cardiology Flashcards
quid of normal axis(2)
upright QRS inleads 1 and AVF
double thumbs up
Ekg in COPD
right bundle branch block
CAuse of AFIB(7)
Pirates P=pulmonar disease I=ischema R=rheumatic heart disease A=Anemia and atrial myxoma T=Thyrotoxycosis E=Ethanol S=sepsis
Ekg in hyperkalemia(3)
Peaked T waves
wide QRS
sinusoidal wave pattern
Ekg in pulmonary embolus
sinus tachycardia
S1Q3T3
QQUID OF s1q3t3(3)
S wave in lead 1
q wave in lead 3
T inverted in lead 3
EKG in wolf parkinson white
Delta waves
EKG of left ventricular hypertrophy(2)
amplitude of R wave in AVL plus amplitude of S wave in V3 > ou egal a 24 in males
a 20 in females
EKG in RVHypertrophy(2)
R wave in v1 . 7 mm
right axis deviation
EKG in atrial hypertrophy in the left
biphasic P wave in lead V1
EKG in atrial hypertrophy in the right
P wave amplitude > 2,5 mm in lead 2
Left bundle branch block on EKG(2)
William
W pattern of QRS in v1-v2
M pattern v3-v6
right bundle branch block on EKG(2)
Marrow
M pattern of qrs in v1 v2
W pattern of qrs in v3-v6
3 types of cardiomyopathy(3)
dilated
restrictive
hypertrophic
PROBLEM IN DILATED CARDIOMYOPATHY
IMPAIRED CONTRACTILITY
PROBLEM IN restrictive CARDIOMYOPATHY
impaired elasticity
PROBLEM IN hypertrophic CARDIOMYOPATHY
impaired relaxation
Ef in hypertrophic cardiomyopathy
increased or normal
Ef in restrictive cardiomyopathy
decreeassed mildly or normal
cause of dilated cardiomyopathy(6)
ABCCCD A=ALCOHOL B=BERIBERI C=COCKSAKIE B C=CHAGAS C=COCAINE D=DOXORUBICIN
THE 2 MOST COMMON CAUSE OF DILATED CARDIOMYOPATHY
LONG STANDING hta
ISCHEMIA
s4 MEANING(2)
STIFFED VENTRICLE
atrial kick associated with hypertrophic ventricle
cause of reccurent CHF FAILURE
forgot medication arythmia/anemia ischemia infarc infection lifestyle upregulation (increased cardiac output) renal failure embolus(pulmonary
cause of increased cardiac output
pregnancy
lifestyle causing reccurrent CHF(2)
hig Na+ intake
low exercice
caution when using Bblockers(ABCD)
asthma
block (heart)
Copd
diabetes
STAGE A using AHA/ACC classification
patients at risk for CHF but no signs or symptoms or structural heart abnormalities
Stage B using AHA/ACC classification
patients with structural heart disease but no symptoms of CHF
rx of stage B(2)
ACE
B blocker
quid of structural hert disease(3)
previous MI
left ventricular systolic dysfunction
valvular disease
quid of stage C of AHA/ACC
patietn with structural heart disease with symptoms of CHF or have prior symptoms
rx of stage C AHA/ACC(4)
diuretics
Ace
digitalis
salt restriction
quid of stage D of AHA/ACC
patient with marked symptoms of CHF at rest despite maximal medical rx
rs of stage D AHA/ACC(4)
MECHANICAL ASSIST DEVICES
HEART TRANSPLANT
CONTINUOUS iv INOTROPIC DRUGS
HOSPICE CARE
SIDE EFFECT OF ace INHINITOR (Captopril)
cough angioedema potassium excess taste changes orthostatic hypotension pregnancy contrindication rash indomethacin inihibition liver toxicity
most common cause of right heart failure
left heart failure
left sided CHF symptoms(4)
rales
S3
pleural effusions
pulmonary edema
right sided CHF symptoms(4)
JVD
hepatomegaly
hepatojugular reflux
bipedal edema
comorbidities associated with systolic heart failure(2)
diated cadiomyopathy
valvular heart disease
comorbidities associated with diastolic heart failure(4)
restrictive cardiomyopathy
hypertrophic cardiomyopathy
renal disease
HTA
physical exam in systolic heart failure(2)
displaced PMI
S3
physical exam in diastolic heart failure(2)
sustained PMI
S4
CXR in in systolic heart failure(2)
pulmonary congestion
cardiomegaly
CXR in in diastolic heart failure(2)
pulmonary congestion
normal heart size
EF in diastolic heart failure(
> 50 %
EF in systolic heart failure(
< 40%
side effect of HMG co a(4)
hepatotoxicity
myositis
girl in pregnancy
coumadin /cyclosporine interactions
target LDL 0-1 risk factor
< 160
target LDL > ou egal a 2 risk factor
< 130
target LDL in cad or risk equivalent
< 70
risk factor to take into consideration in LDL evaluation(6)
diabetes considered as CAD equivalent smoking HTA HDL< 40 age > 45 pour males age> 55 females early CAD in first degree relatives < 55 ans male <65 ans in females
problem in taking bile acid resins(cholestyramine/colestipol/colesevelam)
decrease absorption of other drugs
patient with risk of silent MI(3)
elderly
diabetic
postorthotopic heart transplants patients
indiction of CABG (DUST)(4)
depresed ventricular function
unable to perform PTCA(diffuse disease)
