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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
Q

Chronic cause of stridor in infant that is BETTER when PRONE

A

vascular ring

26
Q

Hypertrophic cardiomyopathy inheritance

A

AD

27
Q

Digeorge assoc with what immune deficiency nad hwat electrolyte abn? what cardio malformation?

A

DiGeorge has T-cell lymphopenia (virus and fungal) and HYPOCALCEMIA. truncus arteriosis.

28
Q

regular tachycardia resoles with cold water immersion =

A

PSVT

29
Q

what does vagal (carotid sinus massage, cold water, valsalva) do in PSVT or AV-nodal -reentrant tachy?

A

incrases PSNS= SLOW AVnode conduction and terminate AVNRT

30
Q

Pediatric pt presents with viral prodrome and then resp distress and HF sx. Dx and MC etiology?

A

A: pediatric viral myocarditis. MCC coxsackie B and adeno

31
Q

non cardiac or pulm conditions associated with afib =

A

obesity, DM, hypothyroid, alcohol avuse,

drugs (amphetamine, cocaine, theophylline).

32
Q

inferior wall MI (RCA) =

A

papillary rupture

  • acute MR regurg
  • , RV failure, basal septal rupture.
33
Q

anterior wall MI (LAD) =

A

free wall rupture, apical septal rupture.

34
Q

beat to beat alteration of QRS in same lead is called _____. pathog for?

A

ELECTRICAL ALTERNANS

PATHOGNOMONIC for PERICARDIAL EFFUSION.

35
Q

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

A

chronic venous insufficiency

36
Q

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.

A

CONSTRICTIVE PERICARDITIS.

37
Q

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?

A

cor pulmonale (prumary pulm HTN) Etiology: MCC is COPD >interstitial lung dz, OSA

38
Q

~Torsades (polymoprhic Vtach) tx:

A

Immediate defibrillation and then IV magnesium.

39
Q

~Amiodaro use:

A
  • just atrial and vetnricular vtach.

is not used for polymorphic Vtach

40
Q

Mobitz 1 v 2. Excercise/atropine will do what to each?

A

IMPROVE 1 and WORSEN 2.

41
Q

Locations of MObitz 1 v 2

A

1 is AVnode, 2 is below AVn at bundle of his.

42
Q

CHADS2-VASC2

A

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
Q

Hypertrophic CardioMyopathy in young pt - what pharm for sx pat (angina, HF, syncope)?

A

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
Q

sensorineural deafness + QTc >600 +sudden loss of consciousnes = ?

A

Jervell and Lange-Nielsen

syndrome –> torsades risk, so LIFELONG PROPRANOLOL AND P ACEMAKER.

45
Q

nitrates dilate what? result?

A

nitrates cause SYSTEMIC venodilation/incr venous capacity = REducE PRELOAD.

46
Q

why does NE cause vasoconstriction?

A

alpha 1 AGONIST

47
Q

in ICU pt on pressors - what three places would be most likley to see ischemia/necrosis?

A

A: fingers/toes, intestines (acute mesenteric ischemia), kidneys (ARF).

48
Q

Major cause of RHF is ________ - leads to incr JVP, peripheral edema, ascites,
hepatic congecstion, cardiac cirrhosis.

A

constrictive pericarditis

49
Q

pulsus bisferiens (biphasic pulse) = (murmur)

A

AR

50
Q

S4 = what lobe etiology?

A

S4 = LV etiology (HTN, AS, HCM, MI)

51
Q

pacemakers are implanted on the right sdie of heart - at SA and AV nodes, so if RHF develops - expect ??

A

TR dt papillary mm injiry

52
Q

MCC of aortic dissection

A

HTN >marfans or cocaine

53
Q

Amiodarone (i.e. for afib), verapamil, quinidine, propafenone INCREASE ____ drug = incr risk of toxicity

A

INCREASE DIGOXIN levels -

toxicity of dig.

Level Two (15 decks)

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