Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiology > Cardio Test #2 > Flashcards

Cardio Test #2 Flashcards

1
Q

NYHA Class I

A

No activity limitations

Ordinary activity causes no fatigue, palpitations, dyspnea, or angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

NYHA Class II

A

Slight activity limitations

Asx @ rest

Ordinary activity causes fatigue, palpitations, dyspnea, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

NYHA Class III

A

Marked activity limitations

Usually Asx @ rest

Less-than-ordinary activity causes fatigue, palpitations, dyspnea, angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

NYHA Class IV

A

Inability to carry out any physical activity w/o discomfort

Sx @ rest

Increased discomfort w/ any physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ACC/AHA Stage A

A

Patient is high-risk for heart failure development in future

Currently no function/structural heart disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ACC/AHA Stage B

A

Structural heart disorder

No sx at this stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ACC/AHA Stage C

A

Previous/current sx of heart failure w/ underlying structural heart problem

Sx are managed w/ medical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ACC/AHA Stage D

A

Advanced disease

Pt requires hospital-based support, heart transplant, or palliative care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drugs that improve left ventricular relaxation

A

ACEI

CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Drugs that regress LVH

A

ACEI/ARB

Aldosterone antagonists

BB

CCB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Drugs that manage tachycardia

A

BB (preferred)

CCB - 2nd line

Digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Systolic heart failure

A

Heart contraction force decreases/pump function failure

Heart can initially dilate to compensate

Hear S3 w/ this

Get pulmonary and systemic edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diastolic heart failure

A

Heart becomes stiff w/ age

Ventricles unable to relax to fill

Pt is more prone to tachycardia

Hear S4 unless pt is in A-fib

Causes elevated pressures/edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pulmonary HTN major sign

A

Dry cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Viral myocarditis causative agent

A

Coxsackievirus most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Excursion

A

Ejection fraction

Heart can dilate to compensate for contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Electromechanical delay

A

Delay between ventricular depolarization and repolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Systolic dysfunction causes

A

Impaired contractility

Volume overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Impaired contractility causes

A

MI

Transient MI

Chronic volume overload - mitral/aortic regurge

Dilated cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Volume overload causes

A

(increase in preload)

Mitral insufficiency

Aortic insufficiency

Atrial/Ventricular septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diastolic dysfunction causes

A

Impaired ventricular relaxation

Increased afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Impaired ventricular relaxation

A

LVH

Hypertrophic cardiomyopathy

Restrictive cardiomyopathy

Transient MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Increased afterload

A

(Pressure overload)

Mitral stenosis

Pericardial constriction/tamponade

Aortic stenosis

Uncontrolled HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CHF causes

A

*homeostatic imbalances of cardiac output*

Coronary atherosclerosis

Persistent HTN

Dilated cardiomyopathy

Valvular heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Coronary atherosclerosis

A

fatty buildup clogs coronaries -> myocardial ischemia

Myocardial ischema causes diastolic and systolic dysfunction

Get angina pectoris +/- MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Persistent HTN

A

Increased peripheral pressure cause myocardial hypertrophy and progressive weakening from stress

Get concentric or eccentric hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Dilated Cardiomyopathy (DCM)

A

Ventricles stretch, become flabby w/ myocardial deterioration

Increased workload increases Ca in cardiac cells and causes activation of the heart enlargment gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Right heart failure “backwards failure”

A

Systemic capillary congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Left heart failure backwards failure

A

Pulmonary vasculature congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Acute decompensation

A

Immediate goal

Nitro, diuretics, NIPPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Head bob w/ each systolic pulsation

A

deMusset’s sign

Severe chronic Aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

“Pistol shot” pulses over femoral artery

A

Corrigan’s pulses

Severe Chronic Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pulsation of the uvula

A

Mueller’s sign

Severe Chronic Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Systolic/diastolic bruit over femoral artery

A

Duroziez’s sign

Severe Chronic Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Capillary pulsations seen in the nailbeds

A

Quincke’s pulses

Severe Chronic Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Pulsation of retinal arteries and pupils

