Cardiology Flashcards
An opening snap on auscultation of the heart should make you think of what diagnosis?
Mitral stenosis
I fixed or consistent split S2 should make you think of what diagnosis?
Atrial septal defect
What are the three major criteria for endocarditis?
2 positive blood cultures, a positive transesophageal echocardiography, new murmur.
Which are painful and found on the fingers and toes, Osler nodes or Janeway lesions?
Ostler nodes
List the four minor criteria for diagnosing endocarditis.
Fever, embolic event (Janeway lesions or petechiae, splinter hemorrhages), immunologic event (osler nodes, glomerulonephritis), 1 positive blood culture
What are the five components of Tetralogy of Fallot?
Ventricular septal defect, right ventricular hypertrophy, right ventricular outflow obstruction (pulmonary valve stenosis), overriding aorta, right sided aortic arch
Define paradoxical pulse
Systolic pressure drop greater than 10 mmHg with inspiration. Seen in Tamponade, constrictive pericarditis
Define pulsus alternans
Alternating pulse: a pulse in which there is a regular alternation of weak and strong beats without changes in cycle length- EKG finding in pericardial effusion & tamponade
On physical exam you hear a harsh systolic murmur along the right sternal border. What is the most likely diagnosis?
Aortic stenosis
A wide pulse pressure with blowing diastolic decrescendo murmur at the right 2nd intercostal space should make you think of what diagnosis?
Aortic regurgitation
Where is disease of the pulmonary valve best heard?
2nd left intercostal space
Name two things that would constitute a positive stress test
A drop in blood pressure, a new arrhythmia, an increase in angina symptoms, ST depressions
A blockage of which artery causes a lateral wall MI?
Left circumflex artery
AV block can be precipitated by…
Hyperkalemia, Lyme disease, MI, lithium
What is represented by ST segment depressions greater than 1mm on EKG?
Ischemia
Where is disease of the mitral valve best heard?
At the apex
A biphasic P wave should make you think of what diagnosis?
Left atrial enlargement
List the components of Virchow’s triad
Stasis, vascular injury, hypercoagulability
Where is disease of the tricuspid valve best heard?
Along the left lower sternal border.
What is the most common congenital heart disease?
Ventricular septal defect
An RSR prime leads V1 or V2 should make you think of what diagnosis?
Right bundle branch block
A blockage of which artery causes an anterior wall MI?
Left anterior descending artery
Giant cell arteritis is associated with what other disease?
Polymyalgia rheumatica
Name a common cause of junctional rhythm
Digitoxin toxicity
Tall peaked T waves should make you think of what diagnosis?
Hyperkalemia
How do you define 1st degree AV block?
The PR interval is longer than 0.2 seconds or one block on EKG.
What’s the other term for Mobitz type I?
Wenckebach
What is the treatment for a patient with a Mobitz II AV block?
Pacemaker
An RSR prime in leads V5 or V6 should make you think of what diagnosis?
Left bundle branch block
Tall peaked P waves should make you think of what diagnosis?
Right atrial enlargement
Where is my murmur of tricuspid regurgitation heard?
Tricuspid regurgitation is associated with a holosystolic soft murmur heard best at the left sternal border and the intensity may increase with inspiration.
What is the first line medication for a patient with symptomatic bradycardia?
Atropine
Which EKG leads are used to diagnose an anterolateral MI?
V5 and V6
What is the first medication you should give for atrial flutter?
Adenosine
Name one aldosterone antagonist.
Spironolactone, eplerenone
A U wave on EKG should make you think of what diagnosis?
Hypokalemia
ST depression of 1 mm on exercise EKG is positive for..
Angina (ischemia)
Horizontal or downsloping ST-segment depression usually indicates:
Ischemia
A pansystolic blowing murmur at the apex and radiating to the axilla is associated with…
Mitral regurgitation
A midsystolic click is associated with..
Mitral valve prolapse, likely a thin female.
MC cause of mitral regurge is..
Mitral valve prolapse
Opening snap following S2 is associated with..
Mitral valve stenosis
Define P-R interval.
From beginning of P wave to beginning of R wave, 3-5 small boxes. If over .2 seconds (5 small boxes or 1 large box) then is 1st degree AV block
Define second degree AV block and what are 2 types?
Some signals get sent through from the SA node to the Ventricles
Second Degree Type 1: Also known as Mobitz type 1 or Wenckebach
Longer and longer PR intervals until one is signal is dropped
May be benign
Second Degree Type 2: Also known as Mobitz 2
Intermittent dropped impulse without lengthening PR intervals
Requires pacing
2:1 AV block = Two p waves for every qrs wave
How long after the onset of myocardial infarction before cardiac troponin I and CK-MB levels elevate?
3 to 12 hours
What normally happens to systolic BP during inspiration?
Usually drops 10mm w/ pulsus paradoxus (paradoxical pulse) in cardiac tamponade, pericarditis and obstructive lung dz (asthma, COPD)
Name one aldosterone antagonist.
Spironolactone, eplerenone
