Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANCE PREP > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Substernal poorly localized exertional chest pain that is short in duration and resolves with rest or nitro
Pain may radiate to arm, teeth, or jaw
Diaphoresis

A

Stable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Levine’s sign

A

fist over heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classes of angina

A

Class I: strenuous activity
Class II: more prolonged or rigorous activity, slight limitation of physical activity
Class III: daily activity, marked limitation of physical activity
Class IV: angina at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute coronary syndrome diagnosis?

A

EKG = initial test of choice

Cardiac enzymes: CK/CK-MB, troponin

Coronary angiography = GOLD STANDARD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stable angina tx?

A

Daily aspirin, beta blockers, nitro, and statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Angina that is new in onset, occurs at rest, or lasts > 30 minutes; not relieved by nitro

A

Unstable angina (acute coronary syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx of angina, UA, or NSTEMI?

A

Nitro, aspirin, beta blockers, heparin, statin, ACEI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

STEMI tx?

A

Nitro, aspirin, beta blockers, ACEI

+ REPROFUSION: PCI within 90 min, if not available within 120 min  fibrinolytics within 30 min (TPA- Alteplase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When should you avoid nitro and morphine in ACS?

A

Inferior wall MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of MI does V1-V4 involvement indicate?

A

Anterior/septal (LAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of MI does I, aVL, V5-V6 involvement indicate?

A

Lateral (LCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of MI does II, III, aVF involvement indicate?

A

Inferior (RCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the systolic murmurs?

A 
Mitral regurgitation
Tricuspid regurgitation
Mitral valve prolapse
Aortic stenosis
Pulmonary stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the diastolic murmurs?

A

Tricuspid stenosis
Mitral stenosis
Pulmonary regurgitation
Aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Harsh systolic crescendo-decrescendo murmur best heard at the right sternal border
Prominent S4
Radiates to carotid

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Blowing diastolic decrescendo murmur best heard at the left sternal border

A

Aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MCC of rheumatic heart disease?

A

Mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Rumbling mid-diastolic murmur with a prominent S1 and opening snap best heard at the apex

A

Mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mid-late systolic ejection click best heard at the apex

A

MVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes an earlier and later click in MVP?

A

Earlier click: Valsalva, standing

Delayed click: leaning forward, squatting, supine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the MCC of mitral regurgitation in the US?

A

MVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Blowing holosystolic murmur best heard at the apex

Radiates to the axilla

A

Mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mid-diastolic murmur best heard at LLSB

Increased intensity: inspiration

A

Tricuspid stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Blowing holosystolic murmur best heard at the left sternal border
Increased intensity: inspiration

A

Tricuspid regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Always congenital
Harsh mid-systolic crescendo-decrescendo murmur beast heard at left sternal border
Increased intensity: inspiration
Radiates to the neck

A

Pulmonic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Always congenital
Graham-Steel murmur: brief decrescendo early diastolic murmur best heard at LUSB
Increased intensity: inspiration

A

Pulmonic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Constant prolonged PR interval (>.20s), all P waves followed by QRS complexes

A

1st degree AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Progressive PR interval lengthening followed by dropped QRS complex

A

2nd degree AV block type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Constant prolonged PR interval and dropped QRS complexes

A

2nd degree AV block type 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

AV dissociation; regular P-P intervals and regular R-R interval, but they are not related to each other

A

3rd degree AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Sawtooth atrial waves, no discernable P waves

Tx?

A

Atrial flutter

Stable: vagal maneuvers, ΒB or CCB
Unstable: direct current synchronized cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Irregularly irregular rhythm, no discernable P waves

A

Atrial fibrillation

33
Q

A. fib tx?

A

Stable: rate control (ΒB or CCB)
Unstable: Direct current synchronized cardioversion
If present for more than 48 hrs, anticoagulate for 21 days prior to cardioversion
Long- term
Anticoagulation based on CHA2DS2-vasc score: Warfarin, Dabigatran, Apixaban, Rivaroxaban
Rate control (BB, CCB, Digoxin, Amiodarone)
*Avoid CCBs in HF

34
Q

Regular, narrow-complex tachycardia, no discernable P waves (MC)
Regular wide-complex tachycardia

A

Paroxysmal Supraventricular Tachycardia (PSVT)

35
Q

Paroxysmal Supraventricular Tachycardia tx?

A

Stable (narrow-complex): vagal maneuvers, Adenosine
Stable (wide-complex): Amiodarone
Unstable: Direct current synchronized cardioversion
Definitive: radiofrequency catheter ablation

36
Q

Delta wave (slurred QRS upstroke), shortened PR interval, wide QRS complexes

A

Wolff-Parkinson-White (WPW)

37
Q

Wolff-Parkinson-White (WPW) tx?

A

Stable: Procainamide
Unstable: Direct current synchronized cardioversion
Definitive: radiofrequency catheter ablation

38
Q

Inverted or absent P wavesAV Junction Dysrhythmias

A

AV Junction Dysrhythmias

39
Q

Wide bizarre QRS occurring earlier than expected; T waves in the opposite direction of the QRS complexes; associated w/ compensatory pause

A

Premature Ventricular Complexes (PVC)

40
Q

Regular wide complex tachycardia with no discernable P waves
Sustained VT = duration of 30+ sec
Monomorphic vs polymorphic based on QRS morphology

A

Ventricular Tachycardia

41
Q

Variant of polymorphic VT (Bow tie appearance)

Tx?

A

Torsades de pointes

IV magnesium

42
Q

VT tx?

A

Stable: Amiodarone
Unstable (with pulse): Direct current synchronized cardioversion
No pulse: Defibrillation + CPR

43
Q

Erratic pattern of electrical impulses, no discernable P waves

A

Defibrillation + CPR

44
Q

Organized rhythm but no pulse

TX?

A

Pulseless Electrical Activity (PEA)

CPR + EPI, check for shockable rhythm every 2 min

45
Q

Dyspnea (MC)
Angina, syncope, arrhythmia
Sudden cardiac death

A

Hypertrophic cardiomyopathy

46
Q

How to dx cardiomyopathies?

A

Echo

47
Q

Hypertrophic cardiomyopathy tx?

A

Beta-blockers = 1st line
CCB = 2nd line
Avoid dehydration, extreme exertion, exercise
Caution use of Digoxin, Nitrates, diuretics

Surgery
Septal myectomy
Alcohol septal ablation

48
Q 
Dyspnea
Paroxysmal Nocturnal Dyspnea (PND)
Pulmonary congestion: cough (blood-tinged sputum), crackles, wheezes
Cyanosis 
Cheyne-stokes breathing
A

L sided HF

49
Q 
Peripheral edema
JVD
Ascites
Weight gain
Hepatosplenomegaly
A

R sided HF (MCC is L sided HF)

50
Q

MC form of HF, commonly caused by MI, dilated cardiomyopathy
There are thin ventricular walls so they cannot pump as strongly to push blood out, hence reduced EF
May hear an S3

A

Systolic HF

51
Q

Commonly caused by HTN, LVH, old age, constrictive pericarditis
Thick ventricular walls so difficult for the heart to fill with blood. However pumping capability is not impacted, hence preserved EF
May hear S4

A

Diastolic HF

52
Q

CHF diagnosis?

A

BNP (>500 very likely)
Cardiac enzymes

EKG
CXR: cephalization, Kerley B lines, pleural effusion

Echo = GOLD STANDARD

53
Q

CHF tx?

A

Wt loss, sodium <2g, fluids <2L
Daily weight monitoring

Loop Diuretics (furosimide)
ACEI/ARB (Check for hyperkalemia)
ΒB

Acute
LMNOP: Lasix, Morphine, O2, Nitrate, position
Avoid CCBs

54
Q 
Leg pain worse with dependency
Improved with walking/elevation
Normal pulses/temp
Stasis dermatitis (itchy, eczematous rash and brownish/dark purple hyperpigmentation of the skin)
Ulcers (medial malleolus)
Dependent pitting edema
A

Chronic venous insufficiency

55
Q

Chronic venous insufficiency dx?

