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USMLE STEP 2CK > Cardio > Flashcards

Cardio Flashcards

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USMLE® Step 1 flashcards
1
Q

What imaging used to follow AAA?

A

Abdominal U/S - facilitates measurement of aneurysm size, show presence of thrombus, etc.

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2
Q

Cause of angina in pts with aortic stenosis

A

Increased myocardial O2 demand.

Aortic Stenosis - large ventricle - more demand

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3
Q

Aortic Dissection:

A

Sx: CP radiating to the back + HTN

  • AR murmur
  • weak/absent peripheral pulses
  • systolic BP > 20 diff btwn arms
  • CXR shows widened mediastinum

RF:

  • Marfan’s
  • HTN
  • cocaine

Dx:

  • Chest CT with contrast
  • TEE (esp if Cr not normal or has contrast allergy)

Tx:
Beta-blockers!
Type A: ascending aorta = medical + surgical
Type B: descending aorta = medical only.

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4
Q

Right Ventricular MI: Features and Tx

A
  • EKG: II, III, aVF
  • Symptoms of MI: Chest pain, diaphoresis, dypsnea
  • Hypotension (due to dec. L heart filling)
  • Distended jugular veins with clear lung fields** (bc R side)

Tx:

  • IVF because need increased RV preload
  • same as others except..

Avoid:
- nitrates, diuretics, opioids - which decrease preload.

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5
Q

Aortic Dissection Sequelae

A

Tearing chest pain radiating to the back

Sequelae: dissection can extend into

  • carotid a -> stroke
  • renal a -> acute renal fail
  • aortic valve -> aortic regurg
  • sympathetic ganglion -> horner’s
  • pericardium -> cardiac tamponade
  • arm vessels -> diff in blood pressure btwn arms
  • mesenteric -> abd pain
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6
Q

Cardiac Tamponade

A

Beck’s Triad:

  1. Hypotension
  2. Increased JVP
  3. Muffled Heart sounds
  4. Pulsus Paradoxus (>10 dec in systolic BP inspiration)
  5. Positive hepatojugular reflex
    (Lungs are clear)

Echo: pericardial effusion
EKG: electrical alternans: varying amplitude of the QRS complexes

Sx due to decreased LV preload!
- intrapericardial pressure increases - restricts venous return to the heart - lowers R and LV preload - dec CO

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7
Q

Acute Pericarditis

A

sharp, pleuritic chest pain that can radiate to left arm/shoulder

can cause effusion, cardiac tamponade
usually due to virus

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8
Q

Isolated Systolic HTN in elderly is caused by?

A

Rigidity of the arterial wall -> systolic HTN, widened pulse pressure

Tx: bc risk of cardio disease

  • low dose thiazide
  • ACEi
  • CCB
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9
Q

Constrictive Pericarditis

A 
Causes: 
TB (endemic areas) 
Viral 
Radiation
Cardiac surgery

Sx: impairs ventricular filling - major cause of RHF.

Dec CO = Fatigue, dypsnea on exertion
Venous overload = JVP, ascites, pedal edema
Kassmaul’s sign (paradoxical rise in JVP on inspiration)
Pulsus Paradoxus
Pericardial knock after S2 (mid-diastolic sound)
Hepatojugular reflex

CXR: pericardial Ca++
EKG: afib or low voltage QRS
JVP - prominent x and y descents

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10
Q

Patients initially diagnosed with HTN should have what basic workup?

A

UA, U p/c
BMP
Lipid
EKG

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11
Q

Hereditary Hemochromatosis

A

Skin: Hyperpigmentation - Bronze Diabetes

MSK: arthralgias, arthropathy, chondrocalcinosis

GI: elevated hepatic enzymes w hepatomegaly -> cirrhosis -> HCC

Endo: DM, hypogonadism, hypothyroidism

Cardiac: Restrictive or Dilated cardiomyopathy; cardiac conduction abnl - sick sinus syndrome

Infections: increased susceptibility to listeria, vibrio, yersinia

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12
Q

AAA vs. Renal artery stenosis - sounds

A

AAA: HTN, smoker

  • pulsatile abd mass
  • systolic bruit may be heard

RAS: HTN
- systolic-diastolic bruit

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13
Q

Troponin vs. CK-MB

A

Troponin T: more sensitive, but stays elevated for 10d

CK-MB: normalizes in 1-2d, good for assessing coronary re=occlusion/recurrent MI

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14
Q

Prinzmetal’s Angina (variant angina)

