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Step 2 U World Wrongs > Cardio > Flashcards

Cardio Flashcards

1
Q

difference between orthostatic syncope and vasovagal syncope?

A
  • orthostatic syncope:
    • prodrome of dizziness and blurred vision
    • pt quickly transitioned from supine (laying in bed) to standing
  • vasovagal syncope:
    • is anticipated and occurs duing event (micturition, giving blood, etc)
    • may include prodromal nausea, diaphoresis, and pallor
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2
Q

what is pulsus paradoxus?

A
  • decrease in BP by more than 10mmHg with inspiration
  • happens in cardiac tamponade
  • breathing in deep decreases intrathoracic pressure, leadin to more volume filling Risde og heart, pushing septum in toward the L side of heart, L ventricle dows not fill as much, BP drastically goes down
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3
Q

name some causes of cardiac tamponade?

A
  • pericarditis (think of person who just got over viral illness)
  • trauma
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4
Q

pt presents with decreased cardiac output, chest pain, and oulsus paradoxus following viral illness. what is the diagnosis?

A

cardiac tamponade resulting from acute pericarditis

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5
Q

what happens to the pressures in the heart chambers during cardiac tamponade?

A

the pressures in all chambers equalize

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6
Q

Medications used to reduce risk of systemic thromboembolism in patients with AFIB and moderate to high CHA2DS2-VASc score (2 or above)?

A
  • warfarin
  • nonvitamin K antagonist oral anticoagulants (rivaroxaban, dabigatran, apoixaban, edoxaban)
    • used only in NONVALVULAR AFIB
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7
Q

lab values indicative of VSD from rupture of the interventricular septum after MI

A
  • acute hemodynamic instability (hypotension, tachycardia)
  • holosytolic murmur
  • O2 sat higher in RV than RA due to mixing of RV blood with oxygenated blood from the left ventricle (normally RA and RV O2 saturation should be equal)
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8
Q

lab values indicative of pulmonry embolism

A
  • low arterial O2 saturation
  • clear lungs on exam
  • elevated right heart pressures
  • elevated pulmonary artery pressure
  • normal pulmonary capillary wedge pressure
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9
Q

ECG Findings of hyperkalemia

A
  • Peaked T wave
  • flattening of P wave
  • prolonged PR
  • Prolonged/widened QRS
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10
Q

what is the treatment for hyperkalemia with ECG changes?

A

calcium gluconate; stabilizes cardiac cell membrane

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11
Q

Peripheral artery disease and intermittent claudication are strong predictors of which event within the next 5 years of a patients life?

A
  • MI
  • stroke
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12
Q

what are the following findings in distributive shock (sepsis, anaphylaxis, systemic inflammatory response syndrome)?

  1. Cardiac Index/Output
  2. systemic vascular resistance
  3. left ventricular end disastolic volume
A
  1. Cardiac Index/Output: increased
  2. systemic vascular resistance: decreased
  3. left ventricular end disastolic volume: decreased
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13
Q

what are the following findings in hemorrhagic shock?

  1. Cardiac Index/Output
  2. systemic vascular resistance
  3. left ventricular end disastolic volume
A
  1. Cardiac Index/Output: decreased
  2. systemic vascular resistance: increased
  3. left ventricular end disastolic volume: decreased
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14
Q

what are the following findings in CHF?

  1. Cardiac Index/Output
  2. systemic vascular resistance
  3. left ventricular end disastolic volume
A
  1. Cardiac Index/Output: decreased
  2. systemic vascular resistance: increased
  3. left ventricular end disastolic volume: increased
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15
Q

what are the following findings in recent/acute MI?

  1. Cardiac Index/Output
  2. systemic vascular resistance
  3. left ventricular end disastolic volume
A
  1. Cardiac Index/Output: decreased
  2. systemic vascular resistance: increased
  3. left ventricular end disastolic volume: normal
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16
Q

treatment for pale, pulseless, cool extremity?

A

IV heparin

17
Q

pt with central opacities on chest x-ray presents with heart blocks or arrythmia, cardiomyopathy, heart failure, etc. what is the underlying cause?

A

sarcoidosis (can infiltrate myocardium)

18
Q

genetic inheritance of hypertrophic cardiomyopathy

A

autosomal dominant

19
Q

right heart catherterization findings in cor pulmonale

A

elevated pulmonary artery systolic pressure (>25 mmHg)

20
Q

pt presents with DVT and elevated homocysteine levels. Treatment?

A

Vitamin B6 (pyridoxine), folate, Vitamin B 12

21
Q

pt with marfans presents with sudden onset chest pain. what is the diagnosis?

A

aortic dissection. will hear diastolic murmur or aortic regurgitation on physical exam at right sternal border

22
Q

initial diagnostic study for suspected acute aortic dissection in hemodynamically stable individual?

A

CT angiography

23
Q

artery trauma/problem, what diagnostic test do you get?

A

CT angiogram

24
Q

when would you use an inferior vena cava filter for DVT instead of anticoagulation?

A
  • active hemorrhage
  • hx of intracerebral hemorrhage
  • platelet count <50,000
25
Q

what is the treatment for beta blocker toxicity? (some old person with AFIB ODed on their BB on accident)

A

IV glucagon

26
Q

what is the very first test you get when someone presents with syncope, no matter what you think is the cause?

A

EKG!!!

Step 2 U World Wrongs (19 decks)

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