A

Venous duplex US

Venography = GOLD STANDARD

56
Q 
Intermittent Claudication
Intermittent claudication
Worse with walking/elevation
Improved with dependency/rest
Decreased/absent pulses
Decreased capillary refill
Atrophic skin changes
Ulcers (lateral malleolus)
Pale with elevation, dependent rubor
A

ABI (positive if < 90)

ANGIOGRAPHY = GOLD STANDARD

57
Q

Virchow’s triad

A
  1. Venous stasis
  2. Endothelial damage
  3. Hypercoagulability
    (DVT)
58
Q

Unilateral swelling of LE (> 2cm)
WARM skin & dusky cyanosis
Normal pulses
Homans sign: calf pain with dorsiflexion (unreliable)

A

DVT

59
Q

DVT dx?

A

Venous duplex US = 1st line

Venography = GOLD STANDARD

60
Q

What test is used to monitor LMWH?

A

PTT

61
Q

What test is used to monitor warfarin?

A

PT/INR

62
Q

LMWH antidote?

Warfarin antidote?

A

LMWH: protamine sulfate
Warfarin: VitK, FFP

63
Q

HTN dx?

A

Diagnosis: 2+ elevated readings on 2+ different visits > 140/90
Pre-HTN: 120/139/80-89
Stage I: 140-159/90-99
Stage II: >160/100

64
Q

Types of AAA?

A

Fusiform: circumferential dilatation of aortic wall
Saccular: outpouching of aortic wall (higher risk of rupture)

65
Q

AAA dx?

A

Stable: CT w/ contrast
Unstable: bedside US

*Pts with known AAA who present w/ classic sx of rupture can be taken to the OR w/o preop imaging

66
Q

AAA screening

A

One-time screening via abd US in men 65-75 who have ever smoked
5.5+ cm or > 0.5 cm growth in 6 mo  immediate surgical repair
> 4.5 cm- surgery referral
4-4.5 cm- monitor; US q 6 mo
3-4 cm- monitor; US q year

67
Q

Types of aortic dissection

A

Stanford Type A: Ascending aorta

Stanford Type B: Descending aorta

68
Q

Aortic dissection dx

A

CXR: widened mediastinum

CT angiography: confirm dx, differentiate from ascending and descending

69
Q

Aortic dissection tx

A

Ascending
BP control + emergent open surgical repair

Descending
Lower SBP to 100-120 and HR to <60 bpm w/in 20 min
BB (Labetalol) = first line
Can add Nitroprusside after HR is controlled
Pain control: morphine (pain & vasodilation)

70
Q

Beck’s triad

A
  1. JVD
  2. Muffled heart sounds
  3. Hypotension
    (cardiac tamponade)
71
Q

Cardiac tamponade dx

A

EKG: low QRS voltage, electrical alternans

Echo = test of choice; effusion + diastolic collapse of cardiac chambers

72
Q

MCC of pericardial effusion?

A

Pericarditis

73
Q

Symptoms due to coronary vasospasm triggered by cold weather, exercise, hyperventilation
Chest pain at rest that is not exertional and not relieved by rest

A

Vasospastic angina (Variant, Prinzmetal)

74
Q

Vasospastic angina (Variant, Prinzmetal) tx?

A

CCBs

75
Q 
Persistent fever
New onset murmur
Osler nodes
Janeway lesions
Splinter hemorrhages
Roth spots
A

Endocarditis

76
Q

What are Osler nodes?

A

Painful violaceous nodules on pads of digits and palms

77
Q

What are Janeway lesions?

A

Painless erythematous macules on palms and soles

78
Q

What are roth spots?

A

Retinal hemorrhages with pale centers

79
Q

How to dx endocarditis?

A

Duke Criteria: 2 major OR 1 major + 3 minor OR 5 minor

Major
Bacteremia (2+ blood cultures)
Endocardial involvement on echo
New regurgitation murmur

Minor
Predisposing condition or IVDU
Fever (>100.4)
Vascular or embolic PNA (Janeway lesions)
Immunologic phenomena (Osler nodes, Roth spots, + RF, glomerulonephritis)
Blood culture not meeting major criteria
Worsening of existing heart murmur

PANCE PREP (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions