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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
BNP levels
500 likley decompensated heart failure
26
preload reducers
nitroglycerine | furosemide
27
afterload reducer
ace inhibitor high dose nitroglycerine nitroprusside
28
tx for htn EMERGENCY
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
2ndary htn
sleep apnea, pheo, coarctation of aorta, renal artery stenosis, cushing, chronic steroid, hyper aldosteroism, estrogen use, renal disease, nsaid use
30
what me do you need to be careful in blacks
acei due to angioedema
31
best meds for blacks htn
ca channel blocker (long acting- amylodipine) | thiazide
32
what antihypertensive is contraindicated in pregnancy
acei and arb
33
most common drug to cause 2ndary htn
nsaids
34
treatment for aorta dissection
labetalol and +/- nitroprusside
35
tx for htn emergency with confusion/ encephalopathy
nicardapine (calcium channel blocker- selectively dilates cerebral blood vessels)- new school nitroprusside- old school tx
36
metabolic syndrome
``` need 3 abdominal obesity triglycerides >150 HDL 110 htn ```
37
what murmur does rheumatic heart disease cause
mitral stenosis
38
mitral stenosis
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
aortic regurg
``` austin flint early diastolic decrescendo murmur look for: wide pulse pressure. bounding pulse aortic dissection hypoperfusion ```
40
tricuspid stenosis
IV drug user endocarditis
41
aortic stenosis
pulsus parvus et tardus (decreased and delayed pulse and loud late peaking split s2) murmur radiates to carotids thready carotid pulse
42
mitral regurgitation
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
tricuspid regurgication
right sided heart failure | cor pulmonale
44
asd
systolic murmur with constant split s1
45
PDA
continuous machinery like murmur
46
pregnancy/still murmur
due to increased blood during pregnancy
47
troponin rises in
4-6 hours | returns no normal in 7-10 days
48
gold standard for acute coronary syndrome
angiography
49
contraindications to fibrinolytic
``` h/o hemorrhagic stroke any stroke in past year intracrnial neoplasm active internal bleeding suspected aortic dissection ```
50
prosthetic valce endocarditis
first 2 months- coag negative steph after 2 months- staph aureus most common staph
51
most common murmur with endocarditis
regurgitant (changing day to day)
52
tx for endocarditis
vanco/nafillin + gentamicin | + rifampin for prosthetic valves
53
tx of pericarditis
high dose nsaids or asa for 1-3 weeks
54
phlebitis/thrombophlebitis
palpable cord | tx- local heat, elevation, nsaid
55
what condition is common with a coarctation of aorta
bicuspid aortic valve
56
sick sinus syndrome syncope
stokes adams attacks (syncope)
57
tet of fallot
vsd, overriding aorta, right ventricular outflow obstruction, right ventricle hypertrophy crescendo-decrescendo holosystolic at LSB
58
cyanotic congenital
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
asd
ostium secundum most common
60
most common congenital heart
vsd | systolic murmur at llsb
61
asd
systolic ejection murmur at 2LICS
62
tx for ulcers from chronic venous insufficiency
wet compress hydrocortisone possibly zinc oxide
63
most common risk factor for aortic dissection
hypertension

PANCE (14 decks)

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