cardio Flashcards
Pt with a history of Hodgkin lymphoma presents with systolic dysfunction (decreased ejection fraction, narrowing pulse pressure, and JBD)
Dilated cardiomyopathy secondary to doxorubicin treatment
Which class of antiarrythmics should be avoided in DM pt’s due to their ability to mask hypoglycemia?
Beta blockers
In a pt with Pulmonary HTN and an allergy to sulfa drugs, which medication should be recommended for diuresis?
Ethacrynic acid - only non sulfa-based loop diuretic
Acetazolamide, Furosemide, HCTZ all contain sulfa
A Turner patient is likely to have which two cardiac anomalies?
Coarctation of the aorta
Bicuspid aortic valve
Pt presents with hypotension, JVP, and pulsus paradoxus. Condition and ECG findings?
Tamponade
Alternations of QRS height with each beat (electrical alterans)
Child presents to ED for arrythmias due to an underlying congenital condition. These arrythmias are worsened by AV nodal block
Wolff-Parkinson-White
The pt has an AV accessory tract that bypasses the AV node going straight from the atrium to the ventricle
Loop diuretics are commonly given for what condition and how do they work?
Dilated cardiomyopathy
Block the Na/K/Cl cotransporter in the loop of Henle.
A young female from Guatemala dies suddenly while lifting a heavy object. Her only cardiac history is a new murmur that started 3-4 years ago. Bx at autopsy shows an area of perivascular fibrinoid necrosis within the myocardium
Rheumatic heart dz
Histology describes an Aschoff nodule
Nausea, vomiting, shortness of breath, diaphoresis suggests?
angina secondary to acute coronary syndrome (MI)
Pt with a rumbling late diastolic murmur preceded by an opening snap heard over the apex
Mitral stenosis due to a previous step pharyngitis infection (rheumatic heart dz)
Cardiac symptoms associated with SLE
Libman-Sacks endocarditis
Small sterile vegetations on BOTH sides of the mitral valve
SLE pt
In a patient with atrial flutter (rapid succession of identical atrial depolarization waves following ST elevation) why would you choose to administer esmolol over metoprolol
It is short acting
Good trial drug to see if the pt can tolerate a Beta Blocker
Pt with a history of HTN and DM in the ED with complaints of severe chest pain radiating to the lower back and asymmetric pulses in the upper extremities. What is the potentially fatal complication of this condition?
Pt has acute aortic dissection
Complication = rupture into any body cavitiy, including causing obstructive shock due to tamponade (most common COD)
PT with CHF exacerbation and peripheral edema becomes tachypneic following treatment. Crackles and tactile fremitus present bilaterally. What medication is responsible?
Mannitol
Furosemid is first line treatment to diures a CHF pt and spironolactone has been shown to improve mortality.
Mannitol is contraindicated because the pt can become hypernatremic and have worsening pulmonary edema due to volume expansion.
What is the difference between direct-acting and indirect-acting sympathomimetics?
Direct-acting enter the CNS less readily than the indirect acting
Direct-acting bind postsynaptic adrenergic receptors, these are more selective.
Indirect-acting cause catecholamine release from pre synaptic terminals (amphetamine)
Young African male with fever, weight loss, diffuse myalgias and arthralgia, abdominal pain. Areas of ulceration and mottled purple discoloration on his lower extremities. Past medical history significant for HTN and Hep B. Elevated WBC count, ESR, and CRP
Polyarteritis nodosa (PAN)
Necrotizing immune complex inflammation of medium-sized, muscular arteries.
Histology would show fibrinoid necrosis
ANA, and RF negative
35 year old with no medical history presents with progressive shortness of breath occurring with activity, weight gain, with a recent history of a URI. Cause of the heart failure?
Viral myocarditis (coxsackie, influenza, adenovirus, echovirus, CMV, HIV) Causes CHF secondary to dilated cardiomyopathy. Direct cytotoxicity via receptor-mediated entry of virus into cardiac myocytes
In a patient with pheochromocytoma what medication will antagonize the vascular and cardiac action of NE?
Letalol - non selective alpha and beta receptors
NE acts on a1, a2, and b1
vascular = a1
Cardiac = b1
Vessel associated with 3rd aortic arch?
Common carotids, internal carotids
Vessel associated with 5th aortic arch?
None. This arch regresses
Vessel associated with 1st aortic arch?
Maxillary a.
Vessel associated with 4th aortic arch?
ascending arch of the aorta, proximal portion of subclavian
Vessel associated with 2nd aortic arch?
Stapedial, hyoid a.
Vessel associated with 6th aortic arch?
pulmonary a.