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GK PANCE > Cardio Things I always Forget > Flashcards

Cardio Things I always Forget Flashcards

1
Q

FROM JANE

A

used to diagnose Bacterial Endocarditis

Fever

Roth Spots (fundoscopy)

Osler Nodes (Hands)

Murmur

Janeway lesions

Anemia

Nail bed hemorrhage

Emboli (CXR)

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2
Q

Bacterial Endocarditis Diagnosis Criteria

A

DUKE Criteria:

2 Major

OR

1 Major + 3 Minor

OR

5 Minor

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3
Q

Major Duke Criteria

A

Bacteremia: 2+ blood cultures

Vegetation: + echo (1st TTE, then TEE)

New murmur

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4
Q

Minor Duke Criteria

A

FROM JANE - the murmur

Fever

Roth Spots (FUndocscopy)

Osler nodes (hands)

Janeway lesions

Anemia

Nail bed hemorrhage

Emboli (CXR)

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5
Q

Unless mentioned otherwise, assume patient has native valve when presenting with Bacterial Endocarditis

That being said….What is the Tx for native valve bacterial endocarditis?

A

Native Valve: Nafcillin + Gentamicin (NG)

OR

VANCO + Gentamicin if IVDA

NG

VG (IVDA)

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6
Q

Tx for prosthetic valve Bacterial Endocarditis

A

RGV:

Rifampin + Gentamicin + Vanco

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7
Q

Bacterial Endocarditis PPX must be done for pts with what conditions?

A
  1. Prosthetic heart valves
  2. Heart repairs using artificial materials
  3. Hx of endocarditis
  4. Congenital Heart Disease
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8
Q

What kind of procedures must you do PPX for (Bacterial Endocarditis)?

A
  1. Dental
  2. Respiratory
  3. Infected Skin/MSK tissue
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9
Q

What is the PPX for Bacterial Endocarditis?

A

Amoxicillin 2G 1 hr prior

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10
Q

Greatest Risk Factors for AAA

A

>60

athersclerosis

smoker

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11
Q

Cpx for AAA

A

old male w/severe abd pain

syncope/HYPOtension

+ tender, pulsatile abd mass

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12
Q

Dx of choice for AAA

A

Abd US

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13
Q

Gold Standard DX for AAA

A

Angiographyq

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14
Q

What will CXR of AAA show?

A

Calcified Wall

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15
Q

Mgmt for AAA

A

≥5.5cm OR >05cm growth within 6 months = immediate surgical repair

>4.5cm = referral to vascular surgeon

4-4.5cm = US q 6 mos (CT or MRI is fine too)

3-4cm = US annually

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16
Q

AAA Sx treatment

A

BB

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17
Q

Bile Acid Sequestrants

A
  1. Cholestyramine
  2. Colestipol
  3. Colesevelam
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18
Q

Fibrates

A

Gemfibrozil

Fenofibrate

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19
Q

SES of Niacin (Vit B3)

A

Flushing, HA, warm sensation, pruritis

Hyperuricemia & Hyperglycemia (Avoid in gout & DM)

NSAIDS/ASA prior to dosing may decrease flushing

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20
Q

Best drug to Increase HDL

A

Niacin (Vit B3)

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21
Q

Best drug to decrease LDL

A

Statins (HMGcoA reductase inhibitors)

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22
Q

SES of Statins

A

myositis/myalgias/rhabdomyolysis (esp in combo w/fibrates)

Hepatitis

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23
Q

Best drug to decrease TGL

A

Fibrates

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24
Q

SES of Fibrates

A

gallstones

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25
Q

SES of Bile Acid Sequestrants

A

Inc TGL

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26
Q

Main Goals of Lipid Control

A

LDL<100

Total Cholesterol < 200

HDL >60

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27
Q

For which Heart Blocks would you implant a PPM?