A

Becker’s sign

Severe Chronic Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Popliteal BP > Brachial BP by >60mmHg

A

Hill’s sign

Severe Chronic Aortic Regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Systolic murmurs

A

Aortic stenosis

Mitral insufficiency

Mitral valve prolapse

Tricuspid insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Diastolic murmurs

A

Aortic Insufficiency

Mitral Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

CHADS2

A

CHF

HTN

Age >75

Diabetes

Stroke (TIA)

>=2 = anticoagulation unless CI

Only applies to pts w/o valve dx -> those get anticoags regardless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Class I agents and MOA

A

Block sodium channels

Quinidine

Procainamide

Disopyramide

Lidocaine

Mexilitine

Flecainide

Propafenone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Class II agents and MOA

A

Beta blockers

Decrease automaticity

Prolong AV conduction

Prolong refractory period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Class III agents and MOA

A

Block potassium channels

Amiodarone

Dronedarone

Sotalol

Dofetilide

Ibutilide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Class IV agents and MOA

A

CCB

Decrease automaticity and AV conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How does digoxin work?

Where is it used the most?

A

Inhibits the sodium/potassium ATPase pump

This prolongs AV conduction and refractory period

Used to help rate control pts w/ A-fib/flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

When is adenosine indicated and what is the dose?

How does it work?

A

Used for rapid treatment of symptomatic atrial tachycardias

6 mg, then 6 mg, then 12 mg

Works by blocking the AV Node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

PEA causes 6 H’s

A

Hypoxia

Hypovolemia

Hypoglycemia

Hydrogen Ion (acidosis)

Hypothermia

Hypo/hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

PEA causes 6 T’s

A

Toxins

Tamponade

Trauma

Tension pneumothorax

Thrombosis - cardiac

Thrombosis - pulmonary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

HACEK

A

Haemophilus sp

Actinobacillus

Cardiobacterium

Eikenella

Kingella

50
Q

Osler’s Nodes

A

More specific for infectous endocarditis

Painful and erythematous nodules

On pulp of fingers and toes

More common w/ subactue IE

51
Q

Janeway Lesions

A

More specific for Infectious endocarditis

Erythematous, blanching macules

Not painful

Located on palms and soles

52
Q

Roth spots

A

More specific for infectious endocarditis

Pale retinal lesions surrounded by hemorrhage

“target spots” usually near optic disk

53
Q

Major Duke’s Criteria

A

Positive blood cultures w/ appropriate organism

Echo finding

New valvular regurgitation

54
Q

Minor Duke’s Criteria

A

High risk, hx IVDA

Fever

Vascular phenomena

Immunologic phenomena

Serologic studies

Blood cultures/echo not meeting major criteria

55
Q

Vascular phenomena

A

Arterial embolism

Septic pulmonary infarct

Mycotic aneurysm

Intracranial hemorrhage

Janeway lesions

56
Q

Immunologic phenomena

A

Osler’s nodes

Roth spots

Glomerular nephritis

Rheumatoid factor

57
Q

Modified Duke’s - Definite IE

A

Microorganisms (culture or histology) in valvular/embolized vegitation or intracardiac abcess

Histologic evidence of vegetation/intracardiac abscess

58
Q

Modified Duke’s Possible IE

A

2 major

1 major + 3 minor

5 minor

59
Q

Modified Duke’s - Rejected IE

A

Resolution of illness <5 days of Abx

60
Q

Empiric Therapy for infective endocarditis

A

NVE acute - Vanco (staph) Or Nafcillin + gentamycin (no staph)

