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Cardio Flashcards

1
Q

What defines unstable angina?

A
  • New onset in the last 2 weeks
  • Increasing severity
  • Pain at rest
  • Hemodynamic changes with pain
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2
Q

What defines pathologic Q waves?

A
  • I square wide

- 1/3 of the height of the QRS

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3
Q

Is a myocardial rupture/valve rupture an early or late complication of an MI?

A

Late

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4
Q

“Good” or “Bad” prognosis arrhythmia: mobitz type 1

A

Good

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5
Q

“Good” or “Bad” prognosis arrhythmia: Mobitz type II

A

Bad

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6
Q

“Good” or “Bad” prognosis arrhythmia: narrow complex bradycardia

A

Good

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7
Q

“Good” or “Bad” prognosis arrhythmia: PVCs

A

Good

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8
Q

“Good” or “Bad” prognosis arrhythmia: persistent tachycardia

A

bad

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9
Q

“Good” or “Bad” prognosis arrhythmia: non-sustained VT

A

Good

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10
Q

“Good” or “Bad” prognosis arrhythmia: new LBBB

A

Bad

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11
Q

What are the complications of an anterior MI? (3)

A
  • CHF/Shock
  • Ruptures
  • Bad bradycardias
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12
Q

What causes PR prolongation/blocks in MIs (2)?

A
  • AV node ischemia

- Vagal tone

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13
Q

How can you tell a RV infarct based on leads II and III?

A

If STE is higher in lead III compared to lead II, more likely to be RV infarct

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14
Q

How can you tell a RV infarct based on leads V1 and V2? (2)

A
  • If STE in V1 more than V2

- If STD in V2 and not V1

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15
Q

What is the treatment for a myocardial rupture?

A

Fluid load and surgery

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16
Q

What is the treatment for an acute VSD 2/2 septal wall rupture?

A

Unload, IABP, surgery

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17
Q

What is the treatment for a papillary muscle rupture?

A

Unload, surgery

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18
Q

When do you start lytics on a STEMI pt? (3)

A
  • CP for over 30 minutes, less than 12 hours
  • No PCI within 90 minutes
  • No contraindications
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19
Q

What are the three broad Sgarbossa criteria?

A
  • If J point on same side as QRS complex
  • If J point over 5 mm on opposite side
  • J point depression/elevation on the same side
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20
Q

What are the absolute contraindications for thrombolytics as they relate to the head? (4)

A
  • Prior ICH ever
  • Ischemic stroke last recently
  • Intracranial neoplasm
  • Close head or facial trauma
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21
Q

What is the risk of ICH with thrombolytics, generally?

A

1-2%

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22
Q

What are the indications that a thrombolytic worked (3)?

A
  • Pain reduced
  • ST segment lowering
  • Reperfusion arrhythmia (accelerated idioventricular rhythm)
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23
Q

How long does accelerated idioventricular rhythm last for, typically?

A

Less than a minute

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24
Q

What is the management for idioventricular rhythm?

A

Observation

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25
Q

What are the three indications (besides STEMI) for PCI in the setting of ACS?

A
  • Shock
  • Contraindications to thrombolysis
  • Failed thrombolysis
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26
Q

What is the pure alpha blocker used in cocaine induced HTN?

A

Phentolamine

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27
Q

What is the most common infected heart valve in a non-IVDU?

A

Mitral

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28
Q

What are the two antibiotics used to treat endocarditis?

A

Vanc and gent

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29
Q

What is the acute treatment for aortic regurgitation?

A

Afterload reduction, then surgery

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30
Q

What is the de Musset’s sign?

A

Head bobbing from aortic regurg

31
Q

What is the Quincke’s pulse sign?

A

Pulsatile nail beds from aortic regurgitation

32
Q

CV collapse in a pregnant women during delivery, has heart murmur = ?

A

Mitral stenosis

33
Q

Myocardial ischemia + shock + new murmur = ?

A

Ruptured chordae tendineae

34
Q

What is the treatment for a chordae tendinae rupture?

A

Decrease afterload (nitroprusside) them, call surgery

35
Q

What are the two most common causes of HF in the developed world?

A

HTN and ischemia

36
Q

What are the most common causes of diastolic HF in the developed world?