stenosis of left main
triple vessel disease
goal HTA in diabetics or patient with renal failure
<130/80
stage 1 HTA
140-159
90-99
rx of stage 1 HTA
monotherapy or combination
stage 2 HTA
> ou egal a 160=systole
> ou egal 100= diastole
rx of stage 2
2 drugs combination
side effect of acetazolamide
acidosis
calcium in diuretics intake(2)
loops loose diuretics
thiazide save it
5 classes of diuretics
osmotic carbonic anhydrase inhibitors loops thiazide K+ sparing agents
example of osmotic diuretics
Mannitol
site of action of Mannitol
proximal tubule
example of carbonic anhydrase inihibitor
acetazolamide
site of action of carbonic anhydrase inhibitor
proximal convoluted tubule
example of loops diuretics(4)
furosemide
acid ethacrinic
torsemide
bumetamide
site of action of loops
loop of henle
example of thiazide diuretics(3)
hctz
chortalidone
chlorothiazide
site of action of thiazide
early distal tubule
example of K+sparing agents(3)
spironolactone
triamterene
amiloride
site of action K+ sparing agent
cortical collecting tubule
mechanism of action of manitol(2)
augmentation of urine osmolarity
increase urine flow
mechanism of action of acetazolamide(2)
NAHCO3 diuresis
decreased total body of NAHCO3-
mechanism of action of loop diuretics(3)
decrease the na+k+2 cl- cotransporter
decrease urine concentration
increase calcium excreion
mechanism of action of thiazides(3)
decraese NACL reabsorption
decrease the diluting capacity of the nephron
decreased calcium excretion
mechanism of action of spironolactone
aldosterone receptor antagonist
mechanism of action of triamterene and amiloride
block Na+ channels
loops diuretics side efffects(5)
ototoxicity hypokaliemia hypocalcemia gout dehydration
K+ sparing side effects(4)
hyperkaliemia
gynecomastia
sexual dysfunction
hirsutism
acetazolamide side effects(4)
NH3 toxicity
sulfa allergy
hyperchloremic metabolic acidosis
neuropathy
manitol side effects(2)
pulmonary edema
dehydration
CI of mannitol(2)
anuria
CHF
action of B blockers(2)
reduce cardiac contractility
decrease renin relaease
quid of centrally acting adrenergic agonists(3)
Methyl dopa
clonidine
guanabenz
mechanism of action of centrally acting adrenergic agonists
inhibit sypathetic nervous system via central alpha 2 receptor adrenergique
side effect of centrally acting adrenergic agonist(4)
somnolence
orthostasis
impotence
rebound HTA
examples of alpha 1 adrenergic blocker(3)
terazocin
prazocin
phenoxybenzamine
mechanism of action of alpha 1 adrenergic blocker
vasodilation by blocking action of norepinephrine on vascular smooth muscle
side effects of alpha 1 adrenergic blocker
orthostasis
side effect of dihydropyridines(3)
headache
flushing
peripheral edema
side effect of verapamil diltiazem
reduced contractility
example of vasodilators(2)
hydralazine
minoxidil
action of vasodilators
decrease peripheral resistance by dilating arteries and arterioles
side effects of hydralazine(2)
headache
lupus like syndrome
side effect od minoxidil(2)
ortstasis
facial hirsutism
side effetc of ARB’s(3)
rashes
leukopenia
hyperkaliemia
HTA and osteoporosis rx
thiazides
BPH and HTA
@ agonists
cause of secondary HTA CHAPS(5)
cushing hyperaldosteronism aortic coarctation pheo stenosis of renal arteries
drug to treat hypertensive emergency or urgency(5)
nitroprusside labetalol nitroglycerin nicardipine hydralazine
cause of renal arteries stenosis in young patient
fibromuscular dysplasia
cause of renal arteries stenosis in elderly
atherosclerosis
why ACE inhibitor is dangerous in bilateral reanl artery stenosis
accelerate kidney failure by preferential vasodilation of the efferent arterioles
rx of renal arteries stenosis(2)
angioplasty
stenting
riis of HTA in OCP use(3)
more than 35
obese
long standing use of OCP
rx of HTA induced by OCP
discontinue OCP
cause of pericarditis CARDIAC RIND
collagen vascular disease aortic dissection radiation drugs infections acute rena failure cardiac rheumatic fever injury neolasms dressler
RISK FACTOR FOR ATHEROSCLEROSIS SAD BET
Sex male Age diabetes BP high Elevated cholesterol Tobacco
virchows triad
endothelial damage
redced blood flow(stasis)
increased coagulability
trousseau syndrome
hypercoagulability caused by malignancy
First cancer involved in trousseau syndrome
adenocarcinoma
cause of secondary HTA(7)
renal disease renal artery stenosis OCP use PHeo conn's syndrome Cushing coarctation
S3 meaning (2)
end of rapid ventricular
filling
associated with dilated
cardiomyopathy