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PANCE > CARDIO > Flashcards

CARDIO Flashcards

1
Q

Treatment for Unstable Bradycardia

A

1st- Atropine 1st Line

Epinephrine or Dopamine infusion

3rd Degree HB = Transcutaneous pacing 1st Line

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2
Q

Bradycardia causes

A

Physiologic- vasovagal reaction (MCC), well conditioned, ICP.

Pathologic- BBs, CCBs, Digoxin, Inferior MI

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3
Q

Irregular Rhythm where HR increases during inspiration.

Otherwise NSR

A

Sinus Arrhythmia

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4
Q

A combination of sinus arrest alternating paroxysms of atrial tachyarrhythmias and bradyarrhythmia

What is the management?

A

Sick Sinus Rhythm

Management: Permanent Pacemaker if symptomatic.

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5
Q

Heart block that requires permanent pacemaker?

A

Second Degree AV HB Type II (Mobitz II)

Third Degree AV Block

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6
Q

HB with progressive PRI lengthening leading to a dropped QRS;

Going, Going, Gone

A

2nd Degree AV Block Type I (Mobitz I)

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7
Q

HB commonly in the bundle of His.

Constant prolonged PRI: 2:1 or 3: 1 P:QRS

What is the management

A

2nd Degree AV Block Type I (Mobitz II)

Management: Atropine or Temporary pacing

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8
Q

Most common chronic arrhythmia. Irregular/ Irregular rhythm with narrow QRS

No discernable P waves (350-600 BPM)

A

Atrial Fibrillation

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9
Q

Stable Atrial fibrillation Management

A
  1. BBs- Metoprolol or Esmolol (Caution w reactive Airway disease
  2. CCBs- Diltiazem (Less Verapamil) Non-dihydropyridines
  3. Digoxin- In elderly (preferred for rate control in patients with HYTN or CHF
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10
Q

All patients with nonvalvular atrial fibrillation should undergo?

A

Anticoagulation (INR 2-3)

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11
Q

Types of Atrial fibrillation

A

Paroxysmal- Self terminates w/i 7 days (recurrent).

Persistent- not terminate w/i 7 days

Permanent- AF> 1 year (refractory to cardioversion)

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12
Q

Unstable Atrial fibrillation Management

A

Synchronized cardioversion

Definitive: Radio frequency Ablation

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13
Q

Unstable Tachycardia: HYTN, AMS, AHF, CP

Narrow QRS

A

Synchronized cardiovert

Consider Adenosine

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14
Q

Unstable Tachycardia: HYTN, AMS, AHF, CP

Narrow QRS

A
  1. Vagal Maneuvers
  2. Adenosine (If regular and narrow QRS)
  3. BBs or CCBs
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15
Q

Management of Wolff-Parkinson-White (WPW)

A

Stable:Procainamide preferred (Class Ia Antiarrhythmic)
Unstable: Synchronized Cardiovert 1st Line

Avoid AV nodal blockers
ABCD= Adenosine, BBs, CCBs, Digoxin

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16
Q

If Left Axis Deviation ECG will show

A

Lead I QRS upright

aVF QRS downward

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17
Q

If normal Axis deviation

A

Lead I QRS upright

aVF QRS upright

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18
Q

If Right Axis Deviation

A

Lead I QRS downward

aVF QRS upright

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19
Q

Normal PR interval

A

0.12-0.20 seconds (3-5 boxes)

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20
Q

Left Atrial Enlargement in ECG will show

A

M shape P wave in lead II with larger terminal component

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21
Q

Right Atrial Enlargement in ECG will show

A

Biphasic and Tall P wave in lead II with larger initial component

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22
Q

Left BBB in ECG will show

A

Wide QRS >0.12 seconds

Slurred R in V5, V6

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23
Q

Right BBB in ECG will show

A

Wide QRS > 0.12 seconds (>3 Boxes)

RSR in V1, V2

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24
Q

Right Ventricular Hypertrophy ECG will show

A

V1: The R is taller than the S (Or R>7mm)

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25
Q

Left Ventricular Hypertrophy ECG will show

A

S in V1 + R in V5 orV6= >35mm
(Sokolow-Lyon criteria) Large box = 5mm
Small box= 1mm

