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Undeleted > Cardio exam 3 > Flashcards

Cardio exam 3 Flashcards

1
Q

% blockage with angina and unstable angina

A

UA-90%

A-75%

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2
Q

Post MI 4-12hr

A

mottling/necrosis/hemorrhage

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3
Q

Post MI 12-24hr

A

Red/blue mottling

pyknosis

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4
Q

Post MI 1-3 days

A

Yellow/tan center
neutrophils
loss of striations/nuclei

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5
Q

Post MI 3-7 days

A

Phyagocytosis (macrophages), decreasing neutrophils
myofiber disintegration
hyperemic border

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6
Q

Post MI 7-10 days

A

Red/tan margin with yellow center

early granulation tissue

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7
Q

Post MI 10-14 days

A

Red/gray border
granulation tissue
neovascularization + collagen

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8
Q

Post MI 2-8 wks

A

scar

collagen

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9
Q

Ankle/brachial index

A

Ankle systolic (higher of the two)/brachial (higher of two)

For peripheral arterial disease

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10
Q

When to tx carotid stenosis

A

symptomatic and over 50% occluded or

asymptomatic and over 80% occluded

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11
Q

3 Criteria for MI dx on EKG

A

acute ST elevation
significant Q waves
deep, symmetrical inverted T waves

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12
Q

1st sign of STEMI on EKG

A

T waves>10mm in precordials

T waves>5mm in limb leads

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13
Q

Most common MI cause

A

spontaneous thrombus

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14
Q

Criteria to use thrombolytics

A

<6hr since onset (most beneficial)
ST elevation over 1mm
new LBBB
ST depression on V1/V2 with prominent R waves

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15
Q

Contraindications for thrombolytics

A

Anything with stroke/ICP

Aortic dissection

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16
Q

Cause of ischemia in UA and NSTEMI

A

vasospasm (not a full occlusion)

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17
Q

Use of CPK cardiac marker

A

detectable for 2-4 days

good to detect reinfarct

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18
Q

Absolute contraindications for thrombolytics

A

UA and NSTEMI and aortic dissection

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19
Q

Long term med tx to avoid with MI

A

NSAIDS

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20
Q

Risks of percutaneous intervention and what would help each

A

hematoma-stop anticoagulants
pseudoaneurysm- thrombin
acute renal failure-decrease contrast use
embolization- decrease cath manipulation

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21
Q

Emergency tx for ruptured AAA

A

avoid over fluid resucitation

surgery ASAP

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22
Q

Aortic dissection vs AAA tx

A

AAA do not need confirmation on radiograph

AD needs confirmation before surgery

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23
Q

Emergency tx for ACS

A

MONA B

morphine, O2, nitrates, aspirin, Beta blockers

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24
Q

Use of fibrinolytic therapy

A

Less than 30 minutes since onset

less than 75 y/o

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25
Q

PCI therapy timeframe

A

<90 min from onset

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26
Q

1st manifestion of thrombophlebitis

A

pulmonary embolism

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27
Q

Lymphangitis sx

A

painful cutaneous red streaks

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28
Q

Lymphedema types

A

I-hereditary (milroy disease)

II-obstructive

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29
Q

Cavernous hemangioma assc and risk

A

von Hippel Lindau disease

risk of rupture (stroke)

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30
Q

Cystic hygroma/cavernous lymphangioma

A

on neck/axilla of children

can cause deformities

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31
Q

Glomus tumor

A

very painful under the nails

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32
Q

Port Wine Stain feature and assc

A

CN V distribution

Sturg-Weber syndrome

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33
Q

Hereditary hemorrhagic telangiectasia sx and assc

A

multiple aneurysmal telangiectasias

assc with Osler Weber Rendu disease

34
Q

Bacillary angiomatosis description and assc

A

red papules with nodules

assc with Bartonella (gram - rod)

35
Q

Types of Kaposi sarcoma

A

Chronic- older men, distal LE involvment
Lymphadenopathic-African distribution/aggresive lymphadenopathy
Transplant assc-from long term immunosuppresion
AIDS assc-LN and viscera

36
Q

Stages of Kaposi sarcoma

A

Patch-distal LE
Plaque-violaceous raised lesions
Nodule-neoplastic, slit spaces

37
Q

Cause of hepatic angiosarcoma

A

carcinogen exposures: arsenical pesticides/thorotrast/polyvinyl chloride

38
Q

Hemangiopericytoma location

A

common LE and retroperitoneum

around capillaries/venules

39
Q

SA node depolarization spike cause

A

Ca2+ entering cell (not Na like in myocytes)

