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PANRE > Cardiology > Flashcards

Cardiology Flashcards

1
Q

which two acute coronary syndromes are treated the same?

A

NSTEMI and unstable

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2
Q

what is the most common cause of shock?

A

gram negative sepsis

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3
Q

what lab can identify and monitor sepsis?

A

serum lactate

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4
Q

how should urine output be monitored in a patient with shock?

A

indwelling catheter - urine output should be 0.5mL / kg / hour

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5
Q

how long should it take to lower BP in a patient with a HTN URGENCY?

A

hours

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6
Q

how long should it take to lower BP in a patient with a HTN EMERGENCY?

A

one hour

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7
Q

what are the findings of malignant HTN?

A
  • papilledema
  • encephalopathy
  • renal failure
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8
Q

what is the most common symptom of HTN?

A

headache

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9
Q

what is the recommended first agent for HTN?

A

diuretic

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10
Q

what diuretic should be used in patients with renal disease?

A

loop diuretics

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11
Q

In which patients are beta-blockers most effective?

A

younger / caucasian

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12
Q

What is the initial drug of choice in a diabetic patient with HTN?

A

ACEI

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13
Q

What is the major side effect of ACEI?

A

cough

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14
Q

What is the preferred agent for HTN in blacks and elderly?

A

calcium channel blocker

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15
Q

What medications are recommended for HTN in aortic dissection?

A

nitroprusside and beta-blockers

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16
Q

What is the HTN med of choice in a pregnant patient?

A

hydralazine

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17
Q

What are cardiac signs of CHF?

A
  • enlarged heart
  • diminished first heart sound
  • S3
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18
Q

What is most useful image with CHF?

A

Echocardiogram

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19
Q

What two meds prolong lives of patients with CHF?

A

ACEI and BB

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20
Q

When is an implantable cardiac defibrillator indicated in a CHF patient?

A

EF < 35%

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21
Q

What is the most common cause of cardiovascular death and disability?

A

Atherosclerosis

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22
Q

What are the risk factors for arterial disease?

A 
Smoking
Age (M > 55, F > 65)
DM
Cholesterol
HTN
Family Hx
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23
Q

Three kinds of angina?

A

Stable
Unstable
Prinzmetal

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24
Q

Most common presentation of unstable angina?

A

chest pain at rest

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25
Q

What is Levine sign?

A

clenched fist / teeth to describe anginal pain

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26
Q

how long does stable angina last?

A

< 3 minutes

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27
Q

What is the most sensitive clinical sign of angina on EKG

A

horizontal or downsloping ST segment depression

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28
Q

What percent of unstable angina patients will have a normal EKG?

A

25%

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29
Q

What is the most useful and cost effective noninvasive test for angina?

A

Exercise stress testing

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30
Q

What makes the definitive diagnosis for angina?

A

coronary angiogram

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31
Q

What is primary pharmacotherapy for angina

A

sublingual nitroglycerin

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32
Q

what is first line therapy for chronic angina?

A

beta-blockers

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33
Q

what medication prolongs exercise duration and time to angina?

A

ranolazine

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34
Q

what diseases encompass acute coronary syndrome?

A
  • unstable angina
  • STEMI
  • NSTEMI
35
Q

what is our primary decision point for patient with chest pain?

36
Q

What is the rhythm that most people die from?

37
Q

when is an acute MI most likely to present?

A

early morning

38
Q

What is Dressler’s (post-MI) syndrome?

A
  • pericarditis
  • fever
  • leukocytosis
  • pericardial / pleural effusion
39
Q

EKG findings of STEMI?

A

1mm ST segment elevation in two contiguous leads

40
Q

what EKG finding is highly suspicious of STEMI?

41
Q

what are the contraindications to a beta-blocker?

A

slow hearts
weak hearts (CHF)
bad pulmonary patients

42
Q

when should aspirin or clopidogrel be used in a patient with STEMI?