A

CP bc of coronary vasospasm

  • occurs at NIGHT
  • TRANSIENT ST elevation/EKG changes

Tx:

  • stop smoking!
  • CCB, nitrates - vasodilate

AVOID - nonselective beta blockers and aspirin - vasoconstricts

Like other vasospastic disorders: Raynaud’s, migranes

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15
Q

Afib in WPW should be treated with:

A

Hemodynamically unstable -> Cardioversion!
Stable -> Rhythm control with Procainamide

Avoid AV nodal blockers: beta blockers, CCB, digoxin, adenosine -> bc increases conduction thru the abberrant pathway

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16
Q

Acute MR develops after MI due to ?

A

Papillary muscle displacement - 2-7d after MI

- leads to increased LV filling pressures -> pulm edema, CHF.

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17
Q

What antiarrhythmic prolongs QRS interval when HR increases?

A

Class IC antiarrhythmic - Flecainide

- when HR increases, stays bound to the Na channel longer bc less time to dissociate - prolongs QRS interval

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18
Q

HOCM

A

Sx:
exertional dypsnea, CP, fatigue, palpitations, syncope
sudden death in athletes

Murmur:
harsh cresendo-descrendo murmur - apex, LLB
INCREASE with DEC PRELOAD
(valsalva, abrupt standing)
DECREASE with INC AFTERLOAD (handgrip, squat)

vs aortic stenosis: dec with dec preload..

EKG: LVH - tall R in aVL, deep S in V3

Patho: 
AD 
- mutation in cardiac myocyte contractility or sarcomere proteins
- interventricular septal hypertrophy 
- abnormal mitral leaflet motion

Tx: HOCM primarily causes diastolic HF

  • Beta-blockers: increase diastole
  • CCB: same
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19
Q

What antiarrhythmic causes lung damage?

A

Amiodarone:

  • Pulm tox - chronic interstitial pneumonitis - depends on total cumulative dose *
  • Thyroid - Hypo > hyper *
  • Hepatotoxicity - elevated transaminases, hepatitis *
  • Cardiac: sinus brady, heart blood, risk of torsades
  • Ocular: Corneal deposits
  • Skin: blue gray skin change
  • Neurologic: peripheral neuropathy
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20
Q

Aortic Stenosis - indications for surgery

A 
Murmur: 
Harsh systolic murmur R sternal border 
Radiates to carotids 
Pulsus Tardus et parvus 
S4 - LVH

Aortic Valve Replacement:

  • SAD: syncope, angina, dypsnea
  • severe AS undergoing CABG/other valve surgery
  • severe AS asymptomatic, but poor LV function
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21
Q

Exertional Heat Stroke

A

T > 104 + CNS or organ damage
Tx: rapid cooling with ice-water immersion

VS:

  1. Serotonin syndrome/Malignant Hyperthermia - has muscle rigidity
  2. Non-exertional heat stroke - elderly people; evaporative cooling as tx instead.
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22
Q

HTN emergency definition

A

HTN URGENCY
- Severe HTN (usually > 180/120) but no sx

HTN EMERGENCY - Severe HTN w. SX!

  1. Malignant HTN - with papilledema, retinal hemorrhages or exudates
  2. HTN encephalopathy - cerebral edema, non-localizing neurologic signs/sx
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23
Q

Why don’t we use lidocaine to prevent the development of vfib in acute MI?

A

Increases risk of asystole.

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24
Q

What cause of restrictive cardiomyopathy is reversible?

A

Hemachromatosis - phlebotomy

Restrictive cardiomyopathy

  • sarcoid, amyloid, hemachromatosis
  • diastolic dysfxn - symmetric thickening of ventricles
  • RHF > LHF but both can occur.
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25
Q

Drugs that improve mortality in CHF:

A 
ACEi
ARB
Beta-blockers
Spironolactone
(Aspirin if due to CAD)

NOT:
Digoxin
Loop diuretics

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26
Q

Mechanical Complications 3-7d after MI

A
  1. MR - papillary muscle rupture - look for murmur!
  2. LV free wall rupture
  3. Interventricular septum rupture

All can cause hypotension.
Look at pic.

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27
Q

Side effect of CCB

A

peripheral edema - due to dilation of peripheral vessels

addition of ACEi (postcapillary venous dilation) can help reduce this.

