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Kaplan Shelf prep > Cardiology > Flashcards

Cardiology Flashcards

1
Q

typical chest pain comprises of ________, ______ and ________

A

substernal chest pain, worsened or provoked with exertion and relieved by rest or nitroglycerin

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2
Q

best initial test in a patient with typical chest pain is ___

A

EKG

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3
Q

How to read an ECG….. (mnemonics)

A 
2RAP PQRSTU
2R - rate and rhythm
Axis - II has more positive  deflection than I and III
P waves. 
PR interval, 
QRS complexes and 
ST segments ; 
T & U waves
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4
Q

EKG findings of STEMI

A

> 1mm ST elevation in 2 anatomically contig. leads OR >2mm in V2 +V3 OR new LBBB (wide, flat QRS)

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5
Q

Localizing infarct:

Anterior: (artery)(lead)

A

Anterior: (LAD) (V1-V4)

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6
Q

Localizing infarct:

Lateral: (artery)(lead)

A

Lateral: (circumflex) (1, aVL, v4-v6,)

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7
Q

Localizing infarct:

Inferior: (artery)(lead)

A

Inferior: (RCA) (II, III, aVF)

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8
Q

Localizing infarct:

R. Ventricular: (artery)(lead)

A

R. Ventricular: (RCA) (V4 on R. sided EKG is 100% specific

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9
Q

Transfer patient for PCI if ____________

A

“door to balloon time” is <90mins

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10
Q

fibrinolytic contraindications:

6

A

-Any hemorrhagic stroke history (ischemic stroke in last 3 mos.)
• Intracranial cancer
• Cerebrovascular malformation
• Active internal bleeding or bleeding diathesis
• Suspected aortic dissection
• Significant closed head trauma in last 3 mos.

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11
Q

if it isn’t a STEMI, what do you do next?

A

cardiac enzymes

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12
Q

how often should troponin be checked

A

q3hrs. x3

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13
Q

if troponin is elevated what are the differential diagnosis? (5)

A

NSTEMI, PE, CHF, myocarditis and renal failure

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14
Q

A patient with typical chest pain, elevated troponin, what is the next step in diagnosis

A

coronary angiography

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15
Q

if blockage is seen on coronary angiography what is the standard management?

A

PCI with stenting and dual antiplatelet (ASA+ Clopidogrel) therapy for 6-12 months

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16
Q

when do you do CABG instead of PCI with stenting

A

if: L main dz., 3 vessel dz. (or 2 vessel dz. + DM or + ↓ EF)

17
Q

sudden death post MI. cause?

A

fatal arrhythmia….V.fib

18
Q

new systolic murmur 2-7 days after MI. cause?

A

papillary muscle rupture

19
Q

acute severe hypotension post MI. cause?

A

ventricular free wall rupture

20
Q

new onset harsh holosystolic murmur, CHF, higher O2 at RV post MI. Cause?

A

ventricular septal rupture

21
Q

Persistent ST elevation ~1 mo later + MR post MI. Cause?

A

Ventricular wall aneurysm

22
Q

QRS’s don’t follow P-waves after MI. Cause?

A

AV-dissociation, 3rd degree block

23
Q

weeks-months later MI, pleuritic chest pain, and low grade temp

A

Dressler’s syndrome (post-MI syndrome), (autoimmune pericarditis)

24
Q

most common arrhythmia presenting palpitations, tachycardia, dizziness in a pt with HTN or CAD

A

A-Fib

25
Q

management of new onset A-Fib

A

cardiovert

26
Q

management for chronic Atrial Fibrillation

A

rate-control and use CHADS2 score to estimate embolic risk

27
Q

Fixed PR interval

A
  • first degree heart block

- second degree heart block Type (Mobitz) II

28
Q

variable PR interval

A
  • second degree heart block Type (Mobitz) I wenkebach

- Third degree heart block

29
Q

Pulmonary embolism on ECG

A

S1Q3T3

30
Q

SEM crescendo/decrescendo, louder w/ squatting, softer w/ valsalva +
pulsus parvus et tardus

A

Aortic stenosis

31
Q

SEM, louder w/ valsalva, softer w/ squatting or handgrip

A

HOCM

32
Q

Late systolic murmur + mobile click (earlier w/ valsalva and handgrip,
later w/ squatting)

A

mitral valve prolapse

33
Q

Holosystolic murmur heard best at apex, can radiate to axilla

A

Mitral regurgitation

34
Q

Loud holosystolic murmur w/ diastolic rumble in kids

A

VSD

35
Q

Continuous machine like murmur

A

PDA

36
Q

Rumbling diastolic murmur with an opening snap

A

mitral stenosis

37
Q

Blowing diastolic murmur with widened pulse pressure

A

Aortic regurgitation

Kaplan Shelf prep (11 decks)

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