A

immediately

43
Q

name the 4 cyanotic heart anomalies

A
  • tetralogy of fallot
  • pulmonary atresia
  • hypoplastic left heart syndrome
  • transposition of the great vessels
44
Q

name the non-cyanotic heart anomalies

A
  • ASD
  • VSD
  • PDA
  • AV septal defect (as seen in Down Syndrome)
  • coarctation of aorta
45
Q

most common ASD?

A

ostium secundum

46
Q

Most common congenital heart anomaly?

47
Q

how do we treat PDA pharmcologically?

A

indomethacin

48
Q

how do we keep ductus arteriosus open?

A

IV prostaglandins E

49
Q

Most common valvular disease?

A

aortic stenosis

50
Q

Most common presentation of valvular heart disease?

A

DOE / exercise intolerance

51
Q

What is the definitive method to identify heart structure and functional abnormalities?

A

Echocardiogram (TTE or TEE)

52
Q

How is the Tetraology of Fallot murmur identified?

A

crescendo / decrescendo holosystolic at left sternal border that radiates to back

53
Q

What heart defect gives a “machinery murmur”?

54
Q

How are all regurgitation murmurs identified?

A

blowing and higher pitch

55
Q

What valvular pathology has an “Austin Flint” murmur

A

aortic regurgitation

56
Q

What is the most common arrhythmia?

57
Q

What is the key principle of treating unstable arrhythmia?

A

synchronized cardioversion

58
Q

What is the initial treatment for a symptomatic bradyarrhythmia?

59
Q

How do we define V Tach?

A

Three or more PVCs in a row

60
Q

What are the two most common causes of Torsades?

A

Hypokalemia and Hypomagnesemia

61
Q

Who is Brugada syndrome most often seen in?

A

Asian population

62
Q

What are the drugs of choice for V Tach?

A

LAP = Lidocaine, Amiodarone, Procainamide

63
Q

How to treat Torsades?

64
Q

How to treat most patients with sick sinus syndrome?

65
Q

What is the most common cardiomyopathy?

A

Dilated (95% of the cardiomyopathies)

66
Q

What are the physical findings of dilated cardiomyopathy?

A

S3, JVD, rales

67
Q

What are the physical findings of a hypertrophic cardiomyopathy?

A

S4 gallop
bisferiens carotid pulse
jugular venous pulsation with prominent “a” wave

68
Q

Key presenting features of pericarditis?

A

pain relieved leaning forward and friction rub

69
Q

Most common bugs that cause infectious endocarditis?

A

Strep Viridians
Staph Aureus
Enterococci

70
Q

Most common bug for endocarditis in IV drug user?

A

Staph Aureus

71
Q

Most common bugs that infect heart valve if infection occurs less than 2m after implantation?

A

Gram Negatives and Fungi

72
Q

4 classic findings of endocarditis?

A

Roth spots
splinter hemorrhages
Osler’s nodes
Janeway lesions

73
Q

Drug of choice for endocarditis prophylaxis?

A

Amoxicillin

74
Q

Most commonly affected valve in Rheumatic heart disease?

75
Q

Major criteria for rheumatic heart disease (Jones criteria)?

A 
Carditis
Erythema Marginatum
Subcutaneous Nodules
Chorea
Polyarthritis
76
Q

What medicaion can provide symptom relief with PVD?

A

Cilostazol

77
Q

What is recommended to prevent travel-associated DVT?

A

Frequent ambulation
Leg exercises
Compression hose

78
Q

Key demographics of temporal arteritis?

A

Age >50

Hx of Polymyalgia Rheumatica

79
Q

Signs / symptoms of Giant Cell Arteritis?

A

unilateral temporal headache
scalp tenderness
jaw claudication
elevated ESR

80
Q

Most common cause of aortic aneurysms?

A

Atherosclerosis

81
Q

Who is the classic patient with aortic dissection?

A

Elderly male smoker with COPD, CAD, and renal insufficency

82
Q

Diagnostic test of choice for AAA?

A

ultrasound

83
Q

Diagnostic test of choice for thoracic aneurysms?

PANRE (18 decks)

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