Cardio Flashcards
AA Diameter
<3
No further testing
AA Diameter
2.5 - <3
rescreen w/ US after 10 years
AA Diameter
3.0 - 3.9
repeat US every 3 years
AA Diameter
Men 4.0 -4.9
Women 4.0 - 4.4
Repeat US annually
AA Diameter
men > 5.0
women > 4.5
repeat US every 6 months
AA Diameter
men > 5.5
Women > 5.0
repair recommended
AA Diameter
What are additional indications for surgery?(5)
- increase in aneurysm size by > 0.5 cm within 6 months
- chronic abdominal pain
- thromembolic complications
- iliac or femoral artery aneurysm causing lower limb ischemia
- aneurysms > 4.5 cm in pts w/ marfan syndrome
Aortic dissections types?
Stanford: Type A (Type I and II) and Type B (Type III)
Debakey: Type 1 (AA + ARCH), Type II ( only AA), Type III ( DA - > Diagphram)
Aortic dissection treatment?
Type A: Surgery
Type B: medically ( beta blockers, aspirin)
What is virchows triad?
- stasis
- endothelial damage
- hypercoagobility
First test for arterial occlusion dx?
doppler US
BP medication for African Americans?
Hydrochlorothiazide
Infective endocarditis dx how?
need 2 blood cultures from 2 different areas
PAD dx how?
ABI first but CTA is absloute
Tearing chest pain tx?
Nicardipine
SVT tx?
adenosine
Sepsis steps
Kid ina motor vehicle accident w/ bradycardia and spinal shock tx?
atropine
Lacted ringers contain what?
calcium
Heart score
Centor critera
Reyes syndrome/ kawaski tx?
aspirin
Inadequate allen test do not perform what?
swan ganz catheter
52 y/o F w/ SOB and no strenous activity
Class 2
57 y/o EF< 30 w/ no life threating arrythmia needs what?
bivent pacemaker to help atria and ventricles beat
Aortic aneurysm location?
superior to common iliac artery bifurcation
Cardiomyocytes fast action potential during phase 2?
Ca 2+ influx
Diastolic dysfunction manifests as?
HTN
Tx to reduce afterload and ventricle CHF?
acei
Restrictive myopathy is described as?
no change in chamber size
Increased NA reabsorption occurs where?
PCT
Beta blockers for reduced EF is?
bisrprolol
What is the risk w/ increased digoxin toxicity?
increased serum creatinine
opening snap arrythmia?
a fib
coarcation of aorta is?
bicuspid
Percardial friction rub is?
worse w/ lying down and better w/ sitting up
SVT first line tx?
vagal manuever
24 y/o ED pt w/ N/V/D treatment choice?
ceftriaxone
What is the minimum duration for anticoagulation for a fib?
3 weeks
7 y/o w/ dark urine (strep glumorlonephritis) most approriate txt?
furosemide to reduce edema
72 y/o w/ stable vitals confused, abdominal pain and w/ generalized weakness (hypercalcemia, dehydration) tx?
0/9 % sodium chloride
Calcium carbonate should be taken how?
1500 BID
35 y/o Er w/ chest pain and ST elevation? dx? tx?
prinzmetal and amlodipine
GFR is gold standard for what?
chronic kidney disease
Chlorathalidone inhibits what?
sodium chloride cotransporter
acei decreases what?
proteinuria
43 y/o w/ hx of thyroidectomy what does he need?
calcium carbonate
Increased creatine w/ bilateral renal artery stenosis tx?
losartan
loss of DTR tx?
clacium gluconate
Despompressin monitor what?
BMP
67 y/o w/ breats cancer needs?
fluid restriction
Hypertension can be caused by medication?
prednisone
57 y/o w/ BP 180/120 has a?
hypertensive emergency
In an ischemic stroke do not lower what?
BP
Medication that increased the risk of Gout?
Chlorthalidone
First line tx for reduced EF?
ARNI
A fib rate control medication?
dilitizem
A fib rythm control medication?
Flecainide
Torsades tx?
sotalol
adverse effect of dofetilide?
QT prolongation
Bradycardia sympts next step?
monitor
A fib at home blood thinner tx?
rivarixiban
patent ductus causes?
decreased sensitivity to 02
Term infant is at risk for?
PT occlusion
Increased SVR and decreased co tx?
milrinone
58 y/o newly diagnosed w/ type 2 diabetes HBA1c is 8.8 tx?
metformin and dulaglutide
liraglutide MOA?
Mimics gluocse lirepeptide 1
Insulin aspart onset?
10 mins
metform can cause?
renal insuffiecency
18 y/o to ER for N/V first step?
0.9 % sodium chloride bolus
What does calcitration do?
increased absorption from GI tract
2 gram elemetal should be given how?
