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PANCE Review > Cardio > Flashcards

Cardio Flashcards

1
Q

What is the number one cause of death world wide?

A

Ischemic Heart Disease

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2
Q

Tx for Printzmetal Angina

A

MC Females

CCB - amlodipine / nifedipine

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3
Q

Absolute contraindications for use of TPA in a STEMI (<70 mins)

A

1) Any prior ICH
2) Any known structural cerebral vascular lesion (AVM)
3) Known CA
4) Hx of ischemic stroke
5) significant closed head/ facial trauma w/in 3 months

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4
Q

TPA timeframe for

1) PCI
2) Ischemic Stroke

A

1) < 90 min

2) <3 hrs

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5
Q

STEMI the big 5

A 
BB
ACE
Statin 
ASA
Plavix (clopidogrel) or Xa inhibitor - no if murmur/valve dz)
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6
Q

ST segment

1) Elevation
2) Depression

A

1) Injury

2) Ischemia

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7
Q

Pharmacologic stress testing vs exercise stress test

A

1) unable to perform exercise
2) AS
3) LBBB
4) Pacemaker
5) Recent MI
6) Severe HTN

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8
Q

Listening to murmurs

A

Start with Diaphragm

S3 (Ventral) + S4 (atrial) are low pitched - BELL, best heard in left lateral decubitus position

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9
Q

Murmur Intensity Scale

A 
I- VI
3= mod loud, no Thrill
4= Thrill 
5= Thrill palpable
6= Thrill visible
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10
Q

Symptoms of AS

A

“SAD” Syncope, Angina, Dyspnea (on exertion)

-Once symptomatic need surgical referral

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11
Q

AR

A

Corrigans
Water-Hammer
Quincke’s pulsation

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12
Q

Etiology of Mitral Stenosis

A

Rheumatic Fever

Opening Snap

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13
Q

Etiology of Mitral Reg

A

Acute: Dyspnea/ PND
IE
Chorda tendinae rupture
Papillary m. ischemia/infarct

Chronic: Fatigue, A-fib
RF, calcification, MVP (MC cx)

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14
Q

S3

A

CHF

Dialated Cardiomyopathy

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15
Q

S4

A

Hypertrophic CM

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16
Q

HCM

A

Sustained/ hyperdynamic PMI
High voltage on ECG
Nml heart size
S4

17
Q

Restrictive Cardiomyopathy

A 
Hemochromatosis 
Wilson's dz
Amyloidosis 
Scleroderma
Sarcoidosis
18
Q

Restrictive Cardiomyopathy

S/S’s

A

RHF
Kussmaul’s sign
Low voltage on EKG
Nml heart size

19
Q

Stroke a/w A-Fib MC where?

A

SMA (Superior mesenteric artery)

20
Q

Anticoagulants approved for A-Fib

A 
1) Warfarin
Those w/out valve dz: 
2) Dabigatran- Pradaxa-DTI
3) Rivaroxaban- Xarelto-Xa
4) Apixaban- Eliquis-Xa
21
Q

Drugs for cardioversion

A

Flecainide
Amiodarone
Quinidine

(prophylaxis 3 wks before and 4 wks after)

22
Q

Etiology of Acute vs Chronic Pericardial Effusion

A

Acute: infectious, inflammatory, trauma, drug induced, AMI

Chronic: malignancy, uremia, radiation

23
Q

CHF or Low CO

Beta sympathetic tone

A

1) Inc HR (+ chronotropy)
2) Inc BP ( sm m constriction)
3) Inc contraction (+ inotropy)

24
Q

CHF or Low CO

Alpha sympathetic tone

A

1) Inc sm m. contriction

2) Increase BP (afterload)

25
Q

Parasymptathetic tone

A

counteracts beta + alpha

1) Dec HR
2) Dec BP

26
Q

DOE, echo perserved

+40%

A

Diastolic dysfunction

MC HTN

27
Q

DOE, echo perserved

+40%

A

Diastolic dysfunction
MC HTN
Tx: BB
*no role for + inotropes like digoxin

28
Q

Abn EF (<40%)

A

Systolic dysfunction

MC MI

29
Q

Precipitating Factors of CHF

A

1) Inc metabolic demands
2) Inc circulating volume
3) Conditions that inc afterload
4) Conditions that impair contractility

30
Q

HF Classes

A

I- Risk, no symptoms
II- Symptoms w/ activity
III- Symptoms w/ ADL
IV- Symptoms at rest

31
Q

+ Inotrope

A

Digoxin

Does not prolong life, only improves QOL, can reach toxic levels

32
Q

Aneurysm size and surgery

A

Abdominal >5.0 cm
Thoracic >6.0 cm (Surgery at >5cm if Marfan’s)
Tx: BB

33
Q

Dx of thoracic aneursyms

A

MC found incidentally on CXR or PE

GS- Aortography

34
Q

Diagnosis for pt with Pain, LE pallor, paralysis, paresthesia, pulselessness, poikilothermia

A

ARTERIAL U/S

35
Q

PAD vs PVD

A

PAD- gangrene (no O2)

36
Q

Dx for PAD

Tx

A

Ankle-brachial Index
>0.9
Exercise, RF modification, ASA/ Plavix

37
Q

PVD (Venous Insufficiency)

A

Increased sxs w/ standing
Heaviness, fatigue of legs
Swelling, warmth, brawny discoloration, ulceration around malleoli

38
Q

PE Syncope

A

Always includes VS w/ orthostatics, cardiac & complete neuro exam
-Vasodepressor/motor only if PE and Hx are nml

PANCE Review (10 decks)

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