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28
Q

Treatment of Pulm HTN

A

Depends on CAUSE: (durh!)

If due to LV dysfunction = Loop diuretic, ACEi

If idiopathic and symptomatic = endothelin-R antagonist (bosentan); PDE5 inhibitors (slidenfil); Prostanoids.

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29
Q

AAA

A

Sx: initially asymptomatic, found incidentally

RF: SMOKING, old age, fhx, athero

Risks for rupture:

  1. smoking
  2. large diameter
  3. rapid rate of expansion

Indications for Repair:

  1. > 5.5 cm
  2. rapid rate expansion (0.5cm/6 mo or 1cm/1yr)
  3. symptoms - abd/back/flank pain; limb ischemia.

Screening: one time Abd US
Smokers or former smokers 65-75

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30
Q

Afib due to hyperthyroidism should be treated with?

A

beta-blocker!

- rhythm control AND diminishes sx of hyperthyroid

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31
Q

Treatment of Angina

A

Antianginal:

  1. Beta blocker - 1st line
    - dec. myocardial contractility, HR
    - improves survival in MI
  2. CCB - add on or alternative
    - peripheral and coronary vasodilation
  3. Nitrates
    - short for acute setting
    - long for chronic
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32
Q

Initial stabilization of STEMI

A
  1. O2
  2. Aspirin
  3. Clopidogrel
  4. Nitrate
  5. Beta blocker
  6. Statin
  7. Anticoag
  • > persistent HTN or pain - NO
  • > persistent pain - morphine
  • > persistent brady - atropine
  • > pulm edema - furosemide

PTCA within 90 minutes!
Thrombolysis if PTCA not within 120 min.

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33
Q

Paroxysmal SupraVentricular Tachycardia

A

NARROW QRS complex TACHY

  • retrograde p waves
  • constant RR intervals

Abrupt onset/offset

AVNRT, AVRT, atrial tachy, junctional tachy

Tx:

  1. If hemodynamically stable -> VAGAL or ADENOSINE -> slow conduction thru AV node
    - can unmask p waves in a flutter/tachy
    - terminate AV node dependent arrhythmias - AVNRT
34
Q

Ventricular Tachycardia

A

WIDE QRS complex TACHY
+ Fusion beats
+ AV dissociation

Tx: 
If unstable (hypotension, resp distress, AMS) -> Cardiovert

If stable, IV amiodarone first line
- can also give lidocaine

Note: Loop diuretics - hypoK and hypoMg which can cause ventricular tachy

35
Q

Digoxin Side effects

A

GI: nausea, vomiting, diarrhea, dec appetite
CNS: confusion, weakness,
Cards: atrial tachy with AV block
Vision: scotomata, color change

Note:

  • hypoK from diuretics increases risk for tox
  • amiodarone can increase serum levels of dig
36
Q

Aortic Regurg

A

Descrendo early diastolic murmur

  • LSB 3-4th intercostal (due to valvular disease)
  • RSB (aortic root disease)
  • sometimes can only be heard if pt sits up, full expiration, firm pressure with stethoscope

Other signs:

  • widened pulse pressure
  • “water hammer” pulse
  • “pounding heart” - due to increase in LVEDV

Causes:
- young, developed country = bicuspid aortic valve, aortic root dilation (marfan’s, syphillis)

  • underdeveloped = rheumatic heart disease
37
Q

Mitral Stenosis

A

Murmur:
Loud S1 + mid diastolic rumbling

Sx: MS -> LA pressure -> Pulm congestion
Pulm congestion (exertional dyspnea, nocturnal cough)
HEMOPTYSIS**
Afib (bc LA dilation)
Emboli (due to Afib)

Cause:
- Undeveloped - Rheumatic fever!!

38
Q

Recent URI and acute cardiac failure in young patient?

A

Dilated Cardiomyopathy - Viral myocarditis

  • dilated ventricles with diffuse hypokinesia (systolic dysfunction)
  • Tx: supportive.

Concentric hypertrophy - due to chronic pressure overload
Eccentric hypertrophy - due to chronic volume overload
Asymmetric septal hypertrophy - HOCM

39
Q

Acute limb ischemia after MI - management?

A

Anticoagulation
Vascular Surgery
ECHO - to look for LV thrombus

40
Q

AV block

A

If p is far from q, then you have a first degree
longer longer longer drop, then you have a wenkebach
if some ps just dont get thru, then you have a mobitz II
if ps and qs just dont agree, then you have a third degree

Location and Tx:
I and Mobitz I above AV node - benign, observe
Mobitz II and III below - pacemaker

PR interval prolonged = >5 small boxes

Normal QRS = 3 small boxes

41
Q

Treatment Atrial Fibrillation

A

Hemodynamically unstable -> Cardiovert

Stable: eIther

  1. Rate control - beta blocker, diltiazem, digoxin
  2. Rhythm control - if unable to control HR, or continued symptoms.

Anticoagulation - warfarin or other anticoags
- CHA2DS2 VASc Scoring
CHF, HTN, Age > 75, DM, Stroke/TIA, Vascular disease (MI, PAD), Age 65-74, Sex Female

Score 0 = no anticoag
Score 1 = none/aspirin/oral
Score 2 or above = oral anticoag

42
Q

Causes of ascending vs. descending Ao aneurysm

A

Ascending: cystic medial necrosis (age) or connective tissue disorders (marfan’s, ehlers-danlos)

Descending: atherosclerosis

43
Q

Pericarditis

A

Diffuse ST segment elevation and PR depression

44
Q

Pulsus Paradoxus

A

Fall >10 mmHg during inspiration.

  1. Cardiac tamponade
    decrease in systolic BP when inspirate. Inspiration lowers intrathoracic pressure -> more preload into RV but uncompliant since tamponade -> shifts interventricular septum towards L -> decreased CO
  2. Asthma, COPD.
    exaggerated drop in intrathoracic pressure -> blood pools in pulm vasculature -> dec. LV preload.
45
Q

Heparin Induced Thrombocytopenia

A

elevated PTT = heparin

Sx:

  1. *Thrombocytopenia OR >50% drop in plt count from baseline 5-10d after initiation of treatment
  2. *Thrombosis (arterial or venous)

Type I HIT: nonimmune, direct effect of heparin on plt activation within first 2 days - normalizes, and okay

Type II HIT:*
Antibodies to platelet factor 4 complexed with heparin
-> plt aggregation, thrombocytopenia, thrombosis (arterial or venous; such as limb ischemia/stroke)
-> *5-10 days after initiation of tx

Tx:
Stop heparin
Direct Thrombin/Factor Xa inhibitor

46
Q

HTN + bilateral palpable masses

A

ADPKD

47
Q

Frequent Epigastric Burning, brought on by exertion.

A

Get an exercise EKG if baseline EKG nl!

- Don’t just think GERD. Must keep ischemic cardiac pain on differential.

48
Q

Asystole/Pulseless electrical activity vs. Defib vs. Cardioversion

A

Asystole/PEA = organized rhythm BUT NO PULSE

  • CPR and epinephrine!
  • Treat reversible causes
  • Do it till get a shockable rhythm.
Reversible causes of asystole/PEA: 
5H's: 
Hypovolemia 
Hypoxia
Hydrogen (acidosis)
Hypo or HyperKalemia
Hypothermia 
5T's 
Tension pneumothorax
Tamponade 
Toxins (narcotics, benzos) 
Thrombosis (pulm or coronary)
Trauma

Defibrillation = Vfib or pulseless VT

Cardioversion

  • symptomatic or sustained monomorphic VT unresponsive to antiarrhythmics
  • hemodynamically unstable afib
49
Q

Symptoms of ATYPICAL presentation of CAD

A

Women
Elderly
Diabetics

Abdominal pain, Epigastric pain
Nausea, Vomiting

MUST EXCLUDE CARDIAC CAUSES!

50
Q

What drugs can potentiate warfarin and increase risk of bleeding?

A

Acetaminophen
NSAIDS
Amiodarone
Antibiotics

51
Q

What type of murmurs on auscultation need to be investigated?

A

Diastolic and Continuous murmurs!! => TTE
Bc organic causes more likely.

Note:
Midsystolic soft murmurs (grade 1-2) in asymptomatic young patient are usually benign

52
Q

Lipid Lowering Therapy Guidelines:

A

STATINS:
HIGH = ator 40-80, rosuvas 20-40
MOD = ator 10-20, rosuvas 5-10, sim 20-40

  1. ATHEROSCLEROTIC disease - ACS, MI, stable or unstable angina, coronary or other arterial revascularization, Stroke, TIA, PAD
    - Age = 75 = HIGH intensity statin
    - Age > 75 = MOD intensity
  2. LDL >/= 190 - HIGH intensity
  3. Diabetes (40-75)
    - 10 year ASCVD risk >/= 7.5% = HIGH intensity
    - 10 year ASCVD risk /= 7.5% = mod to high intensity
53
Q

IVDU Infective Endocarditis associated with what murmur?