A
  • HTN
  • Aortic stenosis
  • Scarring after MI
  • Glycosylation of the heart from DM
  • Ischemia
37
Q

What is the end result for most diastolic heart failure?

A

Systolic HF

38
Q

Who gets pressors in acute HF exacerbations?

A

Only super sick, hypotensive patients

39
Q

What is the role of nesiritide in acute HF?

A

Never indicated ever

40
Q

What is the most common cause of cor pulmonale?

A

Left sided HF

41
Q

What is the most common cardiomyopathy type?

42
Q

What is the functional consequence of dilated cardiomyopathy?

A
  • Poor contraction
  • Low EF
  • dilation is a compensation
43
Q

What is the treatment for dilated cardiomyopathy?

A
  • Remove underlying cause
  • anticoagulation
  • Treat CHF
44
Q

What is the functional consequence of restrictive cardiomyopathy?

A
  • diastolic HF

- fibrosis

45
Q

Does valsalva increase or decrease the murmur of HOCM?

46
Q

Does hand grip/squatting increase or decrease the murmur of HOCM?

47
Q

What position is pericarditis classically better in?

A

Sitting forward

48
Q

True or false: pericarditis may have a trop bump

A

False–myocarditis if this is the case

49
Q

Pericarditis + trop (+) =?

A

Myocarditis

50
Q

What are the stages of pericarditis EKG changes?

A
  1. PR depression, STE diffuse
  2. Return to baseline
  3. TWI
  4. Normalization
51
Q

What is the common rhythm that myocarditis presents with?

A

Unresolving sinus tachycardia

52
Q

How does myocarditis present?

A

Viral syndrome

  • CHF
  • arrhythmias,
  • Pericarditis
53
Q

What drug is used to decrease BP emergently?

54
Q

Where in the CV system does nitroprusside primarily have an effect?

A

Dilates arteries, more so than veins

55
Q

What is the relative half-life of nitroprusside?

56
Q

What is the major side effect of nitroprusside?

A

Cyanide poisoning, especially if poor renal function

57
Q

What is the drug of choice for acute reduction of HTN with neuro s/sx? Why?

A
  • Nicardipine

- Little direct heart effects

58
Q

What are the components of the CHESS mnemonic for syncope?

A
  • CHF
  • HCT less than 30%
  • EKG abnormalities
  • SOB
  • SBP less than 90 mmHg
59
Q

What are the 5 concerning EKG changes for patients with syncope?

A
  • Ischemia
  • WPW
  • Brugada
  • HOCM
  • QTc prolongation
60
Q

What are the EKG changes associated with HOCM?

A
  • Needle like Q waves

- LVH

61
Q

What is the bacteria that is responsible for plague?

A

Yersinia Pestis

62
Q

Blue toe syndrome = ?

A

Peripheral emboli from aorta

63
Q

What is the best way to determine the cause of acute limb ischemia?

A

Feel pulses and work proximally to determine if local or from aorta

64
Q

What is the treatment for an acutely ischemic limb?

65
Q

What are the components of Virchow’s triad?

A
  • Stasis
  • Hypercoagulable
  • Endothelial damage
66
Q

What is the dosing for diltiazem for SVT? (2)

A
  • 15-20 mg/ 2 minutes

- 2.5 mg/min total 50 mg

67
Q

What is the simple way to remember cardioversion doses of electricity?

A

50 J the double until you get response

68
Q

What is the treatment for unstable a-fib?

A
  • Shock

- rate control

69
Q

What does WPW with a-fib look like?

A

Irregular wide and narrow, super fast

70
Q

Where is the reentrant circuit most commonly found with SVT?

A

Within the AV node

71
Q

What are the three major causes of bradycardia? (DIE)

A
  • Electrolytes
  • Drugs
  • Ischemia
72
Q

What type of QRS duration (wide or narrow) will atropine work well for? Why?

A

-Narrow, since it is likely amenable to changes in vagal tone

73
Q

Atropine + ischemia = ?

74
Q

How do you make an epi drip?

A

10 mL of 1:10000 epi in 1 L NS = 1 mcg/mL

-Run at 2-10 mL/min

Hippos (23 decks)

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