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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
What is Levine sign?
clenched fist / teeth to describe anginal pain
26
how long does stable angina last?
< 3 minutes
27
What is the most sensitive clinical sign of angina on EKG
horizontal or downsloping ST segment depression
28
What percent of unstable angina patients will have a normal EKG?
25%
29
What is the most useful and cost effective noninvasive test for angina?
Exercise stress testing
30
What makes the definitive diagnosis for angina?
coronary angiogram
31
What is primary pharmacotherapy for angina
sublingual nitroglycerin
32
what is first line therapy for chronic angina?
beta-blockers
33
what medication prolongs exercise duration and time to angina?
ranolazine
34
what diseases encompass acute coronary syndrome?
- unstable angina - STEMI - NSTEMI
35
what is our primary decision point for patient with chest pain?
EKG
36
What is the rhythm that most people die from?
V-Fib
37
when is an acute MI most likely to present?
early morning
38
What is Dressler's (post-MI) syndrome?
- pericarditis - fever - leukocytosis - pericardial / pleural effusion
39
EKG findings of STEMI?
1mm ST segment elevation in two contiguous leads
40
what EKG finding is highly suspicious of STEMI?
LBBB
41
what are the contraindications to a beta-blocker?
slow hearts weak hearts (CHF) bad pulmonary patients
42
when should aspirin or clopidogrel be used in a patient with STEMI?
immediately
43
name the 4 cyanotic heart anomalies
- tetralogy of fallot - pulmonary atresia - hypoplastic left heart syndrome - transposition of the great vessels
44
name the non-cyanotic heart anomalies
- ASD - VSD - PDA - AV septal defect (as seen in Down Syndrome) - coarctation of aorta
45
most common ASD?
ostium secundum
46
Most common congenital heart anomaly?
VSD
47
how do we treat PDA pharmcologically?
indomethacin
48
how do we keep ductus arteriosus open?
IV prostaglandins E
49
Most common valvular disease?
aortic stenosis
50
Most common presentation of valvular heart disease?
DOE / exercise intolerance
51
What is the definitive method to identify heart structure and functional abnormalities?
Echocardiogram (TTE or TEE)
52
How is the Tetraology of Fallot murmur identified?
crescendo / decrescendo holosystolic at left sternal border that radiates to back
53
What heart defect gives a "machinery murmur"?
PDA
54
How are all regurgitation murmurs identified?
blowing and higher pitch
55
What valvular pathology has an "Austin Flint" murmur
aortic regurgitation
56
What is the most common arrhythmia?
A-fib
57
What is the key principle of treating unstable arrhythmia?
synchronized cardioversion
58
What is the initial treatment for a symptomatic bradyarrhythmia?
Atropine
59
How do we define V Tach?
Three or more PVCs in a row
60
What are the two most common causes of Torsades?
Hypokalemia and Hypomagnesemia
61
Who is Brugada syndrome most often seen in?
Asian population
62
What are the drugs of choice for V Tach?
LAP = Lidocaine, Amiodarone, Procainamide
63
How to treat Torsades?
Magnesium
64
How to treat most patients with sick sinus syndrome?
Pacer
65
What is the most common cardiomyopathy?
Dilated (95% of the cardiomyopathies)
66
What are the physical findings of dilated cardiomyopathy?
S3, JVD, rales
67
What are the physical findings of a hypertrophic cardiomyopathy?
S4 gallop bisferiens carotid pulse jugular venous pulsation with prominent "a" wave
68
Key presenting features of pericarditis?
pain relieved leaning forward and friction rub
69
Most common bugs that cause infectious endocarditis?
Strep Viridians Staph Aureus Enterococci
70
Most common bug for endocarditis in IV drug user?
Staph Aureus
71
Most common bugs that infect heart valve if infection occurs less than 2m after implantation?
Gram Negatives and Fungi
72
4 classic findings of endocarditis?
Roth spots splinter hemorrhages Osler's nodes Janeway lesions
73
Drug of choice for endocarditis prophylaxis?
Amoxicillin
74
Most commonly affected valve in Rheumatic heart disease?
Mitral
75
Major criteria for rheumatic heart disease (Jones criteria)?
``` Carditis Erythema Marginatum Subcutaneous Nodules Chorea Polyarthritis ```
76
What medicaion can provide symptom relief with PVD?
Cilostazol
77
What is recommended to prevent travel-associated DVT?
Frequent ambulation Leg exercises Compression hose
78
Key demographics of temporal arteritis?
Age >50 | Hx of Polymyalgia Rheumatica
79
Signs / symptoms of Giant Cell Arteritis?
unilateral temporal headache scalp tenderness jaw claudication elevated ESR
80
Most common cause of aortic aneurysms?
Atherosclerosis
81
Who is the classic patient with aortic dissection?
Elderly male smoker with COPD, CAD, and renal insufficency
82
Diagnostic test of choice for AAA?
ultrasound
83
Diagnostic test of choice for thoracic aneurysms?
Aortagram

PANRE (18 decks)

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