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Family Med EOR > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Stable angina

A

-Predictable CP that occurs during exercise
-goes away with rest
-lasts less than 15 minutes

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2
Q

Describe unstable angina

A

-unpredicted CP that occurs at rest
-does not go away with rest

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3
Q

Management for stable angina

A

-low pretest likelihood: stress test
-high pretest likelihood: cath
-risk modification
-NTG

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4
Q

Management for unstable angina

A

NTG
Aspirin
Anticoag

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5
Q

Types of HF

A

-Systolic: Reduced EF (less than 40)
-Diastolic: Preserved EF (over 50)

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6
Q

symptoms of left sided HF

A

-DOE
-PND
-orthopnea
-crackles

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7
Q

symptoms of right sided HF

A

-JVD
-ascites
-peripheral edema

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8
Q

NYHA classifications (functional and structural)

A

1: no limitation of physical activity (asymptomatic)
2: slight limitation (symptoms with ordinary activity)
3: moderate limitation (asymptomatic only at rest)
4: symptoms at rest

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9
Q

Dx of HF

A

-CXR
-echo

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10
Q

Dx studies for acute decompensated HF

A

elevated BNP
chest XR: Kerley B lines, effusions
Echo is most helpful diagnostic tool

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11
Q

Tx for HF

A

-diuretics
-SGLT2 (flozins)
-ACE/ARB/ARNI
-BB

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12
Q

In HF, if EF is less than 35% what would you use

A

defibrillator

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13
Q

Management for acute decompensated HF

A

BiPAP: inc oxygenation, inc work of breathing, dec. preload/afterload
NTG: decrease preload/afterload
Furosemide: diuresis
Hypotension w/o signs of shock: dobutamine (may worsen hypotension)
Severe hypotension with signs of shock: norepinephrine (inc systemic vascular resistance, inc HR, inc BP, inc myocardial oxygen demand)

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14
Q

acute HF s/s

PICS

A

-Pink frothy sputum
-Inspiratory rales
-Cyanosis
-Severe dyspnea

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15
Q

management of acute HF

A

-oxygen
-IV loop diuretics
-NTG

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16
Q

CAD workup

A

EKG

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17
Q

STEMI management

A

-NTG and ASA
-cath
-PCI + plavix
-Tpa + UFH if PCI not available

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18
Q

etiology of endocarditis

A

-oral procedures
-IVDU

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19
Q

MC organisms for endocarditis

A

IVDU: staph aureus
Native valve: streptococci, S. aureus (mitral valve)

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20
Q

MC valve for IVDU endocarditis

A

tricuspid

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21
Q

s/s of endocarditis

from jane

A

-fever, chills
-SOB
-murmur
-petechiae
-splinter hemorrhages
-janeway lesions
-osler nodes
-roth spots

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22
Q

PE for endocarditis
(FROM JANE)

A

MC: Fever
Roth spots
Osler nodes
Murmur
Janeway lesions
Anemia
Nail bed hemorrhages
Emboli

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23
Q

janeway lesions vs osler nodes

A

-janeway: painless patches on palms or soles
-osler: painful nodules on pads of fingers

(osler, OW!!)

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24
Q

diagnostic criteria of endocarditis

A

-positive blood culture
-evidence on echo
-symptoms present

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25
Q

management of endocarditis

IVDU
prosthetic valve
native valve

A

-native valve: gent +pen g (UTD: Vanc+Ceftriaxone)
-IVDU: gent+ vanc+ nafcillin
-prosthetic valve: gent + vanc+ rifampin

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26
Q

endocarditis prophylaxis

A

amoxicillin prior to dental or respiratory tract procedures

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27
Q

treatment for sinus arrhythmia

A

none

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28
Q

treatment for sinus bradycardia

A

pacemaker

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29
Q

What is sick sinus syndrome also known as?

A

tachy-brady syndrome

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30
Q

Tx for sick sinus syndrome

A

pacemaker

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31
Q

Tx for sinus tach

A

BB

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32
Q

treatment for 1st degree AV block or 2nd type 1

A

none

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33
Q

Tx for 1st degree AV block or 2nd type 1

A

none

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34
Q

treatment for 2nd degree type 2 or 3rd degree

A

pacemaker

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35
Q

tx of PAC

A

BB or CCB

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36
Q

Describe a PVC. + What is it most commonly caused by?

A

Early, wide, “bizarre” QRS, no P wave seen
Most commonly caused by SA node dysfunction (rosh)

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37
Q

Tx of PVC

A

Pacemaker and medication for rate control (BB)

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38
Q

Tx of PSVT

HR 120-200 beats per minute

A

Vagal maneuvers
adenosine
cardioversion if hemodynamically unstable

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39
Q

Tx of ectopic atrial arrhythmias

A

BB or CCB

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40
Q

What is the most common sustained dysrhythmia in adults?

