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Cardio > Cardio To Know > Flashcards

Cardio To Know Flashcards

1
Q

Large VSD left uncorrected leads to

A

Aortic Regurg - increased heart volume and LV dilation

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2
Q

Classic findings in MIs (3)

A

Chest pain, >1mm ST cnahes, Increased cardiac enzymes

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3
Q

If IVs cant be places, what is alternative route?

A

Intraosseous cannulation. In emergencies, use the extremitites.

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4
Q

Chronic angina with ischemia occurs with what valve disease murmur?

A

Mitral regurg murmur = papillary ischemia

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5
Q

Long standing MS is a ssociated with that EKG and heart condition?

A

A Fib

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6
Q

Most important risk factor for PAD is?

A

Smoking

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7
Q

Most important risk factor for CAD is?

A

Diabetes

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8
Q

Pulsus Paradoxus & JVD is

A

tamp, echo, pericardiocentesis

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9
Q

What medication do you give a HTN with DM?

A

Ace-I

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10
Q

What CAD testing is used in the presence of a LBBB?

and Why?

A

LBBB are hard to see so you use an Adenosine radionuclear scan.

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11
Q

What psych medication can cause HTN?

A

MAOIs

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12
Q

When do you suspect a Pheo? How do you Diag? How do you treat it?

A

Palp, HA, Diaphoresis, and long standing HTN.Diag = uring metaneph & vallinic acid. Tx is with a Pheo

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13
Q

What meds decrease VLDL?

A

Fenofibrates (and trigs).

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14
Q

What is contraindicated in an Inferior wall MI? and why?

A

Nitro. preload dependent. Inferior wall MI = weak right ventricle. Nitro decreases preload.

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15
Q

When do people get Printzmetal Angina

A

AM

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16
Q

What do you do for a patient with STEMIs in II, III, AvF?

A

IV fluids. Fluid dependant RV

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17
Q

angina new in onset that occurs at rest or with minimal exertion

A

UA

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18
Q

Name and hours of Cardiac Markers

A

1) Myoglobin 1 hr, 8 hrs, 1 day
2) CK-MB 2 hrs, 1 day, 3 days
3) TropC 1 hr, 1 day, 1 week

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19
Q

What do you give after PCl for an MI?

A

abciximab, eptifibatide or tirofiban to stop platelets

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20
Q

What is Infliximab used for?

A

Anti-tumor necrosis factor alpha

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21
Q

What is the TIMI score used for? Whats the levels

A

Anticoagulation. 1 = safe to Dc, 3 = Serial Troponin + ASA + Clop. 5 = Antithrobo and PCl

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22
Q

What med proven mortality benefit in ST-elevation myocardial infarction?

A

Aspirin

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23
Q

What are the leads to the 4 wall MIs?

A

Anterior wall ST elevation in leads V1 through V4
Inferior wall ST elevation in leads II, III, and AVF
Lateral wall ST elevation in leads I, AVL, V5, and V6
Posterior wall ST depressions V1 through V3 and elevations in V8 and V9

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24
Q

What EKG finding is a ssociated with myocardial ischemia?

A

ST segment downsloping,

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25
Q

What is the equation for the target heart rate used for an exercise stress test?

A

Target heat rate = 85 % (220 - age (in years)).

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26
Q

What anti-angina med do yo ugive once BB and CCB have been tried?

A

Ranolazine

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27
Q

What is contraindicated in NSTEMI treatment?

A

tPa, there is no thrombus

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28
Q

What is contraindicated with severe COPD, asthma, atrioventricular block, hypotension or bradycardia

A

metoprolol

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29
Q

Men determined to be at low risk (lilidemia) screening for lipid abnormalities at age

A

35 and every 5 years if normal.

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30
Q

Timi score components? (7)

A

> 65, (CAD, Lipids, DM, Smoke), Known CAD, ASA w/n 7 days, Severe angina, EKG 0.5mm, + troponins
65 CACA, 0.5 Trop

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31
Q

contraindication to fibrinolytic therapy?

A

Intracranial hemorrage, Masses, Ischemia <3 months, Trauma, Aortic dissection, Active bleeding disorders, Untrontrolled HTN.

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32
Q

relative contraindication to fibrinolytic therapy?

A

Pregnancy, >180/110, internal bleed, ischemia <3 months.

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33
Q

What is Eisenbergs syndrome? What is the underlysing cause caused by?

A

Right to left shunt VSD, caused by Fetal Etoh, ToF

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34
Q

EKG of LBBB and RBBB?

A

LBBB” RR at Lead I, S wave at V1: Treat like stemi or HCM

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35
Q

How do you tx SSS and Brady?

A

Pace and Atropine

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36
Q

What is Weinchibach associated with?

A

Inferia wall MI

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37
Q

What EKG findings of Hypothermia?

A

Osborn (J point), A fib - Extracorporeal heating.

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38
Q

Lside CHF sxs?

A

Dyspnea, Fatigue, S3, Crackles

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39
Q

Tx for Kawasaki?

A

ASA and IVIG

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40
Q

Aortic Regurg has

A

Bounding Pulses, Water hammer, LSB, 2nd ICS,

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41
Q

Aortic Stenosis has

A

Narrow pulses, Decrease with Valsa, Increase with Squat. Pulsus Parvus and Tardus

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42
Q

MCC Restrictive MC & what are signs

A

Amyloids (shinny) then Sarcoidies (HyperCal, ICS)

Signs = JVD, kussmaul, Rales, Biatrial enlargment

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43
Q

How do you treat high trigs?

A

Fish oil, fenofebrates

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44
Q

What tx is contraindicated in pericarditis?

A

Warfarin (protein C problems)

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45
Q

Most common 2nd HTN cause?

A

Renal stenosis

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46
Q

What med is ionotropic, decrease Pul wedge pressure, and has normal BP?

A

Dobutamine.

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47
Q

How do you treat PEA? and Asystole?

A

CPR and Epi

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48
Q

What meds makes CHF worse?

A

Cilostazil, NSAIDS, Metformine, PDE5

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49
Q

What artery is the most turbulent?

A

Common femoral artery

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50
Q

How do you treat vtach?

A

Sotalol, Amioderone, Lido, Procanimide VS DeFib.

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51
Q

Does CKD respond to thiazides?

A

No

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52
Q

What med decreases preload only?

A

Furosimide

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53
Q

What med decreases both preload and afterload w/o being an ionotrope

A

Ace

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54
Q

Does tPA have allergic rnx?

A

No

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55
Q

Large vs small ASD,longstanding?

A

Large = LVH, Small = RVH, Long = Biventricular Hypertrophy

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56
Q

EKG of BRugada?

A

RBBB, STEMI & T wave inversion in V1-V3

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57
Q

goal of STEMI reprofusion ( PCL and Throbolytic)

A

90 mins and 30 mins

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58
Q

What can cause pericarditis?

How do you tx?

A

INH, Coxsachie, entero, Procanimide, Dressler.

NSAID, Colchicine, ASA, Lean forward

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59
Q

What is the EKG of Pericarditis?

A

Diffuse STEMI, PR depression in AVF

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60
Q

Dressler time and sxs

A

1-2 weeks post MI, fever, Leukocytosis.

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61
Q

What has BEcks, low volt, Elec Alter, and cardio meg

A

Tamponade

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62
Q

What can cause Myocarditis?

How do you tx?

A

Coxsachie, entero, SLE, Rheum, Clonidine.

Ace, Dobutamine, IVIG

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63
Q

What can cause DCM ?

How do you tx?

A

Entero/Cox, EtoH, Parvo, Chaga.

Ace, BB, Diuretic, stop Salt.

64
Q

R-side CHF sxs. Tx

A

S3, pink forth lungs (transudative effusion) EFr, MI, DCM, weak LV. tx = Ace, BB, Dig, LMNOP

65
Q

L-side CHF sxs

A

S4, Stiff vent, JVD, Rales, Edema. tx = Ace, BB, Dig, LMNOP

66
Q

High outflow HF causes?

A

Paget, anemia, Preg, Thyroidtox, beri-beri, AV shunt

67
Q

Low output HF causes?

A

MI, Ischemia, HTN

68
Q

Diag and what do you see on XRAY for HF

A

Batwing, Kerley B (25), cephalization, Peribronch cuff, Cardiomegaly

69
Q

HCM sings and sxs?

