cardio 15 Flashcards by molla asnake

What are symptoms indicate 2ndary HTN secondary to primary hyperparathyroidism?

Hypercalcemia
recurrent renal stone
Neuropsychiatric symptoms

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Pathophysiology?

Increase renin secretion
Sympathetic hyperresponsiveness
Pheripherial vascular constriction

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Other CVS complications of PHPT?

LV hypertrophy
Arrhythmia
vascular and Valvular calcification

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Management of ST elevated MI?

"2ABONS"
O2(O2<90 or dyspnea)
Antiplatlates(asprin and clopidogril)
Beta-blocker(If no CI)
Nitrates(sublingual)
High dose statin
Anticoagulants

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Persistent pain, HTN, or HF despite 2ABONS?

IV nitrates

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Onley persistent pain despite 2ABONS?

Morphin

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Unstable patient with sinus bradycardia?

atrophin

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Pulmonary edema?

diuretics

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The last major treatment?

PCI

Thrombolytics if within 120 min PCI not availabele

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C/I for beta-blocker?

CHF
Bradycardia
heart block
Hypotension
pulmonary edema 2nd to HF

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Why is digoxin C/I in acute MI?

increase o2 demand

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What indicates if CI is low in septic shock?

Late septic shock(grave prognosis)

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What CM indicates peripartum cardiomyopathy?

Onset in last month of Px and within 5 months of postpartum
LV systolic dysfunction with EF <45%
Ruling out of other cause of HF
No heart disease prior to last month of Px

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Associated finding?

hollosystoic murmur at cardia apex

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Diagnosis?

Transthoracic Echocardiography

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management?

like other

Immediate delivery if have advanced HF/hemodynamic instability

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Cause of orthostatic hypotension in aging?

loss of baroreceptor responce

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Another contributing factor?

arterial stiffness
decrease sympathetic neurotransmitter
decrease response to sympathetic stimulation

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Definition of orthostatic hypotension?

Systolic d/c 20 and diastolic d/c 10

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What is the comp of GERD?

Esophageal–EE,Barret esophagus,stricture

Extra esophagial–Asthma and laryngitis

How we treat if pt has this symptom?

8 month of PPI

ECG futur of Pericardial temponad?

Pulses Alterans

Vasospastic angina cause?

Hyperactivity of intimal smooth muscle
Due to
Inbalance Autonomic activation

clinical manifestation?

Age <50
Smoking
Recurrent chest discomfort occurs at rest(sleep) and usually resolves within 15 min.

Diagnosis?

Ambulatory ECG | C.angiography:absent CAD

Treatment?

CCB(Preventive) | Nitroglycerin( abortive)

Which CCB is preferred?

NDP(verapamil and diltiazem)--more coronary vasodilatory effect

What is the cause will be patient with AR develop a sudden sign of C pulmonary edema?

AR--Rapid rise in LVEDP--PVH--PE

Which antiarrhythmic has a use-dependent Effect?

Class IC antiarrhythmic(propafenone and flecainide)

what is the use-dependent Effect?

More pronounced effect(QRS prolongation and QT prolongation) during high HR like during the stress test.

Why?

They attach to activated NA Chanel and detach during repolarization?--so more effective in high HR.

management of cocaine intoxication?

BZD Asprin Ninroglycerine and CCB

BZD benefit?

Decrease sympathetic outflow--Reduce anxiety, HR and B/P

Asprin?

Reduce thrombus formation

NG and CCB?

Vasodilators---reduce pain

Contraindicated management?

BB--increase alpha effect--increase vasoconstriction | Fibrinolytic--Increase the risk of ICH

Drugs used in MI and unstable angina that exacerbate cough in patients with AS?

Asprin Beta-Blocker(non selective /cardioselective in high dose) ACE inhibitor

Symptom of cor pulmonale?

Dyspnea and fatigue on exercise Exertional angina(Due to low CO) Syncope(increase cardiac demand)

PE finding on cvs?

RV heave Loud P2 Functional TR murmur

ECG finding?

Incomplete/complete RBB Right axis deviation RV hypertrophy RA enlargement

ECHO?

RV enlargement TR Pulmonary HYTN

Catheterization?

Elevated pressure Decrease CO Pulmonary HYTN

AF treatment in old >65 and young treatment d/c?

In the young, we may consider rhythm control medication in symptomatic patients but in the old, we should first try improvement with rate controllers to avoid antiarrhythmic s/e.

Indiaction to do scraning U/S for AAA?

Male Any smoking history(>100 cigarettes) age > 65 Family history

Hypertryglycerimia managment?

If TG 150-500(lifstyl modification) - --Wight loss - --Increase Exersise - --Moderate alcohol intake

What if >500-1000?

The goal should be decrease pancratitis risk. - --Fibrates - --Stop alcohol - -fish oil

Secondary cause of HTG?

``` Obeity DM Hypotyroidism Nephrotic syndrome alcohol ```

Drugs cause HTG?

Beta blocker Antiretroviruses Corticosteroids Tamoxifine

sign of acute pericarditis in ECG?

Difuse ST elevation Difuse PR depresion Difuse T wave inversion