Cardiology Flashcards
coronary artery most common site of occlusion
LAD
occlusion of LAD EKG leads
V1-V4
MAP equation
(2/3)DBP + (1/3)SBP
Biggest risk factor for AAA
smoking
lipid lowering agent with SE flushing
niacin
lipid lowering agent with SE elevated LFTs, myositis
statin, fibrates
lipid lowering agent with SE GI discomfort, bad taste
bile acid sequestrants
lipid lowering agent with best effect on HDL
niacin
lipid lowering agent with best effect on triglycerides
fibrates
lipid lowering agent with best effect on LDL/cholesterol
statin
lipid lowering agent which binds c diff toxin
cholestyramine
NTG function acutely in cardiac ischemic episode
peripheral venous dilation, decreased preload and work of heart
mechanism of action of streptokinase
converts plasminogen to plasmin
mechanism of action of aspirin
cox 1 and cox 2 inhibitor
mechanism of action of clopidogrel
ADP receptor blocker
mechanism of action of abciximab
GP2b/3a inhibitor
mechanism of action of tirofiban
Gp2b/3a inhibitor
mechanism of action of ticlopidine
ADP receptor blocker
mechanism of action of enoxaparin
antithrombin 3 activation
mechanism of action of eptifibatide
Gp2b/3a inhibitor
most common cause of death in patients with acute MI
cardiac arrhythmias
drug of choice in PSVT
adenosine
endocrine disorder that causes afib
hyperthyroid
antiarrhythmic drug avoided in patients with preexisting lung disease
amiodarone
tx of sustained v tach
cardioversion
nl range for ejection fraction
55-75%
outpatient tx for chronic CHF
ACEI/ARB
loop diuretics
aldo ant
beta blockers
dig
tx for acute exacerbations of CHF
NO LIP
nitrates, o2, loop diuretics, inotropic agents, positioning
triptans are contraindicated in:
CAD, prinzmetal angina, pregnancy, sulfa drugs
diastolic murmur best heard at left lower sternum that increases inspiration
tricuspid stenosis
late diastolic murmur with an opening snap (no change with inspiration)
mitral stenosis
systolic murmur best heard in second right interspace, parasternal
aortic stenosis
systolic murmur best heard in second left interspace, parasternal
pulmonic stenosis
late systolic murmur best heard at apex
MVP
diastolic murmur with a widened pulse pressure
aortic regurgitation
holosystolic murmur at the left lower sternum that is louder with inspiration
tricuspid regurgitation
holosystolic murmur heard at the apex and radiates to the axilla
mitral regurgitation
disease with heart failure, DM, elevated LFTs
hemochromatosis
most common viruses that cause myocarditis
coxsackie, echo, adeno, EBV, CMV, influ
major Jones criteria for acute rheumatic fever
JONES
joints pancarditis, valvular dx nodules erythema marginatum sydenham chorea
describe janeway lesion, osler node, roth spots, splinter hemorrhages
janeway - painless petechia on palmar surfaces
osler - painful petechia on pads fingers/toes
roth - retinal hemorrhages
splinter hemorrhages - hemorrhages under nails
most common cause of secondary HTN
renal disease
H causes of pulseless electrical activity
hypoxemia hypoglycemia hypothermia hypovolemia H+ hyper/hypo K
first line antiHTN with pt with diabetes
ACEI/ARB
first line antiHTN with pt with heart failure
beta blocker, ACEi/arb, aldo ant
first line antiHTN with pt with BPH
alpha blocker
first line antiHTN with pt with LVH
ACEI/ARB
first line antiHTN with pt with hyperthyroidism
beta blocker
first line antiHTN with pt with osteoporosis
thiazide
first line antiHTN with pt with benign essential tremor
beta blocker
first line antiHTN with pt with postmenopausal woman
thiazide
first line antiHTN with pt with migraines
beta blocker
antiHTN drug with SE first dose orthostatic hypotension
alpha blocker
antiHTN drug with SE hypertrichosis
minoxidil
antiHTN drug with SE dry mouth, sedation, severe rebound HTN
clonidine
antiHTN drug with SE bradycardia, impotence, asthma exacerbation
beta blocker
antiHTN drug with SE reflex tachy
vasodilators
antiHTN drug with SE cough
ACEI
antiHTN drug with SE avoid in patients with sulfa allergy
thiazide and loop
antiHTN drug with SE angioedema
ACEI
antiHTN drug with SE development of drug induced lupus
hydralazine
antiHTN drug with SE cyanide tox
nitroprusside
beck’s triad for cardiac tamponade
decreased BP, distant heart sounds, JVD
hypoperfusion and tissue ischemia can lead to what chemical marker abnormality
lactic acid
complications can arise from use of vasopressors such as NE in treating shock
ischemia/necrosis of fingers/toes
mesenteric ischemia
renal failure
adverse effects of statin use
lab changes
myositis and hepatotoxicity
CPK, LFTs
shock causing decreased CO, decreased PCWP, decreased peripheral vascular resistance
anaphylactic or neurogenic shock
antiHTN drug with SE increased intracranial pressure
nitroprusside
next step in management of pt with DVT with high likelihood of falling
IVC filter
preferred placement of swan ganz catheter
right IJ and left subclavian
vasculitis with weak pulses in upper extremities
takayasu
vasculitis with necrotizing immune complex inflammation of visceral/renal vessels
PAN
vasculitis with young male smokers
thromboangiitis obliterans
vasculitis with young asian women
takayasu
vasculitis with young asthmatics
eosinophilic granulomatosis with polyangitis
vasculitis with infants and young children, involving coronary
kawasaki
vasculitis with most common vasculitis
temporal arteritis
vasculitis with associated hep B infection
PAN
vasculitis with occlusion of opthalmic arteryt leading to bliondness, unilateral HA, jaw claudication
temporarl arteritis
what structure of fetal circulation closes after birth
ductus venosus, foramen ovale, ductus arterosus, umb vein, umb artery (2)
most common congenital heart defect
VSD
five cyanotic congenital heart defects
persistent truncus arteriosus
transposition of great vessels
tricuspid atresia
tetralogy of fallot
TAPVR
abnormalities associated with tetralogy of Fallot
IHOP
interventricular septal defect (VSD)
RVH
Overriding aorta
pulmnoic stenosis
fall in systolic BP of > 10 mmHg with inspiration indicates?
