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PANCE > cardio > Flashcards

cardio Flashcards

1
Q

exercise induced syncope

A

HOCM (sub aortic stenosis)

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2
Q

Change in murmur with HOCM

A

valsalva increases murmur (decreases preload)

squatting decreases murmur (dilates aorta)

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3
Q

tx of hocm

A

Betablockers

avoid exertion and inotropes

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4
Q

causes of dilated cardiomyopathy

A 
alcohol
post viral
pregnancy
genetics
beri beri
idiopathic
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5
Q

sick sinus syndrome

A

classified as bradyarrithmia

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6
Q

2nd degree type 1

A

can be associated with inferior MI

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7
Q

2nd degree type 2

A

can be associated with anterior mi

more likely to progress to type 3

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8
Q

3rd degree

A

can occur with either anterior or inferior mi
if inferior- qrs are more likely to be narrow-better prognosis
if anterior qrs are more likely to be wide- worse prognosis

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9
Q

what to ask about tachycardias

A

narrow or wide
regular or irregular
what is atrial doing

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10
Q

narrow regular tach

A

Sinus tach
SVT (usually no p waves or retrograde)
Atrial flutter (2:1)

tell difference by looking at atrium

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11
Q

narrow irregular

A

a fib
a flutter with variable conduction
Multifocal atrial tach- different p wave morphology

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12
Q

what is multifocal a tach associated with

A

COPD, pulmonary disease (asthma, pneumonia, pulmonary htn, theophyline toxicity)

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13
Q

wide regular

A 
sinus tach with aberrant conduction (BBB) (p waves present)
v tach (has to have HR >120)
svt with aberrant conduction (bbb, wpw) (p waves hidden, wpw delta wave)
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14
Q

v tach associated with

A

hypoxia
cardiomyopathy
ischemia heart disease
electrolyte disorders

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15
Q

wide irregular

A

a fib w/ bbb (qrs same). tx- av nodal blockers (ca channel blocker, beta blocker, digoxin, amiodarone)
a fib w/ wpw (qrs different - hr >200). tx- procainamide or shock

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16
Q

torsades de pointes

A

polymorphic v tach w/ QTc > .500

tx w/ magnesium

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17
Q

causes of prolonged qt

A 
hypomagnesia
hypokalemia
hypocalcemia
sodium channel blockers
elevated ICP
hypothermia
congenital
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18
Q

signs of instability

A

AMS
hypotension
ischemia (chest pain, ekg)
acute chf

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19
Q

tx of 1st degree

A

no treatment

look for underlying cause

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20
Q

2nd degree

A

type 1-atropine, pacer

type 2-pacer

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21
Q

make sure you tx depending on ventricular rate

A

ex- if patient has 2nd degree type 1 with HR of 90 and BP of 80. You don’t give atropine because rate is fine. Fluids or other cause but don’t treat rhythm.

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22
Q

SVT tx

A 
vagal maneuvers
adenosine
av nodal blockers 
cardiovert (shock)
(vans mneumonic)
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23
Q

vtach tx

A

procainaminde

cardioversion

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24
Q

high output heartfailure

A 
beri beri (b1 thiamine deficiency)
severe anemia
thyroxicosis
av fistula
page's disease of bone
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25
Q

BNP levels

A

500 likley decompensated heart failure

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26
Q

preload reducers

A

nitroglycerine

furosemide

27
Q

afterload reducer

A

ace inhibitor
high dose nitroglycerine
nitroprusside

28
Q

tx for htn EMERGENCY

A

24 hr rule
decrease bp by 25% in few hours
then gradual decrease in rest of 24 hours
iv drip meds

exception is aortic dissection - get bp normal as fast as possible

29
Q

2ndary htn

A

sleep apnea, pheo, coarctation of aorta, renal artery stenosis, cushing, chronic steroid, hyper aldosteroism, estrogen use, renal disease, nsaid use

30
Q

what me do you need to be careful in blacks

A

acei due to angioedema

31
Q

best meds for blacks htn

A

ca channel blocker (long acting- amylodipine)

thiazide

32
Q

what antihypertensive is contraindicated in pregnancy

A

acei and arb

33
Q

most common drug to cause 2ndary htn

A

nsaids

34
Q

treatment for aorta dissection

A

labetalol and +/- nitroprusside

35
Q

tx for htn emergency with confusion/ encephalopathy

A

nicardapine (calcium channel blocker- selectively dilates cerebral blood vessels)- new school
nitroprusside- old school tx

36
Q

metabolic syndrome

A 
need 3
abdominal obesity
triglycerides >150
HDL 110
htn
37
Q

what murmur does rheumatic heart disease cause

A

mitral stenosis

38
Q

mitral stenosis

A

mid diastolic rumble
crescendo decrescendo holo dialostolic murmur
look for:
signs of left heart failure (wet lungs)
rheumatic heart disease
can be bad to pregnant women due to the increased blood volume (pregnant women crashing w/ murmur)
embolic phenoma (endocarditis- osler nodes, etc.., strokes)

39
Q

aortic regurg

A 
austin flint
early diastolic decrescendo murmur
look for:
wide pulse pressure. bounding pulse
aortic dissection 
hypoperfusion
40
Q

tricuspid stenosis

A

IV drug user endocarditis

41
Q

aortic stenosis

A

pulsus parvus et tardus (decreased and delayed pulse and loud late peaking split s2)
murmur radiates to carotids
thready carotid pulse

42
Q

mitral regurgitation

A

soft s1 blowing early sustained murmur with split s2
h/o heart attack or current
left sided failure (wet lungs)
murmur radiates to axilla

43
Q

tricuspid regurgication

A

right sided heart failure

cor pulmonale

44
Q

asd

A

systolic murmur with constant split s1

45
Q

PDA

A

continuous machinery like murmur

46
Q

pregnancy/still murmur

A

due to increased blood during pregnancy

47
Q

troponin rises in

A

4-6 hours

returns no normal in 7-10 days

48
Q

gold standard for acute coronary syndrome

A

angiography

49
Q

contraindications to fibrinolytic

A 
h/o hemorrhagic stroke
any stroke in past year
intracrnial neoplasm
active internal bleeding
suspected aortic dissection
50
Q

prosthetic valce endocarditis

A

first 2 months- coag negative steph
after 2 months- staph aureus
most common staph

51
Q

most common murmur with endocarditis

A

regurgitant (changing day to day)

52
Q

tx for endocarditis

A

vanco/nafillin + gentamicin

+ rifampin for prosthetic valves

53
Q

tx of pericarditis

A

high dose nsaids or asa for 1-3 weeks

54
Q

phlebitis/thrombophlebitis

A

palpable cord

tx- local heat, elevation, nsaid

55
Q

what condition is common with a coarctation of aorta

A

bicuspid aortic valve

56
Q

sick sinus syndrome syncope

A

stokes adams attacks (syncope)

57
Q

tet of fallot

A

vsd, overriding aorta, right ventricular outflow obstruction, right ventricle hypertrophy

crescendo-decrescendo holosystolic at LSB

58
Q

cyanotic congenital

A

tet of fallot (4)
tricuspid atresia (3)
transposition of great arteries (2 vessels)
truncus arteriosus (1 vessel)
total anomalous pulmonary venous return (5 words)

59
Q

asd

A

ostium secundum most common

60
Q

most common congenital heart

A

vsd

systolic murmur at llsb

61
Q

asd

A

systolic ejection murmur at 2LICS

62
Q

tx for ulcers from chronic venous insufficiency

A

wet compress
hydrocortisone
possibly zinc oxide

63
Q

most common risk factor for aortic dissection

A

hypertension

PANCE (14 decks)

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