A

Autodom, S4, /\ murmur, increase with valv/clenching.

70
Q

Tx for HCM?

A

BB, Verapamil, Disopyeramid. NO digox or Nitrates. Myomectormy and alcohol ablate.

71
Q

Chronic angina and Ischemia occur due to what?

A

Mitral papillary mucsle death = regurg.

72
Q

LBBB are hard to diagnose. What test can see CAD with LBBB?

A

Adenosine Radio scan

73
Q

VLDL and Chylomicrons are treated with

A

Fenofibrates

74
Q

Decreased murmur with hand grip is associated with

A

HCM

75
Q

Bruits over the groin with a high pulse (115) is pathonmeumonic for?
Specifically in penetrating trauma

A

AV Fistula. Bruits or thrills in veins.

76
Q

What are albuterols SE?

A

Tachy and jittery. NO HTN.

77
Q

TOGA has what kind of S2?

A

Loud

78
Q

TOF has what kind of S2?

High or low hematocrit?

A

Single, High

79
Q

What are the 5 major jones criteria?

A

Carditis, migratory arthritis, chorea, Erythema marginatum, and subcutaneous nodules.

80
Q

Is the annuloplasty preferred over a mitral valve replacement?

A

Yes, in Regurg.

81
Q

Transient ST elevations and Morning chest pain is…

A

Prinzmental- CC, no BB

82
Q

How do you treat Rheum Fever?

A

ASA, ICS, and PCN.

83
Q

What are the major Jones criteria for Rheum?

A

Migratory joint, Carditis, Nodules, Erythema Marginatum, Sydhamns Corea

84
Q

What valvular murmurs increase with hand grips?

A

AR and MR

85
Q

what are Aortic stenosis complications?

A

Angina, syncope, chest pain

86
Q

Chronic AS leads to ..

A

LVH

87
Q

What is the murmur of AS and how do you best hear it

A

/\ systolic dereased with vel, increased with squat. radiates to carotids. lean forward

88
Q

What type of pulse pressure does AS have? And what pulses are they?

A

Narrow pulse pressure. Pulsus tardus and parvus

89
Q

What is the AS murmur and where is it heard best? What kind of pulse?

A

blowing\ diastolic leaning forward. Bounding pulses

90
Q

What increase and decreases the AR murmur

A

increase with squat and hand grip. decrease with Valsalve (like AR)

91
Q

What kind of pulse pressure does AR have?

A

Wide pulse pressure

92
Q

Chronic AR can lead to what other condition?

A

CHF from dilated LV

93
Q

What valve disease causes hemoptysis and ruddy checks

A

MS, Also Afib

94
Q

What valve is best heard at the LLD and has an open snap murmur

A

MS

95
Q

This valve disease an lead to LAE and pulm HTN.

A

MS

96
Q

What is the tx for dilated cardio myopathy? and Diag?

A

Echo - Stop drinking, Ace, BB, Diuretics–> transplant

97
Q

What is the patho of DCM

A

Dilated and floppy heart. poor EF

98
Q

What Cardio myopathy has a diastolic dysfunction?

A

Restrictive CM

99
Q

MCC of Restricitve CM?

A

Amyloid (bright), radiation, Sarcoids (medisteium)

100
Q

Signs of RCM

A

JVD, kussmall

101
Q

Signs of HCM

A

s4, poor EF,

102
Q

Presentation and path of HCM

A

Big and think septum = blood cant leave the heart. Exercised enduced syncope

103
Q

How do you treat HCM?

A

Beta blockers. No other ionotrops. Myomectomy. Alcohol ablate.

104
Q

What is the treatment for Bruggada?

A

BB –> AICD

105
Q

What conduction disorder is associated with Theopheline toxicity? Also with COPD

A

MAT

106
Q

how long do you antigoag afib

A

4 weeks

107
Q

what drugs prolong QT

A

sotolol, aminoderone, hypothermia, erythromycin

108
Q

Which anti-HTN meds are safe in pregs

A

Beta blockers, methyldopa, labetalol

109
Q

what arrhythmia has a delta slope and a shorter PR?

A

WPW

110
Q

What has a suppressed PR?

