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Cardiology Flashcards

1
Q

murmur of mitral stenosis

A

low-pitched, rumbling, diastolic with loud S1 and opening snap

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2
Q

causes of mitral stenosis

A

rheumatic fever, atrial myxoma

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3
Q

murmur of mitral valve regurgitation

A

loud holosystolic murmur best heard at the apex that radiates to the base

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4
Q

murmur of mitral valve prolapse

A

early to midsystolic click with with late systolic murmur best heard at left lateral heart border

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5
Q

causes of acute mitral regurgitation

A

endocarditis, AMI, trauma

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6
Q

murmur of aortic stenosis

A

crescendo-decrescendo systolic murmur radiating to the neck

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7
Q

causes of aortic stenosis

A

calcific valve degeneration, bicuspid aortic valve

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8
Q

murmur of aortic regurgitation

A

high-pitched, blowing diastolic murmur best heard at left sternal border, decreases with valvsalva

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9
Q

causes of acute aortic regurgitation

A

endocarditis, aortic dissection

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10
Q

hypertrophic cardiomyopathy murmur

A

harsh systolic ejection murmur that increases with standing/Valsalva and decreases with squatting and handgrip

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11
Q

signs associated with aortic regurgitation

A

water hammer pulse, de Musset sign (head bobbing with pulse), Quincke sign (pulsating nailbed), wide pulse pressure, Muller sign (visible pulsations of uvula)

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12
Q

symptoms of mitral valve prolapse

A

asymptomatic or may have dyspnea, palpitations, nonexertional chest pain, fatigue

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13
Q

most common cause of aortic regurgitation

A

endocarditis

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14
Q

symptoms of aortic regurgitation

A

exertional dyspnea, angina, symptoms of heart failure

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15
Q

what is austin flint murmur

A

late diastolic murmur best heard at apex.

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16
Q

high intensity statins

A

atorvastatin 40-80 mg
rosuvastatin 20-40 mg

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17
Q

moderate intensity statins

A

lovastatin 40-80 mg, pravastatin 40-80 mg, simvastatin 20-40 mg, atorvastatin 10-20 mg, rosuvastatin 5-10 mg

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18
Q

low-intensity statins

A

pravastatin 10-20 mg, lovastatin 20 mg, fluvostatin 20-40 mg, simvastatin 10 mg

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19
Q

most common type of cardiomyopathy

A

dilated

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20
Q

most common cause of dilated cardiomyopathy (NOT in the setting of CAD)

A

idiopathic

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21
Q

most common infectious causes of dilated cardiomyopathy

A

Viruses (especially enteroviruses, coxsackie virus)

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22
Q

toxic causes of dilated cardiomyopathy

A

ETOH abuse, cocaine, anthracyclines (doxorubicin), radiation

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23
Q

metabolic causes of dilated cardiomyopathy

A

thyroid disorders, thiamine deficiency

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24
Q

less common infectious causes of dilated cardiomyopathy

A

postviral myocarditis, HIV, Lyme disease, Parvovirus B19, Chagas disease

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25
Q

echocardiogram findings of dilated cardiomyopathy

A

left ventricular dilation, thin ventricular walls, decreased ejection fraction, ventricular hypokinesis

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26
Q

hallmark PE finding for dilated cardiomyopathy

A

S3 gallop

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27
Q

Cause of S3 gallop

A

filling of a dilated ventricle

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28
Q

Agents for mortality reduction in dilated cardiomyopathy

A

ACE inhibitors/ARBs, beta blockers

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29
Q

when to use AICD in dilated cardiomyopathy

30
Q

Normal axis

A

predominantly positive QRS in lead I and aVF (unless it is also predominantly negative in lead II, in which case it is left axis deviation)

31
Q

Left axis deviation

A

predominantly positive QRS in lead I and negative in aVF OR predominantly positive QRS positive in lead I and in lead aVF and predominately negative in lead II

32
Q

right axis deviation

A

QRS is mostly negative in lead I and positive in lead aVF

33
Q

normal PR interval

A

0.12-0.2 seconds (3-5 boxes)

34
Q

left atrial enlargement ECG

A

m-shaped P-wave in lead II >0.12 seconds, biphasic P in V1 with larger terminal component

35
Q

right atrial enlargement ECG

A

tall P-wave in lead II >3mm, biphasic P in V1 with larger initial component

36
Q

normal QRS width

A

<0.12 seconds

37
Q

left BBB ECG

A

Wide QRS, broad/slurred R in V5/V6, deep S wave in V1, ST elevation in V1-V3

38
Q

right BBB ECG

A

Wide QRS, RsR’ in V1/V2, wide S wave in V6

39
Q

right ventricular hypertrophy ECG

A

R>S in V1 or R>7 mm in height in V1

40
Q

Left ventricular hypertrophy ECG

A

S in V1 + R in V5 (or V6) > 35 mm in men or 30 mm in women

41
Q

definition of pathological Q waves

A

greater than 1 box in width or in depth

42
Q

ECG findings for LAD occlusion

A

ST elevations/Q waves in leads V1-V4

43
Q

ECG findings for proximal LAD occlusion only

A

ST elevations/Q waves in V1, V2

44
Q

ECG findings for circumflex artery occlusion

A

ST elevations/Q waves in I, aVL, V5, V6

45
Q

ECG findings for RCA occlusion

A

ST elevations/Q waves in II, III, aVF

46
Q

ECG findings for mid LAD +/- circumflex occlusion

A

ST elevations/Q waves I, aVL, V4, V5, V6

47
Q

portion of heart perfused by LAD

A

anterior wall

48
Q

portion of heart perfused by proximal LAD

49
Q

portion of heart perfused by circumflex

A

lateral wall

50
Q

portion of heart perfused by RCA (in most people)

A

inferior wall

51
Q

ECG findings of posterior wall MI

A

ST depressions in V1-V2

52
Q

What arteries perfuse posterior wall

A

RCA, circumflex

53
Q

Normal QRS axis numbers

A

-30 to +90

54
Q

causes of left axis deviation

A

LBBB, LVH, inferior MI, elevated diaphragm, L anterior hemiblock, WPW

55
Q

causes of right axis deviation

A

right ventricular hypertrophy, lateral MI, COPD, left posterior hemiblock

56
Q

preferred antiarrhythmic for WPW

A

Procainamide

57
Q

1st line antiarrhythmic for atrial flutter or atrial fibrillation

A

Beta blocker or CCB

58
Q

what type of CCBs are antiarrhythmics

A

non-dihydropyridines

59
Q

hallmark of sinus arrhythmia

A

heart rate increases with inspiration and decreases with expiration

60
Q

what is sick sinus syndrome

A

dysfunction of sinus node that leads to combination of sinus arrest with alternating paroxysms of atrial tachyarrhythmias and bradyarrhythmias

61
Q

causes of sick sinus syndrome

A

sinus node fibrosis, older age, corrective cardiac surgery, medications, systemic diseases affecting the heart

62
Q

definitive treatment of sick sinus syndrome

A

permanent pacemaker +/- AICD

63
Q

1st degree AV block criteria

A

PR interval >0.2 seconds with all P waves followed by QRS Complexes

64
Q

1st degree AV block treatment

A

often none needed, but can try atropine if symptomatic

65
Q

what is a 2nd degree AV block, type I

A

AKA Wenkebach or Mobitz I, progressive PR interval lengthening followed by a dropped QRS

66
Q

2nd degree AV block, type I causes

A

high vagal tone, inferior wall MI, AV node blocking agents (BBs, CCBs), hyperkalemia

67
Q

what is 2nd degree AV block, type II

A

interruption of electrical impulses resulting in occasional non-conducted impulses (constant PR interval except for the dropped QRS complexes)

68
Q

block location in Mobitz I

A

commonly above the bundle of His

69
Q

block location in Mobitz II

A

commonly at the bundle of His

70
Q

causes of Mobitz II

A

rarely seen in Pts without structural heart disease (AMI, myocardial fibrosis, etc.)

71
Q

what is 3rd degree AV block

A

total AV dissociation (no atrial impulses reach the ventricles)

PANCE (6 decks)

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