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26
Q

T wave inversion abnormal when in

A

Lead I, II, V3-V6 = MI

Normally inverted in aVR

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27
Q

Small box and large box in ECG is

A
  1. 04 seconds = 40 mS

0. 20 seconds = 200mS

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28
Q

If the area of infarction is Lateral wall Q/ ST elevation will show in Leads_______

A

Lead I, aVL, V5, V6

Left circumflex

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29
Q

If the area of infarction is Anterolateral wall Q/ ST elevation will show in Leads_______

A

Lead I, aVL, V4, V5, V6 (Add V4 to Lateral)

Mid Left Anterior Descending or Left Circumflex

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30
Q

If the area of infarction is Inferior wall Q/ ST elevation will show in Leads_______

A

Lead II, III, aVF

Right Coronary Artery (RCA)

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31
Q

If the area of infarction is Anterior wall Q/ ST elevation will show in Leads_______ and _______ Artery

A

V1 through V4

Left Anterior Descending Artery

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32
Q

If the area of infarction is Posterior wall Q/ ST elevation will show in Leads_______and ______Artery

A

ST Depression in V1-V2 RCA, L circumflex artery

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33
Q

Sinus tachycardia with narrow QRS complexes of >150 BPM

Management- Stable and Unstable

A

Paroxysmal Ventricular Tachycardia

Stable- Adenosine (Narrow) Amiodorone (Wide) –> BBs
Unstable- Synchronized Cardiovert (Def.= Ablation)

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34
Q

Atrial fibrillation Pharmacologic rhythm control

A

Ibutilide or Flecainide

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35
Q

Multiple ectopic Atrial Foci

A

> 100 MAT Multifocal Atrial Tachycardia

<100 WAP Wandering Atrial Pacemaker

Tx: CCB or BB if LV function preserved

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36
Q

Multifocal, Bigeminy, or Trigeminy PVCs Tx

A

No treatment needed

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37
Q

> 3 consecutive PVCs >100 BPM

A

Stable V-Tachycardia: Amiodorone, Lidocaine, Procainamide

Unstable V- Tach w pulse: Synchronized cardiovert

V-Tach no pulse: Defibrillation

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38
Q

Torsades de Pointe management

A

IV magnesium

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39
Q

PEA or Asystole

A

CPR + Epinephrine + shockable rhythm check every 2 minutes.

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40
Q

ST depression usually indicates

A

Ischemia (reversible if oxygen to tissue corrected)

transmural (full thickness of heart wall)

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41
Q

ST Elevation usually indicates

A

Infarction (Dead tissue)

Significant if >1mm in Limb lead or >2mm in precordial (0over the heart)

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42
Q

Diffuse concave ST elevation in precordial leads v1-v6

PR depression in ST elevation leads

A

Acute Pericarditis

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43
Q

Low voltage QRS complex

Electrical Alternans

A

Large Effusion or Pericardial Tamponade

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44
Q

Non-specific ST/T changes

S1Q3T3 most specific for

A

Pulmonary Embolism

MC ECG Finding =Sinus Tachycardia
(Most specific ECG changes = S1Q3T3

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45
Q

What does S1Q3T3 mean

A

Wide S in Lead I
Q wave in Lead III
T wave inversion in Lead III

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46
Q

Definitive Diagnosis (Gold Standard) for CAD, PAD, renal artery stenosis, and Abdominal Aortic Aneurysms

A

CT Angiography

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47
Q

Most useful to diagnose HF

A

Echocardiogram

TTE- less invasive
TEE- more invasive better image (Post. cardiac structure)

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48
Q

Initial Test for patients with normal ECG

A

Exercise Stress Treadmill Test

CI: if unbale to exercise

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49
Q

Photon Emission Tomography that localizes regions of ischemia

A

Radionuclide Myocardial Perfusion

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50
Q

Stress testing done in patients unable to exercise done with myocardial perfusion imaging

Localizes region of ischemia

A

Pharmacological Stress testing

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51
Q

Pharmacological Stress testing uses what drugs

CI: in what patients

A

Adenosine or Dipyridamole

Asthma, COPD –> vasospasm

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52
Q

Localizes area of ischemia + depicts wall abnormalities, views structure/function of heart

Used in patients CI of vasodilators:

A

Stress Echocardiography (Used Dobutamine)

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53
Q

Assesses Arterial pulses, Abdominal Aortic Aneurysms, or DVTs

A

Ultrasound

Venous Duplex in DVTs

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54
Q

MCC by atherosclerosis: Reduces Lumen 70% –> symptomatic.