A

Pericarditis

111
Q

what dysrythmia occurs in long-standing constrictive pericarditis

A

A-fib

112
Q

Patient has lost aortic knob, has a widened mediastium, and is HoTN. What does the pt have?

A

Traumatric aortic rupture

113
Q

Common post MI complication with a VSD is

A

HF

114
Q

What medications are contraindicated in Gout?

A

Thiazides

115
Q

If the patient has cardio shock, what will happen if an intraaortic ballon is placed?

A

Systolic BP is normalize, PCWP drops.

Due to offloading the heart

116
Q

firbrinolytic therapy should be continued from 12 hours of onset of chest pain?

A

true, 12 hrs

117
Q

MC valvular disease from Rheum Fever is?

A

MS

118
Q

What med is used in diastolic HF? and in systolic HF?

A

Diastolic PrEF= Beta

Systolic, rEF = Aces

119
Q

uncontrolled HTN can lead to?

A

Chronic HF

120
Q

What is Cannon A waves and what causes it?

A

3rd AV block. Blood hitting a closed tricuspid.

121
Q

is an idioventrical rythm normal after a STEMI?

A

Yes

122
Q

what med SE is constipation & gingival hyperplasia?

A

CCB

123
Q

What chronic condition can lead to absent dorsalis ped pulses and why?

A

A fib = throw a thrombus

124
Q

What electrolyte abnormality is found with AV blocks?

A

Hyperkalemia

125
Q

What medication is contraindicated in PAD?

A

propranolol

126
Q

How do you treat a TIA?

A

1st ASA 2nd Clopidegrol

127
Q

When do you place a resync Pace?

A

Wide QRS, has an auto defib

128
Q

Patient has HoTN, and 0 venous pressure. What does the patient have?

A

Internal bleeding. Tamp would have high venous pressure.

129
Q

How do you calculate mean arterial pressure?

A

MAP = DBP + 1/3(SBP−DBP)

130
Q

What is the order of meds In a Positive CHA2DS2VaS?

A

Rivarobaxan

131
Q

If you See STEMI on EKG, what do you do?

A

PCl within 90 mins

132
Q

What disease has auto dom Fibrillin defect?

A

Marfans

133
Q

What is the patho difference with Ehlers and Marfans?

A

Ehlers has reduced lysyl hydroxylas in collagen. Not tall or arachnodactyly.

134
Q

Does Amioderone have CKD?

A

No

135
Q

Are vasodilators contraindicated in Dissection?

A

Yes - increase sheer forces do to artificial increase in HR.

136
Q

What med is CI in WPW?

A

CCB

137
Q

WHat meds have 1st dose syncope as their SE?

A

Alpha blockers

138
Q

What meds can cause SLE?

A

Procanimide

139
Q

How do you tx Pulm HTN?

A

Diuretics

140
Q

Does digox lead to st depression?

A

Yes

141
Q

Is PSVT’s rate 240 and controlled with vagal + Adenosine?

A

yes

142
Q

ethacrynic acid is a _______ medication

A

Loop diuretic

143
Q

Tirofiban is a _______med

A

glycoprotein IIb

144
Q

How does morphine help with an MI?

A

Pain control and venodilation.

145
Q

What med is an inhibitor to adenosine diphosphate for platelets aggrogation?

A

Clopidegrol

146
Q

idioventricular rhythm + HoTN needs what?

A

Atropine

147
Q

what med as a longer duration of action thiazides or loops?

A

Thiazides.

148
Q

WHats the MOA of Nitroprusside?

A

arterio and veno dilation

149
Q

Systolic HTN is treated with?

A

CCB+ Thiazides (AA) patients.

150
Q

Post strep arthitis is treated with?

A

PCN and ASPIRIN

151
Q

MOA of CCB?

A

Dilate arteries

152
Q

MOA of nitrates?

A

Vasodilation of Coronary arteries

153
Q

Unstable angina is due to incomplete occlusion - why are CCB and Fibrinolytics CI?

A

dont vasodilate - break occlusion and cause a compete block downstream.

154
Q

PACs are treated with?

A

Beta blockers

155
Q

what beta blockers are used in CHF?

A

MCB - metoprolol, Carvadolol, Bisoprolol

Cardio (8 decks)

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