Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 CK > Cardiology 2 > Flashcards

Cardiology 2 Flashcards

1
Q

Pt presents with CP Worse with Exertion and Relieved by Rest, Sharp in nature, Radiates to Jaw lasting 5-15 min. Dx? Next step in management? Rx?

A

Stable Angina. ECG and CIPs for ACS r/o. 02, Aspirin, Plavix, Betas, Nitro. Then Exercise Stress Test (allow us to determine the severity and if there is a need for further intervention.) Do Cardiac Angio if stress test is positive (> 2mm ST depression or hypotension drop in 10mm hg systolic alone or incombination) to determine if pt will benefit from PCI or CABG (checks for how many vessels are diseased.) Meds: Nitro, beta, Aspirin, Statin, plavix.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Management of NSTEMI/UA?

A

Risk stratify according to TIMI score to determine the likelihood of adverse cardiac events. Get EKG and troponins, 02, IV, Aspirin, Plavix, LMWH, Nitrates, Beta (Metoprolol and Carvedilol). If TIMI >3, elevated troponins and ST wave changes > 1mm seen then give Gb2a3b if undergoing Angio + PCI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What EKG diagnosis STEMI? Management of STEMI? Discharge meds: for all patients? Specific pts if they got tPA? Stent? Afib? CHF? Pain?

A
  1. > 1mm elevation in two contiguous limb leads or > 2mm elevation in two contiguous chest leads. 2. EKG and Troponins, 02, IV, Aspirin, Plavix, LMWH, Nitrates, Beta (Metoprolol, Carvedilol) Gb2a3b if under going PCI. tpA w/in 90 minutes if PCI (needs to occur within 12 hrs) not available. Discharge all pts on Aspirin, Plavix (up to 1 month after tPA and up to 12 months if stent placement), Beta and Statins. ACE if there is CHF, Warfarin if Afib, Nitrates for pain.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of V Fib.

A

Defibrillation is used in VF and pulseless VT. Delivery of shock used at any phase of the cardiac cycle. With defibrillation you depolarize the myocytes simultaneously hoping to activate SA node.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of Afib? When is rhythm control done?

A
  1. Check for stability, if not stable then synchronized cardioversion is next 2. Rate control and anticoagulation is the GOAL: Beta blockers, CCB + Warfarin due CHADS Score 3. Rhythm control is only done if symptomatic or If young person or if person can be controled with rate and anticoagulation. 4. Ablation definitive treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

BLS steps?

A
  1. Make sure unresponsive and not just sleeping 2. Call 911 3. Check pulse then start chest compressions 100/min with adequate depth 5cm 2 in Earlier chest compressions and defibrillation are critical elements of CPR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of SVT?

A
  1. Check for stability, if not cardiovert. 2. Carotid massage 3. IV adenosine if massage doesnt work. 4. Beta blockers, CCBs and Dig can help slow down rate.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. Agents for chemical cardioversion in Afib? 2. Agents for maintaing sinus rhytm once cardioversion has worked?
A
  1. Amiodarone, Dofetilide, Flecainide 2. Propaferone and Solatol.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CHADS Score stands for ? HAS BLED score (Bleeding Risk)?

A
  1. Congestive Heart Failure 2. HTN 3. Age 4. Diabetes 5. Stroke 0: Give ASA 1: Give ASA or Anticoagulation 2: Give Anticoagulation. HAS BLED: HTN, Age, Stroke, Bleeding: RENAL and LIVER, Labile INR , Ethanol, Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Management of 1. Asymptomatic Sinus Brady and Type 1 AV Heart block ? 2. Symptomatic Sinus Brady and Type 1 AV Block? 3. 2nd and 3rd Degree Heart block?

A
  1. No intervention 2. Atropine then transcutaneous pacing 3. Atropine then transcutaenous pacing then place pacemaker.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If a patient who’s ASCVD risk factor > 9% (Age, Male Gender, Ethnicity, Smoking, DM, SBP, HTN treatment, Total and HDL cholesterol) Give the recommended statin treatments for moderate-intensity.

A

Simivastatin (Zocor) 20-40mg, Atorvastatin(Lipitor) 10-20, Rouvastatin (Crestor) 5-10 mg most potent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the first line in rx with pt presents with cocaine induced MI/CP. What medication not to use?

A

Benzo (reduces agitation, anxiety, BP and HR) + 02 therapy. Beta blockers should not be used in cocaine induce MI because this can precipitate unopposed alpha adgrenergic blockade.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pt had previous surgery to his R leg months ago. Now presents with the R leg feeling more flushed. Pt has LVH and Soft systolic murmur that does not change with valsava. Dx?

A

AV fistula in his leg s/p that caused him to have high output cardiac failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mos common arrhythmia that can lead to sudden death post MI? And what kind of arrhythmia is it?

A

V. Fib a Re-entrant ventricular arrhythmia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Short PR interval, Delta wave and Narrow complex tachy. Dx. Rx?

A

WPW. Procainamide for medical therapy. Ablation for definitive treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What class is Argatroban, Dabigatran (Pradaxa) and Bivalrudin?

A

Direct Thrombin Inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What class are Fondapurinox, Rivoroxaban (Xerelto), Apixaban?

A

Factor Xa inhibitors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name that trauma: Blunt chest trauma, JVP, Hypotension, no response to fluids, tachycardia. CXR can be normal and show normal cardiac contours. If enough blood is present a globular heart will show.

A

Percardial Tamponade.