RFs: DM-II (Worse factor, Smoking (Most modifiable), hyperlipidemia, HTN, >45 in men or >55 women, FMHx

A

Coronary Artery Disease

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55
Q

Chest < 30 minutes (1-5 minutes) relieved w rest/Nitro

Dyspnea, nausea, diaphoresis; predictable pattern
epigastric or shoulder pain

A

Angina Pectoris (Stable Angina)

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56
Q

Acute Coronary Syndrome includes

A

Myocardial ischemia 2T coronary Artery Thrombosis

Unstable Angina
NSTEMI
STEMI (ST Elevation Myocardial infarction)

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57
Q

Angina new in onset > 30 minutes

ST elevation Total occlusion

Positive Cardiac Enzymes.

A

STEMI (Pain at rest = 90% occlusion)

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58
Q

Angina new in onset > 30 minutes

ST Depression and or T wave inversion partial occlusion

Positive Cardiac Enzymes.

A

NSTEMI

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59
Q

Angina new in onset > 30 minutes

ST elevation/depression

Negative Cardiac Enzymes.

A

Unstable Angina

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60
Q

Chest pain that occurs in the a.m MC or 2T cocaine use

A

Coronary Artery Vasospasm (Prinzmetal Angina)

Management: CCBs Cocaine: Benzodiazipine “NO BBs”

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61
Q

Cardiac Enzyme that returns to baseline in 7-10 days and peaks at 12-24 hours

A

Troponin I and T

Most Sensitive and specific

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62
Q

Cardiac Enzymes CK and CK-MB return to baseline in _____

A

3-4 days

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63
Q

Inhibits receptors on platelet surface

Aspirin, Clopidrogel, Tecagrelor, Prasugrel

A

Antiplatelets P2Y12

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64
Q

Block binding site for fibrinogen in platelets

Abciximab
Eptifibatide
Tirofiban

A

Antiplatelets GP IIb/IIIa

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65
Q

Anticoagulant through inactivation of thrombin

Warfarin, Heparin, LMWH

Fondaparinux, Dabigatran, Rivarobaxan, Apixaban

A

Anti-Thrombotic Therapy

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66
Q

Activates plasmin–> clot breakdown
Prevents clots and Thrombus

Streptokinase, Alteplase, Anistreplase

A

Fibrinolytic

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67
Q

Coumadin (Warfarin) Affects

A

PT and INR

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68
Q

Heparin affects

A

PTT

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69
Q

Reversal (Antidote) for Heparin or LMWH

A

Protamine Sulfate

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70
Q

Reversal Antidote for Coumadin (Warfarin)

A

Vitamin K

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71
Q

Vitamin K dependent Coagulation Factors II, VII, IX, X

A

Extrinsic Pathway (PT)

72
Q

Antithrombotic Tx in UA, STEMI, NSTEMI

A

Antiplatelet- P2Y12 or GP IIb/IIIa
Antithrombin- Heparin, warfarin, FDR-A
MONA
BBs (Metoprolol) CCBs in vasospastic DO (Verapamil/Diltiazem)

Thrombolytic only in STEMI- (Adjunct therapy ACE)

73
Q

HF with normal EF; +/- gallop is _____

Forced atrial contraction into a “stiff” ventricle
Thick walls small chamber

A

Diastolic HF

Gallop S4

74
Q

HF with reduced EF; +/- gallop is _____

Forced atrial contraction into a “sloshing” ventricle
Thin walls dilated (Large) chamber.