NVE Subacute - PCN + gentamycin

PVE - Vanco + gentamycin + Rifampin

Fungal - Amphotericin B w/ valve replacement

61
Q

IE prevention w/ proceduce

A

Dental procedures

Tonsillectomy

Surgery of GI, Respiratory, Urinary, Gallbladder, I and D

Esophageal dilation

Cystoscopy/urethral dilation/urethral catheter w/ infection

62
Q

High risk IE lesions

A

Prosthetic valve

Prior IE

Cyanotic congenital heart dx

Surgical systemic-pulmonary shunt

PDA, VSD, coarctation

AR/AS/MR/MS w/ MR

63
Q

Antimicrobial prophylaxis

A

Recommended in high-risk pts

Prosthetic valves

Previous IE

RHD/aquired valve dysfunction

Hypertrophic cardiomyopathy

MVP (esp w/ murmur)

64
Q

Crawford Classification of TAA

A

I: L subclavian to renal arteries

II: L subclavian to iliac bifurcation

III: Midthoracic to infrarenal

IV: Distal thoracic to infrarenal

65
Q

6 P’s of acute limb ischemia

A

Pain

Pallor

Pulselessness

Paresthesia

Paraparesis (paralysis)

Poikilothermia (cold limb)

66
Q

Virchow’s triad

A

Venous stasis

Vessel wall injury

Hypercoagulable state

67
Q

Systolic dysfunction

A

Pump function failure

Usually from myocardial dysfunction/destruction (MI)

Hear S3

68
Q

Diastolic dysfunction

A

Ventricles are stiffened and cannot relax

Inadequate filling causes elevated pressures

Pt is prone to bouts of tachycardia (a-fib)

Hear S4, but never w/ a-fib

69
Q

Acute decompensation

A

Immediate goal: reestablish perfusion/oxygenation

Tx: Nitro, diuretics, NIPPV

70
Q

Carcinoid syndrome

A

Carcinoid tumor in small bowel/appendix

1st mets -> liver, serotonin released straight to the heart

2nd mets -> lungs, cause left-side abnormalities

Commonly causes tricuspid regurge/stenosis

71
Q

Annular dilation

A

Most common R heart dx in adults

Tricuspid regurge w/ anterior and posterior sides dilating while septal side remains the same -> uneven dilation

72
Q

Causes tricuspid regurge

A

Aortic dissection

Tertiary syphilis

Carcinoid syndrome

Annular dilation

Rheumatic disease

Endocarditis

Ebstein anomaly

73
Q

Cause tricuspid stenosis

A

Carcinoid syndrome

Rheumatic disease

74
Q

Ebstein’s anomaly

A

Congenital defect

Posterior tricuspid leaflet deformed -> causes TR

Usually concomitant w/ ASD/WPW

75
Q

High V wave w/ JVD

High-pitched systolic murmur - blowing/coarse/muscial

A

Tricuspid regurge

Usually functional cause - HTN, Chordae malfunction

76
Q

High A wave w/ JVD

Low-pitched, rumbling, presystolic murmur w/ loud S1

A

Tricuspid stenosis

77
Q

Hyperdynamic PMI

Visible carotid/nailbed (Quincke) pulsations

deMusset’s sign

Diastolic, blowing, faint murmur right after S2

A

Aortic regurgitation

78
Q

Sustained PMI w/ palpable heaves

Murmur between S1 and S2, harsh rough murmur

Prominent S4

A

Aortic Stenosis

79
Q

Pansystolic, blowing, high-pitched musical murmur

Possible mid-systolic clicks

Prominent S3 if severe

A

Mitral Regurgitation

80
Q

Diastolic low-pitched, rumbling murmur

Merges w/ loud S1

Palpable S2 @ 2nd intercostals

A

Mitral stenosis

81
Q

Tricuspid valve disorder treatment

A

Fluid restriction

Diuretics

Rhythm disturbances

Treat symptoms

82
Q

Pulmonary regurgitation

A

Treatment is difficult

Congenital -> abnormal cusp number development/complete lack of valve

Acquired -> Pulmonary HTN, Annular dilation w/ structural distortion

83
Q

Pulmonary Stenosis

A

Congenital - most common

Acquired -> Rheumatic heart dx, Carcinoid syndrome, IE (fungus grows rapidly, occludes opening)

