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Clinical Medicine- Cardiology > Cardiovascular diseases > Flashcards

Cardiovascular diseases Flashcards

1
Q

Acute MI can be caused by?

A

Ischemia to coronary artery or blood clot that occludes artery

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2
Q

Symptoms of AMI?

A

Chest pain, radiation of left arm, jaw, back, neck, mimics heartburn, N & V, dyspnea, lightheadedness, diaphoresis, anxiousness, palpitation, LOC

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3
Q

Emergency treatment of AMI

A

Morphine 2-4mg IV q 15 mins, oxygen via nasal canula, aspirin 325mg PO, Nitroglycerin 0.4mg SL q 5 mins (3 doses)

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4
Q

Treatment for adjunct pulmonary embolism?

A

Lasix-Morphine-Nitro-Oxygen-Position/Positive pressure ventilation

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5
Q

Reperfusion therapy for AMI?

A

Thrombolytic drugs, balloon angioplasty, CABG

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6
Q

What leads would an inferior MI show up on and what artery affected?

A

II, III, aVF. RCA and PDA

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7
Q

What leads would an anterior MI show up on and what artery affected?

A

V1-V6. LAD

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8
Q

What leads would a lateral MI show up on and what artery affected?

A

I, aVL, V5, V6. Left circumflex artery

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9
Q

What leads would a posterior MI show up on and what artery affected?

A

V1-V4. RCA

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10
Q

Labs to run if suspect MI

A

Troponin occurs 2-6 hours and peaks 12-24 hours, CK-MB occurs 4-6 hours and peaks 12-24 hours, myoglobin occurs 1-3 hours and peaks 4-12 hours

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11
Q

When should thrombolytics be used and which ones?

A

Useful for STEMI when PCI is not available for >90 mins. Drugs to use tenecteplase, t-PA, r-PA

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12
Q

What are contraindications of thrombolytics?

A

Hx of hemorrhagic event in brain, intracranial neoplasm, active internal bleeding, suspected aortic dissection, hemorrhagic retinopathy, poorly controlled HTN, INR>2, pregnancy, recent trauma or major surgery, prolonged CPR

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13
Q

If someone has had an MI and they present with abrupt onset of hypotension with increased venous pressure and PEA what is the most likely cause?

A

Myocardial rupture

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14
Q

What are some contraindications of anticoagulation?

A

Recent stroke, pericarditis, ulcer disease

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15
Q

If someone has an PE following MI what should you treat with?

A

Heparin (80u/kg bolus, then 18u/kg/hr) or enoxeparin (1mg/kg q 12h SC). With massive PE consider t-PA and surgical consult

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16
Q

When would you not use a beta blocker?

A

Cocaine induced MI, increased risk of cardiogenic shock, heart block, asthma, reactive airway

17
Q

Treatment for unstable, prinzmental agina?

A

Oxygen, serial EKG, enzymes and admit. Morphine, NTG, beta blocker, ASA, anticoagulants, GP IIB/IIIA inhibitors. PCI if patient doesnt respond to treatment

18
Q

What is the treatment plan for CHF following MI?

A

Oxygen/venous access, Morphine, diuretics, nitroglycerin

19
Q

What dosing would you use for nitroglycerin for CHF following MI? What do you want to look out for?

A

Give IV, start at 10 microgram/minute and tritrate. Beware of inerior MI or RV infarct.

20
Q

When would you use nitroprusside? What dosing?

A

If CHF is directly related to hypertensive emergency. (2-20microgram/kg/min. Titrate for desired BP

21
Q

What do you need to what out for with hypertension & hypertensive crisis?

A

Beware of aggressive treatment of asymptomatic patients with hypertension.

22
Q

What drugs would you use in a hypertensive emergency and doses?

A

Nitroprusside ( 2-20microgram/kg/min), Labetalol ( 20mg IV over 2 minutes then double dose every 10 minutes as needed, maximum 300mg), Hydralazine (10-40mg IV every 15-30 minutes)

23
Q

What medication can you use in a hypertensive emergency if the patient is pregnant?

A

Hydralazine (10-40mg IV every 15-30 minutes)

24
Q

If a patient is planned to have a PCI following UA.NSTEMI, what should they be given?

A

Loading dose of P2Y12 inhibitor

25
Q

What should not be administered routinely in patients with UA/NSTEMI before angiography, or patients who are being medically treated?

A

Prasugrel

26
Q

How long should patients on P2Y12 inhibitors withhold their dose before a CABG?

A

5-7 days

27
Q

Hypertensive emergency medications?

A

IV furosemide; vasodilators: IV sodium nitroprusside, IV nitroglycerin, IV fenoldopam; BB; IV metoprolol/labetolol; CBB; dihydropyridine

28
Q

In patients with continuing or frequently recurring ischemia and whom beta blockers are contraindicated, what drug should be used?

A

Verapamil and diltiazem. In the absence of LV dysfunction

29
Q

When should an ACE inhibitor be administered with UA./NSTEMI?

A

Pulmonary congestion or LV ejection fraction

30
Q

How long should you wait to take nitro after taking PDE-5 inhibitor?

A

24hrs for sildenafil (Viagra) and 48hrs after tadalafil (cialis)

31
Q

Which anitplatelet drug is metabolized by 2C19? What other drug are should you watch out with these?

A

Clopidogrel (Plavix), 50% asians have 2C19 genetic variants. Watch out for PPI

32
Q

Which beta blockers prevent unopposed alpha 1 properties?

A

Carvedilol

Clinical Medicine- Cardiology (5 decks)

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