A

R-sided more - Tricuspid Regurg (holosystolic murmur that increases with inspiration)

Septic emboli common.

S. aureus most common - Vanco empiric treatment.

54
Q 
Best Initial therapy for HTN for the following: 
CAD
DMII
BPH
Depression/Asthma 
Hyperthyroid 
Osteoporosis
A

Initial: Thiazide, CCB, ACEi, ARB

CAD - BB, ACEi, ARB
DMII - ACEi, ARB
BPH - alpha blocker 
Depression/Asthma - NOT BB
Hyperthyroid - BB 
Osteoporosis - Thiazide
55
Q

Indications for Carotid Endarterectomy:

A

Carotid artery stenosis -> TIA

indications:
Symptomatic with 70-99% stenosis.
Consider in Males: Asymptomatic 60-99%

Prevention:
Aspirin, Antiplatelet agents, optimization of RF

56
Q

Pericardial Effusion on CXR

A

CXR: “Water bottle” heart with clear lungs
Diminished heart sounds
PMI difficult to palpate.

57
Q

Torsades - Treatment?

A

Torsade de Pointes

  • polymorphic VTach
  • due to congenital or acquired QT prolongation (fluconazole, moxifloxacin, hypoK)

Tx:

  • if unstable -> defib
  • stable -> Magnesium (works even if not hypomg)
58
Q

Key Antiarrthymics

A

Adenosine: terminate PSVT
Amiodarone: atrial and ventricular tachy
Atropine: sinus bradycardia, AVNRT

59
Q

Coronary Steal

A

Dipyridamole and Adenosine (coronary vasodilators):

- diseased vessels are already maximally dilated, so blood flow goes to ‘non-diseased areas

60
Q

HOCM vs. AS

A

Cresendo-Descrendo Systolic murmur LLB
Both can cause syncope, dypsnea, CP

AS - radiates to the carotids, dec with dec preload
HOCM - increased with dec preload.

61
Q

S4

A

Before S1 - right after atrial contraction as blood is forced into stiffened ventricle

Normal - healthy older adults

Abnormal

  • Ventricular hypertrophy
  • Acute MI
62
Q

S3

A

After S2 - turbulent blood flow to ventricles due to increased volume

Normal - children, young adults, pregnancy

Abnormal

  • restrictive cardiomyopathy
  • high output states, HF
63
Q

Most common paroxysmal tachycardia in people without structural heart disease?

A

PSVT - most commonly, mech is re-entry into AV node

Treat: Decreased conduction thru AV node

Manuevers

  • Carotid sinus massage
  • Valsalva manuever
  • Breath holding
  • Head immersion in cold water

Pharm:

  • IV adenosine
  • if unstable, DC cardiovert
64
Q

New cardiac conduction abnormality in patients with infective endocarditis?

A

Perivalvular abscess extending into conduction pathways

65
Q

Pt with palpitations and sx of CHF with Afib and evidence of systolic dysfxn on echo - how to treat to restore LV function?

A

Rate or Rhythm Control

Tachycardia-Mediated Cardiomyopathy
- chronic tachy causes LV dilation and myocardial dysfxn

66
Q

What is the most common cause of sudden cardiac arrest in the immediate post-infarction period of acute MI?

A

Reentrant VENTRICULAR arrhythmias

Any ventricular arrhythmia can occur, but ventricular fibrillation is most common cause of sudden cardiac arrest.

If occurs within 10 minutes of acute MI - “immediate” or phase Ia ventricular arrhythmias = reentrant!

If occurs 10-60 min after, ‘delayed” or phase 1b arrhythmia - abnormal automaticity!

