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PANCE/EOC > Cardiology #4 > Flashcards

Cardiology #4 Flashcards

1
Q

Best initial test for AAA

A

CT scan with IV contrast

(For those who are symptomatic, hemodynamically stable) to get size, presence, and extent

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2
Q

What is the recommendation for screening for AAA?

A

One-time screening via abdominal US in men 65-75 years of age who have ever smoked

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3
Q

What is the pathophysiology of AAA?

A

Proteolytic degeneration of aortic wall and connective tissue inflammation

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4
Q

Risk Factors for AAA

A
  • Smoking
  • Age > 60
  • Men
  • Caucasians
  • Connective tissue disorder (Marfan)
  • Hypertension
  • Syphilis
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5
Q

If a patient has DM or CKD and hypertension, what medications are recommended?

A

ACEi, ARB

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6
Q

Hypertensive medications to use in AA?

A

Thiazides, CCB

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7
Q

Name some CCBs

A
  • Amlodipine
  • Diltiazem
  • Verapamil
  • Nicardipine
  • Nifedipine
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8
Q

Name some ARBs

A
  • Losartan
  • Olmesartan
  • Valsartan
  • Telmisartan
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9
Q

With gout, what medications should be used in hypertension?

A

CCB

-Losartan is the only ARB that doesn’t cause hyperuricemia

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10
Q

If a patient has Raynaud’s, what hypertensive medication should also be used?

A

CCB

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11
Q

What hypertensive medications are likely to help A-fib?

A

BB, CCB

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12
Q

If a patient has hypertension and depression, what medications should be avoided?

A

BB

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13
Q

What is the treatment for a hypertensive urgency?

A

Clonidine

Captopril

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14
Q

However, with Clonidine, what is an adverse effect?

A

Rebound hypertension if discontinued abruptly (mimics Pheochromocytoma)

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15
Q

What are some examples of end-organ damage with hypertensive emergency?

A
  • General: headache, dyspnea, AMS, n/v
  • Neurologic: stroke, seizure
  • Cardiac: Aortic dissection, acute heart failure
  • Renal: acute kidney injury, hematuria
  • Retinal: malignant hypertension, retinopathy
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16
Q

Adenosine MOA

A

-Slows AV node conduction time and blocks AV nodal reentry pathways

17
Q

Amiodarone MOA

A
  • Class III anti arrhythmic (K+ channel blocker) with class I through IV properties
  • Prolongs action potential
18
Q

Common side effect of Loop Diuretics (Furosemide)

A

Ototoxicity

19
Q

What loop diuretic do you use in sulfa allergy or history of gout?

A

Ethacrynic Acid

20
Q

What is one common side effect of Spironolactone?

A

Gynecomastia

21
Q

What two drug classes should you NOT use in pregnancy?

A

ACE and ARB

22
Q

Regarding CCB, what three endings should you look for to determine if a medication belongs to this class?

A

ZEM, PINE, MIL

23
Q

Regarding CCB, what two drugs are NON-dihydropyridines and what is the MOA?

A

Verapamil, Diltiazem

Vasodilation and slow conduction through AV node leading to decreased cardiac conduction and contractility

24
Q

Two major adverse reactions to CCB

A

Peripheral edema
Constipation
Headache

25
Q

When should you NOT use CCB?

A
  • Patients with LV dysfunction and CHF
  • Patients with 2nd or 3rd degree heart block
  • Patients taking BB (do not double up on decreasing contractility of the heart)
26
Q

What are the cardio selective BB? (They only affect Beta-1 receptors)

A

BEAM

Bispoprolol
Esmolol
Atenolol
Metoprolol

27
Q

What is true about Nonselective BB?

A

They affect Beta-2 receptors in the lungs and should be avoided in patients with COPD, asthma, etc.

28
Q

Side effects of BB

A
  • Can make the symptoms of hyperglycemia

- Fatigue, Impotence, Depression

29
Q

What is Eisenmenger Syndrome?

A

Pulmonary HTN and cyanotic heart disease occurring when a left-to-right shunt switches and becomes a right-to-left shunt (cyanotic).

-Patients develop cyanotic lower extremities, cyanosis and clubbing of the feet

30
Q

What is the MC innocent physiologic murmur?

A

Still Murmur

31
Q

Describe a Still Murmur

A

Musical, vibratory, noisy, twanging best heard in inferior aspect of the LLSB and apex

32
Q

What is Tricuspid Atresia?

A

Absence of tricuspid valve leads to hypoplastic right ventricle

-A PDA or VSD is necessary for pulmonary blood flow and survival

33
Q

What does a CXR show with tricuspid atresia?

A

Normal or enlarged cardiac silhouette with DECREASED pulmonary flow

34
Q

Treatment for Tricuspid Atresia

A
  • Maintain patency of ductus arteriosus (prostaglandin E1 Alprostadil) to stabilize initially
  • Surgical repair is definitive
35
Q

MCC of subacute endocarditis

A

Strep Viridans

PANCE/EOC (63 decks)

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