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PANCE > Cardio > Flashcards

Cardio Flashcards

1
Q

First line tx for CAD

decreases mortality

reduces myocardial O2 requirements during stress/exercise

A

Beta blockers

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2
Q

Increases vasodilation
prevents ischemia induced by coronary vasospasm

*decreases contractility
*decreases HR
*decreases afterload

A

CCB

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3
Q

PCI or CABG:

1 or 2 vessel disease NOT involving main left coronary artery PLUS normal or near normal LV function

A

PCI

*plavix and aspirin after procedure

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4
Q

PCI or CABG:

Left main coronary artery disease
Symptomatic 3 vessels disease
EF < 40%

A

CABG

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5
Q

MC cause of MI

A

atherosclerosis

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6
Q

appears at 4-8 hours

peaks at 12-24 hours

A

troponins

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7
Q

how long until troponins return to baseline?

A

7-10 days

*most sensitive and specific

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8
Q

Goal time window for PCI?

A

90 mins

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9
Q
  1. abdominal obesity
  2. triglycerides > 150
  3. HDL < 40 for males, <50 for females
  4. fasting glucose >110
  5. HTN
A

metabolic syndrome (if 3 or more)

*RF for CAD

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10
Q

horizontal or downsloping ST depression

*but, 25% will be normal

=ECG for..?

A

Angina

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11
Q

Which drug class will prolong life in CAD

A

Beta blockers

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12
Q

“post MI syndrome”

pericarditis
fever
leukocytosis
pericardial or pleural effusion

A

Dressler Syndrome

*usually 1-2 weeks post MI

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13
Q

ST elevation >1mm in 2 contiguous leads

Peaked T waves –> ST elevation –> Q waves –> T wave inversion

A

STEMI ECG changes

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14
Q

ST elevation in:

II, III, aVF

*where is the MI?

A

Inferior

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15
Q

ST elevation in:

V1, V2

*where is the MI?

A

Posterior or anteroseptal

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16
Q

ST elevation in:

v1, v2, v3

*where is the MI?

A

Anterior

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17
Q

ST elevation in

v4, v5, v6

MI?

A

Anterolateral

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18
Q

DOC for cocaine induced MIs or Prinzmetals?

A

CCBs

DO NOT USE BETA BLOCKERS

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19
Q

Timeline for…

  • PCI?
  • Thrombolytics?
A

PCI= 90 mins

Thrombolytics= 3 hours

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20
Q

Decreased EF
S3 gallop

*MC type of HF

A

Systolic HF

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21
Q

Normal EF
S4 gallop

A

Diastolic HF

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22
Q

Dyspnea, orthopnea, PND
Pulmonary congestion, rales, rhonci
Cheyne stokes

what side HF?

A

Left sided

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23
Q

Deeper, faster breathing with gradual decrease and periods of apnea

A

Cheyne Stokes

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24
Q

Peripheral edema
JVD
GI/hepatic congestion (hepatojugular reflex)

what side HF?

A

Right sided HF

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25
Q

DOC for CHF?

26
Q

Kerley B lines
Butterfly pattern
Cardiomegaly
Pleural effusion

27
Q

ACE
ARB
Beta blockers
Hydralazine, nitrates

….are all ______ that decrease _____

A

vasodilators that decrease afterload

28
Q

Diuretics work to decrease…

29
Q

Are CCBs used in SYSTOLIC or DIASTOLIC HF?

A

Diastolic only

30
Q

At what ejection fraction can you start to consider an ICD?

31
Q

MC cause= viral (coxsackie, echovirus)

CP, sharp and worse w inspiration
Worse with lying flat
Improved when leaning foreward

diffuse ST elevations in V1-V6

A

Pericarditis

32
Q
  1. distant heart sounds
  2. increased JVP
  3. systemic hypotension
A

Beck’s triad

*seen in cardiac tamponade

33
Q

>10 mmHg in SBP with inspiration

A

Pulsus paradoxus

seen in tamponade

34
Q

2 things youll see low voltage QRS complexes

A
  1. cardiac tamponade
  2. pericardial effusion
35
Q

MC cardiomyopathy

*50% idiopathic
*can be viral (coxsackie, echo, parvovirus)
*ETOH, cocaine

A

Dilated cardiomyopathy

36
Q

How does dilated cardiomyopathy present?

A

Like systolic HF

*S3 gallop

(tx like HF…ACE, diuretics, beta blockers)

37
Q

Apical left ventricular ballooning

*follows events that cause catecholamine surge

  • -> ST elevations
  • -> positive enzymes
  • -> normal arteries on cath
A

Takotsubo cardiomyopathy

38
Q

harsh systolic crescendo-decrescendo murmur best heard at LUSB

A

HCM murmur

39
Q

what does the HCM murmur do with:

squatting and lying down

A

DECREASES

(bc venous return is increased)

40
Q

what does HCM murmur do with:

standing, valsalva

A

INCREASES

(decreases venous return)

41
Q

Most uncommon form of cardiomyopathy

*caused by amyloidosis, sarcoidosis, etc.

A

Restrictive cardiomyopathy

42
Q

Valve most affected with Rheumatic fever?

A

Mitral valve

43
Q
  1. migratory polyarthritis
  2. active carditis
  3. sydenhams chorea
  4. subcutaenous nodules
  5. erythema marginatum
A

major criteria for rheumatic fever

(minor= fever, arthralgias, ESR/CRP/WBC, prolonged PR)

44
Q

Rheumatic fever tx?

A

Penicillin G

45
Q

Seen following: TB, radiation therapy, cardiac surgery

right sided HF
+ kussmal’s
septal bounce
decreased mitral inflow velocities w inspiration

A

constrictive pericarditis

46
Q

systolic ejection murmur in 2nd and 3rd ICS parasternally

*can lead to paradoxic emboli (lead to stroke)

A

patent foramen ovale

47
Q

true or false

Right coronary artery supplies inferior heart
blockage would be shown in II, III, aVF

48
Q

the LAD supplies which portion of the heart

A

anterior

(V2, V3, V4)

49
Q

which lab is best to examine recurrent chest pain:

trops, CK-MB or CK

51
Q

true or false

ostium secundum is the MC cause of ASD

52
Q

often seen in premies

continuous machine like murmur

53
Q

BP UE > LE
weak femoral pulses

rib notching, 3 sign on CXR

A

coarcation of aorta

*angiogram= gold standard

54
Q

blue baby syndrome
heard at pulmonic area (LUSB)

boot shaped heart

A

tetralogy of fallot

55
Q

for hypertensive emergency, want to lower BP 10% within…

A

the first hour

*then another 15% in 2-3 hours

56
Q

target LDL goals for….

  1. DM/CAD
  2. other RFs
  3. no RFs
A
  1. <100
  2. <130
  3. <160
57
Q

true or false…

naficillin and gent for endocarditis

58
Q

screening for AAA for:

  1. 3-4 cm
  2. 4-4.5 cm
  3. 5.5 or more than 0.5 cm growth in 6 mo
A
  1. U/S q 1 year
  2. U/S q 6 mo
  3. SURGERY
59
Q

BP difference in limbs is seen in..

A

aortic dissection

60
Q

U waves associated with…

A

hypokalemia

61
Q

RBCs break down or lyse in response to some meds, infections or stressor

*can be seen with hydroxychloroquine

A

G6PD deficiency

62
Q

prazosin can be used for both…

A

HTN and BPH

PANCE (10 decks)

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