19
Q

Name that trauma: Pulmonary infiltrate on CXR.

A

Pulmonary Contusion.

20
Q

Name that trauma: Widened Mediastinum with left Hemothorax and HTN. Can occur from fall or MVC.

A

Aortic Rupture.

21
Q

Name that trauma: Air in the mediastinum on CXR, Crepitus felt on palpation. Increase Amylase and lipase in the Pleural Effusion.

A

Esophageal Rupture.

22
Q

Name that trauma: Occurs with tension pneumothorax that does not resolve with chest tube placement, Pneumomediastinum or subcutaneous emphysema. Can have JVP.

A

Bronchial Rupture.

23
Q

Name that trauma: Occurs with sternal fracuture. Arrhythmia, New bundle branch block.

A

Myocardial Contusion.

24
Q

Give the management for each person with HTN: 1. CAD 2. DM 3. BPH 4. Depression and asthma 5. Hyperthyroidism 6. Osteoporosis

A
  1. ACEI, ARB, BB, 2. ACEI 3. Alpha Blockers 4. Avoid in Depression and Asthma 5. BB first 6. Thiazides.
25
Q

What is amiodarone used for?

A

Supraventricular tachycardias (A. fib, A. flutter) and ventricular tachycaridias (V tach.)

26
Q

Name that rhythm: Narrow QRS complex tachycardia. R-R intervals are constant. No regular P waves seen becuase they are buried within the QRS complexes. Retrograde P waves (inverted P waves are seen) Befre the QRS (psuedo R waves) and after the QRS (psusedo S waves)

A

Supraventricular Arrhythmia.

27
Q

Name that rhytm: Prolonged QRS, long S wave, RsR’.

A

RBBB (Bunny Ears)

28
Q

How are Uremia, Post- MI status, Viral and Autoimmune disorders related?

A

They all can cause Pericardial effusion (Globular Heart) and Pericarditis (Diffuse ST segment elevation with PR depression)

29
Q

Name that condition: 1. Acute onset(few days) of tachypnea + Respiratory Alkalosis 2. Chronic onset tachypnea (more than a week) + Respiratory Alkalsosis 3. Chronic onset tachypnea with Respiratory Acidosis.

A
  1. PE 2. CHF 3. COPD
30
Q

Early heart sound after S2 and calcifications seen on heart on CXR. Dx?

A

Early heart sound after S2 is a pericardial knock. Constrictive Pericarditis.

31
Q

Sudden onet of palpitations and generalized weakness in a young patient. Dx? Cause? Rx?

A

PSVT (Paroxysmal Supraventricular Tachycardia due to re-entry in the AV node) Rx with decreasing the vagal tone, carotid massage, Adenosine, Cold water immersion. If unstable then shock.

32
Q

Life threathening accumulation of fluid around the heart s/p cardiac surgery, especially in kids. Pt present with hypotension, distant heart sounds and JVP. Dx?

A

Post-pericardiotomy Syndrome.

33
Q

Rx for Torsades De Points

A

IV Mag Sulfate.

34
Q

Best initial test for CHF? Most accurate test?

A

CHF is a clinical diagnosis ( ROS: SOB, Orthopnea***, PE: edema, rales, JVD, S3 gallop) Best initial test is Transthoracic Echo. MUGA or nuclear ventriculogram which is mainly done when administering Doxorubicin to monitor wall motion.

35
Q

Rx for Systolic CHF ? Which drugs lower mortality?

A
  1. ACE/ARB 2. Beta blocklers (Metoprolol, Bisoprolol, Carvedilol) 3. Spiranolactone ( use eplereone if gynocomastia develops in male.) 4. Dieurtics 5. Digoxin (lowers hospitlization) Digoxin and Diuretics are used for symptomatic rx and do not lower mortality.
36
Q

Rx for Diastolic CHF?

A
  1. Beta blockers 2. Diuretics. ACE/ARB, Digoxin, sprinalocatone have no benefit in diastolic CHF.
37
Q

Name that diagnosis: SOB, Circumoral numbness, caffeine use, history of anxiety.

A

Panic Attack

38
Q

Name that diagnosis: Pallor, SOB gradual over days to weeks.

A

Anemia

39
Q

Name that diagnosis: SOB, Palpitations, syncope

A

Arrhytmia of almost anykind

40
Q

When would you use defribrillator or biventricular pacemaker in CHF?

A
  1. Defibrillator for ishemic cardiomyopathy and EF < 35% 2. Biventricular pacemaker ( when left and right ventricles contract when they are not in synch) QRS > 120 ms and EF < 35% with persistent symptoms.
41
Q

Sudden onset, over whelming emotional stress and anger leads to CP, SOB, ST segment Elevation. Coronary angio is normal and no absence of vasospasm. Echo reveals ballooning. Dx? Rx?

A

Tako-Tsubo Cardiomyopathy (massive catecholamine discharge) Rx: Beta blockers.

42
Q

Give the diagnosis, best initial test and most accurate test: Radiation to back, unequal blood pressure between arms.

A

Aortic Dissection. Initial test is CXR (widened mediastinum) Chest CT most accurate/confirms disease.

43
Q

Give the diagnosis and most accurate test: Epigastric discomfort, pain is better when eating.

A

Duodenal ulcer disease. Endoscopy.

44
Q

Give the diagnosis and most accurate test: Sharp, pleuritic pain, tracheal deviation.

A

Pneumothorax. CXR.

Step 2 CK (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions