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MCCEE > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the acute treatment of HF?

A 
Lasix - frusemide 
Morphine 
Nitrates
Oxygen 
Position - upright
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2
Q

Chronic treatment of CHF

A

Lifestyle: limit Na and fluid intake

Drugs

  • beta blocks and ACE/ARB for class II-IV
  • Loop diuretic
  • low dose spironolactone
  • daily ASA and statin if the cause is prior history of MI
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3
Q 
Which drug out of this has been shown to reduce mortality risk in HF? 
thiazide 
CCB 
spironolactone 
ACE
A

Spironolactone

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4
Q

what are the symptoms of LHF?

A 
L sided S3/S4 gallop 
Bilateral basically rales 
Pleural effusion 
Pulmonary edema 
PND
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5
Q

what are the symptoms of RHF?

A

R sided S3/S4 gallop
JVD
Hepatojugular reflex
peripheral edema

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6
Q

what is systolic dysfunction

A

EF is reduced

L ventricular end-diastolic volume is increased

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7
Q

what is non-systolic dysfunction

A

reduced ventricular compliance with systolic function

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8
Q

what are 4 side effects of loop diuretics (frusemide)?

A 
HypoCalcemia 
HypoKalemia 
Ototoxicity 
Dehydration 
Gout
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9
Q

what are side effects of thiazide?

A

HyperGLUC

  • glycemic
  • lipidemia
  • uricemia
  • calcemia
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10
Q

what are side effects of K+ sparing?

A

Hyperkalemia
Gynecomastia
Sexual dysfunction

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11
Q

what is the most common cardiomyopathy?

A

dilated

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12
Q

What happens to left ventricular size at end of diastole and systole in dilated cardiomyopathy?

A

increase in size of both

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13
Q

What happens to EF in dilated cardiomyopathy?

A

Decreases

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14
Q

What happens to left ventricular size at end of diastole and systole in hypertrophic cardiomyopathy?

A

Decreases in size

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15
Q

What happens to EF in hypertrophic cardiomyopathy?

A

Increases

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16
Q

What is the most common cause of cardiomyopathy?

A

Idiopathic

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17
Q

Which infections can cause a cardiomyopathy?

A

Cocksackievirus
Chagas
HIV
Parasites

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18
Q

Which drugs can cause a cardiomyopathy?

A

doxorubicin
AZT
Cocaine

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19
Q

What does S4 suggest?

A

Hypertrophic cardiomyopathy
Aortic stenosis
Systemic HTN
Idiopathic hypertrophic sub aortic stenosis

atria contracting forcefully in an effort to overcome an abnormally stiff or hypertrophic ventricle

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20
Q

How is hypertrophic obstructive cardiomyopathy inherited?

A

Autosomal dominant

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21
Q

How does hypertrophic cardiomyopathy present

A

Crescendo-Decrescendo increasing with reduced preload

reduced preload = standing, Valsalvs

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22
Q

what is the treatment of stable angina?

A

ASA
B-blocker
NG

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23
Q

U ain’t got enzymes with ….

A

Unstable Angina

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24
Q

When your patient is MOANing from an MI remember

A

Morphine
Oxygen
Aspirin
Nitrogen

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25
Q

What patients have atypical MI’s?

A

Diabetics
Women
Post-heart transplant

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26
Q

What is the mainstay treatment of a STEMI?

A

Emergency angiography and PCI if within 90 minutes

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27
Q

what is the treatment of STEMI if it is after 90mn of symptoms?

A

thrombolysis but has to be within the 3 hours of presentation

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28
Q

What is the long-term treatment of STEMI?

A 
ASA 
ACE 
B-blocker 
High dose statin 
Clopidogrel (if PCI was performed)
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29
Q

What are the side effects of statin medication?

A

Raised LFT
Myositis
Warfarin potentiation

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30
Q

What are SE of fibrates?

A

GI upsets
Cholelithiasis
Myositis
Raised LFT

31
Q

What are the side effects of niacin?

A 
Skin flushing 
Parasthesia 
Pruritus 
GI upset 
RaisedLFT
32
Q

What is the definition of HTN

A

BP >140 and/or > 90 on 3 occasions

33
Q

what is the treatment goal for HTN in a patient who is over 60?

A

150/90

34
Q

what is the treatment goal for HTN in a patient who is less 60?

A

140/90

35
Q

What is the treatment of a hypertensive emergency?

A

IV labetalol/nitroprusside/nicardipine

Don’t lower BP more than 25% over the first 2 hours to prevent hypo perfusion

36
Q

What is the Conn’s disease triad?

A

HTN
HypoK
Metabolic alkalosis

37
Q

What is Conn’s Disease ?

A

Hyperaldosteronism

38
Q

What are the causes of pericardial disease?

A

CARDIAC RIND

Collagen vascular disease 
Aortic dissection 
Radiation 
Drugs 
Infections 
Acute renal failure 
Cardiac MI

Rheumatic fever
Injury
Neoplasm
Dressler syndrome

39
Q

What are the symptoms of pericarditis

A

Pleuritic chest pain
Cough
SOB
Fever

40
Q

What is the treatment of pericardial tamponade?

A

Volume expansion with IV fluids
Urgent pericardiocentesis

May need to do a pericardial window

41
Q

Commonest sites of aortic dissection

A

Aortic valve

Distal to L subclavian artery

42
Q

What are the symptoms of aortic dissection?

A

Hypertension

Asymmetric pulse and BP measurements

43
Q

What is the gold standard for imaging of aortic dissection?

A

CT angiography

44
Q

What is the treatment of aortic dissection?

A

manage BP

give beta-blocker before vasodilators

45
Q

What is a type A aortic dissection?

A

proximal to L subclavian artery

46
Q

What are the SE of ACE inhibitors?

A

ANGIOEDEMA
Cough
Rash
HyPERkalemia

47
Q

What are the side effects of Dihydropyridines

A

Headache
Flushing
Peripheral edema

48
Q

What drugs are dihydropyridine

A

Nifedipine
Felodipine
Amlodipine

49
Q

What drugs are nonDihydropyridines

A

diltiazem

verapamil

50
Q 
Which one of these nitrates is not administered sublingual? 
Isosorbide dinitrate 
Isosorbide monodinitrate 
Glyceryl trinitrate 
Erythrityl tetranitrate
A

isosorbide mononitrate

51
Q 
Which one of these nitrates needs to be dilated? 
Isosorbide dinitrate 
Isosorbide monodinitrate 
Glyceryl trinitrate 
Erythrityl tetranitrate
A

Erythrityl tetranitrate

52
Q

What is the name of angina that occurs lying down?

A

Angina decubitus

53
Q

What are the side effects of nonDihydropyridines

A

bradycardia

54
Q

What is the main side effect of amiodarone?

A

Thyroid dysfunction

55
Q

In what patients should PDE be avoided? (cilostazol)

A

CHF``

56
Q

What effect does Digoxin have on the heart?

A

Reduces filling pressure
Increases contractility
Increases CO
Decreases HR

57
Q

Fixed splitting of S2 suggests

A

ASD

58
Q

What is the commonest SE of aspirin

A

rigning in the ears

59
Q

What is the presentation of aortic regurgitation?

A

Blowing/descrendo diastolic murmur
Widened pulse pressure
3rd intercostal space on the L

60
Q

What is the presentation of aortic stenosis?

A

Ejection systolic murmur
split S2
Plusus parvus et tardus

61
Q

What is the presentation of mitral stenosis?

A

Mid-diastolic murmur at the apex

62
Q

What is the presentation of mitral regurgitation?

A

Holosystolic murmur radiating to the axilla

63
Q

This presentation suggest:

  • Genital ulceration
  • Oral ulceration
  • Ocular involvement
  • Skin lesions
A

Behcet’s Syndrome

64
Q

Which disease has painless ulcers?

A

Syphilis

65
Q

What is the cause of axillosubclavian vein thrombus?

A

Repeated use of arm in a raised position.

66
Q

Which drugs reduce preload and after load?

A

ACE inhibitors
AngII
Nitroprusside
Prazocin

67
Q

Why should NSAID’s be avoided in HF?

A

Cause fluid retention

68
Q

What is a normal ABI?

A

0.9-1.2

69
Q

What is the ABI of someone with claudication?

A

0.7- 0.4

70
Q

What is the ABI of someone with claudication at rest?

A

< 0.4

71
Q

What is a normal EF?

A

55-75%

72
Q

Symptoms of digoxin toxicity?

A 
AV-block 
Thrombocytopenia 
Delirium 
Severe bradycardia 
Ventricular arythmie
73
Q

Which drugs are Beta 1 selective blockers?

A

Atenolol
Acembutol
Metoprolol
Esmolol (IV)

74
Q

What is the treatment of HTN in a patient who is having a stroke?

A

Monitor if < 220/120

MCCEE (16 decks)

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