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PGY-3 and 4 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Elevated BP in Kids less than 13

A
  • 90th percentile to less than 95th percentile
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2
Q

Elevated BP in Kids more than 13

A

120-129/80

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3
Q

Stage 1 HTN in Kids less than 13

A
  • 95th percentile to 95 + 12 mmHg
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4
Q

Stage 1 HTN in Kids more than 13

A

130/80 to 139/89

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5
Q

Stage 2 HTN in Kids less than 13

A
  • 95th percentile + 12 or more
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6
Q

Stage 2 HTN in Kids more than 13

A

more than 140/90

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7
Q

ASDs- murmur

A

mid-systolic murmur in pulmonary area (similar to pulm stenosis)
fixed split S2 (delayed closure of pulm valve)
diastolic murmur at LLSB (tricuspid valve)

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8
Q

ASDs and typical age for closure

A

3-4

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9
Q

ASD closure in adults

A

Right sided heart dilation
symptoms of dyspnea
Qp:Qs >1.5:1

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10
Q

ASD differential

A

isolated anomalous pulmonary venous connection (looks identical on TTE)

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11
Q

Worrisome about ASD In adults??

A

paradoxical embolism

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12
Q

Risk of ASD, including when closed…

A

atrial fibrillation

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13
Q

VSD murmur

A

pansystolic over LLSB

can have mid diastolic rumble at apex (across mitral valve)

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14
Q

VSD size

A

related to AV area

small is 1/3, moderate 1/3 to 2/3, large is >2/3

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15
Q

Pulmonary Stenosis Murmur

A

SEM

Click (mild or moderate stenosis) at LLSB or LUSB, louder with exhalation

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16
Q

Diagnosis of Pericarditis (MKSAP)

A

2 of the following

  • typical chest pain
  • pericardial friction rub
  • EKG findings
  • pericardial effusion
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17
Q

Coarctation of Aorta - classic findings

A

HTN in upper extremities
radial to femoral artery delay
rib notching on x-ray

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18
Q

Tetralogy of Fallot

A

VSD
Overriding aortic arch
RV outflow obstruction (pulmonary stenosis)
RVH

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19
Q

Pulm HTN Group 1

A

pulmonary arterial HTN

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20
Q

Pulm HTN Group 2

A

Left heart disease

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21
Q

Pulm HTN Group 3

A

Lung disease and/or hypoxia

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22
Q

Pulm HTN Group 4

A

Chronic thromboemobolic pulm HTN

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23
Q

Pulm HTN Group 5

A

Multifactorial

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24
Q

Aortic Stenosis related bleeding diathesis

A

acquired von Willebrand syndrome

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25
Q

Further evaluation for patients with WPW

A

stress test

normalization of QRS indicates low risk for SCD

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26
Q

AE ticagrelor

A

dyspnea

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27
Q

P2Y12 Blockers in STEMI

A

PCI- ticagrelor (brilinta) or prasugrel (effient)
Fibrinolytics- clopidogrel
No intervention- ticagrelor