67
Q

Actions of ATII (CHF -> RAAS activation -> ATII)

A
  1. vasoconstricts BOTH efferent and afferent - decreased renal blood flow
  2. BUT PREFERENTIAL vasoconstriction of EFFERENT renal arterioles - increases intraglomerular pressure to maintain adequate GFR
  3. direct stimulation of Na absorption in proximal tubules and increased aldo - increased in ECF, decreased Na delivery to distal tubule
68
Q

Thiazide Diuretic Side Effects:

A

Electrolytes:

  • HypoNa
  • HypoK
  • HyperCa

Metabolic:

  • Hyperglycemia
  • Increased LDL
  • Increased TAG
69
Q

Supraventricular Tachycardias and their locations

A

Afib: pulmonary veins
- absent p waves, fibrillatory waves, irregularly irregular RR intervals, narrow QRS

Aflutter: tricuspid annulus
- “sawtooth” flutter waves

AVNRT: reentrant circuit formed by 2 separate conducting pathways - one fast and other slow within AV node
- absent p waves or retrograde p waves, constant RR intervals, narrow QRS

AVRT/WPW: accessory AC bypass tract
- slurred upslowing p wave (delta wave), shortened PR interval, narrow QRS

70
Q

What electrolyte change parallels severity of HF?

A

Hyponatremia!

Treatment: fluid restriction, ACEi, Loop

71
Q

Arteriovenous Fistula

A

High-output cardiac failure
- shunts blood from arterial to venous side, increasing cardiac preload. Thou CO is increased, get HF because can’t meet O2 requirements of tissue

Signs:

  • widened pulse pressure
  • strong arterial pulses (brisk carotid upstroke)
  • systolic flow murmur, tachycardia
  • flushed extremities
  • displaced PMI, LVH
Causes: 
Acquired: 
Trauma - knife/stab wound* 
Femoral cath
Atherosclerosis - aortocaval fistula 
Cancer

Congenital
PDA
Angioma
Pulm or CNS AVF

72
Q

2 months after acute MI, pt develops HF - what complication?

A

Ventricular Aneurysm

  • late complication (5d - 3mo)
  • EKG: persistent ST segment elevation after recent MI and deep Q waves in the same leads
  • LV enlargement -> HR, refractory angina, ventricular arrhythmias, mural thrombus, annular dilation with MR.

VS. Papillary muscle rupture

  • more acute 2-7d
  • gives you severe MR + hypotension + pulm edema

VS. RV infarction

  • inferior wall MI
  • hypotension, elevated JVP, and clear lungs

VS. LV free wall rupture

  • several hours - 2 wks
  • cardiac tamponade and progresses rapidly to PEA, death
73
Q

How does beta blocker overdose present? Treatment?

A

Beta Block overdose:

  • hypotension *
  • bradycardia *
  • wheezing *
  • hypoglycemia
  • delirum, serizures
  • cardiogenic shock

Treatment:

  • IVF
  • IV atropine
  • IV glucagon *** - increases cAMP
74
Q

MVP

A

most common cause of MR in developed countries

MVP due to myxomatous degeneration of the MV leaflets/chordae and causes mid-systolic click + mid-late systolic murmur

Chronic severe MR - holosystolic murmur, LA and LV enlargement -> CHF, afib

75
Q

Lifestyle Modifications for HTN in order of efficacy

A 
weight loss
DASH
exercise
dec. Na intake
dec. EtOH intake
76
Q

Chagas Disease

A

Megacolon/Megaesophagus
CHF

Trypanosoma cruzi (protozoa) - endemic to Latin America.

77
Q

What should be avoided in cocaine induced STEMI?

A

Beta-blockers - unopposed alpha agonist activity worsens vasospasm

78
Q

How do nitrates work for anti-ischemic and anti-anginal effects?

A

Although they do vasodilate coronaries, primary effect is thru systemic venous venodilation -> lowers preload -> lowers LVEDV -> reduce wall stress and myocardial O2 demand.

79
Q

Scleroderma renal crisis presents with what on peripheral blood smear?

A

Scleroderma renal crisis: increased vascular permeability, activation of coag cascade, increased renin

  1. acute renal failure - UA normal or mild proteinuria
  2. malignant HTN - headache, blurry vision, nausea
  3. microangiopathic hemolytic anemia, DIC (schistocytes)
80
Q

Lipid Lowering Agents

A

LDL - Statins, Ezetimibe, Cholestyramine (bile acid sequestrants), NIacin

TAG - Fenofibrate/Gemfibrozil, Niacin

81
Q

Antimicrobial PPX for endocarditis in dental procedures

A

Oral amoxicillin

Only those with:

  • prosthetic valves
  • prior hx of IE
  • unrepaired congenital heart disease

(NOT isolated aortic or mitral valve disease)

82
Q

Shock with WARM extremities

A

Distributive!

USMLE STEP 2CK (3 decks)

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