40
Q

Cause of spontaneous depolarization in SA node

A

funny channels that allow Na to enter cell slowly

more (-) hyperpolarization, the more open and the faster the depolarizationAV Need -60mV to open at minimum

41
Q

Sx of supraventricular tachycardia

A

syncope

42
Q

AV nodal reciprocating tachycardia types

A

typical- slow is antegrade (short RP interval)

atypical-slow is retrograde (no P wave)

43
Q

AVNRT on EKG

A

delta wave (pre-excitation)

44
Q

Orthodromic v Antidromic AVRT

A

Ortho-retrograde up accessory

Anti-ant down the accessory (AAA)

45
Q

Tx for AVRT

A

ibutilide
procainamide
flecaninide

46
Q

COPD associated arrhythmia

A

multifocal atrial tachycardia

47
Q

Cause of idiopathic VT

A

increased cAMP/Ca2+

48
Q

Arrhymogenic RV dysplasia on EKG

A

epislon wave

49
Q

Brugada’s Sign

A

R to S length is 0.10sec

50
Q

Josephson’s sign

A

notch near low point of S wave

51
Q

Condition assc with Brugada’s and Josephson’s sign

A

ventricular tachycardia

52
Q

Early afterpolarization result

A

prolonged QT inteval

can cause Torsades

53
Q

Cause of delayed afterpolarization

A

increased intracellular Ca2+

54
Q

EKG changes for Class I antiarrhythmics

A

1A-prolonged repolarization (long phase 2)
1B-shortened repolarization (short phase 2)
1C-decreased slope of phase 0

55
Q

Impact of class I antiarrhythmics

A

block fast Na channels of phase 0

56
Q

Class 1A antiarrhythmics

A

quinidine
procainamide
disopyramide

57
Q

Quinidine

A

class 1A antiarrhythmic
strong antimuscarinic
can cause cinchonism (tinnitus/vertigo)

58
Q

Procainamide

A

calss 1A antiarrhythmic
weak antimuscarinic
less QT prolongation (less Torsades)

59
Q

Disopyramide

A 
class 1A antiarrhythmic
negative inotropic effect
60
Q

Class 1B antiarrhythmics

A

lidocain
mexiletine
phenytoin

61
Q

Phenytoin

A

tx digoxin induced arrhythmias

62
Q

Class 1C antiarrhythmics

A

flecainide
propafanone
for A fib/SV in healthy pts

63
Q

Class II antiarrhythmics

A

beta blockers

decrease mortality

64
Q

Class III antiarrhythmics

A 
block K+ current
amiodarone
sotalol
bretylium tosylate
dofetilide
65
Q

Amiodarone

A 
1st line for emergency VT
less proarrhythmic
blocks K+ rectifier current and some Na+ channels
causes peripheral vasodilation
long t1/2
66
Q

Side effects of amiodarone

A

pulmonary fibrosis
hyper/hypothyroidism
corneal deposits

67
Q

Sotalol

A

inhibits K+ currents
can cause Torsades
inhibits conduction of bypass tracts

68
Q

Bretylium tosylate

A

IV for emergency VT/V fib

decreases NE release

69
Q

Dofetilide

A

selective K+ blocker
for A fib/A flutter
can cause Torsades

70
Q

Class IV antiarrhythmics

A

verapamil
diltiazem
block Ca2+ currents

71
Q

Adenosine

A

short t1/2
hyperpolarizes with K+ rectifier activation
for PSVT

72
Q

Digoxin

A

for CHF with A fib
decreases AV conduction
prolongs PR interval

73
Q

MgSO4

A

prevents current Torsades

74
Q

Indications for ICD (internal defibrillator)

A 
sx bradycardia
HR 3sec  (asystole)
75
Q

Pacing codes for ICD

A

I-chamber placed
II-chamber sensed
III-mode of response

76
Q

When is asynchronus pacing used?

A

surgery

77
Q

Demand pacing for ICD

A

inhibited by intrinsic P or R waves

78
Q

Telangiectasias v reticular v.

A

Telangiectasias- red

Reticular-blue

79
Q

Virchow’s triad

A

stasis of blood
hypercoagulability
vascular damage

80
Q

Side effect of hydralazine + IDN

A

Lupus like syndrome

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