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Panre > Cardiology > Flashcards

Cardiology Flashcards

0
Q

Murmur associated with Atrial Septal Defect

A

Systolic ejection murmur
Fixed split S2
2nd and 3rd intercostal space

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1
Q

Murmur associated with Tetrology of Fallot

A

Crescendo decrescendo holosystolic along left sternal border radiating to back

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2
Q

Murmur of patent Ductus Arteriosus

A

Machine like with a thrill

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3
Q

Murmur associated with Coarctation of the Aorta

A

Harsh systolic murmur heard in the back

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4
Q

Treatment of Patent Ductus Arteriosus in a neonate

A

NSAIDS, by stopping prostaglandin production(prostaglandins keep the shunt open in utero so blood can bypass the lungs)

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5
Q

Coarctation of the Aorta, key physical exam findings

A

Delayed or weak femoral pulses

Hypertension in upper extremities, hypotension in lower

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6
Q

Treatment of coarctation of the aorta

A

Pts < 50 open surgical repair

Pts > 50 stenting

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7
Q

Mitral valve stenosis physical exam findings

A

Opening snap following S2
Low pitched murmur at the apex
Rales secondary to pulmonary congestion
Tachycardia t

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8
Q

Diagnostic test for Mitral Valve Stenosis

A

ECHO with Doppler

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9
Q

Murmur for mitral valve regurgitation

A

Pansystolic blowing murmur at the apex radiates to axilla

Loud S3

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10
Q

Aortic stenosis murmur

A

Harsh crescendo decrescendo systolic murmur along right sternal border
May radiate to carotids

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11
Q

Orthostasis/Postural hypotension definition

A

Greater than 20mm Hg drop in systolic BP or greater than 10mm Hg drop in diastolic BP between supine and standing measurements

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12
Q

Initial treatment for essential hypertension

A 
Thiazide diuretics
( loop diuretics should be used only in those with renal dysfunction, with close electrolyte monitoring)
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13
Q

What is first line therapy for HTN in those with chronic kidney disease and diabetes?

A

ACE inhibitors, they help preserve kidney function

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14
Q

ACE inhibitor mode of action

A

Inhibit bradykinin degradation and stimulate synthesis of vasodilating prostaglandins

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15
Q

Major side effect of ACE inhibitors

A

Cough

Hyperkalemia is another

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16
Q

Calcium channel blockers are a preferred treatment for HTN in what group of people?

A

Blacks and elderly patients

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17
Q

Treatment for aortic dissection

A

Nitroprusside and B-blocker (labetalol Or esmolol) and urgent surgery

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18
Q

Preferred HTN treatment in pregnancy

A

Hydralazine

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19
Q

Side effects of Beta blockers

A 
Asthma exacerbation 
Bradycardia
Hypoglycemia
Nausea/vomiting
Not to be used for cocaine induced acute coronary syndrome
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20
Q

Thiazides diuretics side effects

A 
Decrease in Na
INCREASE in CA 
Decrease in K
Decrease in Mg
Increase in Uric Acid(think gout)
Increase in glucose (pay attention in the diabetic pt)
21
Q

Losartan

A

Angiotensin Receptor Blocker (ARB)
Reduces vasoconstriction
Reduces aldosterone secretion
Side effects: less cough than ACEI, teratogenicity, hyperkalemia

22
Q

Dressler Syndrome

A 
1-2 weeks post MI:
Pericarditis
Fever
Leukocytosis
Pericardial Effusion
Pleural Effusion
23
Q

Treatment of fibromyalgia

A

Pregabalin (lyrica)
SSRIs, sSNRIs, TCAs
NSAIDS Do NOT help

24
Q

Polymyositis treatment

A

High dose steroids
Methotrexate
Azathioprine

25
Q

Heart failure and ACE inhibitors both cause this common side effect

A

Cough

26
Q

What is pulses alternans?

What condition do you see it in?

A

Alternating strong and weak pulse force

Seen in heart failure

27
Q

What is paradoxical pulse?

What conditions is it seen in?

A

> 10mmHg drop in systolic blood pressure during inspiration

Seen in obstructive lung disease and tamponade

28
Q

What heart conditions cause a reversed split S2 (split during expiration)?

A

LBBB
LVH
AS

29
Q

S4 is best heard in what position?

A

LL decubitus with the bell

It is never heard in a fib

30
Q

Mitral valve prolapse causes what murmur?

A

Midsystolic click

Heard brst at apex and LLSB with diaphragm

31
Q

Most common holosystolic murmurs?

A

Mitral and tricuspid regurgitation

VSD

32
Q

Diastolic rumble is heard in?

A

Mitral stenosis

33
Q

Most common continuous murmur?

A

Patent ductus Arteriosus

“Machinery like”

34
Q

Meds indicated to prevent recurrent ventricular tachycardia

A

Sotalol

Amiodarone

35
Q

Med used during a v tach episode to convert the rhythm

A

Lidocaine

36
Q

Side effects of amiodarone

A

Sinus bradycardia
AV block
Increase in defibrillation threshold

37
Q

Recommended INR before cardioversion

A

1.8 for three weeks

38
Q

Recommended INR for patients with long standing A Fib in which cardioversion has failed?

A

2.0 to 3.0

39
Q

What are the ECG findings associated with Wenckebach heart block?

A

(Type 1 second degree AV block)

Progressive lengthening of the PR interval with a dropped beat

40
Q

Risk factors for metabolic syndrome include

A

Trig >150
BP>130/85
Fasting blood sugar>110
Abdominal girth >35 in women and >40 in men

41
Q

Treatment of unstable bradycardia

A

Vagolytic (atropine)
Positive chronotropic (epinephrine or dopamine)
Transcutaneous pacing may be indicated

42
Q

Treatment of unstable tachycardia

A

Synchronized cardioversion

May also need anti arrhythmic therapy: amiodarone, B Blocker, lidocaine

43
Q

A regular narrow complex tachycardia is usually from AV node (such as PSVT). What is the treatment?

A

Adenosine via rapid IV push

44
Q

Treatment of A flutter in an unstable patient

A

Electric cardioversion

45
Q

Treatment of A flutter in a stable patient

A

First, anticoagulate with heparin, enoxaparin or warfarin

Next, control rate with B Blocker, metoprolol or esmolol ( or diltiazem or verapamil)
Then, cardioversion

46
Q

What anti arrhythmic drug is first line for chronic A flutter?

A

Dofetilide

47
Q

What is Brugada syndrome?

A

A genetic disorder causing syncope, v fib, and sudden death often during sleep.
Asian men

48
Q

What are the preferred drugs for acute V tach

A

Amiodarone
Lidocaine
Procainamide

49
Q

Treatment of torsades de pointes?

A

IV magnesium
Correct electrolyte abnormalities (hypomagnesemia or hypokalemia)
Withdrawal of drugs that may have caused it
Isoproterenol infusion and override pacing may then be necessary

50
Q

What is first degree heart block

A

All atrial beats are conducted to ventricles, but PR interval is greater than .21 seconds

Panre (2 decks)

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