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MJ- PCS1 EOR > Cardio > Flashcards

Cardio Flashcards

1
Q

MCC Torsades?

A

hypomagnesemia

hypokalemia

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2
Q

Tx for stable sustained VT

A

Amiodarone

(can also use lidocaine or procainamide)

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3
Q

Unstable VT with a pulse

A

Synchronized cardioversion

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4
Q

VT (no pulse) tx

A

Defib + CPR

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5
Q

Tx for Torsades de pointes

A

IV magnesium

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6
Q

Delta waves seen on EKG

A

Wolff-Parkinson-White

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7
Q

Tx for stable wolff parkinson white

A

Vagal maneuvers

_**Procainamide**_, Amiodarone, flecainide, Ibutilide

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8
Q

1st line tx for unstable wolff parkinson white

A

Synchronized cardioversion

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9
Q

Fixed split of S2 (doesnt vary with inspiration)

A

ASD, VSD

Pulmonary HTN

Mitral regurgitation

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10
Q

ejection click heard in systole

A

Mitral valve prolabse

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11
Q

Diastolic murmur:

Opening snap

Best heard where?

A

Opening snap= MS (also heard in TS but later)

MS- Best heard @ apex

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12
Q

Murmurs: Harsh/rumble= regurg or stenosis?

A

stenosis

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13
Q

Murmurs:

blowing= regurg or stenosis?

A

Regurg

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14
Q

which murmur radiates to carotid

A

AS

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15
Q

which murmur radiates to LUSB

A

AR

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16
Q

Which murmur radiates to the axilla

A

MR

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17
Q

Which murmur has no radiation

A

MS

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18
Q

Murmurs:

Carvallo’s sign (increased murmur intensity with inspiration

A

TR

(helps distinguish TR from MR)

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19
Q

Cheyne Stokes Breathing

A

Heart Failure

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20
Q

Pt comes to ER with dyspnea and has elevated BNP

A

Heart failure

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21
Q

Kerley B lines on CXR

A

heart failure

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22
Q

management for congestive (decompensated) heart failure

A

“LMNOP”

Lasix

Morphine

Nitro

Oxygen

Position (upright)

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23
Q

Pre HTN?

Stage 1?

Stage 2?

A

Pre= 120-139/80-89

Stage 1= 140-159/90-99

Stage 2= >160/100

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24
Q

What 5 drugs can be used to tx HTN urgency

A

Clonidine

Captopril

Furosemide

Labetolol

Nicardipine

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25
Q

What BP is HTN emergency

A

>180/120

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26
Q
A
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27
Q

3 meds used to tx HTN encephalopathy in HTN emergency

A

Nicrdipine or clevidipine

Labetalol, Fenoldopam

Sodium nitroprusside

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28
Q

2 meds used to tx hemorrhagic/ischemic stroke in HTN emergency

Note: decrease BP ONLY if >220/120 (not a thrombolytic candidate), >185/110 (if a thrombolytic candidate)

A

Nicardipine or Labetalol

29
Q

tx for cardiogenic shock (4 + 1 if refractory)

A

O2 + Isotonic fluids (sm amounts) + dobutamine + epi

Refractory= + amrinone

30
Q

What is Becks triad?

A
  1. Distant heart sounds
  2. Incr. JVP
  3. Systemic hypotension

= PERICARDIAL EFFUSION

31
Q

Tx for acute pericarditis

A

Aspirin or NSAIDS (tx of choice)

2nd line= colchicine

Refractory (sxs >48h)= Steroids

32
Q

What is Dresslers syndrome? how do you tx?

A

Acute pericarditis s/p MI

Tx: Aspirin or Colchicine

33
Q

Tx for pericardial tamponade

A

pericardiocentesis

34
Q

ECG findings:

Low voltage QRS complex

electrical alternans*

A

Pericardial effusion

35
Q

MCC myocarditis

A

Enteroviruses (esp. Coxsackie B)

also SLE, Rheumatic fever

36
Q

Tx for myocarditis

A

Supportive mainstay of tx, standard systolic HF tx:

  • Diuretics, ACE, Inotropic drugs if severe- Dopamine, dobutamine, etc
  • BB (not in peds)
  • +/- IVIG
37
Q

gold standard in dx myocarditis

A

endomyocardial bx

38
Q

5 MAJOR jones criteria for rheumatic fever?

A
  1. Joint (migratory polyarthritis)
  2. Oh my heart (active carditis)
  3. Nodules (subcutaneous)
  4. _E_rythema marginatum
  5. _S_ydenham’s chorea

+ evidence of recent group A strep infection (pos throat culture or elevated ASO)

39
Q

dx of rheumatic fever

A

jones criteria- 2 major or 1 major +2 minor

40
Q

4 minor jones criteria for rheumatic fever

A
  • Fever (>101.3)
  • Arthralgia
  • Incr. ESR, CRP or leukocytosis
  • ECG: prolonged PR

+ evidence of recent group A strep infection (pos throat culture or elevated ASO)

41
Q

Tx of rheumatic fever

A
  • Aspirin (2-6wks w/ taper)
  • +/- corticosteroids in severe cases w/ carditis
  • _Penicillin G*_
42
Q

MCC subacute bacterial endocarditis

A

strep viridans

(subacute= infection of abnormal valves)

43
Q
A
44
Q

MCC acute bacteroial endocarditis and IVDA

A

S. aureus

(acute= infection of normal valves)

45
Q

MCC infective endocarditis in men 50y/o w/ h/o GI/GU procedures

A

Enterococci

46
Q

MCC prosthetic valve endocarditis

A

Staph epidermidis

(early, w/in 60d)

47
Q
  • Janeway lesions (painless erythematous macules on palms/soles)
  • Roth Spots (retinal hemorrhages)
  • Oslers nodes (tender nodules on the pads of the digits)
  • Splinter hemorrhages
A

infective endocarditis

48
Q

Tx for acute (NV) infective endocarditis

A

Nafcillin + Gentamicin x4-6wks

OR

Vanco + gentamicin

49
Q

Tx for subacute (NV) infective endocarditis

A

PCN or Ampicillin + Gentamicin

Vanco in IVDA

50
Q

Tx for prosthetic valve infective endocarditis

A

Vanco + Gentamicin + Rifampin

51
Q

Endocarditis prophylaxis tx

A

Amoxicillin 30-60 min prior to procedure

PCN allergic= Clindamycin

52
Q

5 indications for endocarditis prophylaxis

A

1. Prosthetic (artificial) heart valves

2. Heart repairs using prosthetic material (not including stents)

3. H/o endocarditis

4. Congenital heart dz

  1. Cardiac valvulopathy in a transplanted heart
53
Q

Management of AAA:

3-4cm

A

monitor- U/S every year

54
Q

Management of AAA:

4-4.5cm

A

monitor by US q6mo

55
Q

Management of AAA:

>4.5cm

A

Vascular surgeon referral

56
Q

Management of AAA:

>5.5cm or >0.5cm expansion in 6mo

A

immediate surgical repair (even if asxs)

57
Q

Initial Dx of choice for AAA?

A

Abdominal ultrasound

(esp if abd pain >60y/o)

58
Q
A
59
Q

Test of choice for thoracic aneurysms

A

CT scan

60
Q

Dx gold standard for AAA

A

Angiography

61
Q

most important predisposing factor for aortic dissection

A

hypertension

62
Q

test of choic for aortic dissection

gold standard?

A

CT w/ contrast

Gold= MRI angiography

63
Q

What is seen on CXR in aortic dissection

A

widening of mediastinum

64
Q

Tx for aortic dissection

A
  • acute proximal or acute distal w/ complications= surgery
  • Descending w/o complications= medical (esmolol, labetolol 1st line)
65
Q

Q wave/ST elevations in V1 through V4

A

(anterior wall) Left Anterior Descending

66
Q

Q wave/ST elevations in I, aVL, V4, V6

A

Lateral wall (circumflex)

67
Q

Q wave/ST elevations in I, aVL, V4 + V5 + V6

A

Anterolateral wall

mid LAD or CFX

68
Q

Q wave/ST elevations in II, III, aVF

A

Inferior wall

Right coronary artery

69
Q

ST depressions V1-V2

A

Posterior wall

RCA, CFX

MJ- PCS1 EOR (5 decks)

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