84
Q

Mitral Chordae tertiary stands/head

A

10

Each papillary muscle has 6 heads

85
Q

Gerbode defect

A

VSD around AV node

Shunt created between LV into RA

No pressure abnormalities

86
Q

Mitral stenosis

A

Usually caused by Rheumatic fever, also congenital, carcinoid, amyloid

Progressive, lifelong dx - 20-40 yr onset, 10 yr to disabled

Left side failure, A-fib common

Orthopnea, PND

87
Q

Mitral stenosis grading and treatment

A

MVA = 1.5-2.5 cm2 w/ minimal sx = Mild

MVA = 1.0-1.5 cm2 w/o sx @ rest = Moderate

MVA < 1.0 cm2 = Severe

Tx: Diuretics, BB/CCB (a-fib), Anticoags (a-fib)

Balloon valvuloplasty, surgical repair/replacement

88
Q

Mitral Regurgitation

A

Abnormality to any component of mitral valve

Dyspnea, orthopnea, PND, fatigue

Can cause A-fib

89
Q

Mitral valve prolapse

A

Congenital, Marfans, Ischemic sequela

Hear a click w/ a late systolic murmur

Hemodynamicly unstable if also have MR

90
Q

Chronic Mitral Regurgitation

A

Monitor if asx

Aggressively treat HTN (ACEI) and A-fib (BB, anticoag)

Preload reduction: diuretics

Afterload reduction: vasodilate

91
Q

Acute mitral regurgitation

A

Abrupt decline in stroke volume w/ increase in LA volume/pressure => drastic increase in pulmonary pressure

Pt goes into cardiogenic shock, rapidly fatal

Acute severe dyspnea, CHF, HOTN w/ loud S1

Tx: O2, Positive inotrope, DO NOT OVERLOAD W/ FLUID

92
Q

Aortic stenosis

A

Disruption of LV outflow, increases pressure w/ hypertrophy and diastolic impairment

Heart cannot increase stroke volume on demand

Cardinal symptoms, sudden death w/ arrhythmias, bruit heard in carotids

Tx: All symptomatic until valve replacement

93
Q

Cardinal symptoms of severe aortic stenosis

A

Dyspnea

Angina (increase O2 demand)

Syncope (vasodilation w/ fixed C.O.)

94
Q

Aortic regurgitation

A

Leaflet dysfunction/aortic root dilation (Marfans)

LV has both pressure and volume load increase, can be chronic or acute

Decompensation when LV systolic fails and dilation occurs

Wide pulse pressure, bounding pulse, early diastolic murmur

Tx: Vasodilate, diuretics, digoxin

DO NOT SLOW HR

95
Q

Austin Flint murmur

A

Mitral valve

Mid-late diastole

Valve pushed closed by aortic jet (AR)

96
Q

Infective endocarditis

A

Acute: usually staph on tricuspid, rapidly destructive

Subacute: usually Strep, on damaged valve, indolent nature

IV drug use: Staph, fungus, pseudomonas

97
Q

Venturi effect

A

Creation of low pressure sink w/ a jet from valve regurgitation

Bacteria tend to settle on opposite side of valve in sink

98
Q

Pediatric IE

A

Almost all cases occur w/ underlying valve defect

Neonate: Staph aureus, coagulase-negative staph, group B strep

Older: usually staph or Strep

99
Q

Infectious endocarditis signs

A

Acute: Toxic, high-grade fever and chills, SOB, arthralgias, Abdominal pain, pleuritic chest pain

Subacute: low-grade fever, anorexia, weight loss, fatigue, abdominal pain, nausea/vomiting

Fever, heart murmur (not w/ IVDA), splenomegaly, petechia, splinter hemorrhages, clubbing, neuro changes

100
Q

IE diagnostic tests

A

TTE = 1st line for suspected IE w/ native valves

TEE = 1st line for prosthetic, intracardiac complications, inadequate TTE, fungal/staph/bacteremia

101
Q

IE treatment

A

Parenteral Abx - high concentrations and prolonged therapy

Empirical therapy (covers staph) = Vancomycin

Viridans = PCN

Fungal = Ampho B + replacement/repair

Should see fever reduced w/in 7-10 days - think wrong bug or mets if not

102
Q

Acute pericarditis

A

Sudden inflammation

Usually viral, sometimes metastatic, meds, radiation, Dressler’s syndrome

Pleuritic chest pain w/ fever, Troponin elevated longer

Widespread STEMI w/ PR depression

Tx: ASA, NSAID, Colchicine

103
Q

Dressler Syndrome

A

2-3 weeks post-MI

Develop necrosis which inflames the pericardium

104
Q

Chronic/Recurrent Pericarditis

A

6 weeks - 18 months after acute

Usually AI

Tx: NSAIDS, colchicine, steroids, activity restriction until echo clean

Pericardiectomy as last resort

105
Q

Beck’s Triad

A

Sign of cardiac tamponade

Hypotension

JVD

Muffled heart sounds

106
Q

Kussmaul sign

A

JVD doesn’t resolve with inhalation

107
Q

Pericardiocentesis

A

Supine pt w/ HOB @ 30-60 degrees

1: 5th-6th intercostal space @ LSB @ left lung cardiac notch = Parasternal approach
2: Infrasternal angle = Subxiphoid approach

108
Q

Moenckeberg medial calcific sclerosis

A

Calcium deposits in tunica media

Genetic predisposition

Poor prognosis

Form of Arteriosclerosis

109
Q

Rheumatic fever

A

Group A strep - Strep pyogenes/pharyngitis

Antibody cross-reactivity

Strawberry tongue, petechia, beefy red tonsils w/ exudates

Tx: ASA/NSAIDs (kids), PCN/Clarithromycin

Also treat heart failure - ACEI, diuretics, BB, steroids

110
Q

Rheumatic fever major criteria

A

Migratory arthritis

Carditis/valvulitis - CHF w/ SOB, pericarditis w/ rub, new onset murmur

CNS involvement

Erythema Marginatum

Syndenham’s Chorea

111
Q

Sydenham’s Chorea

A

Rapid arm and face movements without purpose

Late stage Rheumatic fever

112
Q

Rheumatic fever minor criteria

A

Fever 100.8-102

Joint pain w/o swelling

Elevated ESR/CRP

Leukocytosis

EKG: Heart block w/ prolonged PR

Previous hx rheumatic fever

113
Q

Buerger’s Disease

A

Thromboangitis Obliterans - finger gangrene

Medium vessel

Young, male smokers - recurring progressive inflammation

Tx: Smoking cessation, CCB for vasospasms

114
Q

Type 1 PAD

A

Least common

Younger/smokers/hyperlipidemia

Aorta and common iliacs

115
Q

Type 2 PAD

A

Aorta, common and external iliacs

116
Q

Type 3 PAD

A

Most common

Multi-level disease

Aorta, iliac, femoral, popliteal, tibial

117
Q

PAD diagnosis and treatment

A

ABI - <0.8 = claudication, < 0.4 = severe

-not accurate w/ diabetics - no vessel elasticity left

Tx: ASA, Cilostazol (stop platelet aggregation), lifestyle, surgery

118
Q

Dilated Cardiomyopathy and treatment

A

IDC, pregnancy, CHF, alcoholism

Tx: Diuretics, ACEI, nitrates, positive inotropes

Allow 6 months to heal on its own - then transplant

Limit salt intake, digoxin will make them feel better

119
Q

Hypertrophic cardiomyopathy and treatment

A

Thick septum, aortic valve obstruction

Harsh, blowing murmur, resolves w/ Valsalva maneuver

Sudden death may occur

Tx: BB, vasodilators, diuretics, inotropes

120
Q

Restrictive cardiomyopathy

A

Looks like constrictive pericarditis

Right-side problems, dyspnea, edema, ascites, hepatomegaly, JVD, S3, S4

Tx: perfect volume balance - use diuretics, vasodilators, CCB

121
Q

Constrictive pericarditis history

A

History of trauma, TB, pericarditis, collagen-vascular disorders

Cardiology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions