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cardiology Flashcards

1
Q

What is the hallmark ECG finding of a STEMI?

A

ST elevation ≥1 mm in 2 contiguous leads

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2
Q

What is the time goal for PCI in STEMI?

A

≤90 minutes from first medical contact

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3
Q

What is the first-line reperfusion therapy for STEMI if PCI is unavailable?

A

Fibrinolysis (e.g., tenecteplase)

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4
Q

What is the dose of aspirin in suspected ACS?

A

300 mg chewed stat

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5
Q

What is the loading dose of clopidogrel in ACS?

A

300-600 mg orally

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6
Q

What is the anticoagulant of choice in STEMI undergoing PCI?

A

Heparin (70-100 units/kg IV)

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7
Q

What is the classic presentation of ACS?

A

Retrosternal chest pain radiating to the left arm

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8
Q

What ECG leads indicate an inferior STEMI?

A

II, III, aVF

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9
Q

What is the most common vessel occluded in inferior STEMI?

A

Right coronary artery (RCA)

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10
Q

What ECG finding suggests right ventricular infarction?

A

STE in V4R

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11
Q

What is the management of RV infarction?

A

Fluid loading (avoid nitrates)

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12
Q

What is the dose of tenecteplase for STEMI?

A

0.5 mg/kg IV bolus (max 50 mg)

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13
Q

What is the contraindication to fibrinolysis in STEMI?

A

Prior hemorrhagic stroke

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14
Q

What is the target door-to-needle time for fibrinolysis?

A

≤30 minutes

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15
Q

What is the ECG finding of posterior STEMI?

A

ST depression in V1-V3 with tall R waves

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16
Q

What vessel is typically involved in posterior STEMI?

A

Circumflex artery

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17
Q

What is the role of nitrates in ACS?

A

Relieve ischemic chest pain (0.4 mg SL)

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18
Q

What is the loading dose of ticagrelor in ACS?

A

180 mg orally

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19
Q

What is the dose of morphine in ACS?

A

2-5 mg IV titrated

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20
Q

What is the definition of unstable angina?

A

New or worsening chest pain without ST elevation

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21
Q

What is the biomarker for myocardial injury?

A

Troponin (I or T)

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22
Q

What is the time frame for troponin elevation in MI?

A

3-6 hours after symptom onset

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23
Q

What is the management of NSTEMI with ongoing pain?

A

Urgent angiography

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24
Q

What is the ECG finding of Wellens syndrome?

A

Deeply inverted T waves in V2-V3

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25
Q

What does Wellens syndrome indicate?

A

Critical LAD stenosis

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26
Q

What is the rhythm of ventricular tachycardia?

A

Regular, wide-complex tachycardia

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27
Q

What is the initial treatment for unstable VT?

A

Synchronized cardioversion (100 J biphasic)

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28
Q

What is the dose of amiodarone for VT?

A

150 mg IV over 10 minutes

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29
Q

What is the initial energy for defibrillation in pulseless VT?

A

200 J biphasic

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30
Q

What is the treatment for stable monomorphic VT?

A

Amiodarone or procainamide

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31
Q

What is the ECG finding of atrial fibrillation?

A

Irregularly irregular rhythm, no P waves

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32
Q

What is the rate control agent of choice in AF?

A

Beta-blocker (e.g., metoprolol)

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33
Q

What is the dose of metoprolol IV for AF rate control?

A

2.5-5 mg IV every 5 minutes (max 15 mg)

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34
Q

What is the anticoagulation threshold for AF cardioversion?

A

CHADS-VASc ≥2

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35
Q

What is the dose of apixaban in AF?

A

5 mg BD (2.5 mg BD if criteria met)

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36
Q

What is the treatment for AF with hemodynamic instability?

A

Synchronized cardioversion (100-200 J)

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37
Q

What is the ECG finding of SVT?

A

Narrow-complex tachycardia, rate >150

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38
Q

What is the first-line treatment for stable SVT?

A

Vagal maneuvers (e.g., Valsalva)

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39
Q

What is the dose of adenosine for SVT?

A

6 mg IV rapid push, then 12 mg if needed

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40
Q

What is the complication of adenosine?

A

Transient asystole

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41
Q

What is the ECG finding of torsades de pointes?

A

Polymorphic VT with twisting QRS

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42
Q

What is the treatment for torsades de pointes?

A

Magnesium sulfate 2 g IV

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43
Q

What is the ECG finding of complete heart block?

A

Dissociated P waves and QRS complexes

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44
Q

What is the temporary treatment for symptomatic bradycardia?

A

Atropine 0.5 mg IV (max 3 mg)

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45
Q

What is the pacing threshold for bradycardia?

A

HR <40 or hemodynamic instability

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46
Q

What is the dose of adrenaline in bradycardia?

A

2-10 mcg/min IV infusion

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47
Q

What is the classic triad of aortic dissection?

A

Sudden tearing chest pain, unequal pulses, widened mediastinum

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48
Q

What is the imaging of choice for aortic dissection?

A

CT aortogram

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49
Q

What is the BP target in aortic dissection?

A

SBP 100-120 mmHg

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50
Q

What is the first-line antihypertensive in aortic dissection?

A

Labetalol (10-20 mg IV)

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51
Q

What is the surgical indication for aortic dissection?

A

Type A (ascending aorta involvement)

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52
Q

What is the mortality rate of untreated Type A dissection?

A

1-2% per hour

53
Q

What is the dose of esmolol in aortic dissection?

A

500 mcg/kg IV bolus, then 50-200 mcg/kg/min

54
Q

What is the ECG finding in aortic dissection with coronary occlusion?

A

ST elevation (e.g., inferior STEMI)

55
Q

What is the risk factor for aortic dissection?

A

Hypertension or Marfan syndrome

56
Q

What is the Stanford classification of aortic dissection?

A

Type A (ascending), Type B (descending)

57
Q

What is the Wells score component for PE?

A

Clinical symptoms of DVT (3 points)

58
Q

What is the imaging of choice for PE?

A

CT pulmonary angiogram (CTPA)

59
Q

What is the ECG finding of massive PE?

A

S1Q3T3 pattern

60
Q

What is the treatment for massive PE?

A

Thrombolysis (e.g., alteplase 100 mg IV)

61
Q

What is the dose of heparin in PE?

A

80 units/kg IV bolus, then 18 units/kg/h

62
Q

What is the target INR for warfarin in PE?

63
Q

What is the risk stratification tool for PE?

A

PESI score or sPESI

64
Q

What is the thrombolysis indication in PE?

A

Hemodynamic instability

65
Q

What is the dose of rivaroxaban in PE?

A

15 mg BD for 21 days, then 20 mg OD

66
Q

What is the ECG finding of right heart strain in PE?

A

Right axis deviation, RBBB

67
Q

What is the D-dimer threshold to rule out PE?

A

<500 ng/mL (age-adjusted if >50)

68
Q

What is the treatment for submassive PE with RV dysfunction?

A

Anticoagulation ± thrombolysis

69
Q

What is the classic presentation of acute heart failure?

A

Dyspnea, orthopnea, bilateral crackles

70
Q

What is the first-line diuretic in acute heart failure?

A

Furosemide 20-40 mg IV

71
Q

What is the dose of GTN in acute pulmonary edema?

A

0.4 mg SL or 5-10 mcg/min IV

72
Q

What is the BP target in acute heart failure with hypertension?

A

SBP reduction by 25% in first hour

73
Q

What is the role of NIV in acute heart failure?

A

Reduces intubation rate (CPAP/BiPAP)

74
Q

What is the ECG finding of acute heart failure?

A

Tachycardia, possible ischemia

75
Q

What is the biomarker for heart failure?

A

BNP or NT-proBNP

76
Q

What is the NT-proBNP threshold for heart failure?

A

> 300 pg/mL

77
Q

What is the treatment for cardiogenic shock in heart failure?

A

Inotropes (e.g., dobutamine)

78
Q

What is the dose of dobutamine in cardiogenic shock?

A

2-20 mcg/kg/min IV

79
Q

What is the complication of excessive diuresis in heart failure?

A

Hypokalemia

80
Q

What is the ECG finding of pericarditis?

A

Diffuse ST elevation, PR depression

81
Q

What is the treatment for pericarditis?

A

NSAIDs (e.g., ibuprofen 600 mg TDS)

82
Q

What is the classic sign of cardiac tamponade?

A

Beck’s triad (hypotension, muffled heart sounds, JVD)

83
Q

What is the imaging for cardiac tamponade?