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28
Q

normal capillary wedge pressure

A

8-12 mmHg

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29
Q

Elevated JVP

A

3-4 cm above sternal angle

or 7-8 above RA

30
Q

Hypoplastic Left Heart Syndrome - Features

A

underdeveloped left ventricle
underdeveloped aorta
PDA dependent
ASD

31
Q

Hypoplastic Left Heart Syndrome - Procedures

A

Norwood –> Glenn –> Fontan

32
Q

Norwood Procedure

A

1st procedure
Neoaorta from main pulmonary artery tissue
RV to PA conduit

33
Q

Glenn Procedure

A

2nd procedure
anastomose SVC to pulm arterial system
take down conduit

34
Q

Fontan Procedure

A

3rd procedure

connect IVC to pulm arterial system

35
Q

Two continuous murmurs in pediatrics

A

PDA

venous hum

36
Q

WPW- What are the TWO consequences

A

1) SVT

2) Sudden Cardiac Death

37
Q

DAPT

A

6 months after drug-eluting stent
12 months after CABG
1 year after ACS

38
Q

Normal Axis

A

Positive, upright in I and AvF

0-90

39
Q

LAD

A

Positive in I, negative AvF

40
Q

RAD

A

Negative in I, positive in AvF

41
Q

Extreme RAD

A

Negative in I and Avf

42
Q

Small and Large Blocks on EKG

A

.04 sec and .2 sec

43
Q

Sinus rhythm

A

upright P wave in I, II and inverted in aVr

Positive QRS in I, II, AvF

44
Q

TOF Repair

A

VSD Repair

Transannular patch to relieve pulmonary stenosis

45
Q

TOF Murmur

A

harsh SEM over pulm area 2/2 pulmonary stenosis

46
Q

Tet Spell- Physiology

A

increased pulmonary vascular resistance and increased HR

decrease ventricular filling and pulmonary flow

47
Q

Tet Spell - Treatment

A 
Increase SVR (knees to chest)
oxygen
IV bolus
IV BB
phenylephrine
48
Q

Pulmonary Stenosis Murmur

A

SEM

Click (mild or moderate stenosis) at LLSB or LUSB, louder with exhalation

49
Q

PDA Murmur

A

loud systolic (continuous machinery) at left precordium

50
Q

Eisenmenger Syndrome

A

severe pulmonary HTN from reversal of shunt (now R to left)

51
Q

LBBB

A

large S wave (rS) in V1

R in V6 (short bunny ears)

52
Q

Mitral Regurgitation Murmur

A
  • holosystolic at apex

- can be preceded by clicks (think MVP)

53
Q

CHD associated with DiGeorge Syndrome

A

Truncus Arteriosus

54
Q

precordial catch syndrome

A

short stabbing pains in chest
often with inspiration
possibly due to irritation of an intercostal nerve

55
Q

Hypertrophic Cardiomyopathy- features/pathology

A

Left ventricular hypertrophy (with normal or small ventricle size)
Diastolic Dysfunction
Can Have
- LV outflow obstruction
- Systolic anterior motion of mitral valve

56
Q

Hypertrophic Cardiomyopathy Murmur

A

systolic ejection murmur at LLSB or apex (think similar to aortic stenosis since its LVOT)
increase with Valsalva or standing
decrease with squat, hand grip, leg elevation

57
Q

HCM First Line Treatment

A

Beta Blockers

58
Q

Aortic Stenosis Murmur

A 
SEM
Click (mild or moderate stenosis) at apex and RUSB, no change with respirations
59
Q

CoA/IAA Murmur

A

Harsh systolic murmur, loudest over the back/infraclavicular region

60
Q

Adult Aortic Coarc Murmurs

A

1) systolic, continuous murmur in left infraclavicular region or over back
2) murmurs from intercostal vessels over chest wall

61
Q

Figure 3 Signs in Coarcs

A

dilation of area below and above coarct

62
Q

Rib Notching in Coarcs

A

dilation of intercostal collateral arteries

63
Q

High Intensity Statin

A

atorva 40-80

rosuva 20-40

64
Q

Indications of low cardiac output in shock

A

narrow pulse pressure
cool extremities
delayed cap refill

65
Q

Indications of high cardiac output in shock

A

wide pulse pressure +/- low diastolic pressure
warm extremities
bounding pulses

66
Q

Pericarditis –> CAUSES

A

viral or post viral (entero, adeno, parvo)
TB
Lyme
Immune (JIA, KD)

67
Q

Pericarditis Treatment

A

NSAIDS

sometimes colchicine

68
Q

Myocarditis –> CAUSES

A

enterovirus (coxsackie) is classic
Lyme dz
Chagas/trypanosma cruzi in developed world
Duchene Muscular Dystrophy

69
Q

Myocarditis Treatment

A

Supportive + HF therapy

can sometimes consider IVIG, immunosuppression

70
Q

Myocarditis Complication/Progression

A

chronic dilated cardiomyopathy (CDM)

71
Q

Vessels of the Aortic Arch

A

brachiocephalic, left common carotid, left subclavian

72
Q

How to Discern Left vs Right Sided Aortic Arch

A

trachea on the left versus the right

PGY-3 and 4 (13 decks)

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