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PANCE Review > Cardiology > Flashcards

Cardiology Flashcards

1
Q

ejection fraction will remain normal in _____ heart failure Decreased ejection fraction usually less than 50% in ____ heart failure

A

diastolic systolic

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2
Q

most common etiology of heart fialure is ____

A

coronary artery disease.

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3
Q

MC presenting sxs of heart failure are ____ and ____

A

fatigue, SOB

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4
Q

dx exams for heart failure

A

ECG: arrhythmia, Q waves, ischemia, LVH stress test: assess exercise tolerance and risk stratification.

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5
Q

When do you order a CXR for a pt with heart failure?

A

to evaluation of dyspnea & rule out other etiologies of SOB (not to diagnose CHF).

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6
Q

what meds lower mortility in pts with HF?

A

ACE/ARBs (Ivabradine and Sacubitril-valsartan) BBs (carvedilol, bisoprolol, and metoprolol succinate)

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7
Q

What medications can you give to reduce sxs in heart failure?

A

Diuretics: fluid overload Digoxin: SOB

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8
Q

___ is used when the ejection fraction is below 35% in a pt with HF, those with sustained VT, and/or those with un-explained syncope to prevent a fatal arrhythmia.

A

ICD

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9
Q

Work up for pt in acute exacerbation of HF

A

ECHO ECG: arrhythmias, MI. BNP: distinguish btCHF exacerbation and COPD exacerbation as the cause of dyspnea. Cardiac enzymes: rule out MI

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10
Q

Treatment for acute exacerbation of CHF

A

LMNOP Loop diuretics Morphine Nitrates Oxygen Position (head up)/positive pressure

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11
Q

____ is a disease of the heart muscle associated with cardiac dysfunction that usually has no etiology

A

cardiomyopathy

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12
Q

what are the 3 types of cardiomyopathy

A

Dilated Restrictive Hypertrophic

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13
Q

what dx test is used to differentiate bt Dilated, Restrictive, Hypertrophic cardiomyopathy

A

echocardiogram

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14
Q

what is the only way to definitively dx restrictive cardiomyopathy?

A

biopsy

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15
Q

what is the tx of dilated cardiomyopathy?

A

same as CHF

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16
Q

what is the tx of hypertrophic cardiomyopathy?

A

BB, CCB ** no diuretics!

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17
Q

This heart defect is described as a systolic ejection murmur with a fixed wide splitting of S2

A

atrial septal defect

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18
Q

What may cause the The ductus arteriosus is kept open?

A

low oxygen environment prostaglandins.

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19
Q

machine like continuous murmur describes what heart defect?

A

PATENT DUCTUS ARTERIOSUS

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20
Q

what are the 4 components of tetralogy of fallot?

A

Right ventricular hypertrophy VSD Overriding aorta Right ventricular outflow obstruction

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21
Q

___ is a heart defect that sounds like a holosystolic murmur is heard that does not increase with respiration.

A

VSD

22
Q

how do you dx HTN?

A

elevated BP >140/90 on two separate occasions

23
Q

MC cause of secondary HTN

A

renal disease

24
Q

what labs should be ordered upon HTN dx

A

urine analysis urine micro albumin EKG CBC BMP lipid panel

25
Q

What PE findings should you look for in a pt newly dx with HTN?

A

fundoscopy (hemorrhage or papilledema) thyroid assessment carotid bruit size and rhythm of heart crackles in lungs renal bruit pedal edema confusion or weak-ness

26
Q

HTN tx for a pt w/ DM

A

ACE/ARB

27
Q

HTN tx for a pt w/ CHF/Ischemia/CAD?

A

Beta blocker or ACE/ARB

28
Q

HTN tx for a pt w/ Angina

A

Beta blocker or calcium channel blocker

29
Q

HTN tx for a pt w/ BPH

A

Alpha blocker

30
Q

HTN tx for a pt w/ Hyperthyroid

A

Beta blocker

31
Q

HTN tx for a pt w/ CKD?

A

ACE/ARB

32
Q

HTN tx for a pt w/ Raynaud’s syndrome?

A

Calcium channel blocker

33
Q

HTN tx for a pt w/ Migraine?

A

Beta blocker or calcium channel blocker

34
Q

____ is hypertension that is not responsive to at least three medications, one of which must include a diuretic.

A

Resistant hypertension

35
Q

Common causes of secondary HTN?

A

Renal artery stenosis Hyperaldosteronism Primary kidney disease Pheochromocytoma Cushing’s disease Sleep apnea Coarctation of aorta

36
Q

___ is Severely elevated HTN is considered to occur when the systolic is over 180 and/or when the diastolic is over 120, patient is asymptomatic and no end organ damage.

A

HYPERTENSIVE URGENCY

37
Q

as a rule of thumb, how much should you drop BP by in hypertensive urgency?

A

lower pressure no more than 30% in the first few hours reduce over 1-2 days

38
Q

__ is Severely elevated hypertension usually over 180/120 with end organ damage

A

HYPERTENSIVE EMERGENCY

39
Q

what are two main consequences of hypertensive emergency?

A

malignant hypertension hypertensive encephalopathy

40
Q

what are s/s of Malignant hypertension due to hypertensive emergency?

A

papilledema exudates retinal hemorrhage acute kidney injury (hematuria or proteinuria) and/or focal neurological findings.

41
Q

what are s/s of Encephalopathy due to hypertensive emergency?

A

cerebral edema: Headache, N/V, confusion, seizure, coma.

42
Q

dx tests of pts w/ hypertensive emergency?

A

EKG, CXR, UA, serum creatinine, and cardiac enzymes (is MI suspected)

43
Q

____ is a state characterized by decreased perfusion and decreased oxygenation of tissues.

A

Shock

44
Q

___ shock stems from the heart not being able to pump normally.

A

Cardiogenic

45
Q

MC cause of Cardiogenic shock?

A

MI

46
Q

Tx of cardiogenic shock

A

aggressive fluid resuscitation (careful!) pressors (norepinephrine or dopamine) balloon-tipped pulmonary artery (Swan-Ganz) catheter

47
Q

Common etiology of orthostatic hypothension

A

Medications hypovolemia anemia heart disease diabetes Parkinson’s disease.

48
Q

how is orthostatic hypothension dx?

A

The diagnosis is made if the systolic blood pressure falls 20mmHg or if the diastolic falls 10mmHg or more when going from laying to stanging positions

49
Q

tx for orthostatic hypotension

A
  1. Treat the underlying etiology. 2. Arise slowly from supine to seated to standing 3. increase fluid and sodium intake. 4. If no response, give fludrocortisone (mineralo-corticoid) as first line medical therapy.
50
Q
A

PANCE Review (2 decks)

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