7500 BID
what is a dopamine agonist?
cabergo
Dequervin tx?
naproxen
HF w/ reduced EF tx?
Empagliflozin
45 yo African American type 2 DM tx?
Hydrochlorothiazide
which medication is known to decrease mortality in the treatment of stable ischemic heart disease?
losartan
which medication should be given to a patient within the first 24hours of STEMI presentation?
Carvedilol
which of the following is a cardioselective beta blocker?
metoprolol
propanolol increases the risk for which ADR?
depression
vignette: ECG shows inferior MI do not give what?
nitroglycerin
for prinzmetal angina which medication would you give to prevent symptoms?
amlodipine
highest pecentage of sodium reabsorption occurs where?
PCT
what is the most common ADR associated with amlodipin
gingival hyperplasia
which medication is recommended in the treatment of HF with reduced ejection fraction?
bisprolol (NOT propanolol)
sick sinus syndrome (SSS), what is the next best step?
atropine
59yo M, hx - CHF, sxs x 2wks, stable vitals, irregular HR, LVEF <40%, what is the first line medication?
metoprolol
pt unstable, EKG: narrow AVNRT, what is first-line treatment?
cardioversion
pt has a mitral valve prolapse and anxiety/palpatations w/o dyspnea or exercise intolerance. how to treat?
beta blockers
what is the first-line treatment for patent ductus arteriosus (PDA) in full term infants?
percutaneous transcatheter occlusion
which medication will decrease systemic vascular resistance (SVR) and increase cardiac output (CO)?
milrinone
which medication is used first-line in preventing myoischemia for patients with stable angina?
metoprolol
what is the next step in the treatment of symptomatic bradycardia after treating with atropine?
transcutaneous pacemaker
what is the maximum atropine dose given?
3mg
what is an adverse drug reaction from using atropine?
blurred vision
which is the following medications can cause heart blocks?
diltiazem
35yoF, nightly chest pain x 2months, EKG: ST elevations without carotid artery stenosis = “prinzmetal angina”,
how would you treat?
CCB (amlodipine)
which medication is known to decrease mortality in patients w/ ischemic heart disease?
losartan
which of the following circumstances would make a patient more at risk for digoxin toxicity?
high serum creatinine
patient with HF is on all standard GDMT medications, now complains of angioedema, you discontinue the neprilysn inhbitor, what is the next step?
add hydralazine
which of the following medications is the most a-1 selective?
norepinephrine
which medication should be given to a fluid overloaded patient?
lasix (furosemide)
peds resuscitation fluids?
0.9% normal saline
PDE inhibitor infusion makes infants more at risk for what?
apnea
what explains why there is a reduced rate of spontaneous ductus arteriosus in preterm infants?
decreases sensitivity to oxygen
which of the following are considered first-line life modifications for orthostatic hypotension?
compression stockings
a-1 receptor stimulators effect on CV system?
increases mean arterial pressure (MAP)
what is the effect of fludrocortisone of patient’s volume status?
increases IV volume
chest pain, worse with laying down, better with sitting up and leaning forward?
pericarditis
pt presents w/ possible STEMI symptoms. what should be done next?
start ticagrelor
stable patient with atrial fibrillation and other SVTs. what should be given for rate control?
CCB — diltiazem
which valve is most likely to be affected in an IV drug user diagnosed with infective endocarditis?
tricuspid valve
machine murmur?
patent ductus arteriosus (PDA)
mid systolic murmur that lessens in intensity with squatting and loudens with strain?
hypertrophic obstructive cardiomyopathy (HOCM)
hx of hypertension. diastolic murmur heard best in the upper sternal border which is accentuated with sitting up leaned forward?
aortic regurgitation (AR)
echocardiogram: no tricuspid valve, ductal dependent lesion?
tricuspid atresia
narrow QRS, irregular rhythm, >180bpm?
rapid atrial fibrillation
what is an acute complication of an acute myocardial infarction seen on ECG?
mitral regurgitation (MR) — reason: due to papillary mm. or chordae tendineae rupture
mcc of cardiogenic shock?
MI
How dox 56 y/o w/ aneurysm
1.5 increase in diameter
severe uncontrolled hypertriglyceridemia?
pancreatitis
55 y/o F w/ jaw claudication tx?
corticosteriod
compensated shock tx?
reestablish adequate perfusion and oxyen delivery
55 M w/ stemi activation tx?
norepi
26 y/o w/ motor vehicle accident w/ narrow pulse preesure tx?
percardial centesis
65 y/o M w/ pain in both legs with ambulation first line dx?
ABI
65 y/o M w/ hx of MI tx?
unsyndcronized cardioversion
