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PANCE > Cardiology > Flashcards

Cardiology Flashcards

1
Q

LBBB

- describe

A
  • Wide QRS > 0.12 sec
  • Broad, slurred R V6
  • Deep S V1 and V2
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2
Q

LBBB

- newly diagnosed, what step is next

A
  • Echo

- Cardiac stress test

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3
Q

Medication s/p PCI

A
  • ASA
  • Clopidogrel, prasugrel, ticagrelor (P2Y12 receptor inhibitors)
  • BB in stable patients
  • Heparin during procedure
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4
Q

Length of Dual antiplatelet treatment after PCI

A

Min 6 to 12 months

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5
Q

Sick Sinus Syndrome

- sx

A
  • dizziness
  • fatigue
  • dyspnea
  • palpitations
  • pre- and syncope
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6
Q

Sick Sinus Syndrome

- R/O

A
  • MI
  • AV node dysfunction such as heart blocks
  • other causes of syncope
  • Hypothyroidism (causes bradycardia)
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7
Q

CHF

- pathophys behind edema

A
  • CO down = blood backed up = increased venous pressure

- Renal perfusion decreases = compensatory renal sodium retention

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8
Q

CHF

- Edema types (left vs. right)

A
  • Left HF = pulmonary edema

- Right HF = lower extremity edema/ascites

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9
Q

CHF

- mgmt

A
  • tx underlying condition
  • restrict sodium and fluid intake
  • daily monitoring of weight
  • lose weight
  • ACE i, ARB, BB, diuretics
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10
Q

Abdominal aortic aneurysm

  • definition
  • MC locations
A
  • Aorta dilated > 50% normal size

- peri-renal arteries, iliac bifurcation MC locations

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11
Q

Abdominal aortic aneurysm

- RF

A
  • Smoking (MC preventable factor)
  • male
  • age
  • caucasion
  • fam hx
  • atherosclerosis
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12
Q

Ruptured Abdominal aortic aneurysm

- sx

A

Triad

  1. abd pain
  2. hypotension
  3. palpable pulsatile abdominal mass
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13
Q

Abdominal aortic aneurysm

- imaging

A

US

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14
Q

Abdominal aortic aneurysm

- Screening

A
  • men with smoking history

- One time US between 65 and 75, US f/u based on results

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15
Q

Abdominal aortic aneurysm

- mgmt

A

<4.5 cm: annual US
>4.5 cm with expansion: US every 6 months
- >5.5 cm or >0.5 cm growth in 6 months: surgery

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16
Q

Aortic dissection

- HTN treatment

A
  • correct promptly

- IV esmolol, IV labetalol, IV sodium nitroprusside

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17
Q

Ductus arteriosus

- Fetal circulation

A
  • Pulmonary artery to aorta

- Kept open via prostaglandins and low O2

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18
Q

Ductus arteriosus at birth

A

Fetal changes: increased pulmonary pressure, lung expansion

- changes from right ot left to left to right shunt = closure of ductus arteriosus and foramen ovale

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19
Q

Ductus arteriosus

- shunt if doesn’t properly close

A

Left to right shunt from aorta to pulmonary artery bc now aorta is higher pressure

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20
Q

PDA

- effects

A
  • volume overload
  • pulmonary HTN
  • right-sided HF
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21
Q

PDA

- RF

A

prematurity

low birth weight

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22
Q

PDA

- clinical presentation

A
  • murmur: harsh, machine-like continuous at pulmonic position
  • respiratory sx: tachypnea, apnea, hypercapnia
  • heart failure
  • bounding peripheral pulses
  • widened pulse pressure
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23
Q

PDA

- murmur

A
  • continuous “machinery-like” murmur

- left second intercostal space

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24
Q

PDA

- imaging

A

Echo

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25
Q

PDA

- mgmt

A
  • watchful waiting
  • Pharm: indomethacin, ibuprofen
  • sx
26
Q

Hypertriglyceridemia

- mgmt at diff levels

A
  • 150-199: lifestyle
  • 200-499: consider pharm for high risk pts
  • > 500: pharm
27
Q

Dressler Syndrome

  • timing
  • presentation
A
  • 2-10 weeks s/p MI

- persistent low-grade fever, pleuritic chest pain, pericarditis

28
Q

Dressler Syndrome

- mgmt

A
  • ibuprofen/ASA
  • steroids
  • colchicine
29
Q

Unstable Angina

- length of chest pain

A

> 20 minutes at rest

30
Q

Varicose Veins

- mgmt

A
  • Compression stockings and lifestyle (smoking cessation, exercise, elevation of limb) X 3 months
  • Sclerotherapy
  • Thermal vein ablation
  • Surgical excision of veins
31
Q

