Cardiology Flashcards
Why do patients with ASD have a fixed split S2?
Prolonged RV ejection
What causes pulsus bigemonus?
Electrolyte imbalance e.g. hypo or hyperkalemia Hypothyroidism Beta-blocker therapy Digoxin Myocardial infarction
What anti-arrhythmic causes neonatal goitre and hypothyroidism?
Amiodarone
What drugs cause QT prolongation?
a) Fluroquinolones, macrolides, TMP/SMX
b) Azoles
c) TCA
d) Haloperidol, risperidone, chlorpromazine
e) qunidine, procainamide, amiodarone
f) lasix
g) glyburide
What causes a wide split S2?
- ASD
- PS
- Ebstein anomaly
- TAPVR
- RBBB
What causes a single S2?
- Pulmonary atresia
- Aortic atresia
- Severe PS
- Severe AS
- Truncus arteriosus
- TGA
What is the first line therapy for familial hypercholesterolemia?
12m of lifestyle therapy, then statin
Which murmurs disappear when lying flat?
- Venous hum
2. Still’s murmur
What is the murmur for ASD?
SEM over LSB
Fixed widely split S2
Diastolic rumble
What is a vein of Galen malformation?
Large intracranial AV fistula in newborn infants
- CHF
- Seizures
- Hydrocephalus
What are the EKG features of LVH?
- Depression of ST segments V5, V6, V7
- Inversion of T waves in V5, V6, V7
- deep Q waves in left precordial leads
- increased voltage of S wave in V3 R and V1 or the R wave in V6-V7 or both
What EKG finding is classic for hypothermia?
Osborn waves (upward deflections)
How many shocks can be given if the patient’s T <30?
3
When can meds be given in a patient with hypothermic cardiac arrest?
T>30
What are the SE of PGE?
- Apnea
- Bradycardia
- Hypotension
- Flushing
- Fever
- Hyperthermia
What are the SE of indomethacin?
- Oliguria/altered renal function
- Platelet dysfunction
- NEC
- GI perf
- Electrolyte abn: hyperK, hypoNa
What are clinical signs of endocarditis?
- New or changing heart murmur
- Splenomegaly in >40%
- Dental caries or gingivitis often present
- Petechia, Osler nodes, splinter hemorrhages, Janeway lesions
- Roth spots
What are causes of cyanotic congenital heart disease with decreased pulmonary blood flow?
- Tetralogy of Fallot w/ Pulmonary atresia
- Pulmonary atresia w/ intact ventricular septum
- Tricuspid atresia
- Double outlet right ventricle
- Transposition of the great arteries w/ VSD and pulmonary stenosis
- Ebstein anomaly of the tricuspid valve
