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STEP2 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is the most common cardiac complication in Hemachromatosis?

A

arrhythmia; paroxysmal A fib

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2
Q

Carcinoid syndrome affects which heart valve?

A

pulmonic; pulmonary stenosis

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3
Q

Pts with a subclavian or jugular CRBSI MUST be treated w/ what AB(s)?

A

VANCOMYCIN (MRSA protective)

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4
Q

Pts with a femoral CRBSI MUST be treated w/ what AB(s)?

A
  • VANC
  • cefepime (pseudomonas)
  • caspofungin (candida)
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5
Q

Methadone, Ondasteron, and Amiodarone cause what change in the EKG> deadly arrhythmia?

A

== QT prolongation&raquo_space; torsades de pointes (TdP)

  • norm = <440
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6
Q

Citrate toxicity from recurrent blood transfusions depletes what 2 electrolytes?

A

Calcium & Magnesium

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7
Q

what is the most common post-op arrhythmia?

how is it identified on EKG?

A

premature ventricular complex

EKG = bigeminy = finding in which every normal complex is followed by a premature complex

**also see trigeminy

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8
Q

what are some causes of post op arrhythmias (PVCs) ??

A

high levels of catecholamines (endogenously due to the perioperative stress state; exogenous in the case of cardiovascular support)

***electrolyte or acid-base imbalances (e.g., hypokalemia, hypomagnesemia)

reduced ventilation

certain drugs

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9
Q

what treatment reduces the risk of SCD in pts with HOCM?

A

SCD is caused by Vfib / Vtach

SOOO

Placement of an automated, implantable cardioverter defibrillator (AICD) is the best method to prevent sudden cardiac death (SCD) in patients with HOCM

AICD averts fibrillation = no death

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10
Q

what kind of murmur continuously radiates to the neck but disappears when pt flexes the neck?

A

venous hum (veins are easy to compress)

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11
Q

how can pts on hemodialysis with a created AV fistula end up with HFpEF?

A

AV fistulas send blood from systemic circulation to pulm circulation > dec in SVR> increased HR w/ decreased filling pressures triggers RAAS activation

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12
Q

what dx test is performed prior to anticoag therapy or cardioversion in a pt with AFib?

why?

A

alway visualize the heart w/ TEE prior to giving anticoags/cardioversion bc you want to see if there is an active thrombus sitting in the heart waiting to be thrown around

(anticoags & cardioversion will loosen a thrombus from a heart wall/valve)

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13
Q

what is the difference between synchronized cardioversion and defibrillation?

A

synchronized cardioversion waits for a R wave before admin a shock === SOOO there must be a PULSE in order to shock!

defibrillation is given when there is NO PULSE & you are trying to bring pt back

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14
Q

which arrhythmias receive synchronized cardioversion?

A

arrhythmias with a PULSE:

  • A fib
  • A flutter
  • AVNRT
  • Pulsing Vtach
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15
Q

which arrhythmias receive defibrillation?

A

arrhythmias with NO PULSE:

  • ventricular fibrillation
  • Pulseless VTach
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16
Q

BP for hypertensive emergency?

A

> 180 / >120

either one is an emergency

17
Q

which patients are recommended evaluation/screening for AAA?

A

65-75 yo w/ PMHx smoking & ATHEROSCLEROTIC diseases (claudication/PAD/HLD/HTN)

18
Q

Afib is almost always likely to occur in pts with what

  • arrhythmia
  • valve disease
A

pre-excitation WPW > Afib in 20% of pts

Mitral stenosis; hx of rheumatic fever enlarges the L.atria> excites the Pulm VEIN > Afib in 2/3 of pts

19
Q

Pts with new onset Afib should always be evaluated for what valve disease?

A

Mitral valve stenosis!

20
Q

Pts with UNSTABLE Afib/AFib w/ RVR need to be treated with what ASAP (aka this takes priority over any med!!)

A

EMERGENCY synchronized cardioversion (controls RHYTHM)!!

21
Q

what are the 2 complications of AFib?

A
  1. Afib w/ RVR

2. emboli

22
Q

Dx criteria for AFib w/ RVR

drug Management of AFib w/ RVR

A

AFib w/ HR >100 pt can be stable or unstable

1st= Bblockers
2nd= CCB Nondihydropyridines (verapamil & diltiazem)
3rd (if cant tolerate above)= Digoxin or Amiodarone

23
Q

what is the PARASITE mnemonic for the etiology of AFib ?

THIS IS VERY IMPORTANT

A 
P- Pulm dx (COPD, PE, PNA)
A- Anemia 
R- Rheumatic heart disease/Mitral Stenosis
A- Atrial Myxoma
S- Sepsis or Hypovolemia (dehydration)
I- Ischemia
T- Thyroid dx (Hyperthyroidism or Thyrotoxicosis)
E- Ethanol
24
Q

when is the ONLY time SVR is decreased?

A

when shock is SEPTIC/distributive or NEUROGENIC shock!

25
Q

when is the ONLY time CO index (how MUCH blood is pumped out) is high?

A

CO index is increased SEPTIC/Distrubutive shock only (bc SVR is low so CO is high)

CO pump function is dec in:

  • cardiogenic (heart not pumping= less blood leaves heart)
  • hypovolemic (less blood passing through heart)
  • neurogenic (dead heart = no blood passing)
26
Q

why would you perform a exercise or adenosine stress test ?

what pt characteristics (CC, PMHx, FHx, etc) would make you consider a stress test?

A

to evaluate if a pt has obstructive coronary artery disease

do a stress test in pts who you worry may have a MI soon:
new onset SOB on exertion, PMH HLD/DM/HTN, FHx MI in 1st degree relatives, etc

27
Q

sound and location of Aortic regurg vs MV regurg

A

Aortic regurg= a DECRESCENDO murmur heard after S2 (= DIASTOLE); located at either side of the sternal border (BUT best heard at the right 2ND intercostal space where the aorta starts)

Mitral regurg= HOLO-SYSTOLIC apical murmur (bc normally the MV is closed during systole, but in MR blood regurges back into LA during systole); located at left 4th/5th intercostal space @ mid clavicular line & radiates to axilla

28
Q

what is a common brain complication of coarctation of the aorta & what is the pathophys?

A

intracranial hemorrhage!!

  • pts w/ Coarctation of the aorta are GENETICALLY predisposed to berry aneurysms.
  • the coarctation> secondary HTN> aneurysm rupture> ICH
29
Q

myxomatous valve degeneration is associated with what valve defects?

A

MVP that worsens to become MR

30
Q

what valve defect is known for causing ANXIETY?

A

MVP!!

31
Q

what is the order of drugs/protocol for management of CHF?

A
  1. Lasix (diuretic will give pt comfort)
  2. ACEi (#1 for CHF for controlling BP)
  3. Add beta blocker after the pt is stable on the ACEi

ACEi is ALWAYS b4 Bblocker bc blockers take longer to kick in

32
Q

an IE pt with a new conduction finding (ex. heart block) is a sign that the IE has spread to what part of the heart?

A

VALVE involvement in IE causes conduction problems

STEP2 (12 decks)

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