A

Systolic HF (MC)

Gallop S3

75
Q

HF MCC by coronary Artery Disease and Hypertension

A

Left sided HF

76
Q

HF MCC by Left sided HF

A

Right sided Heart failure

77
Q

HF most common symptom

A

Dyspnea

other: Edema, JVD, GI/hepatic congestion

78
Q

Diagnosis of HF

Most important determinant of prognosis

A

Echocardiogram EF

Normal = 55-60% <35%= Increased Mortality

79
Q

Enzyme that may identify CHF as cause of dyspnea

> than ____ level

A

B-Type Natriuretic Peptide (BNP) >100= CHF Likely

80
Q

1st Line of HF, decreases remodeling, and decrease mortality in post-MI

–> hyperkalemia, cough, angioedema
1st dose renal insufficiency

A

ACE Inhibitors -pril

81
Q

Decreases mortality, Incr. EF, and reduces Ventricle size

Not in vasospastic DO

A

BBs -lol

82
Q

No increase in Bradykinin –> no cough or Angioedema

A

ARBs -sartan

83
Q

Most effective treatment for mild-mod HF/ Edema

works at loop of Henle–> hyperglycemia/uricemia hypokalemia/calcemia/natremia

A

Loop Diuretics -ide

84
Q

Aldosterone antagonist; Potassium sparing: added in severe CHF

–> Hyperkalemia and Gynecomastia

A

Spironolactone

Epleronone= better

85
Q

Best in African Americans

–> hyperglycemia/uricemia
Hyponatremia/kalemia

A

Hydrochlorothiazide (Also CCB)

Metolazone

86
Q

Medication that lowers mortality and hospitalization

Leads to Increase of BNP: used in class II-IV w reduced EF

A

Sacubitril-Valsartan (Entresto)

87
Q

cephalization occurs at Pulmonary capillary wedge pressure (PCWP) of ______ .

Worsening of dyspnea, rales, pink frothy sputum.

A

12-18 mmHg of PCWP

Normal = 6-12 mmHg

88
Q

MC Caused by enterovirus (coxsackie); fever usually +

Chest pain that is worse with inspiration: worse when supine, relieved by sitting or leaning forward.

A

Acute pericarditis

89
Q

Pericardial friction rub is best heard when

A

upright and at end of expiration

90
Q

Acute Pericarditis (Dressler) Treatment

A

Aspirin (NSAID) or Colchicine

91
Q

Restriction of cardiac ventricular filling leading to decreased output.

Diastolic collapse of cardiac chambers

A

Pericardial Tamponade

92
Q

Pericardial Tamponade Triad

A

Beck’s Triad: Muffled HS, JVP, hypotension.

93
Q

What is pulsus paradoxus in Pericardial Tamponade

A

> 10mmHg decrease in systolic BP with inspiration

94
Q

Pericardial Knock high pitched 3rd HS 2t sudden stop of ventricular filling is associated with?

A

Constrictive pericarditis

95
Q

What is the difference between constrictive pericarditis and Acute pericarditis

A

Constrictive pericarditis- Calcified pericardium
(Pericardiectomy Tx)

Acute pericarditis- Inflamed pericardium

96
Q

Inflammation of the heart muscle most commonly caused by the Coxsackie Virus.

Dx: Bx is Gold standard: X-ray = cardiomegaly
S/Sx: fever, myalgias, malaise, with exercise intolerance

A

Myocarditis

97
Q

Myocarditis treatment

A

Supportive: ACE, Dopamine, IVIG

98
Q

What are the types of cardiomyopathies

A

Hypertrophic: 4%: Dyspnea MC; large septum: Sudden death: >15mm Syst Anterior wall motion of MV

Dilated-95%: Coxsackie: LVD: <30-35% EF= AICD

Restrictive-1% Amyloidosis/Sarco MCC: R heart failure:
normal wall thickness.

