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Family Med > Cardio > Flashcards

Cardio Flashcards

1
Q

ST segment depression and/or T wave inversions suggests

A

NSTEMI or Unstable Angina

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2
Q

If a pt with ACS is allergic to ASA, what do you give?

A

Clopidogrel

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3
Q

If a pt with ACS has the following RF: DVT, reinfarction, stroke, LV thrombus, reocclusion, what do you give?

A

Heparin

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4
Q

CI of nitroglycerin?

A

Sildenafil within 24 hrs

RV infarction

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5
Q

If possible, pt with a STEMI should get PCI within

A

<90 min from door to surgery

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6
Q

If you’re in a rural community >120min from PCI center, give

A

Antithrombolytics (TPA or other ~ase) within 30 min of arrival to ED

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7
Q

ST elevation in Leads I and aVL means infarct where?

A

Lateral wall

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8
Q

ST elevation in leads II, III, aVF means infarct where?

A

Inferior wall (could be right ventricle)

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9
Q

Pt presents with inferior wall infarction and bradycardia. The pt likely received what that led to the bradycardia?

A

Nitro

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10
Q

ST elevation in leads V1 and V2 =

A

Infarct in septum

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11
Q

ST elevations in V3 and V4 =

A

Infarct in anterior wall

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12
Q

ST elevations in V5 and V6 =

A

Lateral wall infarct

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13
Q

Who is more likely to have an atypical presentation of an MI?

A

Elderly, women, diabetics, hx of stroke or HF

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14
Q

Initial ECG changes with heart ischemia

A

T wave prolongation

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15
Q

Pt presents with chest pain, new onset murmur, positive cardio biomarkers, no ST changes would indicate what? May also hear a new S4 or paradoxical S2

A

NSTEMI

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16
Q

What 4 drugs have been shown to decrease mortality in patients with hx of an MI?

A

ACE-inhibitors, statins, ASA, BBs

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17
Q

After PCI and stent placement, what two drugs should be given to decrease coronary artery stent thrombosis?

A

ASA + Clopidogrel (ticagrelor, prasugrel)

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18
Q

After stent placement, what two drugs should be continued and for how long to decrease risk for coronary artery stent thrombosis?

A

ASA indefinitely

Clopidogrel for 1 year

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19
Q

Hydrochlorothiazide can cause elevation of what electrolyte?

A

Ca2+

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20
Q

MC atypical presentation of ACS in elderly pts?

A

Dyspnea

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21
Q

CI of fibrinolytic therapy

A

Absolute: Hx of intracranial bleed or neoplasm, stroke, facial trauma

Relative: diastolic BP >110, chronic HTN, pregnancy, and anticoagulant use

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22
Q

Risk stratification tool used for unstable angina and NSTEMI to determine treatment

A

TIMI = thrombolysis in myocardial infarction tool

23
Q

Pt presents with chronic stable angina (treated), but is still symptomatic. What do you give?

A

Ranolazine

24
Q

What is the most specific finding for myocardial ischemia in an exercise stress test?

A

2mm downsloping of the ST segment

25
Q

Target HR in exercise stress test

A

85% of max HR

26
Q

When should a high intensity statin be recommended?

A

When ASCVD risk is >20%

27
Q

If LDL is >100 on a moderate intensity statin, what two drugs could be considered?

A

Ezetimibe or PCSK9-1 inhibitor

28
Q

LDL >190 at age 40-75 y/o indicates you should start

A

a moderate intensity statin

29
Q

EKG shows ST elevation in V1-V4. What artery is blocked?

A

LAD

30
Q

EKG shows ST elevation in leads II, III, and aVF. What artery could be blocked?

A

Left circumflex or RCA

31
Q

EKG shows ST elevation in leads I, aVL, V5, and V6. What artery could be blocked?

A

Left circumflex or LAD

32
Q

Chronic stable angina first line treatments

A

BBs, ASA, Statin

33
Q

Pt with chronic stable angina is still symptomatic on atenolol, ASA, and a stain. What could you try next?

A

CCBs like amlodipine, nifedipine, verapamil

34
Q

Pt with chronic stable angina does not respond to BBs OR CCBs. What could you give next?

A

Ranolazine or Nitro

35
Q

Pt presents with syncope and HR is the 40s. She is in sinus rhythm. First line treatment is?

A

Atropine

36
Q

You see SVTs on the cardiac monitor. First line treatment is

A

Adenosine

37
Q

What anti platelet drugs are recommended with a STEMI?

A

ASA, clopidogrel, ticagrelor, epitifibatide, prasugrel

38
Q

When do troponin levels return to baseline post STEMI?

A

5-14 days

39
Q

At what age should men with low CVD risk start lipid screenings?

A

35

40
Q

Men with higher CVD risk or women with higher CVD risk should start lipid screenings when?

A

Men: 25 y/o
Women: 35 y/o

41
Q

If pts are below the threshold to begin lipid lowering drugs, they should be screened

A

every 5 years

42
Q

Children should have a lipid screening when?

A

Once before and after puberty

43
Q

If a pt has LDL level of 140 and a 10 year ASCVD risk between 10-20%, you should

A

Initiate drug therapy (statin)

44
Q

At what blood LDL level should a statin immediately be started?

A

> or = 190mg/dL

45
Q

52 y/o pt presents with T2D. What therapy should you consider to protect their CVD risk?

A

Statins are recommended to pts with T2D btw ages 40-75y/o

46
Q

LDL consistently above what level is considered an ASCVD risk factor?

A

160mg/dL

47
Q

Chest pain early in the morning is a characteristic of

A

prinzmental/vasospastic angina

48
Q

First line treatment for prinzmental angina

A

CCB or nitrates

49
Q

What drugs are contraindicated in an NSTEMI?

A

Thrombolytics!!!! Altepase, reteplase

50
Q

Pt presents with elevated cardiac enzymes but no ST elevation. What is the treatment regimen?

A

O2 if needed
Nitrates w/ L-sided HF and NO hypotension
BBs or ACEi
Antiplatelet (ASA, clopidogrel)
Anticoagulant (enoxaparin, bivalirudin, faundaparinux)

51
Q

ST elevation in leads II, III, aVF. What drug is CI?

A

Nitrates

52
Q

Earliest EKG finding in an acute STEMI

A

hyperacute T waves

53
Q

What is commonly seen on EKG after a STEM

A

Q wave (smooth curve)

Family Med (2 decks)

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