Cardiovascular Flashcards
revascularization is indicated when stenosis of the left main coronary artery is greater than what?
50%
What medication is contraindicated with prinzmetal angina because it can exacerbate vasospasm?
propanolol (non selective bb)
What is the gold standard dx test for prinzmetal variant angina?
coronary angiography with injection of provocative agents into the coronary artery
What is used to prevent sx of vasopastic angina?
CCBs
What virus is most common cause of acute pericarditis?
coxsackievirus
What can a water bottle silhouette on chest XR indicate?
acute pericarditis
What will a CXR show for a patient with an aortic dissection?
Widened mediastinum
What is the USPSTF recommendation for Aortic aneurysm?
one time screening by US in med ages 65-75 who have ever smoked.
At what size should an AAA be referred to a vascular surgeon?
> 4.5cm
What is the gold standard test for Pleural Effusion?
Spiral CT scan
What is the gold standard definitive test for dx but used in cases which dx of PE uncertain after noninvasive testing?
pulmonary angiography
What is the gold standard for dx of pulmonary HTN?
Right heart catheterization
What medicine needs to be used ASAP to decrease co morbidity and co mortality in CHF?
ACEI
What are the three specific BBs in reducing mortality from heart failure?
bisoprolol, carvedilol, metropolol
What is the best test for dx CHF?
echocardiogram
How do you treat systolic left HF?
ACEI, BB, Loop diuretic
how do you treat diastolic HF?
ACEI, BB or CCB
Whats the mc bacteria in endocarditis with IV drug users?
Staph. aureus
Whats the mc bacteria in endocarditis with a prosthetic valve?
Staph. epidermidis
What’s the empiric treatment for endocarditis?
IV vanc or ampicillin/sulbactam PLUSaminoglycoside
At what age does USPFTF recommend screening for patients with NO evidence of CVD and no other rfs?
35 yo
What is hypertensive urgency?
very high BP >/ 180 systolic or >/120 diastolic without target-organ damage
What’s the time frame for reducing BP in a hypertensive emergency?
reduced within 1 hour to prevent progression of end-organ damage or death
What is hypertensive retinopathy (malignant HTN)?
diastolic reading greater than 140 with papilledema + either encephalopathy or nephropathy
Whats the treatment for hypertensive urgency?
clonidine (drug of choice)
Whats the treatment for hypertensive emergency?
sodium nitroprusside (drug of choice)
What is the treatment of choice for malignant hypertension?
hydralazine
What is a normal level for triglycerides?
less than 150
Moderate to severe hypertriglyceridemia (>500) may cause what?
pancreatitis, eruptive xanthomas, lipemia retinalis
What is the major reason to treat hypertriglyceridemia?
to prevent pancreatitis
isolated elevated triglycerides levels are treated with what?
Fibrates and niacin
Soft HIGH PITCHED, BLOWING DIASTOLIC murmur along LSB with the patient sitting, leaning forward after exhaling
Aortic regurgitation (diastolic murmur)
DIASTOLIC low-pitched DECRESCENDO and rumbling with OPENING SNAP at the APEX
mitral stenosis
High pitch, decrescendo murmur at LUSB, increases with inspiration
Pulmonary regurgitation (diastolic murmur)
Mid diastolic rumbling at LLSB with opening snap
tricuspid stenosis
What are the most common kind of heart murmurs?
midsystolic (ejection murmurs)
Systolic ejection crescendo-decrescendo RUSB
Aortic stenosis
HARSH MIDSYSTOLIC EJECTION CRESCENDO-DECRESCENDO murmur with WIDELY SPLIT S2 at LSB that RADIATES TO THE LEFT SHOULDER & NECK
Pulmonic stenosis
Medium-pitched, mid-systolic murmur that decreases with squatting and increases with straining
hypertrophic cardiomyopathy
Mid systolic ejection click at apex
Mitral valve prolapse
blowing holosystolic murmur at apex with a split s2
mitral regurgitation
High-pitched holosystolic murmur at mid LSB
tricuspid regurgitation
HARSH HOLOSYSTOLIC murmur heard best at the LSB with WIDE RADIATION and a fixed, split S2
ventricular septal defect