99
Q

Hypertrophic cardiomyopathy Treatment

A

1st Line- BBs

ICD placement: Myomectomy: Alcohol Septal Ablation

100
Q

Dilated Cardiomyopathy Treatment

A

HF Tx- ACEi, diuretics, BBs

AICD if <30-35%

101
Q

Cause- infection with GABHS (Strep Pyogenes). Stimulates Ab production to host–> organ damage

2-6 week onset

A

Rheumatic Fever

102
Q

Rheumatic fever most common valve affected

A

Mitral Valve 75-80%

103
Q

what is the criteria for rheumatic fever

A

JONES criteria (Polyarthritis MC)

Joints (MC), Oh my heart (Carditis), Nodules, Erythema Marginatum, Sydenham’s chorea (MAJOR CRITERIA)

104
Q

Rheumatic Fever Treatment

A

Penicillin G (Erythromycin if PCN allergy)

Aspirin

105
Q

Erythema Multiforme is associated with

A

Herpes HSV (Target Lesion with Halo)

SOAPS- Sulfa, hypoglycemic, A-convulstant, PCN, NSAIDS

106
Q

Erythema Migrans is associated with

A

Lyme Disease

107
Q

Erythema Infectiousum is associated with

A

Parvo B19 (5th Disease) URI S/Sx 3-4 days prior to rash

108
Q

Erythema Marginatum is associated with

A

Rheumatic Fever (Macule with central clearing)

109
Q

Systolic Murmurs

A

MR: AS: TR: MVP: + HCM and PS

110
Q

Diastolic Murmurs

A

AR: MS: MS: TS

111
Q

“Crescendo-Decrescendo” Radiates to carotid [Aortic]
MC valve disease

Opening Ejection click: Increased= sitting leaning FWD
-Pulsus parvous e Tardus-

A

Aortic Stenosis

Tx-Not effective (No Nitrates/dilators in mod-severe)

112
Q

“Holosystolic blowing” [Apex] radiates to axilla

Increase w Left lateral decubitis * handgrip
MCC- MVP Rheumatic disease

A

Mitral Regurgitation

Tx- Sx repair

113
Q

“Mid-late systolic ejection click” [Apex] MC young women.

MCC: Marfan’s, Ehler’s Danlos, Osteogenesis Imperfecta
Increased with Valsalva/standing

A

Mitral Valve Prolapse

Tx- BB only (Good prognosis)

114
Q

“Harsh Crescendo-Decrescendo” Associated with activity CP. Dyspnea MC complaint [LLSB]

Increased with Valsalva * Standing: +/- S4

A

HCM

Tx-BBs 1st line– myectomy

115
Q

“Holosystolic High Pitched” [L midsternal border]

Carvallo’s sign- Increases with inspiration

A

Tricuspid Regurgitation

Tx- Diuretics (sx-severe)

116
Q

“Decrescendo Blowing” [LUSB] rheumatic/endocarditis

Increased w sitting forward
Double pulse carotid upstroke- “Head bobbing” Musets

A

Aortic Regurgitation

Tx: ACEi— Sx definitive

117
Q

“Opening snap” + mid-systolic rumble [Apex LLD]
Always Rheumatic fever

P Mitrale +/- A-fib

A

Mitral Stenosis

Tx- Mitral Valve Repair

118
Q

“Mid-diastolic Rumble” [LLSB xyphoid]

R sided HF: increased with inspiration

A

Tricuspid Stenosis

119
Q

Diagnosis of Hypertension is made after

A

> = X2 Elevated readings on >=X2 different visits.

140/90 mmHg

120
Q

Types of HTN

A

Primary- Idiopathic w RF

Secondary-Renal Artery Stenosis MCC, BC (estrogen), NSAIDS: Aldosteronism (conn’s Hyper-), Pheo (“Refractive”)

Pseudo Resistant- Decr. Adherence/Tx or white coat

121
Q

HTN w/o organ damage: oral drug used an treatment?

A

HTN Urgency

Decrease BP by 25% 24-48 hrs PO to < 160/100
DOC: Clonidine or Captopril

122
Q

HTN w Organ damage >180/120: Tx?