A

2nd Degree Mobitz Type II & 3rd degree block

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28
Q

CPx for DVT

A
  • unilateral swelling/edema of calf: >3cm = most specific sign
  • calf pain/tenderness
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29
Q

1st line imaging of choice for DVT

A

venous duplex US

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30
Q

Most sensitive test for DVT

A

D-dimer: r/o DVT in low risk pt

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31
Q

Gold Standard Diagnostic test for DVT

A

Venography

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32
Q

Anticoag will be lifelong in pt w/

A

Protein C/S def or Factor V Leiden Mutation

1st DVT w/ unreversible Risk Factors

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33
Q

You do not need to monitor PTT in

A

LMWH

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34
Q

Unfractionated Heparin PTT should be titrated to

A

1.5-2.5 x nml

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35
Q

Antidote for Heparin Toxicity

A

Protamine Sulfate

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36
Q

Antidote for Warfarin Toxicity

A

Vit K

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37
Q

How long should you take anticoag agents for if pt has 1st DVT w/ reversible Risk Factors

A

3 mos

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38
Q

Anticoag of choice in pregnancy

A

LMWH (does not cross placenta)

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39
Q

This type of Heparin has an increased chance of HIT

A

Unfractionated Heparin

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40
Q

Well’s Criteria for DVT

A

Active Cancer

Immobilization of lower extremity

Bedridden > 3 days due to surgery

Localized tenderness

Swelling of entire leg

Unilateral calf swelling >3cm

Unilateral Pitting edema

Collaterol SF veins

Alt dx more likely (-2)

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41
Q

Kussmaul’s sign + Pericardial Knock

A

Kussmaul’s sign = increased JVD during inspiration

Constrictive Pericarditis

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42
Q

What is Pulsus Paradoxus?

A

Decreased strength of radial pulse during inspiration

Constrictive Pericarditis

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43
Q

Which laboratory test helps define a cardiac versus a pulmonary cause of dyspnea?

A

Brain Ntriuretic Peptide

44
Q

6 Ps of Arterial Occlusion

A

Pain

Pallor

Pulselessness

Paresthesia

Poikilothermia

Paralysis

45
Q

MC site of thromboembolism

A

femoral artery bifurcation

46
Q

Flow of electricity through heart

A

SA node

AV node

Bundle of His

Bundle Branches

Purkinje Fibers

47
Q

Temporal (Giant Cell) Arteritis can lead to what complications?

A

Aortic involvement can lead to valvular insufficiency, aortic arch syndrome, and dissection.

48
Q

Tx of Temporal Arteritis if no vision loss

A

Prednisone

49
Q

Tx of Temporal Arteritis w/ vision loss

A

Methylprednisone IV

50
Q

Capture beats and fusion beats confirm the diagnosis of which cardiac dysrhythmia?

51
Q

CPx of Kawasaki Disease

A

CRASH + Burn

Conjunctivitis

Rash (polymorphous)

Adenopathy (cervical)

Strawberry tongue

Hands and feet edema

Fever must be present > 5 days

52
Q

Main complication of Kawasaki Dz

A

coronary vessel arteritis: coronary artery aneurysm, MI

53
Q

What will UA show for Kawasaki?

A

Sterile Pyuria

54
Q

Tx for Kawasaki Dz

A

IVIG + High dose ASA

55
Q

Most imp predisposing factor for Aortic Dissection

56
Q

Most commonly seen symptom in Aortic Dissection

A

chest pain

57
Q

Is syncope/HYPOtension a presentation for AAA or Aortic Dissection?

58
Q

CPx for Aortic Dissection

A

Chest pain: sudden onset severe, tearing upper back pain

Decreased peripheral pulses

HYPERtension

acute new onset aortic regurgitation

59
Q

Test of choice for Aortic Dissection

A

CT scan w/contrast

OR

TEE

60
Q

Gold Standard Aortic Dissection Dx

61
Q

Medical Tx for Aortic Dissection

A

Esmolol, Labetolol

62
Q

Transudate causes of Pleural Effusion

A

Heart Failure

Cirrhosis

Nephrotic Syndrome

Pulmonary Embolism

63
Q

Exudative causes of Pleural Effusion

A

Malignancy

Bacterial/Viral Pneumonia

TB

Pancreatitis

64
Q

Major Criteria for Rheumatic Fever

A

JONES:

Joints (migratory polyarthritis)

Oh no, Carditis!

Nodules (subcutaneous)

Erythema Marginatum

Sydenham Chorea

65
Q

Minor Criteria for Rheumatic Fever

A

Fever

arthralgias

Increased ESR + CRP

66
Q

Diagnostic Criteria for Rheumatic Fever

A

2 Major

OR

1 Major + 2 Minor

Jones Criteria

67
Q

What 3 BB are approved for tx of heart failure?

