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Level Two > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Medication resistant HTn + systolic-diastolic abdominla bruit = dx?

A

renovascular HTN

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2
Q

b9 or pathologic in kids: mumurs that decreaes iwth standing

A

b9

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3
Q

name the murmurs:

  1. SQUEAKy at LLSB.
  2. High pitched LUSB.
A
  1. SQUEAKy at LLSB = Still’s

2. Pulm flow murmur is high pitched LUSB.

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4
Q

tx vfib or pulseless vtach with?

A

defibrillation

vfib = AMio or epi

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5
Q

Atrial tachycardia or flutter or supraventricular or PULSE v tach
(all are TACHYARRHYTHMIAS)

A

synchronized cardiovert.

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6
Q

slow heart ACLS = tx wtih what drug?

A

ATropine to incr sympathetics

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7
Q

Narrow complex tachycardia = SVT = any sinus tachycardia, any MAT, atrial flutter/fib/ AVNRT, AVRT, junctional tachy = ?tx

A

adenosine

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8
Q

Crescendo-decrescendo systolic murmur along LSB in a young pt that INCREASES with valsalva, nitro and DECREASES with squatting, hand grip

A

HOCM - increases with increased preload / decreases with incr afterload

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9
Q

Descending v ascending aortic aneurysms - difference in etiology

A

DESCENDING aortic aneurysms MCC is cystic medial necrosis dt connective tissue disorders.

ASCENDING aortic aneurysms are usually dt atherosclerosis.

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10
Q

AMiodarone SE

A

Amiodarone is quite toxic and can be a “BITCH” - great mnemonic!

Bradycardia / Blue man
Interstitial Lung Disease
Thyroid (hyper and hypo)
Corneal (ocular) / Cutaneous (skin)
Hepatic / Hypotension when IV (due to solvents)
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11
Q

Postop w/i 14 days of a sternotomy - F/Tachycardia/leukocytosis/chest pain/sternal wound draina Note pus in mediastinum and widened mediastinum.

Dx and treatment

A

Think MEDIASTINITIS.

Treat with abx an surgical debridement/drainage.

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12
Q

Carotid endarterectomy indications:

A

> 70% in sx men and women

> 60% in asx men

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13
Q

person falls from >10ft - think what injury and what first test?

A

CT to look for aortic injury.

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14
Q

a person with arrythmia is taking a drug chronically and developes peripheral edema. what durg?

A

CCB

caused by vasodilation, which incr hydrostatic pressure, causeing fluid extravasation

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15
Q

what drug can be used in vasospastic angina that causes potent coronary artery dilation (with weak systemic arterial dilation)

A

dilitazem

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16
Q

After two intial HTN readings, what four test should be performed?

A
  1. UA for hematuria and urine protein:Cr ratio
  2. Lipid panel
  3. baseline ECG
  4. CBC
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17
Q

uremic pericarditis (friction run LLSB)–> tx?

A

HD

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18
Q

cocaine = vasodilation Treat the sympathetic hyperactivity (HTN) and anxiety with ____. DO NOT USE beta blockers - why?

A

BENZOS

dont use BB because unopposed alpha stim worsens vasoconstriction.

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19
Q

statin MOA

A

inhibits HMG-CoA (RLS in intracellular hepatic cholesterol synthesis).

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20
Q

pt with HTN presents with: bradycardia, hypotension, wheezing, hypoglycemia, delirium, seizures, cardiogenic shock.

what OD and first line of tx

A

beta blocker.

Atropine, IVF and give GLUCAGON.

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21
Q

a person with an anterior STEMI presents wtih f acute limb ischemia/distal arterial occlusion uspcted, so echo to screen. pt is at high risk of thrombus ML from where?

A

left ventricular thrombus

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22
Q

DDx of stridor in infants = acute (2)

A

croup v foreign body

23
Q

DDx of stridor in infants = Chronic (2) =

A

laryngomalacia

vascualr ring

24
Q

Chronic cause of stridor in infant that is WORSE when SUPINE

A

laryngomalacia

25
Chronic cause of stridor in infant that is BETTER when PRONE
vascular ring
26
Hypertrophic cardiomyopathy inheritance
AD
27
Digeorge assoc with what immune deficiency nad hwat electrolyte abn? what cardio malformation?
DiGeorge has T-cell lymphopenia (virus and fungal) and HYPOCALCEMIA. truncus arteriosis.
28
regular tachycardia resoles with cold water immersion =
PSVT
29
what does vagal (carotid sinus massage, cold water, valsalva) do in PSVT or AV-nodal -reentrant tachy?
incrases PSNS= SLOW AVnode conduction and terminate AVNRT
30
Pediatric pt presents with viral prodrome and then resp distress and HF sx. Dx and MC etiology?
A: pediatric viral myocarditis. MCC coxsackie B and adeno
31
non cardiac or pulm conditions associated with afib =
obesity, DM, hypothyroid, alcohol avuse, | drugs (amphetamine, cocaine, theophylline).
32
inferior wall MI (RCA) =
papillary rupture - acute MR regurg - , RV failure, basal septal rupture.
33
anterior wall MI (LAD) =
free wall rupture, apical septal rupture.
34
beat to beat alteration of QRS in same lead is called _____. pathog for?
ELECTRICAL ALTERNANS | PATHOGNOMONIC for PERICARDIAL EFFUSION.
35
common cause of LE edema accompanied by varicose veins, skin discoloration, medial skin ulceration. Risk factors = age, obesity, FHx, preg, Hx of LE trauma or LE Venous thormbosis
chronic venous insufficiency
36
Pericardial thickening and calcification = ? Limits diastolic filling, so see RHF. Etiology cna be idiopathic or dt prior cardiac surery - CABG, vavle - or mediastinal irriation, TB, malignancy, uremia.
CONSTRICTIVE PERICARDITIS.
37
Sx: DOE, fatigue, lethargy, extertional syncope (dt decr CO), exertional angina (dt incr myocardial demand). Findings: incr JVP, PERIPHERAL EDEMA, TR murmur, RBBB on ECG/pulm HTN,* RIGHT HEART CATH=PULM HTN AND RIGH TVENTRICULAR DYSFUNCTION. Dx: ? MCC?
cor pulmonale (prumary pulm HTN) Etiology: MCC is COPD >interstitial lung dz, OSA
38
~Torsades (polymoprhic Vtach) tx:
Immediate defibrillation and then IV magnesium.
39
~Amiodaro use:
- just atrial and vetnricular vtach. is not used for polymorphic Vtach
40
Mobitz 1 v 2. Excercise/atropine will do what to each?
IMPROVE 1 and WORSEN 2.
41
Locations of MObitz 1 v 2
1 is AVnode, 2 is below AVn at bundle of his.
42
CHADS2-VASC2
Condition Points C Congestive heart failure (or Left ventricular systolic dysfunction) = 1 H Hypertension: blood pressure consistently above 140/90 mmHg (or treated hypertension on medication) = 1 A2 Age ≥75 years = 2 D Diabetes Mellitus = 1 S2 Prior Stroke or TIA or thromboembolism = 2 V Vascular disease (e.g. peripheral artery disease, myocardial infarction, aortic plaque) = 1 A Age 65–74 years = 1 Sc Sex category (i.e. female sex) = 1
43
Hypertrophic CardioMyopathy in young pt - what pharm for sx pat (angina, HF, syncope)?
BB or CCBs to prolong diastole and decrease myocardial contractility to decrease LVOT obstruction and improve sx of angina. (negative inotopic agents). Reducing LV preload and SVR, as with vasodilators/ACE/ARB - worsens LVOT gradient and sx.
44
sensorineural deafness + QTc >600 +sudden loss of consciousnes = ?
Jervell and Lange-Nielsen | syndrome --> torsades risk, so LIFELONG PROPRANOLOL AND P ACEMAKER.
45
nitrates dilate what? result?
nitrates cause SYSTEMIC venodilation/incr venous capacity = REducE PRELOAD.
46
why does NE cause vasoconstriction?
alpha 1 AGONIST
47
in ICU pt on pressors - what three places would be most likley to see ischemia/necrosis?
A: fingers/toes, intestines (acute mesenteric ischemia), kidneys (ARF).
48
Major cause of RHF is ________ - leads to incr JVP, peripheral edema, ascites, hepatic congecstion, cardiac cirrhosis.
constrictive pericarditis
49
pulsus bisferiens (biphasic pulse) = (murmur)
AR
50
S4 = what lobe etiology?
S4 = LV etiology (HTN, AS, HCM, MI)
51
pacemakers are implanted on the right sdie of heart - at SA and AV nodes, so if RHF develops - expect ??
TR dt papillary mm injiry
52
MCC of aortic dissection
HTN >marfans or cocaine
53
Amiodarone (i.e. for afib), verapamil, quinidine, propafenone INCREASE ____ drug = incr risk of toxicity
INCREASE DIGOXIN levels - | toxicity of dig.

Level Two (15 decks)

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