A

Echocardiography (RV collapse)

84
Q

What is the treatment for cardiac tamponade?

A

Pericardiocentesis

85
Q

What is the ECG finding of tamponade?

A

Electrical alternans

86
Q

What is the dose of colchicine in pericarditis?

87
Q

What is the risk factor for myopericarditis?

A

Recent viral infection

88
Q

What is the treatment for hypertensive emergency?

A

Labetalol or GTN IV

89
Q

What is the BP target in hypertensive emergency?

A

Reduce by 25% in first hour

90
Q

What is the ECG finding of hyperkalemia?

A

Peaked T waves

91
Q

What is the treatment for hyperkalemia with ECG changes?

A

Calcium gluconate 10 mL 10% IV

92
Q

What is the dose of salbutamol for hyperkalemia?

A

10-20 mg nebulized

93
Q

What is the ECG finding of hypokalemia?

A

U waves, flattened T waves

94
Q

What is the treatment for severe hypokalemia?

A

Potassium chloride 10-20 mmol IV

95
Q

What is the classic presentation of endocarditis?

A

Fever, new murmur, embolic phenomena

96
Q

What is the first-line antibiotic for suspected endocarditis?

A

Vancomycin + ceftriaxone

97
Q

What is the Duke criteria for endocarditis?

A

2 major or 1 major + 3 minor

98
Q

What is the imaging for endocarditis?

A

Transesophageal echo (TEE)

99
Q

What is the surgical indication for endocarditis?

A

Heart failure or abscess

100
Q

What is the ECG finding of Brugada syndrome?

A

ST elevation in V1-V3 with RBBB pattern

101
Q

What is the treatment for Brugada syndrome with VT?

A

ICD placement

102
Q

What is the risk factor for Takotsubo cardiomyopathy?

A

Emotional stress

103
Q

What is the ECG finding of Takotsubo?

A

ST elevation mimicking MI

104
Q

What is the echo finding of Takotsubo?

A

Apical ballooning

105
Q

What is the treatment for Takotsubo cardiomyopathy?

A

Supportive care, beta-blockers

106
Q

What is the ECG finding of WPW syndrome?

A

Short PR, delta wave

107
Q

What is the treatment for WPW with AF?

A

Procainamide or cardioversion

108
Q

What is the contraindication in WPW with AF?

A

AV nodal blockers (e.g., adenosine)

109
Q

What is the dose of procainamide in WPW?

A

20 mg/min IV (max 1 g)

110
Q

What is the ECG finding of second-degree AV block Mobitz I?

A

Progressive PR lengthening, dropped QRS

111
Q

What is the treatment for Mobitz I with symptoms?

A

Atropine or pacing if unstable

112
Q

What is the ECG finding of Mobitz II?

A

Constant PR, intermittent dropped QRS

113
Q

What is the treatment for Mobitz II?

114
Q

What is the definition of cardiogenic shock?

A

Hypotension (SBP <90) with hypoperfusion

115
Q

What is the first-line inotrope in cardiogenic shock?

A

Dobutamine

116
Q

What is the dose of milrinone in cardiogenic shock?

A

0.375-0.75 mcg/kg/min IV

117
Q

What is the complication of inotropes?

A

Tachyarrhythmias

118
Q

What is the ECG finding of pulmonary edema?

A

Tachycardia, S3 gallop on exam

119
Q

What is the dose of enalaprilat in heart failure?

A

1.25 mg IV

120
Q

What is the role of IABP in cardiogenic shock?

A

Augments coronary perfusion

121
Q

What is the contraindication to nitrates in ACS?

A

Hypotension (SBP <90)

122
Q

What is the dose of heparin in NSTEMI?

A

60-70 units/kg IV bolus

123
Q

What is the target aPTT for heparin in ACS?

A

1.5-2.5 times control

124
Q

What is the ECG finding of ischemic T-wave inversion?

A

Symmetrical, deep T-wave inversion

125
Q

What is the treatment for Prinzmetal angina?

A

Calcium channel blockers

126
Q

What is the dose of verapamil in Prinzmetal angina?

A

40-80 mg orally TDS

127
Q

What is the ECG finding of LV aneurysm?

A

Persistent ST elevation post-MI

128
Q

What is the complication of LV aneurysm?

A

Ventricular arrhythmias

paul acem (13 decks)

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