Cardio 13 Flashcards

1
Q

What is the best treatment for a patient with hyperthyroidism and AF?

A

Beta-blocker(propranolol, atenolol..)

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2
Q

Why?

A

Treat the underlying cause by decreasing pheripherial conversion of T3 to T4 inanition to HR decreased.

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3
Q

Why not amiodarone?

A

Used for paroxysmal one

Exacerbate hyperthyroid symptom

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4
Q

AVNRT CM?

A

The most common cause of SVT
Common in females
Intermittent palpitation
Chest pain, lightheadedness, and dyspnea during an attack

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5
Q

Pathophysiology?

A

Presence of fast and slow pathway in RA–Normally fast pathway transmit signal–Slow pathway transmits a signal back to atrium when FP is refractory period–form circuit–atrial preexitation.

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6
Q

What differentiates it from AVRT?

A

the pathways like AV node But in AVRT the pathways like ventricular myocardium

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7
Q

What maneuver decreases symptoms?

A

Vegal (Valsalva, aye ball pressure, cold water imersion..)

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8
Q

FMD screning indication?

A
female age <50 with one of following
age <35 with a family history
Sever/resistant hypertension
sudden rise in BP
Increase creatinin 0.5-1 mg after ACE/ARB started without BP-lowering effect
systolic-diastolic bruit
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9
Q

What Is the CM Cerebrovascular FMD involvement?

A
Brain ischemia sign include
amaurosis fugags
Horner syndrome
TIA
Stroke
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10
Q

What Is the CM carotid and vertebral artery FMD involvement?

A

Unexplained Headache
Pulsatile tinnitus
Dizziness

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11
Q

What artery other than mentioned can be involved?

A

all but comonly
Subclavian
visceral
iliac

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12
Q

Diagnosis

A

Doppler u/s or CT angiography

If inconclusive on CT/U/S–catheter-based angiography

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13
Q

management?

A

Medical–Evry 3-4 month Cr and B/P
6-12 month ultrasound
Asprin if cerebral and vertebral involvement
percutaneous angioplasty if indicated

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14
Q

Plasma aldostrone /renin Ratio?

A

normal is <20

If >20—indicate primary hyperaldosteronism.Hyperkalemia

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15
Q

managment of vasovagal syncope?

A

reasurance

Avoidance of trigers

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16
Q

Which drugs used for cardiac disease in patients with digoxin will develop toxicity other than Lasix?

A

Quinidine
Verapamil
Amiodadron

17
Q

How?

A

Decrease digoxin tissue binding–Increase serum level.

18
Q

what are these symptoms?

A

GI(anorexia, nausea, vomiting, and abdominal pain)dominate in acute toxicity.
Neurologic(Fatigue, confusion, weakness, and loss of color vision)–Dominate in chronic toxicity

19
Q

what will be the long-term effect of ISCHEMIC disease including MI that results in systolic dysfunction not treated?

A

Eccentric hypertrophy(which occur also in chronic volume overload)

20
Q

What pathology eccentric hypertrophy produce?

A

Muscle hypertrophy
Scaring
dilated ventricle

21
Q

What is the complication of this pathologic change?

A

systolic dysfunction

Arythemia–SCD

22
Q

How we prevent this pathologic progresion?

A

ACE/ARB
Beta-blocker
Aldostron antagonists

23
Q

what about antiplatelets?

A

Reduce CVS event in 1 year but have no role in preventing remodeling

24
Q

CM os sick sinus syndrome?

A

elderly
bradycardia(fatigue,lightheadedness,syncope..
Brady-techy arrhythmia(AFib, palpitation)-due to atrial fibrosis

25
Why elderly?
Due to degeneration of sinus node and conduction system
26
Other cause?
Infiltrative diseases like sarcoidosis and amyloidosis
27
ECG?
sinus bradycardia sinus pause (delayed P wave) SA node exit block(dropped P wave)
28
management.
peacemaker | blocker in case of tachyarrhythmia