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IM > Cardio > Flashcards

Cardio Flashcards

1
Q

What are 3 alarm signs for ACS

A

Chest pain not ameliorated with nitro infusion
Heart failure sx
New brady, tachy or hypotension
AVR ST elevation

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2
Q

What are the indications to work someone up for secondary hypertension

A

Onset < age 30 or abrupt onset
(Newly) Drug-resistant
+++end organ damage out of proportion
HypoK+
New diastolic HTN in age >65

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3
Q

What is the duration of DAPT after a bare metal stent is inserted?

A

1 month

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4
Q

What is the duration of DAPT for a drug routine stent to treat ischemic heart disease?

A

6 months

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5
Q

What is the duration of DAPT for DES for NSTEMI

A

12months

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6
Q

What are the two most common congenital cardiac malformations in individuals with Turner syndrome

A

1.Bicuspid aortic valve
2.coarctation of the aorta

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7
Q

What are the characteristics of high-probablity cardiac ischemic chest pain?

A

central, pressure, squeezing/gripping tightness, heaviness, exertional, retrosternal

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8
Q

What are the high-risk features of angina that make you suspect ACS?

A

Angina at rest, or new onset, or increasing angina (more frequent, occurs with less exertion, or lasts longer).

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9
Q

If you have a normal ECG yet have a high suspicion of ACS, what can you try?

A

Order a 15 lead (V7-V9) and repeat the ECG if symptoms change/persist or trop positive.

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10
Q

In the office or home setting, if you have a patient c/o of suspiscious cardiac chest pain what should you tell them to do?

A

Call 9-1-1 (don’t get them to drive to the hospital)

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11
Q

What are the findings on ECG consistent with NSTEMI

A

new horizontal or down-slope ST depression or new T wave inversion

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12
Q

What is the localization of a STEMI with 2+ precordial leads?

A

anterior wall

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13
Q

What is the localization of a V1-V3 STEMI?

A

Anteroseptal

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14
Q

What is the localization of a I II AVL STEMI

A

Lateral

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15
Q

What is the localization of an ST elevation in III AVF?

A

Inferior wall MI

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16
Q

When you see an R in V1 V2 and S in V5 V6 what do you look for?

A

Right Bundle Branch Block

17
Q

What are the signs of a left bundle?

A

You’ll see wide QRS everywhere with ST elevation in the V1-V3

18
Q

What are the criteria for acute STEMI with LBBB?

A

ST elevation that is discordant (so with R wave you should have ST elevation) or ST elevation >5mm or ST depression in V1-V3

19
Q

When you see a biphasic T wave in the precordial leads, what do you think?

A

This is Wellen syndrome -> you have proximal LAD and need cath.

20
Q

What is the purpose of checking pulses in chest pain?

A

Look for aortic dissection! Check BP in both arms

21
Q

What type of aortic dissection presents as STEMI

A

Type A (ascending aorta)

22
Q

What is the initial management for ACS

A

Manage pain with morphine or nitrate (but caution if suspiscion for RV MI or inferior MI)
Give antiplatelet drugs (loading dose of aspirin 160mg). If sending for urgent cath do not have to give DAPT (in case they need CABG). They can give ticagrelor on the table.
GIve anticoagulation (LMWH or Fonda, UFH if renal dysfunction)
Move to monitored setting.

23
Q

For patients with A fib, how should they be managed after PCI

A

Triple therapy for 1 week, then double therapy for 12 months then DOAC only. If at high risk of bleeding, you do 6 months double therapy (DOAC+Plavix). If at high risk of ischemia, continue to triple therapy for 1 month.

24
Q

What are the contraindications for fibrinolytic therapy in STEMI

A

Piror ICH, known cerebral AVM or intracranial alignancy or ischemic stroke within 3 months (except acute stroke within window),

25
Q
A
26
Q

What diagnosis should you consider in a person who smokes cigarettes and comes in with retrosternal chest pain and ST elevation on EKG;; but has no evidence of coronary narrowing on cardiac Cath

A

Prinzmetal Angina

27
Q

What is the first line treatment for prinzmetal angina?

A

CCB

28
Q

What is first line therapy for RV infarction

A

Normal saline / ?RL

29
Q

What is the treatment of choice for hemodynamically stable VTach in the setting of WPW

A

Procainamide (or ibutilide)

IM (9 decks)

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