A

HTN Emergency

Neuro= Nicardipine, Labetolol or Clevidipine

Cardio= Dissection-Esmolol/Labetalol
ACS- Nitro+ BBs
HF-Nitro (Nitroprusside) + Lasix

Renal=Fenoldopam

123
Q

Hypertensives

Contraindicated medications for CHF or 2nd/3rd HBs

A

CCBs Specially Non-dehydropyridines

124
Q

Hypertensives:

Contraindicated in 2nd/3rd HBs and decompensated HF

A

BBs

125
Q

Hypertensives:

Contraindicated in Pregnancy

A

ACEi

126
Q

Hypertensives:

CI in sulfa allergies

A

Loop Diuretics

127
Q

Hyoertensives:

CI in renal failure/ hyponatremia

A

Potassium Sparing diuretics

Spironolactone + Eplerenone

128
Q

Signifies an advanced stage of malignant hypertension

A

Fundoscopic Papilledema

129
Q

Goal BP for over 60 y/o

A

< 150/90

130
Q

Initiation of Statin therapy guildelines

A

DM I-II = 40-75 yoa

> 7.5% Risk MI or stroke in 10 years

> 21 with LDL> 190 mg/dL

Any atherosclerotic cardiovascular disease

131
Q

Best meds to lower LDL

A

Statins (DM-II) SE: Myalgias

132
Q

Best meds to lower triglycerides

A

Fibrates (Severe renal Dz/Hepatic) or Niacin

133
Q

Best meds to increased HDL

A

Niacin (hyperglycemia/ flushing)

134
Q

Only lipid lowering medication safe in pregnancy

A

Bile Acid Sequestrants (Cholest- /Colest-)

135
Q

High intensity Statin

A

Atorvastatin

Rosuvastatin

136
Q

Low intensity

A

Pravastatin
Lovastatin
Fluvastatin
Simvastatin

137
Q

Fever of unknown origin (80-90%), fatigue, anorexia, WL

Janeway lesions; Roth Spots, Osler’s nodes, Splinter hemorrhages

A

Infective Endocarditis

138
Q

Infective Endocarditis MC Valve Involved

A

Mitral

139
Q

MC IV Drug User Infective Endocarditis valve involved

A

Tricuspid

140
Q

What is a Janeway Lesion

A

Painless erythematous macules @ palms and soles

Osler @ pads of digits

141
Q

What is a Roth spot

A

Retinal hemorrhages

142
Q

Infective Endocarditis DX + Tx?

A

Dx- Blood cultures X3 sets 1 hour apart: Inc- ESR/RF
Duke Criteria

Tx- Nafcillin+ Gentamycin 4-6 weeks (Vanco if MRSA)

143
Q

Prophylaxis Indications for Endocarditis

A

Amoxicillin 2G 30-60 min prior to procedure

Clindamycin if PCN allergy

144
Q

MCC of Endocarditis Normal valve/Abnormal? IVDU? Prosthetic valve?

A

Normal valve= Virus or S. Aureus

Abnormal = S. Viridans

IVDU= MRSA

Prosthetic Valve= S. Epidermis

145
Q

Clinical Manifestation of Peripheral Arterial disease X5

A

Resting leg pain: Intermittent claudication: Gangrene: Acute Arterial Embolism:

Atherosclerotic disease of lower extremity

146
Q

Quickest non-invasive most useful screening tool for Chronic PAD?

A

positive if ABI < 0.90 (Ankle-Brachial Index norm 1-1.2)

147
Q

Gold standard Dx tool for PAD?

Tx?

A

Arteriography

1st- Cilastazol (claudication) –> Angiplasty/Saph bypass grafts

148
Q

PE findings in PAD

A

Pain, paralysis, pale (on elevation), Pulseless, paresthesia:

Lateral malleolus ulcers ( Medial Malleolus= CV insuff.)

149
Q

Seen in Increased estrogen OCPs, pregnancy, prolonged standing and obesity.

venous Stasis ulcers, pain/edema relieved with elevation, tortuous veins: Tx

A

Varicose Veins

Tx: Elastic compressions: Sclerotherapy/ Laser Ablation

150
Q

Cerulea Albans + Cerulea Dolens are ass. with what?

A

Deep Vein Thrombosis

Albans= white pallor Dolens= Cyanotic Hue

151
Q

what is the triad for DVT?

