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Step 2 > Cardio > Flashcards

Cardio Flashcards

1
Q

Acute Pericarditis Presentation, Dx, and Tx

A

Pleuritic chest pain, +/- fever, Pericardial rub on auscultation.

Diffuse ST segment changes on EKG

Echo shows effusion

Tx: NSAIDS + Colchicine, Steroids for contraindications or refractory dz

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2
Q

Mitral Stenosis

A

Opening snap then rumbling mid diastolic murmur

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3
Q

Mitral Regurgitation

A

Holosystolic with Mid-systolic click, apex to axilla, dyspnea, fatigue, heart failure.

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4
Q

Pulsus parvus et tardus

A

“Weak and late pulse” caused by severe aortic stenosis

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5
Q

VSD

A

Harsh holosystolic murmur usually 3/6 or greater, requires echo to evaluate. Most will close spontaneously.

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6
Q

Transposition of the Great Vessels

A

Single loud S2, +/- VSD, egg on a string heart

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7
Q

ToF

A

Harsh pulmonic stenosis murmur, VSD murmur, boot-shaped heart (right hypertrophy)

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8
Q

Tricuspid atresia

A

Single S2, VSD murmur, Minimal pulmonary blood flow

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9
Q

Truncus Arteriosis

A

Single S2, systolic ejection murmur, increased pulmonary blood flow and edema.

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10
Q

Total anomalous pulmonary venous return with obstruction

A

severe cyanosis and resp distress. Pulmonary edema, snowman sign (englarge supracardiac veins & SVC)

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11
Q

Constrictive pericarditis

Causes

Presentation

A

idiopathic, post viral, post radiation, post hodgkins lymphoma, tuberculosis (most common in 3rd world).

Acites, elevated JVP, edema, pericardial knock, pulsus paridoxus, Kussmaul’s sign.

May see pericardial calcifications on xray

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12
Q

RV heave

A

Sign of RV hypertrophy, commonly due to pulmonary arterial hypertension (as seen in SS)

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13
Q

papillary muscle rupture

A

2-7 days post MI, severe MR, RCA associated MI

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14
Q

ventricular wall aneurysm

A

5 days to 3 months, functional MR, mural thrombus, LAD

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15
Q

Cardiac effects of thyroid hormone

A

Increased contractility, increased CO, decreased SVR, increased myocardial O2 demand.

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16
Q

Multifocal Atrial Tachycardia

A

Exacerbation of pulmonary disease, hypokalemia, catecholamine surge (sepsis). 3 or more P-wave forms with an atrial rate greater than 100. Correct underlying disturbance, Verapamil if refractory.

17
Q

Physiology of HCM

A

Autosomal Dominant, more common in AA Anything that increases the volume of the left ventricle will decrease the murmur by improving the obstruction. -Increasing Afterload or Preload: Handgrip (Preload), Squatting (Preload and afterload), passive leg raise (preload).

18
Q

Intraventricular Septum Rupture

A

3-5 days post-MI, LAD, chest pain, shock, new holosystolic murmur.

19
Q

PVCs in patients with heart history

A

BB or CCB

20
Q

Causes of Acute Pericarditis

A

post Viral, autoimmune (Lupus), Uremia, Postmyocardial infarction (Dressler’s Syndrome)

21
Q

Severe Aortic Stenosis

A

Aortic Jet velocity >4 m/s

Mean transvalvular pressure gradient >40mmHg

Valve area is usually less than 1cm

22
Q

Indication for AS intervention

A

Severe stenosis plus one of the following

Symptomatic

LVEF <50%

Undergoing other cardiac surgery

23
Q

Indications for Mitral Valve Repair

A

LVEF <60% regardless of symptoms

24
Q

Electrical alternans

A

Changes in QRS complex amplitude from beat to beat

Seen in pericardial effusions

25
Q

Mobitz I

A

Progressively longer PR interval until a beat is dropped

26
Q

Mobitz II

A

PR interval constant, random dropped beats.

27
Q

Severe AS

A

Late peaking systolic murmur

Soft single S2

pulsus parvus et tardus

28
Q

Most common heart defect in down syndrome

A

complete atrioventricular septal defect

29
Q

Thready pulses that disappear with inspiration

A

Pulsus paradoxus

think cardiac tamponade

30
Q

Young person with heart failure after viral illness

A

Myocarditis –> Dilated Cardiomyopathy

Coxsackie B

31
Q

Infective Endocarditis vs Cardiac tumor

A

IE: Vegitations + regurg

Tumor: Mass + Stenosis

32
Q

S4

A

Normal older adult

Ventricular Hypertrophy

Acute MI

33
Q

S3

A

Children, young adults, pregnancy

Heart Failure, Restrictive CM, High output state

34
Q

Suspected Aortic dissection/aneurysm with elevated Cr

A

TEE

35
Q

Afib after sternotomy

A

Relatively common, most will go away in less than 24 hours. Rate control.

If it persists then you can consider cardioversion and anticoagulation.

36
Q

Mediastinitis

A

5% of sternotomies

Fever, tachycardia, chest pain, leukocytosis

Widened mediastinum on xray

draining woud

Tx: Surgical debridement and abx

37
Q

Old guy, CP, syncope, recent viral illness, markedly enlarged heart

A

HAVE to consider aortic dissection, even without differences in UE BP.

38
Q

Palpable thrill with harsh, holosystolic murmur

Left 4th intercostal space

A

VSD

Step 2 (22 decks)

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