cardiology Flashcards
Can hypertriglyceridemia improve with strict glucose control in PT with DM?
Yes
hypertriglyceridemia may be in part due to diabetes, it is reasonable to treat this patient’s diabetes first and observe if her triglyceride levels improve.
Which type of cardiomyopathy does sarcoidosis cause?
Restrictive cardiomyopathy
most common atypical presenting complaint in an elderly patient diagnosed with acute coronary syndrome?
Dyspnea. Considered an angina equivalent.
What helps to differentiate heart failure as being systolic or diastolic?
Ejection fraction
Drugs which shorten the QT-interval can cause what?
Torsades
Heart failure which sound?
S3
Which heart sound in diastolic failure and hypertrophic cardiomyopathy?
S4
mid-systolic murmur heard best at the second intercostal space near the right sternal border
Aortic stenosis
most suggestive of an asymptomatic abdominal aortic aneurysm?
abdominal mass
most common physical finding in patients with infective endocarditis?
heart murmur
Which murmur diastolic low-pitched decrescendo murmur best heard at the cardiac apex?
Mitral stenosis. Likely d/t rheumatic heart dz.
Ebstein’s anomaly= malformed right atrium and ventricle. What 1 other thing?
Tricuspid insufficiency (leaflets attach to RV wall)
Right axis deviation in newborns <1mo normal?
Yes normal. D/C and send home.
diastolic, rumbling murmur best heard with the bell over the left sternal border at the fourth intercostal space and is louder during inspiration.
Tricuspid regurg
systolic murmur in the left infraclavicular area and under the left scapula
Coarctation of aorta
When to fix an asx AAA?
≥ 5.5 cm
or grows more than 0.6 to 0.8 cm over 6 months
How do congenital cardiac defects present in newborns?
congestive heart failure (pulmonary or peripheral edema or both)
Can Propanolol be used for heart failure?
No. It’s not beta-1 selective.
Which 3 beta blockers for HF?
Bisoprolol, carvedilol, and metoprolol
Yellow deposits on extensor surfaces due to…?
elevated TGL levels
Pericarditis will have ST elevations and PR depressions in which leads? (Hint: in eleven leads)
Diffuse ST elevations and PR depressions in V2-V6, I, II, III, aVL, and aVF are seen in the first hours to days of illness
Which lead will have ST depression and PR elevation with pericarditis?
ST depression and PR elevation in aVR
What will ST segments be shaped like in pericarditis?
ST segments are concave, diffuse
Which syndrome 2-10 weeks post-MI?
Dressler’s syndrome
What can NSAIDs do to HF?
Make it worse. If exacerbation happens then d/c the NSAID.
Short systolic murmur innocent or pathologic?
Innocent murmur
MC primary cardiac tumor in adults?
Myxoma
MC location of aortoenteric fistula formation?
Duodenum
Crescendo-desrescendo systolic murmur?
Mitral valve prolapse
Tx for Brugada Syndrome?
Impantable cardioverter defibrillator
Brugada Syndrome dysfunction of what?
Cardiac ion channel dysfunction
Brugada Syndrome resting EKG shows what?
RBBB pattern ST-elevation in V1-V3
Any STEMI in the inferior leads should lead to what type of EKG occurring?
Right-sided EKG to check for RV infarct
Can give Atenolol in WPW?
NO! Will slow AV-node conduction.
WPW wave called?
Delta wave
WPW bundle?
Bundle of Kent
Which meds can slow AV node conduction? (Hint: ABCD)
Adenosinde
Beta-blockers
CCBs
Digoxin
FIRST changes seen on EKG in acute STEMI?
Hyperacute T-waves (then J-point, then STEMI)
LBBB shows what in Lead I and what in V1?
Lead I=Large wide R-wave
V1=negative wave QS or rS in V1
Female QTc >460 treatment if stable?
Metoprolol
Male QTc >440 treatment if stable?
Metoprolol
Prolonged QT-interval is associates with which tachydysrhythmia?
Polymorphic ventricular tachycardia
Murmur in ASD? S2 sound?
crescendo-decrescendo murmur in pulmonic area.
Widely split and fixed S2.
Early or small ASD cyanotic?
No. Non-cyanotic.
Late or large ASD cyanotic?
Yes. RA to LA. Leads to Eisenmenger’s syndrome.
Can give Verapamil to infant with SVT?
No. Profound hypotension and CV collapse.
Murmur of mitral valve regurg sounds like?
Soft S1, loud blowing holosystolic
What substance closes the ductuc arteriosis in the post-natal period?
Bradykinin
Not Prostaglandin E1, this keeps it open!
Med to close patient ductus arteriosus?
Indomethacin (prostaglandin inhibitor)
Which med for rate control for A-fib w/RVR in setting of compensated systolic HF?
Carvedilol
Can use diltiazem for rate control for A-fib w/RVR in setting of compensated systolic HF?
NO
Patient ductus arteriosis Murmur sounds like?
Continuous machine-like murmur
Type of surgery for Patient ductus arteriosis?
Ligation
Prinzmetal angina daily prophylaxis tx?
Amlodipine
Which heart block is progressive lengthening of PR interval until QRS complex dropped?
2nd degree Type 1
Constant PR interval with absent QRS complex?
Second degree Type 2
Which bacteria in tricuspid IE from IVDA?
Staph Aureus
Which bacteria in mitral valve IE?
Strep and staph
Percent goal of treatment for hypertensive emergency in FIRST HOUR?
10-20% in first hour
Goal percent of hypertensive emergency after 24 hours?
25% reduction from baseline
Cardiac Arrest Score uses which pressure for mortality prediction?
Systolic BP after ROSC
Pericardial knock consistent with which cardiomyopathy?
Constrictive
Tx for acute HF?
Furosemide (loop diuretic)
Known adverse rxn to Prostaglandin E1 infusion for PDA?
Apnea. Intubate before administering.
Factor V Leiden deficiency is what type of CI to fibrinolytic therapy?
Relative CI.
Preferred anticoagulant for DVT if preggers?
LMWH (enoxaparin)
Flecainide is which class of anti-arrythmic?
IC
Tx for unstable WPW?
Cardioversion
HOCM murmur?
Crescendo-decrescendo murmur left sternal border
Harsh mid-systolic cresdendo-derescendo heart at left sternal border?
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy murmur increases with…?
Valsalva
Hypertrophic cardiomyopathy murmur decreases with…?
Squatting
MC cause of sudden death in young atheletes?
HOCM
MC risk factor for developing AAA?
Smoking
When to tell PT to follow up with PCP if DBP 80-104?
2 months f/u with PCP
If PT’s DBP ≥115 when to evaluate it?
Immediately
Ventral Septal Defect in which portion?
Membranous portion
How to evaluate PT with possible PE if they have an elevated creatinine?
V/Q scan
Which type of replacement valve is more prone to leak? (Mechanical or bioprosthetic)
Mechanical valves more prone to paravalvular leak
Formula for measuring Mean Arterial Pressure?
MAP=DBP = 1/3(SBP-DBP)
QRS complex in severe hyperKalemia?
Widened QRS (and peaked T-waves)
Minimum SBP in a 3 year old?
76mmHg
Minimum SBP=70 + (2 x age in years)
Tx for afib from Holiday Heart Syndrome?
observe with continuous cardiac monitoring. If no improveent in 24-48h then rate control.
Tx for systolic HF with EF <35%
Spironolactone