pulsus paradoxus
what causes a short systolic murmur at the cardiac apex that decreases with squatting and is sometimes associated with benign CP that lasts only a few seconds?
MVP
which etiology of restrictive cardiomyopathy is pathology reversible with phlebotomy?
hemochromatosis
vasodilating effects of NTG
venous dilation
vasodilating effects of DHP CCB
dilates veins and arteries
vasodilating effects of hydralazine
dilates arteries
vasodilating effects of nitroprusside
dilates veins and arteries
antihypertensive contraindicated in patients with COPD
non selective beta blockers
antihypertensive contraindicated in patients with bilateral renal artery stenosis
ACEI/ARBs
antihypertensive contraindicated in patients with pregnancy
ACEI/ARBs
antihypertensive contraindicated in patients with advanced renal failure
ACEI/ARBs
antihypertensive contraindicated in patients with gout
thiazide and loop diuretic
most common cause of hypertension in young women
OCPs
heart defect associated with chromosome 22q11 deletion
tetralogy of fallot, truncus arteriosus
heart defect associated with trisomy 21
endocardial cushion, tet, PDA
heart defect associated with congenital rubella
PDA, pul, artery stenosis
heart defect associated with turner syndrome
coarctation of the aorta
heart defect associated with marfan syndrome
aortic regurg
medical management of peripheral artery disease
smoking cessation, exercise, glucose control, diet, BP control, cilostazol
antihypertensive class used for patient with DM
ACEI/ARB
antihypertensive class used for patient with heart failure
beta blockers, ACEI/ARB, aldo antagonist
antihypertensive class used for patient with BPH
alpha blocker
antihypertensive class used for patient with LVH
ACEI/ARB
antihypertensive class used for patient with hyperthyroidism
beta blocker
antihypertensive class used for patient with osteoporosis
thiazide
antihypertensive class used for patient with essential tremor
beta blocker
antihypertensive class used for patient with migraines
CCB or beta blocker
smoker has rapid onset JVD, facial swelling, and AMS. What is the dx and treatment?
superior vena cava syndrome
tx: steroids, endovascular stent, emergency radiation therapy
antihypertensive with side effect first dose orthostatic hypotension
alpha blocker
antihypertensive with side effect hypertrichosis
minoxidil
antihypertensive with side effect dry mouth, sedation, severe rebound HTN
clonidine
antihypertensive with side effect bradycardia, impotence, asthma exacerbation
beta blocker
antihypertensive with side effect reflex tachy
vasodilators
antihypertensive with side effect cough
ACEI
antihypertensive with side effect avoid in patients with sulfa allergy
loop diuretics
antihypertensive with side effect angioedema
ACEI
antihypertensive with side effect development of drug induced lupus
hydralazine
antihypertensive with side effect cyanide toxicity
sodium nitroprusside
classic findings of HSP?
palpable purpura on lower extremities
GI sx
Renal dx
transient arthritis/arthralgia
Most likely cause of aortic stenosis in a 50 year old patient?
congenital bicuspid aortic valve
Type of heart murmur that diastolic murmur heard best in left lower sternum that increases with inspiration
tricuspid stenosis
Type of heart murmur that late diastolic murmur with an opening snap (no change with inspiration)
mitral stenosis
Type of heart murmur that systolic murmur heard best in the second right interspace
aortic stenosis
Type of heart murmur that systolic murmur heard best in second left interspace
pulmonic stenosis
Type of heart murmur that late systolic murmur heard best at the apex
mitral valve prolapse
Type of heart murmur that diastolic murmur with a widened pulse pressure
aortic regurg
Type of heart murmur that holosystolic murmur that is louder with inspiration at the left lower sternum
tricuspid regurg
Type of heart murmur that holosystolic murmur heard at the apex and radiates to the axilla
mitral regurg
JONES criteria for rheumatic fever?
JONES
joints endocarditis nodules erythema marginatum sydenham chorea
IV drug user has JVD and a holosystolic murmur at the left sternal border. What is the diagnosis? What is the treatment?
tricuspid regurg
vanc, heart failure tx, replace valve