A

Virchow’s Triad

Venous Stasis, hypercoagulation, and endothelial damage

152
Q

Most specific symptom/ sign of DVT

A

Unilateral LE swelling >3cm

153
Q

DVT Dx (1st Line and GS) and Tx?

A

Dx- Venous duplex US “1st Line” Venography GS
D-Dimer Wells score< 1

Tx- LMWH (PTT 1.5-2.5) Preferred in PREGO/Malignancy

154
Q

Male >60, severe back or abdominal pain with syncope/hypotension

+ tender pulsatile abdominal mass.

A

Abdominal Aortic Aneurysm

155
Q

MC RF for Abdominal Aortic Aneurysm

A

Atherosclerosis#1—–> >60, smoking, HTN

156
Q

Surgical repair recommendations for AAA

A

Immediate- >5.5 cm or 0.5 w/i 6 mos

> 4.5 cm= Sx referral

4-4.5 cm = Monitor every 6 mos

> 3= US every year

157
Q

AAA Dx + Tx ?

A

Dx- 1st Line US TOC= CT GS=Angiography

TX: Initial= BBs Definitive= Sx

158
Q

MC site for AAA

A

Infrarenally

159
Q

Most important predisposing factor is HTN: Sudden
Severe tearing pain @ chest/upper back.

Decreased peripheral pulses, new onset aortic regurgitation.

A

Aortic Dissection (Tear of Aorta Intima)

160
Q

Aortic Dissection Dx? Tx?

A

TOC-CT GS-MRI Angiography CXR- Widening Media

Tx-Esmolol/Labetalol (100/120 <60BPM target) +
Nitroprusside or Nicardipine

161
Q

Non-atherosclerotic inflammatory medium artery and vein disease. Strongly associated with tobacco.

Distal extremity ischemia, ulcers, and gangrene.

A

Thromboangiitis Obliterans (Buerger’s Disease)

162
Q

Aortic Dissection type that involves the ascending aorta and aortic arch and beyond distally

A

Debakey Type I

163
Q

Aortic Dissection type that involves the ascending aorta

A

Debakey Type II

164
Q

Aortic Dissection type that involves the descending aorta

A

Debakey Type III

165
Q

Inflammation or thrombus of a superficial vein: Palpable cord non-compressible vein

MC in IV catheterization, trauma, pregnancy, varicose V

A

Superficial Thrombophlebitis

166
Q

Superficial Thrombophlebitis Dx + Tx?

A

Dx- Venous Duplex US

Tx- Supportive: NSAID, stockings, elevate extremity
Heparin or warfarin: Phlebectomy

167
Q

MC occurs after superficial thrombophlebitis, DVT or trauma. Leg pain/edema, color improves with elevation

Stasis dermatitis- scaling, itching, rash, erosion, crusting
Brownish hyperpigmentation.

A

Chronic Venous insufficiency

168
Q

Most common primary cardiac tumor in adults (rare). Pedunculated.

Flu like, fever, palpitations, +/- murmur 90% Atrial

A

Atrial Myxoma

169
Q

Dx with tilts (what is tilts)

A

Postural Hypotension (Orthostatic) After 5 min. supine

< Sys. BP >= 20 mmHg
Dia >= 10mmHg

> 15 BPM increase within 2-5 min of quiet tanding

170
Q

4 main types of shock

A

Distributive
Obstructive
Cardiogenic
Hypovolemic

171
Q

Distributive shock

A

Neuro, Endo, Septic, Anaphylactic

172
Q

Obstructive

A

PE, Tamponade, PTX, Aortic Dissection

173
Q

Cardiogenic

A

MI, arrhythmia, HF

174
Q

Hypovolemic

A

Blood loss

Fluid Loss

175
Q

Difference between SIRS and Sepsis?

Systemic Inflammatory Response Syndrome

A

SIRS- state of systemic inflammation

Sepsis- Presence of SIRS with a source of infection

176
Q

What is the difference between Sepsis and septic shock

A

Septic shock is sepsis with refractory HYTN

177
Q

Systemic Inflammatory Response Syndrome (SIRS)

you musts have at least 2 of the following?

A

Temperature
Tachycardia
Tachypnea
WBC >12,000 or <4,000

PANCE (13 decks)

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