinopathy- hemorrhages, exudates, papilledema
elevated BUN/creatinin

Q

Treatment for Acute aortic syndrome with

hypertensive emergency

A

this one you can decrease BP as fast as you can
IV bblocker
<60bpm, systolic 100/120

Q

Treatment for Neuologic hypertensive emergency

A

CCB first line

Nicradipine

Q

Treatment for Aortic hypertensive emergency

A

bblocker : Esmolol

2. Nitroprusside

Q

Treatment for Acute MI hypertensive emergency

A

Nitro

2. BBlocker - give 2

Q

Treatment for

Acute heart failure hypertensive emergency

A

Nitroprusside

Q

What cardiac drug can cause cyanidie toxicity and drug is light sensitivity

A

Nitroprusside

Q

Treatment for

Renal hypertensive emergency

A

CCB- nicardipine

2. BBlocker- lobetalol

Q

Treatment for

Pregnancy with hypertensive emergency

A

Hydralazine
Labetalol
magnesium sulfate with preclampsia/eclampsia