CARDIO Flashcards

1
Q

MC valve affected by infective endocarditis

A

Mitral (tricuspid if IVDA)

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2
Q

MC organism to cause acute infective endocarditis

A

staph aureus (esp IVDA)

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3
Q

MC organism to cause subacute infective endocarditis

A

streptococcus viridans

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4
Q

MC organism in early prosthetic valve endocarditis

A

staph epidermidis

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5
Q

Endocarditis in men >50 years old with recent GI or GU procedure, likely caused by this organism

A

enterococcus

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6
Q

Suspect these organisms in pt with endocarditis and negative bcx

A

HACEK organisms
Haemophilus aphrophilus
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae

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7
Q

Dx for endocarditis

A

Modified Duke criteria

Rq. +2 major, +1 major and +3 minor, or +5 minor
–major: pos bcx, pos echo
–minor: predisposing condition (recent procedure, ivda, etc), fever, vascular or embolic phenomena (janeway lesions, septic arterial or pulmonary embolic, etc), immunologic phenomena (Osler’s node, Roth spots, +RF, acute glomerulonephritis), +BCx or +TTE not meeting major criteria

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8
Q

Tx for endocarditis

A

anti-staphylococcal pcn (nafcillin or oxacillin) and ceftriaxone or gentamicin x4-6 weeks

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9
Q

Tx for prosthetic endocarditis

A

Vancomycin, gentamicin, and rifampin x4-6 weeks

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10
Q

Endocarditis ppx indications

A
  1. predisposing cardiac condition (prosthetic valve, h/o endocarditis, congenital heart disease, cardiac valvulopathy in heart transplant pt) AND 2. Routine dental, respiratory, or skin procedure (includes I&D)
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11
Q

Endocarditis ppx tx

A

amoxicillin 2g 30 min preop (clinda 600mg if allergic)

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12
Q

2 MC causes of pericarditis

A

idiopathic and viral (enterovirus, coxsackie virus)

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13
Q

Triad in Dressler syndrome:

A

post-MI pericarditis, fever, pleural effusion

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14
Q

electrical alternans is seen in this condition

A

pericardial effusion
(alternating QRS complex amplitude)

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15
Q

Dx of cardiac tamponade:

A

TTE w/ pericardial effusion and diastolic collapse of chambers

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16
Q

Tx of cardiac tamponade:

A

immediate pericardiocentesis

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17
Q

Dx for constrictive pericarditis:

A

TTE w/ pericardial thickening or calcifications (CT scan or MRI more sensitive than TTE)

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18
Q

pericardial knock may be heard in this condition

A

constrictive pericarditis

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19
Q

Tx for constrictive pericarditis:

A

sxs: diuretics
definitive mgmt: pericardiectomy

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20
Q

MC valvular disease

A

aortic stenosis

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21
Q

MC innocent physiologic murmur

A

still murmur

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22
Q

MC continuous benign murmur

A

cervical venous hum

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23
Q

Congenital heart disease that can lead to paradoxical embolic or cryptogenic strokes

A

PFO, ASD

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24
Q

MC type of ASD

A

ostium secundum

25
Q

congenital narrowing of the aortic lumen at the distal arch, often associated w/ bicuspid aortic valve

A

COA

26
Q

MC cyanotic congenital heart disease

A

TOF
“blue baby syndrome”

27
Q

MC cyanotic congenital heart disease presenting in neonatal period

A

TOGA

28
Q

MC type of congenital heart disease in childhood

A

VSD

29
Q

MC type of VSD

A

perimembraneous

30
Q

Most common RF for CAD

A

DM (considered anginal equivalent)

31
Q

Most common modifiable RF for CAD

A

smoking

32
Q

CI to myocardial perfusion imaging

A

severe bronchospastic disease

33
Q

MC cause of MI

A

atherosclerosis

34
Q

Drug of choice for HTN in post-MI

A

ACEi, BB

35
Q

Drug of choice for HTN in HF

A

ACEi, ARB, BB

36
Q

Drug of choice for HTN in BPH

A

alpha1 blockers (prazosin, terazosin, doxazosin)

37
Q

Drug of choice for HTN in DM

A

ACEi, ARB

38
Q

Drug of choice for HTN in AA

A

TZDs, CCB

39
Q

Drug of choice for HTN in gout

A

CCB

40
Q

Drug of choice for HTN with concurrent afib/flutter

A

BB, CCB

41
Q

CI to CCB

A

CHF and 2nd/3rd AVB

42
Q

CI to BB

A

CHF and 2nd/3rd AVB (nonselective CI in asthma/copd)

43
Q

MC cause of syncope

A

vasovagal (includes prodomal phase)

44
Q

Beck’s triad is seen in this condition

A

pericardial tamponade (increased JVP, hypotension, muffled heart sounds)

45
Q

Define SIRS:

A

Rq 2/4:
1- Temperature (>38 or <36)
2- Pulse >90
3- RR > 20 or PaCO2 <32mmHg
4- WBC >12k or <4k

46
Q

Define sepsis:

A

SIRS + source of infx (often lactate >4mmol/L)

47
Q

Define severe sepsis:

A

sepsis + end organ damage

48
Q

Define septic shock:

A

sepsis + refractory hypotension despite fluids (SBP <90, MAP <65, or drop in SBP 40mmHg from baseline)

49
Q

only major type of shock associated with increased cardiac output

A

distributive

50
Q

Best meds to lower LDL

A

Statins

51
Q

Best meds to lower Tg

A

Fibrates

52
Q

Best meds to increase HDL

A

Niacin

53
Q

MC cause of ventricular tachycardia and fibrillation

A

ischemic disease

54
Q

Define CHADS2-VAS:

A

CHF
HTN
Age > 75 (+2)
DM
Stroke (+2)
Vascular (prior MI, PAD)
Age >65
Sex (female)

55
Q

sinus arrest w/ alternating paroxysms of atrial tachyarrhythmias and bradyarrhythmias

A

sick sinus syndrome (Brady-tachy syndrome)

56
Q

Initiate statin in patients with: (5)

A
  1. Age 40-75 yo with diabetes
  2. Age 40-75 yo with >7.5% CVD risk for MI or CVA in 10 years
  3. Age >21 with LDL >190
  4. Age <19 yo with fam hypercholesteremia
  5. Clinical CVD
57
Q

MC cause of primary HTN

A

idiopathic

58
Q

MC cause of secondary HTN

A

renovascular

59
Q

MC cause of ESRD

A

DM