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Family Medicine EOR > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the best initital test for all forms of chest pain?

A

ECG

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2
Q

Q waves are consistent with what?

A

a prior MI

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3
Q

What is used to confirm the diagnosis of angina?

A

stress test

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4
Q

How is ischemia detected on a stress test?

A

ST segment depression > 2mm

+/- T wave

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5
Q

If a patient has a positive stress test what’s next?

A

cardiac catheterization

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6
Q

What test is more sensitive in detecting ischemia?

A

exercise stress echocardiography

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7
Q

Stress test is C/I in who?

A

unstable angina , MI, aortic dissection , aortic stenosis, uncontrolled HTN, ventricular arrhythmias

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8
Q

How do you diagnosis stable angina pectoris?

A

positive stress test

perfusion scintigraphy testing

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9
Q

What is the txt for stable angina?

A

beta blockers, ACEI, statins, aspirin, CCB, coronary angioplasty, coronary artery bypass graft surgery

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10
Q

How many times can sublingual nitroglycerin be admin?

A

q 5mins up to 3x

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11
Q

What is the definitive procedure for angina?

A

coronary angiography

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12
Q

What medication is used for immediate relief of acute angina?

A

nitroglycerin

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13
Q

What is the 1st line therapy for angina?

A

b blockers

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14
Q

If a pt can’t take a beta blocker for their angina what’s the alternative?

A

CCB

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15
Q

Metabolic Syndrome

A

abdominal obesity, triglycerides > 150, HDL <40 men, <50 women, fasting glucose >110 and HTN

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16
Q

What drug is associated with MI?

A

cocaine

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17
Q

What is the #1 risk factor for MI?

A

Smoking

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18
Q

Angina w/wo ST elevation, but normal artery

A

Prinzmental variant angina

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19
Q

How is prinzmetal’s angina diagnosed?

A

ECG at time of attack

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20
Q

How does prinzmetal’s angina look on ECG?

A

ST elevation

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21
Q

What is the txt for prinzmetal angina?

A

CCB

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22
Q

What is C/I in Prinzmetal angina?

A

beta blockers

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23
Q

What is the best test for diagnosing CHF?

A

Echocardiogram

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24
Q

What is the gold standard for diagnosing right heart failure?

A

right heart cardiac catherization

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25
Q

What lab is elevated in CHF?

A

BNP

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26
Q

What is the treatment of systolic left heart failure?

A

ACEI + Beta blocker + Loop Diuretic

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27
Q

What is the txt for diastolic heart failure?

A

ACEI + B blocker or CCB

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28
Q

What are the 3 beta-1 selective used for CHF?

A

Bisoprolol
Carvedilol
Metoprolol succinate

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29
Q

What is a feature of systolic heart failure?

A

S3

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30
Q

What does S3 mean?

A

rapid ventricular filling during early diastole

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31
Q

What feature is diastolic heart failure?

A

S4

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32
Q

What drug should NEVER be used for diastolic CHF?

A

Digoxin

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33
Q

What is the most common cause of right heart failure?

A

left heart failure

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34
Q

Left sided heart failure is characterized by?

A

pulmonary congestion, exertional dyspnea and cough, fatigue, orthopnea, basilar rales, nocturnal dyspnea

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35
Q

Right sided heart failure due to chronic lung disease?

A

Cor pulmonale

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36
Q

What is Dressler syndrome?

A

pericarditis, fever, leukocytosis, and pericardial or pleural effusion occurring 1-2 weeks after MI

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37
Q

Two complications of pericarditis?

A

pericardial effusion and cardiac tamponade

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38
Q

Chest pain that is worse when supine and during inspiration and alleviated when leaning forward

A

pericarditis

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39
Q

When is pericardial friction rub best heard?

A

upright and leaning forward

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40
Q

What is Dressler’s syndrome?

A

pericarditis 2-5 days after an acute MI

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41
Q

MC viral cause of pericarditis?

A

Coxsackievirus

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42
Q

What does EKG show for pericarditis?

A

diffuse, ST segment elevations in the precordial leads

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43
Q

What is Kussmaul’s sign?

A

an increase rather than normal decrease in CVP during inspiration

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44
Q

Txt of pericarditis?

A

txt the underlying disease

NSAIDs

45
Q

Txt of pericardial effusion?

A

pericardiocentesis

46
Q

What causes uremic pericarditis?

A

effect of untreated kidney disease

47
Q

Define primary hypertension?

A

> 130/80 on two readings at two separate visits with NO identifiable cause

48
Q

stage 1 hypertension?

A

130-139/ 80-89

49
Q

stage 2 hypertension?

A

> 140/90

50
Q

What is seen on fundoscopic exam for a pt with hypertension?

A

arteriovenous nicking

51
Q

Txt for most hypertension also those w/ diabetes?

A

Ace or CCB or Thiazide diuretic

52
Q

Txt for stage 2 HTN?

A

2 hypertensive meds

53
Q

Txt for black adults w/ hypertension?

A

Thiazide and CCB

54
Q

SDE of acei

A

cough, hyperkalemia, C/I preggo

55
Q

Sde of spironolactone?

A

hyperkalemia

56
Q

Beta blockers are C/I in?

A

Asthma

57
Q

What does alpha blockers txt?

A

HTN and BPH

58
Q

sde of CCB?

A

leg edema

59
Q

sde of hydralazine?

A

lupus like syndrome and pericarditis

60
Q

Acute rebound hypertensive episode have been reported to occur with the sudden withdrawal of?

A

Clonidine

61
Q

sde of thiazide?

A

hypokalemia

62
Q

MC cause of secondary hypertension?

A

Primary aldosteronism

63
Q

In a hypertensive emergency, blood pressure must be reduced in ?

A

1 hr

64
Q

Bp of a hypertensive emergency?

A

> 180/ > 120

65
Q

What is a hypertensive emergency

A

bp >180/>120 with end-stage organ damage

66
Q

What is a hypertensive urgency?

A

bp >180/>120 WITHOUT target end organ damage

67
Q

What is malignant HTN?

A

diastolic > 120 associated w/ papilledema and either encephalopathy or nephropathy

68
Q

Consequence of untreated malignant HTN?

A

progressive renal failure

69
Q

What drug can cause malignant htn?

A

MAOI

70
Q

DOC for hypertensive emergency?

A

sodium nitroprusside

71
Q

DOC for hypertensive urgency?

A

Clonidine

72
Q

DOC for malignant htn?

A

hydralazine

73
Q

Sde of sodium nitroprusside?

A

cyanide toxicity

74
Q

antidote for cyanide toxicity caused by sodium nitroprusside?

A

sodium thiosulfate

75
Q

Which hyperlipidemia medication cause flushing?

A

Niacin

76
Q

Severe hypertriglyceridemia >500 causes?

A

pancreatitis
eruptive xanthomas
lipemia retinalis

77
Q

Xanthomas are seen in?

A

hyperlipidemia

78
Q

Guidelines for fasting lipid panel on asymptomatic pts?

A

q 5 yrs

79
Q

Txt for hyperlipidemia?

A

statins, fibrates, niacin, fish oil

80
Q

Sde of statin?

A

myopathy, rhabdomyolysis

81
Q

What drug is used for the txt of isolated hypertriglyceridemia

A

gemfibrozil

82
Q

What is is endocarditis?

A

infection of the endocardium

83
Q

What causes acute bacterial endocarditis?

A

S. aureus

84
Q

What causes subacute bacteral endocarditis?

A

Strep viridans

85
Q

What causes endocarditis in IV drug users?

A

Staph aureus

86
Q

What causes prosthetic valve endocarditis?

A

Staph epidermidis

87
Q

Large vegetations in endocarditis is caused by?

A

Candida

88
Q

What is the txt for large vegetations in endocarditis?

A

Amp B

89
Q

MC cause of endocarditis?

A

Strep viridans

90
Q

What pathonogemics are seen in endocarditis?

A

Splinter hemorrhages
Osler nodes- painful lesions
Roth spots
Janeway lesions

91
Q

Dx of endocarditis?

A

Blood cultures- before abx 3sets- 1hr apart

Transesophageal echocardiogram

92
Q

What is the gold standard for dx endocarditis?

A

Transesophageal echocardiogram

93
Q

Whom should receive prophylactic for endocarditis prior to dental procedure?

A 
prosthetic heart valves
hx of endocarditis
unrepaired cyanosis heart disease
congenital heart disease repaired w/ prosthetic device
heart valve dx after heart transplant
94
Q

Txt for native valve endocarditis?

A

IV ampicillin plus nafcillin + gentamicin

95
Q

Txt for prosthetic valve endocarditis?

A

vancomycin + gentamicin + raifampin

96
Q

Txt for IV drug user endocarditis?

A

IV nafcillin

97
Q

Txt for pcn allergic pts with endocarditis?

A

vancomycin, clindamycin, cephalexin, azithromycin

98
Q

What is the abx prophylaxis for endocarditis?

A

2g of Amoxicillin 30-60 before procedure

99
Q

Which valve is affected with IV drug users w/ endocarditis?

A

Tricuspid

100
Q

What are Osler nodes?

A

PAINFUL, violaceous raised lesions of the fingers, toes, or feet

101
Q

What are Janeway lesoins?

A

PAINLESS, red lesions of the palms or soles

102
Q

What are Roth spots?

A

exudative lesions in the retina

103
Q

What criteria is used to establish endocarditis?

A

Duke

104
Q

Initial txt for pt with suspected endocarditis?

A

Vancomycin + cefepime

105
Q

What should be routinely check with statins?

A

CMK and LFTs

106
Q

1S Line thx for triglycerides?

A

Fibrates gemfibrozil

107
Q

What is the 2nd line txt for triglycerides?

A

Niacin

108
Q

High levels of triglycerides increase the chance of?

A

acute pancreatitis

Family Medicine EOR (15 decks)

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