Cardiology Tintinalli Q&A Flashcards
Pulmonary Embolism Risk Stratification
Hestia Crietria or SPESI (Simplified Pulmonary Embolism Severity Score)
SPESI elements
Cancer
Age >80
HR >110
SBP <100
Fio2 <90%
HF
Chronic Lung Disease
Adjusted D-Dimer Formula
Age x 10ng/ml
PERC Rule
Age ≥ 50
HR ≥ 100
O2 <95%
Unilateral leg swelling
Hemoptysis
Sx or Trauma (w/in 4 wks)
Prior PE or DVT
Hormone Use
All have a value of 1
Maneuver to increase murmur in hypertrophic cardiomyopathy
Standing
> Any intervention to decrease left ventricular filling and distending pressure in the left ventricular outflow tract or that increase force of myocardial contraction
San Francisco syncope rule
CHF
Hematocrit <30%
ECG Changes
Shortness of breath
SBP <90
Left Circumflex Artery MI
ST elevation in lead: I, aVL, V5
ST depression in lead: V1-3
Obtuse marginal artery MI
Same as Left Circumflex artery MI
ST elevation in lead: I, aVL, V5
ST depression in lead: V1-3
Left anterior descending MI
ST elevation in V1-V3
ST depression in II,III,aVF
Right coronary artery MI
ST elevation in II, III (greater than II), aVF
ST depression in I and aVL
Thrombolysis in Acute MI (TIMI Score)
Age ≥ 65
> 3 Risk Factors for Coronary Artery Disease
Known CAD >50% stenosis
Aspirin use in the past 7 days
Severe angina w 2 or more episodes in 24 hours
All 1 point.
Score 0-1: Low risk of adverse outcome
Higher score: require a more aggressive intervention
What are prostanoids
Potent vasodilators for pulmonary arterial hypertension
(Epoprostenol [HL 2-5mins] , Treprostinil, Iloprost)
Intraaortic balloon pump counterpulsation effects
DECREASED: Afterload and O2 Demand
INCREASED: Diastolic Blood Pressure and Coronary perfusion
D-Dimer Factors that could cause a False POSITIVE result
> 70yo
Cancer
Liver Disease
Infeciton
Surgery within 7 days
Trauma
D-Dimer Factors that could cause a False NEGATIVE result
Warfarin
Symptoms lasting > 5 days
Small Isolated Pulmonary Infraction
Small Clots
Lipemia
Which population requires prophylaxis for endocarditis when undergoing dental procedures than involve manipulation of gingival tissue, periapical region of the teeth or perforation of the oral mucosa?
(+) Mitral valve prolapse and concomitant mitral regurgitation
Blue toe syndrome
Also known as purple toe syndrome or Trash foot
(+) warfarin intake, pain in feet during summer, toes are dusky, cool, and tender with delayed CRT
Normal cardiac exam
6 P’s of ALI
Pain
Pallor
Paresthesia
Pulselessness
Paralysis
Polar/Poikilothermia
Characterize a patient with an embolic disease
No history of claudication
Normal contralateral leg
Sudden onset of pain
Minimal Peripheral Disease
No Contralateral circulation
Afib is the most common cause
Characterize a patient with a thrombotic disease
(+) Claudication
(+) Peripheral artery disease findings in both extremities
Gradual onset of pain
(+) Collaterals on imaging
Widespread disease
