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Final review for Step 2 Ck > Cardio > Flashcards

Cardio Flashcards

1
Q

when do you treat bradycardia?

A

treat bradycardia when there are not syx, then use atropine and follow with Epi or Dopa and if not response then you pace them

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2
Q

whend oyou treat first degree AV block

A

first degre AV block is just an icnreased PR interval and is treated when QRS is long

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3
Q

what is it called when PR is lon

A

long PR is a first degree heart block and is only treated wth QRS is long as this indicates slow conduction elow the AV node

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4
Q

What heart block (1,2 (I or II)) do you treat

A

Only treat type 2 degree 2 heart block as it progresses to third degree heart block

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5
Q

what is type II, mobitz ii herat block

A

no change of PR with dropped beats, it progresses to third degree so oyu treat it with pacemaker

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6
Q

What is diff between type I and type II mobitz physio

A

Type I is due to transient delay in AV node versus type II which is due to conduction delay below the AV node and therefore progress to third degree you only treat type II mobtiz second degree block as it is not a conduction isse in the AV node

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7
Q

What is SSS

A

tachy and brady arrhtymia which is MCC for pacemaker placement

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8
Q

How is stable sinus tachy treated?

A

With observation or vagal maneurvers or IV adenosine

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9
Q

when is IV adenosine and vagal maneuvers used in sinus tachy?

A

Use IV adenosine or vagal maneuvers in stable tachycardia, versus DC conversion in unstable tachy

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10
Q

drug of choice for supraventricular stable tachycarrhtymia?

A

IV adenosine

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11
Q

Unstable supraventricularly sinus tachy

A

DC convert.

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12
Q

Who gets anticoag in afib

A

do CHA2DS2VASc and 1-2 get warfarin in afib

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13
Q

what does Afib cause?

A

Afib causes dilated cardiomyopathy

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14
Q

how is dilated cardiomyopathy of afib prevented

A

rate control reverses afib cardiomyopathy with RVR

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15
Q

How is wafarin necrosis treated

A

warfarin necrosis is treated with d/c warfarin and adding vitK then bridging with heparin until the necrotic lesions heal

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16
Q

what causes atrial flutter

A

atrial flutter is due to a reentrant circut around the tricuspid annulus with saw tooth appearance

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17
Q

how is atrial flutter treated

A

treat atrial flutter same as afib, rate and rhythm control and cardiovert if unstable

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18
Q

common rate control drug?

A

diltizaem and verapamil are common rate control blockers

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19
Q

what do you suspect retroperitoneal hematoma

A

in MVA with vague backpain and some weakness

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20
Q

what do preatrial complexes look like?

A

Look different than normal P waves and also cause irregular rhtyhm, but P waves are seen. Reduce alcohol and cigarettes and only treat if symptomatic

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21
Q

What does AV-node tachy look like

A

it is increased conduction throught he node so there is normal conduciton below the AV node which means it is narrow complex and the P wave is often burried

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22
Q

how is AVNRT traeted?

A

Rapid WRS with P wave buried is IV adneosine or bagal maneuvers with cardioversion if unsable

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23
Q

what drugs are AV blockers

A

BB, diltiaezem, verapamil, adenosine

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24
Q

how is WPW treated?

A

WPW is due to conduciton outside AV node so ther proainadme and ibulitilide are sued

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25
Q

How is VT treated

A

stable is adenosine, unstable is cardiovert

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26
Q

What does VT look like

A

VT is wide complex tachycardia

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27
Q

What is a common use of amiodarone

A

amiodarone and lidocaine are commonly used in VT

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28
Q

When do you do Defrib

A

Pulseless VT and VF you defrib

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29
Q

Why is hyponatremia a bad sign in CFH

A

hyponatremia means there is excessive activation of RAA by the kidney due to malperfusion and is a bad prognostic sign as this can also worsen remodels

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30
Q

what is a normal EF > 55%

A

EF >55%

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31
Q

How is constrictive percarditis treated?

A

Due to fibrosis of the pericardial sac, you just remove the sac with pericardiectomy if refractory to diuresis

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32
Q

Prolonged tacharrythmia like AF.RVR leads to what?

A

Prolonged tachyarrhytmia causes cardiomyopathy and you treat by controlling valve

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33
Q

What type of effect does chronic inflammation have on the heart

A

chronic inflammation leads to AL (MM) or AA (RA/IBD/TB) restrictive cardiomyoapthy wiht normal chamber size but thickened wall.

34
Q

What liver disease causes heart dysfunction

A

Remember that hemochromatosis often causes iron deposition in the myocardium

35
Q

+ stress test what common med used

A

Aspirin/anti-plt NOT anticoag (protect against plaque rupture)

36
Q

What does variant (prinzmetal) show on EKG

A

it shows ST depressions

37
Q

Dual effects of dypradimole?

A

Antiplatelets and coronary vasodilator causing coronary steal syndrome

38
Q

Best enzyme for reinfarct

A

CKMB is the best enzyme for reinfarct

39
Q

best and msot senstiive enzyme

A

troponin I

40
Q

In suspected MI and no dissection, what is give immediately

A

Give ASA right away as this decreases mortality in MI and stabilizes the plaque and prevents more formation

41
Q

Why does acute limb ischemia happen post-MI

A

it commonly happen in LAD MI due to emboli that are ARTERIAL and cause PPPPP – treat with heparin and get echo to see where thrombi in the heart is coming from (YOU NEED ECHO TO EVAL THROMBUS)

42
Q

Acute pericarditis post MI causes what?

A

Acute pericarditis causes pleuritic chest pain post-MI

43
Q

Why does ventricular anerysm occur months after infarct

A

ventricular aneurysm occurs month after infarct due to cardiac remodeling of thin, fibrotic tissue and presents with Q waves and acute STEMI on EG

44
Q

What complication of MI (that isn’t Dressler) Commonly happens months later?

A

Ventricular aneurysm happen smotnhs later

45
Q

What type of nephritis does analgesics cause

A

Papillary calcificatin/damage and tubulointerstitial nephritis is secondary to chronic analgesic use

46
Q

Long term analgesics, WBC casts, papillary necrosis due to?

A

Tubulointerstitial nephritis from analgesic use

47
Q

Classic signs of interstitial nephritis

A

a person who just started a drug and gets rash/eosioniphilia in their urine and s/s of nephritis with WBC casts

48
Q

When do you see a waterbottle heart and hard to palpate PMI

A

pericardial effusion

49
Q

when do you go right to pericardiocentesis in pericardial effusion

A

if patient is unstable

50
Q

Common complication of RHD

A

atrial fibrillation

51
Q

What other murmus improves with preload beside HOCM?

A

MVP improves with more preload as it causes the myocardium to stretch and approx the leaflets better

52
Q

HOw can a young person have angina who is female

A

bicuspid aortic valves acuse angina in young people

53
Q

when is there pulsus parvus et tardus

A

pulsus parvus et tardus ia d elaye dand weak carodtid upstraoke and a split S2 commonly in aortic stenosis

54
Q

when do you see parvus et tardus

A

AS

55
Q

How is aortic stenosis treated

A

AS is aortic replacement (calcification)

56
Q

when do you see water hammer pulse and head bob

A

water hammer pulse and head bob in aortic regurg

57
Q

why water hammer pulse and head bob in aurtoci regurg

A

regurg causes increased stroke volume then the regurg sucks it out

58
Q

what is a common cause of aortic regurg

A

a common cause of aortic regurg is bicuspid aortic valve

59
Q

mitral stenosis common complication

A

atrial fibrillation is a common complicaiton of mitral stenosis

60
Q

foreigner with hemoptysis and afib consider?

A

mitral stesnosis

61
Q

how is mitral stenosis treate

A

balloon valvotomy

62
Q

Holosytolic murmur increasing during inspiration?

A

100% sensitive for tricuspid regurgitation

63
Q

Aortic dissection dx

A

Bedside TEE then CT with contrast if no C/I to it (good renal fucntion)

64
Q

Other than volume, why do elderly get orthostatics commonly

A

elderly have an imparied baroreceptor sensitivity and are often volume depleted (BUn Cr ratio)

65
Q

What does fibromuscular dysplasia affect?

A

Fibromuscular dysplasia affects NOT just renal arterires, but carotids, vasculature or arteries anywhere it is systemic, not just renal

66
Q

Is FMD inflammatory or atherosclerotic?

A

FMD is NON inflammatory NON athersclerotic that affects any vasuclautre in the body not just kidney and so syx can vary

67
Q

Diffuse ST elevation everywhere and a PR depression with pleuritis pain?

A

Acute pericarditis

68
Q

Diastolic heart disease go

A

EF normal (50-55%) with a history of HTN/infiltrative disease, radiation

69
Q

Syncope with a h/o recent MI or heart disease/valve disease with no prodrome or seizre/postictal confusino

A

In recent heart disease with syncope or valve disease that causes cardiac manifestations first thought in a syncopal episode is cardiogenic due to arrhythmia

70
Q

What CHADSVASC score needs Warfarin

A

4 or higher

71
Q

Odd signs of cholesterol embolism (other than skin mottling) in labs after cath/vasc surgery?

A

Eosinophilia, hypocomplementemia with CNS/ocular and kidney invovlement in s/s

72
Q

When do you defibrillarte?

A

In VF or pulseless VT

73
Q

Risks for PAC?

A

Smoking and tobacco

74
Q

Tx for PAC

A

stop smoking and tobacco

75
Q

cause of PAC

A

different foci in atria with odd/dipped P waves and some feelings of palps due to smoking and tobacco rarely preceding afib

76
Q

Diff between PAC and afib

A

P waves in PAC and none in afib, both can cause rythm irregularity

77
Q

When is S4 heard acutely

A

S4 is often heard acutely during MI

78
Q

when is S4 heard chronically

A

S4 is heard chronically due to stiff ventricles

79
Q

WHy do you stop statins with muscle pain and high CPK

A

avoid renal rhabdomyolysis

80
Q

why does CCB amlodipine cause edema

A

dilation of precapillary arterioles

81
Q

how is CCB edema prevented

A

prevent CCB edema with ACEi/ARB which dilated the post venou capillary and reduce the hydrostatic pressure responsible for it

82
Q

What does prolonged QRS indicate in heart block

A

Prolonged QRS (not just long PR without drop in first degree block) suggests a block in conduction below the AV node needs more evaluation

Final review for Step 2 Ck (12 decks)

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