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Step 2 Last Minute > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Elevation and equalization of RA, RV, and PCWP after cardiac surgery

A

Cardiac tamponade

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2
Q

Causes of pulseless electrical activity?

A

5 H’s and T’s, + Anaphylaxis
Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hypo/hyperkalemia, Hypothermia
Tension pneumo, Tamponade, Trauma, Thrombosis (MI or PE), Toxins (narcotics, benzos)

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3
Q

Immunologic (immune complex) phenomena in endocarditis

A
  1. Osler nodes (painful fingertip nodules)
  2. Rosh spots (retinal hemorrhages with pale centers)
  3. Glomerulonephritis
  4. Positive rheumatoid factor
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4
Q

Embolic phenomena in endocarditis

A
  1. Janeway lesions (painless)
  2. Splinter hemorrhages
  3. Conjunctival hemorrhages
  4. Infarcts: stroke, renal infarct, splenic infarcts, digital gangrene
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5
Q

Endocarditis with nosocomial UTI

A

Endocarditis

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6
Q

Endocarditis with new AV block

A

Perivalvular abscess

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7
Q

Medications to hold prior to cardiac stress testing

A

Beta-blockers, CCBs, nitrates for 48 hours prior (caffeine for 12 hours prior)
(Continue ACEIs/ARBs, diuretics, statins, digoxin)

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8
Q

Persistent ST elevation well after an MI

A

LV Aneurysm (late complication, seen 5 days - 3 months after)

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9
Q

Type of cause of cardiac arrest in the first 10 minutes after an MI?
10-60 minutes after?

A

First 10: Re-entry

10-60: Abnormal automaticity

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10
Q

Location of MI with ST elevation in precordial leads? Vessel?

A

Anterior MI due to LAD occlusion

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11
Q

Location of MI with ST elevation in I, aVL, V5, and V6? Vessel?

A

Lateral MI due to circumflex or diagonal artery (off LAD)

May also see ST depression in inferior leads (II, III, aVF

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12
Q

Location of MI with ST depression in V1-V3? Vessel?

A

Posterior MI, usually due to RCA (right dominant, 70%), less commonly circumflex (left-dominant, 20%)

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13
Q

Posterior MI with ST depression in V1-V3. How can you tell whether it is RCA or circumflex occlusion?

A

RCA: ST depression in left lateral limb leads (I and aVL)
Circumflex: ST elevation in left lateral limb leads (I and aVL)

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14
Q

Location of MI with ST elevation in II, III, and aVF? Vessel?

A

Inferior MI, usually due to RCA (80%), sometimes circumflex

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15
Q

Signs of right ventricle MI on regular 12-lead EKG? Vessel?

A

ST elevation in V1 > V2 (or elevation in V1 and depression in V2) and elevation in III > II. (Confirm with ST elevation in V3R-V6R)

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16
Q

Vessel obstructed for MI with SA node block?

A

Either RCA (60%) or LCX (40%)

17
Q

Vessel obstructed for MI with AV node block?

A

Usually RCA (80%), sometimes LCX (20%)

18
Q

Malignant HTN

A

Severe HTN with retinal hemorrhage, exudates, or papilledema

19
Q

What can prevent flushing and pruritis due to niacin?

A

Low-dose aspirin beforehand

20
Q

Initial treatment for symptomatic sinus bradycardia

A

IV atropine (if fails, can externally pace or use dopamine or epi)

21
Q

Electrophysiological cause of a-fib? Atrial flutter?

A

A-fib: Ectopic foci around pulmonary veins

Flutter: Reentry around tricuspid valve

22
Q

Treatment for AVNRT

A

Try vagal maneuvers, then go to adenosine (Gi/Go, leads to transient AV node block)

23
Q

Regular rhythm at 180-200 with retrograde P waves buried in the QRS complex

A

AVNRT

24
Q

Treatment for sustained v-tac in a hemodynamically stable patient?

A

IV Amiodarone

But TdP is treated with magnesium sulfate

25
Q

Treatment for Torsades de Pointes in a hemodynamically stable patient?
Hemodynamically unstable?

A

Stable: Magnesium sulfate
Unstable: Defibrillation (not cardioversion, even if have pulse)

26
Q

Treatment for hereditary long QT syndrome

A

Beta-blocker, plus pacemaker or AICD if symptomatic or history of syncope

27
Q

Medication that can lead to acquired angioedema

A

ACEIs (ACE breaks down bradykinin)

28
Q

Antihypertensives that can lead to hyperglycemia and hyperlipidemia

A

Thiazides

29
Q

Diuretics leading to hypercalcemia? Hypocalcemia?

A

HyperCa: Thiazides
HypoCa: Loop diuretics

30
Q

Amiloride

A

Potassium-sparing diuretic that blocks ENaC

31
Q

Atrial tachycardia with AV block

A 
Digoxin toxicity (atrial tachycardia due to ectopic activity, AV block due to vagal tone).
(Also look for N/V/D and vision changes. Can be triggered by other cardiac drugs like amiodarone and verapamil)
32
Q

Treatment for beta blocker overdose

A

First IV fluids and atropine. If still hypotensive, give IV glucagon (also Gs)

33
Q

What is the big side effect of amiodarone you have to monitor for?

A

Chronic interstitial pnuemonitis (get CXR and PFTs before starting)
(Others: bradycardia, heart block, thyroid disease, liver toxicity, neurologic symptoms, visual disturbances, blue-gray skin discoloration).

34
Q

Fleicanide and propafenone

A

Class 1C antiarrythmics (use-dependent K+ block) sometimes used for rhythm control for paroxysmal a-fib

35
Q

Hypertension control in aortic dissection

A

Beta-blockers, goal is systolic 100-120.
(Nitroprusside can be added if beta-blockers not enough, but don’t give it alone as it can lead to reflex beta stimulation)

Step 2 Last Minute (19 decks)

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