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Cardiology PANCE Flashcards

1
Q

Dilated cardiomyopathy

A

Etoh, idio, viral, chemo, cocaine, pregnancy
systolic HF
Weak floppy heart
S3 systolic
Low EF
BASD = BB, ACE, Spiron, Diuretics

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2
Q

Restrictive Cardiomyopathy

A

Right sided HF
Filling problem, Diastolic
Kussmaul’s sign (jvd on inspiration)
Normal ventricle walls with dysmotility
Speckled on echo
Echo, biopsy for definitive
Treat underlying cause, sarcoid, amyloid, etc

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3
Q

Takasubo cardiomyopathy

A

Transient ST elevation
Stress, depression, sad
Transient Systolic failure
water bottle shape heart

Treat initial like ACS
Then symptomatic tx

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4
Q

Hypertrophic cardiomyopathy

A

Autosomal dominant Genetic
Outflow tract obstruction
Dyspnea on exertion, angina, CP
Sudden cardiac death
Harsh systolic murmur
S4
THick septum
NO dig, no nitro, no diuretics
Give BB to keep Cardiac demand low

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5
Q

Myocarditis

A

Inflammation of heart muscle (young adults)
Viral - coxsackie, SLE, RA, Meds
Fever sick for few days, then systolic Dysfunction
(dilated cardiomyopathy, S3, HF)
Cardiomegaly, tachy, Diffuse st elevation
Biopsy is gold standard
Supportive, treat HF - BASD

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6
Q

Constrictive cardiomyopathy (pericarditis)

A

Pericardial effusion
Tamponade
Becks triad ect.

Thick Pericardium

Knock
Kussmaul
Pulsus paradoxus (pulse decreases on inspiration)

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7
Q

Unstable patient equals (symptomatic)

A

AMS
CP
Hypotension
HF with a low pulse

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8
Q

First degree block

A

BB,Dig, CCB
MI, Lyme
R far from P
Symptomatic Atropine pacemaker

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9
Q

Mobitz 1 (wenke)

A

BB,Dig, CCB
MI, Lyme
longer longer drop
Asymptomatic no treatment
Symptomatic Atropine
pacemaker

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10
Q

Mobitz 2

A

Structural heart disease
Some p’s dont get through
Symptomatic Brady Atropine
Trans pace
Permanent pacemaker

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11
Q

3rd degree block

A

AV Dissociation
P’S and Q’s Don’t agree
Trans pacing
Permanent Pacemaker

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12
Q

AFlutter

A

CHA2DS2 VASc
(anticoagulation same as non valve afib)
Stable - vagal, BB, CCB
Cardiovert (sync) if unstable)
Ablation definition

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13
Q

Afib

A

Paroxysmal, persistent, permanent, Lone
Holter or loop if not all the time
GIve BB, CCB (Dilt etc), can use dig
unstable = cardio vert
—TEE first
afib over 48 hours
—DOACs for 3 weeks then cardiovert, then doac for 4 weeks

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14
Q

CP Meds

A

ASA
BB or CCB
Statin
Nitro

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15
Q

angina meds

A

BANS

BB
ASA
Nitro
Statin

MONA

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16
Q

STEMI Leads and Vessel and Heart Region
- Anterior Wall

A

V1-V4
LAD

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17
Q

STEMI Leads and Vessel and Heart Region
-V1-V4

A

Anterior wall
LAD

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18
Q

STEMI Leads and Vessel and Heart Region
- LAD

A

Anterior wall
V1-V4

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19
Q

STEMI Leads and Vessel and Heart Region
-Septal

A

V1-V2
Proximal LAD

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20
Q

STEMI Leads and Vessel and Heart Region
-V1-V2

A

Septal
Proximal LAD

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21
Q

STEMI Leads and Vessel and Heart Region
- Proximal LAD

A

V1-V2
Septal

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22
Q

STEMI Leads and Vessel and Heart Region
- Lateral Wall

A

I, AVL, V5-V6
Left Circumflex

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23
Q

STEMI Leads and Vessel and Heart Region
- I, AVL, V5-V6`

A

Left Circumflex
Lateral Wall

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24
Q

STEMI Leads and Vessel and Heart Region
- Left Circumflex

A

I, AVL, V5-V6
Lateral wall

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25
Q

STEMI Leads and Vessel and Heart Region
- Inferior Wall

A

II, III, AVF
RCA

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26
Q

STEMI Leads and Vessel and Heart Region
- II, III, AVF

A

RCA
Inferior

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27
Q

STEMI Leads and Vessel and Heart Region
- RCA

A

II, III, AVF
Inferior

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28
Q

CHA2DS2VASc

A

CHF =1
HTN =1
AGE >75 =2
DM = 1
Stroke = 2
Vascular disease = 1
Age 65-74 = 1
Sex - female = 1

2 or more gerts anticogs
NOAC

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29
Q

Pericardial knock

A

Constrictive pericarditis

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30
Q

Aortic stenosis

A

Pulsus Parvus and tardus (low and slow)
Preload dependent
Give fluids if symptomatic

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31
Q

Positive ECG finding in Stress test

A

ST depression

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32
Q

Aortic dissection greatest risk factor

A

HTN

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33
Q

Prinzmetal

A

Transient ST Elevation
Angina
gets better with nitro

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34
Q

Hypertensive emergency Med

A

Labetalol

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35
Q

Test for LBBB in setting of CAD

A

Adenosine radionucleotide test

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36
Q

Long standing HTN can cause what heart sound

A

S4 (stiff ventricle)

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37
Q

Acute pulmonary edema 1st line meds

A

Lasix
Nitro
O2
Morphine
Levophed (norepi)

ACE if those fail

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38
Q

Hypertrophic Cardio myopathy First line

A

BB

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39
Q

Arrhythmia seen in MVP

A

PVC’s

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40
Q

ACE effects

A

Reduce preload and afterload
does not affect inotropic activity (contraction)

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41
Q

Coarctation findings

A

3 sign on CXR
Murmur heard in back
BP different in upper/lower extremities

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42
Q

What does IABP do for BP and CWP

A

maintains SBP
reduces Cap Wedge pressure

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43
Q

Most common S/S of MI

A

Substernal CP
diaphoresis

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44
Q

MC S/S of constrictive pericarditis

A

JVD

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45
Q

Syndrome X

A

CP with exertion but clean cath

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46
Q

Most common site of acute arterial occlusion

A

Common femoral Artery

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47
Q

Anti coag for new onset afib over 48 hrs
(non valvular)

A

Anti coags for 3 weeks
TEE
Cardiovert
Anticoag for additional 4 weeks

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48
Q

Common sign in cardiogenic shock

A

Distended neck veins

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49
Q

Valve problem commonly associated with STEMI

A

Mitral Regurg

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50
Q

What happens with verapamil in CHF

A

can worsen CHF

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51
Q

Gold standard for DVT

A

Venography

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52
Q

What STD is risk factor for aortic aneurysm

A

Syphilis

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53
Q

Carvallo sign

A

Tricuspid regurg
increases with inspiration

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54
Q

Med contraindicated with peripheral claudication

A

BB

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55
Q

what is seen on echo in amyloidosis

A

Speckled pattern

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56
Q

Things linked to Multi focal atrial tachycardia

A

COPD
Hypoxia
Pulmonary HTN

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57
Q

First sign in mitral stenosis

A

dyspnea

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58
Q

Most common valve in AFIB

A

Mitral Valve

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59
Q

Digoxin Side effects

A

Yellow/blue vision changes

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60
Q

Digoxin ECG changes

A

ST Depression
PVC’s

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61
Q

Valve problem with hemoptysis

A

mitral stenosis

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62
Q

Best diuretic for CHF and kidney issue

A

Loop

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63
Q

Ebstein anomaly Valve

A

Tricuspid

Abnormally located or shaped tricuspid valve

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64
Q

Stable WPW first line

A

Vagal

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65
Q

Orthodromic

A

Orthodromic
Narrow
Adenosine

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66
Q

Antidromic

A

Antidromic
Wide
Procainamide

Avoid Adenosine, BB, CCB, AV node blockers

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67
Q

Med to keep PDA open

A

Prostaglandin

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68
Q

most common cause of syncope

A

vagal

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69
Q

HTN Urgency treatment
inpatient or out patient?

A

outpatient
(no benefit shown for rapid BP lowering)

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70
Q

How to confirm Inferior MI

A

Right sided ECG
(no nitro or morphine)
Preload dependant

71
Q

Heart issue that can be caused by kawaski

A

Aortic aneurysm

72
Q

most common Congenital heart defect

73
Q

to ways to stratify ACS

A

Heart Score
TIMI

74
Q

Bacteria of non IVDU without valve replacement
With poor dental

A

Strep Viridians

75
Q

Bacteria of non IVDU without valve replacement
no dental issues

A

Staph aureus

76
Q

Rubella is associated with what valve issue

A

Pulmonic stenosis

77
Q

PAD tx

A

stop smoking
exercise
ASA
pletal (reeval in 3 months)

ABI to diagnose
<0.9 bad (normal 1.2-1.0)

NO BB

78
Q

MCC of aortic regurg

A

bicuspid aortic valve

79
Q

MCC of mitral valve disease

A

myxomatous degeneration
(MVP)

80
Q

Myocarditis MCC

A

MCC Viral - coxsackie

81
Q

Myocarditis S/S

A

Fever
Viral prodrome
Cardiomegaly
S3
URI s/s

82
Q

Long standing pericarditis can lead to?

83
Q

what does a tetralogy of fallot patient need

84
Q

Aortic regurg sound

A

Paradoxical splitting of S2

All Weird named murmurs

85
Q

Pericardial effusion heart shape

A

water bottle

86
Q

What can be seen in neck of tricuspid stenosis

A

Large A wave

87
Q

ECG finding of tricuspid stenosis / regurg

A

Peaked P wave
(P Pulmonale)

88
Q

Key finding in carotid stenosis

A

Delayed carotid upstroke

89
Q

What sound is decreased in mitral stenosis

A

Decreased S1 intensity

90
Q

Tx for new onset AFIb with mitral stenosis

A

balloon valve commissurotomy

91
Q

What is seen in aortic regurg in pulse pressure

A

Wide pulse pressure

92
Q

What will atria look like in afib with chf

A

large left atrium

93
Q

Kawasaki tx

A

ASA
IVIG
Steroids
(IVIG first with high dose ASA)

Goal is to prevent coronary artery aneurysm

94
Q

MCC of kawasaki

A

Strep Pyogenes
(GAS)

95
Q

What is ivabrandine

A

SA node inhibitor
used in CHF with HR over 90

96
Q

CHF exacerbation first line

A

Diuretics
Nitro

97
Q

Eisenmenger

A

VSD
L to R shunt
That later becomes
R to L shunt

Cyanosis, Hypoxia, Fatigue
Usually shows up in adolescence

98
Q

Key finding of SSS or SND

A

Tachy brady

99
Q

WHat can chagas lead to

A

Biventricular HF

100
Q

What is conn syndrome

A

Primary Hyperaldosteronism (adrenal aldosteronoma)

HTN
Metabolic alkalosis
Hypokalemia

MANAGEMENT OF CONN SYNDROME
• Surgical excision + Spironolactone (blocks aldosterone).

101
Q

Pulmonary edema gets what med

102
Q

ACE side effects

A

Hyperkalemia
Hyperuricemia
Cough
Angioedema

103
Q

HCTZ causes what in gout

A

increased uric acid

104
Q

What med is contraindicated in Cocaine use

105
Q

HTN Stages
Normal

A

less than 120 / 80

106
Q

HTN Stages
Elevated

A

120-129
less than 80

107
Q

HTN Stages
High (stage 1)