A

A fib

41
Q

Describe A fib

A

No discernable p waves
irregularly irregular
uncoordinated atrial activity
MC sustained dysrhythmia in adults
Variable ventricular response rate

42
Q

Tx of stable afib

A

Rate control (diltiazem, metoprolol)
rhythm control
anticoag (if condition persists >48 hrs, patient should be anti coagulated for 21 days prior to cardioversion)

43
Q

Tx of unstable A fib

A

synchronized cardioversion

44
Q

CHADS2VASc score

A

0: no anticoagulant
1: ASA
2: oral anticoagulation

45
Q

Tx of atrial flutter

A

same as a fib

46
Q

treatment of junctional arrhythmia

A

tx underlying cause

47
Q

Tx of accelerated idioventricular rhythm

A

none

48
Q

Tx of nonsustained Vtach

A

BB

49
Q

Tx of sustained vtach

HR >100 bpm

stable
unstable
pulseless

A

Stable: amiodraone
Unstable: cardioversion
Pulseless: defibrillation``

50
Q

Brugada

A

RBBB + ST elevation

51
Q

Management of brugada

A

ICD implantation

52
Q

If a patient is hemodynamically unstable….

A

cardioversion

(rosh said: a fib, a flutter, WPW syndrome, PSVT, V tach)

53
Q

tx of v fib

A

defibrillation

54
Q

tx of LBB

A

none

55
Q

Tx of RBB

A

none

56
Q

Elevated lipid levels

A

total: >200
triglycerides: >150
LDL: >100
HDL: <60

57
Q

Tx for HLD in ASCVD patients

A

high intensity statin

58
Q

treatment of HLD for patients with LDL >190

A

high intensity statin

59
Q

treatment of HLD for patients 40-75 without DM and LDL is 70-189

A

-calculate ASCVD risk
-probably moderate intensity
-lifestyle management if low risk

60
Q

treatment of HLD for patients 40-75 with DM and LDL>70

A

moderate intensity statin

61
Q

indications for hypertriglyceridemia management

A

-triglycerides between 175-499: lifestyle modifications
->500 or ASCVD risk: statin therapy

62
Q

HTN classifications

A

-normal: <120 /and <80
-elevated: 120-129/<80
-stage 1: 130-139/80-89
-stage 2: >140/>90

63
Q

s/s of PAD

A

-claudication
-limb ischemia
-ulcers
-diminished pulses

64
Q

dx of PAD

A

ABI

<0.9 indicates >50% stenosis
<0.4 indicates ischemia

65
Q

interpretation of ABI

A

-1.4: noncompressible and atherosclerosis
-1.4-1: normal
-.99-.91: borderline
-.9-.7: PAD

66
Q

gold standard peripheral vascular imaging

A

digital subtraction angiography

67
Q

tx of PAD

A

-lifestyle modifications
-ASA or plavix

Cilostazol

68
Q

s/s of acute arterial occlusion

A

-pallor
-pain
-pulseless
-paralysis
-poikilothermia
-paraesthesia

69
Q

management of acute occlusion

A

immediate revascularization (within 3 hrs of symptoms) and IV heparin

irreversible tissue damage at 6 hrs

70
Q

s/s of buergers disease

A

digital ischemic pain
ischemic ulcers

MC plantar and digital vessels of foot/leg

71
Q

Buergers disease typical presentation

A

Male, cigarette smokers, <40 yo
involves distal extremeties causing severe ischemia, progressing to tissue loss

72
Q

tx of buergers dx

A

tobacco cessation

73
Q

tx of varicose veins

A

compression stockings

74
Q

s/s of chronic venous insufficiency

A

-pitting edema
-taut, shiny skin at the ankle (d/t edema)
-stasis dermatitis
-ulcers

75
Q

tx of chronic venous insufficiency

A

compression stockings

76
Q

s/s of superficial venous thromphlebitis

A

-redness and tenderness along superficial vein
-palpable cord

77
Q

treatment of superficial venous thrombophlebitis

A

-NSAIDs
-elevation and warm compress
-if over 5cm, anticoagulation

78
Q

Cram the pance Diastolic murmurs

A
79
Q

s/s of aortic stenosis

A

-harsh systolic murmur
-radiates to carotids

80
Q

treatment of aortic stenosis

A

-surgery if symptomatic

81
Q

s/s of aortic regurg

A

-rumbling diastolic murmur
-radiates to apex

82
Q

treatment of aortic regurg

A

-surgery if symptomatic
-vasodilators

83
Q

MCC of mitral stenosis

A

rheumatic fever

84
Q

s/s of mitral stenosis

A

-diastolic murmur at apex
-opening snap

85
Q

treatment of mitral stenosis

A

BB and diuretics

86
Q

sign of mitral regurgitation

A

-systolic murmur that radiates to the axilla and back

87
Q

treatment of mitral regurg

A

-vasodilators
-diuretics

88
Q

sign of MVP

A

-midsystolic click followed by late systolic murmur

89
Q

treatment of MVP

A

-mild: none
-severe: repair or replacement

90
Q

MCC of tricuspid stenosis

A

rheumatic heart disease

91
Q

signs of tricuspid stenosis

A

-diastolic murmur on the left sternal border
-increases with inspiration

murmers on R side of heart increase w RINspiration

92
Q

treatment of tricuspid stenosis

A

diuretics

93
Q

s/s of tricuspid regurg

A

-systolic murmur at left sternal boarder

94
Q

treatment of tricuspid regurg

A

treat underlying cause

95
Q

s/s of pulmonic stenosis

A

-systolic murmur at pulmonic post
-opening click

96
Q

treatment of pulmonic stenosis

A

-mild: asymptomatic
-moderate: surgery

97
Q

s/s pulmonic regurgitation

A

-diastolic murmur pulmonic post

98
Q

treatment of pulmonic regurg

A

-treat pulmonary HTN

99
Q
A

Family Med EOR (14 decks)

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