What tick borne disease is most likely to be associated with AV heart block

A

Lyme

- consider Lyme carditis in any patient presenting with new-onset AV block

32
Q

Primary aldosteronism

- best initial test

A

Aldosterone to renin ratio

* aldosterone is usually elevated and renin suppressed

33
Q

Pulsus bisferiens

  • describe
  • seen with what heart condition
A
  • two distinct peaks of arterial pulse during systole

- hypertrophic cardiomyopathy

34
Q

Infective endocarditis

- empiric abx

A

vancomycin

- covers staph (MSSA and MRSA), strep, enterococci

35
Q

Infective endocarditis
abx for
- MSSA
S- trep viridans

A
  • nafcillin or oxacillin

- penicillin or ceftriaxone

36
Q

Hypertensive emergency

  • def
  • mgmt
A
  • elevated bp (>180/120) AND signs of end organ damage
  • lower bp 10-20% first hour
  • then 5-15% over next 23 hours
  • Use IV agents (hydralazine, esmolol, nitroprusside, labetalol, nitroglycerine)
37
Q

PEA

- mgmt

A
  • CPR + epi q 3-5 min

- manage underlying condition

38
Q

Infective endocarditis

- MC clinical manifestation

A

Fever

39
Q

Acute rheumatic fever

- complication of what

A

Group A strep infection (about 1%)

40
Q

Acute rheumatic fever

- patho

A
  • multisystem autoimmune response: ab vs. strep bacteria cross react with host tissue
41
Q

Acute rheumatic fever

- timing and age

A
  • children 5-15

- 2-4 weeks after step pharyngitis

42
Q

Acute rheumatic fever

- sx

A
  • arthritis
  • pancarditis
  • sydenham chorea
  • erythema marginatum
  • subcutaneous nodules
  • fever
43
Q

Acute rheumatic fever

- heart issues

A

carditis

  • damages endocardial layer: impacts valves
  • Mitral stenosis MC
44
Q

Acute rheumatic fever

- diagnostic criteria

A

Jones Criteria

  • Joints
  • Oh no, carditis
  • Nodules
  • Erythema marginatum
  • Sydenham chorea
45
Q

Acute rheumatic fever

- labs

A

evidence of preceding GAS infection:

  • throat culture
  • rapid antigen detection test
  • elevated anti streptococcal ab titer (antistreptolysic O) *most sensitive
46
Q

Acute rheumatic fever

- mgmt

A
  • NSAIDS for arthritis

- Abx (PCN or erythromycin) for strep

47
Q

Restrictive Cardiomyopathy

- patho

A
  • fibrotic processes
  • reduced ventricular filling
  • increased diastolic pressure / decreased diastolic volume
  • restricted ventricular filling
48
Q

Restrictive Cardiomyopathy

- common casues

A
  • Amyloidosis
  • Sarcoidosis
  • Hemochromatosis
  • Tropical endomyocardial fibrosis
49
Q

Restrictive Cardiomyopathy

- clinical

A
  • R sided HF symptoms
  • Dyspnea, fatigue, LE swelling
  • Rales, JVD, hepatomegaly
  • Kussmaul’s Sign (incr JVP during inspiration)
50
Q

Constrictive Cardiomyopathy

- pathophys

A

scarring and loss of elasticity of the pericardial sac (vs. restrictive with is fibrotic process)

51
Q

Constrictive Cardiomyopathy

- causes

A
  • infection
  • post-cardiac surgery
  • post-radiation therapy
  • connective tissue disorder
  • idiopathic
52
Q

Wandering atrial pacemaker

- overview

A

atrial dysrhythmia caused by 3+ ectopic atrial foci

53
Q

Wandering atrial pacemaker

- disease MC at increased risk

A

COPD

54
Q

Wandering atrial pacemaker

- EKG

A
  • variable P wave morphology
  • variable PR interval duration
  • Irregularly irregular rhythm
55
Q

Wandering atrial pacemaker

- mgmt

A
  • no specific tx required

- focus on treating underlying condition

56
Q

Coarctation of the aorta

- MC location

A

Distal to left subclavian artery, at insertion of ductus arteriosus

57
Q

Coarctation of the aorta

- RF

A
  • Fam history

- Turner syndrome

58
Q

Coarctation of the aorta

- MC sign

A

HTN

59
Q

Coarctation of the aorta

- diagnosis

A
  • Systolic HTN in arms
  • Delayed or decreased femoral pulses
  • low or undecteable arterial BP in legs
  • Echo: definitive dx
60
Q

Coarctation of the aorta

- CXR

A
  • notching of ribs

- Figure “3” appearance due to indentation of aorta at site of coarctation

61
Q

Coarctation of the aorta

- mgmt

A
  • sx repair

PANCE (14 decks)

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