A

130-139
80-89

108
Q

HTN Stages
High Stage 2

A

140 and up
and/or
99 and up

109
Q

HTN Stages
Crisis

A

over 180
and/or over 120

110
Q

HTN emergency

A

over 180
over 120
with EOD
Brain, Eye, Heart, Kidney

111
Q

HTN Urgency

A

Over 180
Over 120
No EOD

112
Q

Post stent meds

A

SABA
Statin
Antiplatelet (DAPT)
BB
Ace

113
Q

AAA screening

A

Abdominal US
65 and up
Once

114
Q

LBBB Ekg

A

L axis
LVH (mitral regurg)
Big floppy heart, S3

115
Q

HOCM first line

A

BB (keep heart calm and slow)
Then CCB,
Then Dig

S4 seen in hocm

116
Q

Non dihydropyridine CCB

A

DI-VER
cardio selective CCB
Diltiazem
Verapamil

117
Q

dihydropyridine CCB

A

not cardio selective
-dipines
ie amlodipine

118
Q

Murmurs that are blowing

A

Mitral and aortic regurg

119
Q

most common ASD

A

ostium secundum

120
Q

Ostium primum is linked to what

A

Fetal alcohol syndrome
Downs

121
Q

ASD sound

122
Q

Describe R to L shunt

A

Too much blood in atrium
leads to R HF
arrhythmia
Pulmonary HTN

123
Q

What is it if you give BB or Digoxin and the HR increases

A

Accessory pathway such as WPW

124
Q

Amiodarone Side effects

A

Optic Neuritis
THyroid
Hepatitis
Pulmonary Fibrosis

125
Q

Afib tx with valve replacement

126
Q

Afib Anti coag tx

A

DOAC
Rivaroxaban
Edoxaban
Apixaban
Dabigatran

127
Q

Anti arrythmic meds
Class 1 and 3

A

Used for Rhytm control

128
Q

Anti arrythmic meds
Class 2 and 4

A

Rate control

129
Q

Anti arrythmic meds
1A

A

PDQ
SE - Torsades, Drug incuced Lupus

Used for WPW

130
Q

Anti arrythmic meds
1b

A

Lidocaine

Can be used for stable VT

dont give with narrow complex SVT

131
Q

Anti arrythmic meds
1C

A

Flecanaide, Propafenone

last line for VT

Used in AFib without stuctural heart disease

132
Q

Anti arrythmic meds
class 3

A

Amiodarone

Eye, thyroid, pulm fibrosis, hepatitis
Blue green skin

133
Q

Anti arrythmic meds
Class 4

A

non dihydrapyridien
DI-VEr

134
Q

Post Mi meds

A

BB
ASA
ACE
Nitro
Statin

135
Q

Best BB for ACS

A

metoprolol

136
Q

Entresto

A

Saccubatril and Valsartan

Neprolysin Breaks down BNP
ARB

137
Q

What increase with Loops

A

Uric acid
Hyperglycemia

Na and K go down

138
Q

Spironalactone Adverse effects

A

Potassium sparring

met Acid
Gynecomastia
Hyper K

139
Q

Acute exacerbation of CHF

A

LMNOP

Lasix
Morphine
Nitro
O2
Position and CPAP

140
Q

HCTZ electrolyte

A

NA and k go down

Uric acid, sugar go up

141
Q

Why ar BB given carefully in DM

A

BB can mask Hyperglycemia

142
Q

What meds dont you give for HTN and asthma

A

BB and ACE

143
Q

Potassium goes and up and down with what electrolyte

144
Q

Torsades refractory to mag

A

Overdrive pacing

145
Q

Brugada can lead to what

146
Q

First sign of STEMI is
STEMI Wave progression

A

Hyperacute t waves

J point elevation

ST elevation

Q wave formation (loss of R)

T wave inversion

147
Q

pulmonary htn shows what axis

A

Right axis deviation

148
Q

Major side effect of prostaglandin E1
(used to keep open PDA)

149
Q

Treatment for SSS

150
Q

MC sign of congenital heart defect

A

Basilar crackles
peripheral edema

151
Q

Holiday Heart

A

AFIB after drinking

152
Q

MC s/s of ACS in the elderly

153
Q

Common drug contraindicated in HF

154
Q

Most common stemi vessel

155
Q

Is coarctation of the aorta ductal dependent

156
Q

Early morning chest pain is most likely what?

A

Prinzmetal

157
Q

WHat EKG changes are seen in dilated cardiomyopathy

A

low voltage QRS

158
Q

What can an extra cervical rib be an indicator of

A

Thoracic outlet syndrome

159
Q

What medication for chronic stable angina increases coronary mortality

A

Short acting CCB

160
Q

Hyperkalemia Progression in Ecg

A

Peaked T wave
Widening QRS
Flattening and then dropped p wave
Sine wave - stretched out T wave

161
Q

Fastest Cardiac biomarker

162
Q

PCI timeline

A

90 minutes

If not give thrombolytics (up to 12 hours)

163
Q

STEMI / NSTEMI Anticoag

164
Q

What Common med don’t we use in ACS with COPD

165
Q

Heart Score

A

History (none, suspicious, yes)
ECG (none, nonspecific, significant)
AGE (<45, 45-64, >65)
Risk factors (none, 1-2, 3 or more)
Troponin (normal, 1-3x normal, >3 times normal)

166
Q

Cardiogenic shock pressor

A

Dobutamine
Norepi
Milrinone

167
Q

Pulmonic stenosis Murmur

A

Wide split S2
(anyone other than infant)

168
Q

Aortic valve fix

A

Not repaired
always replaced

TAVR

169
Q

Lovenox, fondaparinux, rivaroxaban are excreted where

170
Q

Kidney disease anticoag

A

Heparin
Warfarin

171
Q

Liver disease anticoag

172
Q

Pregnancy anticoag

173
Q

Rheumatic fever tx

A

1.2 benzathine penicillin Q month
until 21

174
Q

Diagnostic of aortic dissection

A

Unstable
TEE, TTE

Stable
CTA
MRA

Prep Study (10 decks)

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