A

Carvedilol

Bisoprolol

Metoprolol

68
Q

Area of claudication in buttock, hip, groin

A

Aortic bifurcation/common iliac

69
Q

Leriche’s syndrome

A
  1. claudication (buttock, thigh pain)
  2. impotence
  3. decreases femoral pulses

aortic bifurcation/common iliac

70
Q

Area of claudication in thigh, upper calf

A

femoral artery/branches

71
Q

Area of claudication in lower calf, ankle, foot

A

Popliteal artery

72
Q

pale on elevation

dusky red w/ dependency (dependent rubor)

lateral malleolar ulcers

73
Q

Most useful screening tool for PAD

A

Ankle-Brachial Index: +PAD if <0.90

74
Q

Gold Standard for PAD

A

Arteriography

75
Q

1st line Tx for PAD

A

Cliostazol

76
Q

Sxs of Left Sided Heart Failure

A

Think Pulmonary Circulation Disruption

DOE

Tachypnea

Pulmonary Crackles/Rales

Cough

Paroxysmal Nocturnal Dyspnea

77
Q

Sxs of Right Sided Heart Failure

A

Think Systemic Circulation Disruption:

Fatigue

Distended Jugular Veins

Lower Extremity Edema

Weight Gain

Hepatosplenomegaly

78
Q

Characteristics of Diastolic Heart Failure

A

nml/Increased EF

Thich Ventricular Walls

Small LV chamber

+S4

79
Q

Characteristics of Systolic Heart Failure

A

Decreased EF

Think Ventricular Walls

Dilated LV chamber

+S3

80
Q

What causes acute HF?

A

systolic causes: acute MI, HTN crisis

81
Q

What causes chronic heart failure?

A

dilated cardiomyopathy

valvular dz

82
Q

Dx of HF

A

Echo: shows EF

CXR: cardiomegaly, Kerley B lines

Increased BNP

83
Q

Outpatient HF regimen

A

1st: ACE + Diuretic

Then: BB +/- Hydralazine

84
Q

Diet/Exercise regarding HF

A

Na+ restriction <2G/day

Fluid restriction <2L/day

smoking cessation

85
Q

1st line Tx of HF

86
Q

HF pt not able to tolerate ACE-I

87
Q

What med do you add after ACE-I in HF pt?

A

BB

**stop or reduce BB dose during decompensated CHF**

88
Q

HF pt unable to tolerate ACE-I or BB

A

Hydralazine + Nitrates

89
Q

Best symptomatic Tx for mild-mod CHF

A

Diuretics: Loops, K+ sparin

90
Q

What meds can be used short term in acute CHF?

A

Digoxin, Dobutamine, Dopamine

91
Q

If EF<35% in HF

A

implantable cardioverter defibrillator

92
Q

Mgmt of Acute Pulmonary Edema/CHF

A

LMNOP:

Lasix (Furosemide)

Morphine

Nitrates

Oxygen (BIPAP)

Position (upright to decrease venous return)

93
Q

4 types of shock

A
  1. Hypovolemic
  2. Cardiogenic
  3. Obstructive
  4. Distributive
94
Q

Causes of Hypovolemic Shock

A

hemorrhage, GI bleed

95
Q

CO, PCWP and SVR in Hypovolemic Shock

A

↓CO, ↑SVR

↓PCWP

96
Q

All shocks have decreased ____ and increased ____.

Except…

A

All shocks have decreased CO and increased SVR.

Except Septic Shock: early septick Shock has Increased CO

97
Q

All shocks have Increased PCWP except…

A

Hypovolemic Shock: Decreased PCWP

98
Q

Cpx of hypovolemic shock

A

pale, cool mottled skin

prolonged cap refill

decreased skin turgor, dry mucous membranes

_NO resp distress***_

99
Q

Cpx of Cardiogenic Shock

A

_Severe Resp Distress**_

cool clammy skin

100
Q

CPx of Obstructive Shock

A

Severe Respiratory Distress

Cool, clammy skin

101
Q

Tx for cardiogenic shock

A

dopamine, dobutamine, PDE-I, Norepinephrine

102
Q

Must have 2/4 following to Dx with SIRS (septic shock)

A
  1. >38 degrees Celsius Fever or <36 hypothermia
  2. >90 bpm
  3. RR>20 or PaCO2<32
  4. WBC > 12,000
103
Q

Sepsis

A

SIRS + focus of infection

Lactate > 4

104
Q

Gen Mgmt of Shock

A

ABCDE:

Airway: intubation

Breathing: Mechanical ventilation

Circulation: isotonic crystalloids

Delivery of O2

Endpoint of resuscitation

GK PANCE (26 decks)

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