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family medicine EOR exam > cardiology > Flashcards

cardiology Flashcards

1
Q

most frequent cause of diastolic heart failure

A

LVH

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2
Q

NYHA class 1 HF

A

asymptomatic

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3
Q

NYHA class 2 HF

A

symptomatic with mod activity

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4
Q

NYHA class 3 HF

A

symptomatic with mild activity

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5
Q

NYHA class 4 HF

A

symptomatic at rest

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6
Q

most predominant symptoms of L HF

A

dyspnea

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7
Q

most predominant symptoms of R HF

A

signs of fluid retention (edema, hepatic congestion, ascites, loss of appetite)

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8
Q

labs to order for HF

A

CBC, BNP, CXR, ECG, echo

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9
Q

initial pharm treatment of HF

A

diuretic and ACE (mild use HCTZ, severe use lasix. remember GFR must be above 30 to use HCTZ)

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10
Q

side effects of ACE

A

cough, dizziness, hypotension

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11
Q

what do beta blockers do to EF?

A

decrease due to decreasing catecholemines

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12
Q

when is digitalis used for HF?

A

in patients who remain symptomatic when taking diuretics and ACE or in HF and Afib and need rate control

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13
Q

signs of digitalis toxicity

A

anorexia, nausea, HA, blurring or yellowing of vision

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14
Q

what HTN med can accelerate CHF progression?

A

CCB–if have to use one, amplodipine DOC

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15
Q

causes of acute pulmonary edema

A

acute MI, valvular regurg, mitral stenosis, noncardiac causes such as opioids, increased ICP, sepsis, shock, DIC

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16
Q

sxs of pulmonary edema

A

severe dyspnea, pink frothy sputum, diaphoresis, cyanosis. wheezing rales and rhonchi

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17
Q

butterfly pattern of alveolar edema

A

acute pulmonary edema

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18
Q

tx pulmonary edema

A

put in sitting position, oxygen, may need to intubate…morphine 2-8mg IV, IV lasix,

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19
Q

symptoms of paroxysmal SVT

A

may be asymptomatic. rapid heart beat, mild chest pain or SOB.
EKG findings? HR 140-240, regular, P wave can be buried in QRS

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20
Q

causes of Afib

A

pericarditis, chest trauma, cardiac surgery, thyroid disorders, acute alcohol withdrawal, older age

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21
Q

tx of Afib

A

if stable, rate control with BB and anticoagulation. if unstable (shock, hypotension), cardioversion. if fails, give IV ibutilide and try again

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22
Q

BB unsuccessful at rate control for Afib. now what?

A

try CCB (diltiazem)

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23
Q

sawtooth baseline on EKG

A

a flutter

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24
Q

tx a flutter

A

rate control. Amiodarone and dofetilide DOC

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25
Q

premature ventricular beats

A

isolated beats originating from ventricular tissue, sudden death occurs when these are in presence of organic heart disease

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26
Q

tx premature ventricular beats

A

no tx if asymptomatic. bb for symptomatic

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27
Q

v tach

A

defined as run of 3 or more consecutive ventricular premature beats

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28
Q

lab findings in torsades

A

hypokalemia and hypomagnesmia

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29
Q

tx v tach

A

synchronized cardioversion if hypotension, HF, or myocardial ischemia. if patient is tolerating rhythm, use amiodarone or lidocaine

30
Q

V fib treatment

A

cardiover-defibrillator

31
Q

tx first degree AV block

A

none

32
Q

2nd degree AV block AKA mobitz 1

A

progressively lengthening PR interval until beat drops. no tx

33
Q

3rd degree AV block aka mobitz 2

A

multiple P waves per QRS then bradycardia. tx is pacemaker because can turn in to complete block

34
Q

most common cause of secondary htn

A

renal parenchymal disease. others are cushings, genetics, kidney diseases, hyperaldosteronism, pheos, renal artery stenosis

35
Q

JNC 7 HTN category 1

A

bp over 140/90

36
Q

JNC 7 HTN category 2

A

bp over 160/100

37
Q

action of beta blockers

A

decrease HR and CO, decrease renin release

38
Q

BB side effects

A

bronchospasm, AV node depression, raynauds, fatigue, can mask sxs of hypoglycemia

39
Q

CCB action

A

peripheral vasodilation with less reflex tachycardia and fluid retention

40
Q

who are ccb best for?

A

blacks and elderly

41
Q

MOA of alpha antagonists (sins)

A

relax smooth muscle and reduce bp by lowering PVR

42
Q

side effects of alpha antagonists

A

hypotension, palpitations, HA, nervousness

43
Q

what can hydralazine cause?

A

lupus

44
Q

what are good drug combos?

A

Ace and BB, CCB and diuretic. never use CCB and BB together.

45
Q

hypertensive urgencies

A

bp over 220/110

46
Q

tx HTN emergency

A

reduce pressure by no more than 25% then to a level of 160/100 over 2-6 hours using labetalol or nicardipine

47
Q

if HTN caused by pheo or cocaine, what HTN drug needs to be avoided?

A

BB

48
Q

classic sxs of chronic stable angina

A

lasts less than 3 minutes, brought on by exertion and leaves with rest, can be brought on by heavy meal. tightness, squeezing, burning pressing or aching pain

49
Q

management of coronary artery disease

A

LDL goal of

50
Q

symptoms of PVD

A

intermittent claudication (pain on exertion). severe cramping of calf muscles, relieved with rest.

51
Q

workup of PVD

A

doppler, ABI (less than 1 is abnormal), CT angiography

52
Q

pallor, paresthesia, paralysis, pulses, pain

A

acute arterial occlusion

53
Q

systolic ejection murmur that ratiates to the carotids

A

AS

54
Q

AS treatment

A

INR maintained between 2 and 3

55
Q

aortic insufficiency symptoms

A

exertional dyspnea and fatigue, PND or pulmonary edema

56
Q

watter hammer pulse, quincke pulses, head bobbing, high pitched decrescendo murmur

A

aortic regurg

57
Q

AR treatment

A

serially monitor by echo. surgery indicated when LV dysfunction is less than 55%

58
Q

pansystolic murmur heard best at apex and radiates to axilla

A

mitral regurg

59
Q

mid systolic click

A

mitral valve prolapse

60
Q

most likely causative organism of endocarditis

A

subacute–s viridans. staph aureus. late prosthetic valve usually due to strep

61
Q

physical exam findings of endocarditis

A

splinter hemorrhages, petechiae, osler nodes (painful), janeway lesions, roth spots on retina

62
Q

duke criteria for endocarditis

A

2 positive blood cultures, echo showing endocardial involvement, development of murmur

63
Q

complications of endocarditis

A

stroke, myocardial abscesses, peripheral emboli

64
Q

tx of endocarditis

A

vanco plus ceftriaxone. replacement may be required, and anticoagulation is contraindicative in native valve endocarditis b/c of increased risk of intracerebral hemorrhage

65
Q

CI of statin

A

pregnancy, liver disease

66
Q

drug interactions of statins

A

diltiazem and verapamil

67
Q

what do bile acid sequestrants do to LDL and TG?

A

decrease LDL, increase TG

68
Q

what is ezetimibe?

A

cholesterol absorption inhibitor that decreases LDL

69
Q

drugs for hypertriglyceridemia

A

Niacin and fibric acid

70
Q

side effect of fibric acid

A

choleylithiasis, myopathy and liver tox

71
Q

side effects of niacin

A

hyperglycemia and hyperuricemia (avoid in DM and gout) can also cause flushing

family medicine EOR exam (14 decks)

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