Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Rosh Review > Cardiovascular Disorders > Flashcards

Cardiovascular Disorders Flashcards

1
Q

Types of Brugada Syndrome

A

*Picture from Q1 Exam 3 (154481)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What classic ECG finding is identified in arrhythmogenic right ventricular cardiomyopathy?

A

Epsilon wave - positive ecg deflection after QRS segment in leads V1-V3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Most common bowel site of secondary aortoenteric fistula?

A

Duodenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Monitoring the progression of AAA (by size)

A

< 5.5 cm - US annually
>/= 4.5cm with greater expansion rate - US every 6 months
Can also use CT or MRI
> 5.5 cm - Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for superficial thrombophlebitis

A
  • Intrinsic hypercoagulable states
  • Varicose veins
  • IV catheter use
  • Pregnancy
  • Hx of vein excision or ablation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Differences in diagnosis and management between uncomplicated and complicated superficial thrombophlebitis

A

Uncomplicated:
- Venous segment <5cm
- Remote from saphenofemoral or saphenopopliteal junctions
- Lack of medical risk factors for hypercoagulability
TX: NSAIDs, extremity elevation, compression

Complicated:
- Venous thrombosis >5cm
- Within 5cm of a deep vein
- Recurrent or migratory thrombophlebitis
- Suppurative thrombophlebitis
TX: Anticoagulation, often require antibiotic administration or vein ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What test is gold standard to confirm myocarditis?

A

Endomyocardial biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common cause of myocarditis worldwide/US

A

T. cruzi (Chagas disease)/viruses such as parvovirus B19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which is the best sonographic view to assess for cardiac wall motion abnormalities?

A

Parasternal short-axis view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most common presenting symptom in patients with acute aortic dissection?

A

Chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First step in evaluation of an LVAD patient

A

Auscultate precordium to detect a hum or “whirr” to determine if pump is functioning - absence points to mechanical failure including an interrupted power source or controller malfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to check BP of an LVAD patient

A

With a doppler or arterial line - may not have a pulse if there is no longer innate cardiac contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Definitive tx for constrictive pericarditis

A

Paricardiectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Symptoms of constrictive pericarditis

A

Similar to heart failure (especially right-sided HF)

  • Fluid overload (dependent edema, anasarca)
  • Diminished cardiac output (fatigue, dyspnea on exertion)
  • Kussmaul sign (increase in JVP during inspiration)
  • “Dip and plateau” LV filling (diastolic) tracing
  • Pericardial knock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of constrictive pericarditis

A
  • Idiopathic
  • Infectious (viral, TB, fungal, parasitic)
  • Postcardiac surgery
  • Postradiation therapy
  • Connective tissue disorder
  • Misc (uremic, malignant, drug-induced, sarcoid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Constrictive Pericarditis vs. Restrictive Cardiomyopathy

A

CP: results from scarring and consequent loss of elasticity of the pericardial sac

RC: disease of the myocardium that results in restricted ventricular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Causes of restrictive cardiomyopathy

A
  • Amyloidosis
  • Sarcoidosis
  • Hemochromatosis
  • Tropical endomyocardial fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What nerve overlies the pericardium and must be carefully avoided at surgery?

A

Phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What dissection presentation predicts a poorer outcome?

A

In or near the carotid artery resulting in stroke-like symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most frequent site of arterial embolism?

A

Bifurcation of common femoral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common presentation in patients who are diagnosed with an abdominal aortic aneurysm?

A

Asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to monitor AAA by size

A

4-4.9cm - US annually
5-5.4cm - US every 6 months
>5.5cm or aneurysms with rapid expansion rate - elective surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Screening criteria for AAA

A

One-time screening for AAA by ultrasonography in men aged 65-75 who have ever smoked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Low flow (ischemic) vs. high flow (nonischemic) priapism

A
  • Low flow painful
  • Pathophys of low flow = decreased venous outflow; high flow = increased arterial inflow
  • Shaft rigid and painful in low flow; shaft partially rigid and painless in high flow
  • Glans soft in low flow; hard in high flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Causes of low flow priapism

A
  • Sickle cell
  • Erectile dysfunction drugs
  • Other medications and drugs
  • Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Causes of high flow priapism

A
  • Arterial-cavernosal shunt formation (groin or straddle injury)
  • High spinal cord injury or lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Way to distinguish between low flow and high flow priapism

A

Cavernosal blood gas - normal in high flow and with pH <7.25, CO2>60 and O2<40 in low flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which type of priapism is urologic emergency?

A

Low flow - requires draining corpora cavernosa blood or injecting phenylephrine into corpora cavernosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ECG findings indicative of posterior wall MI

A
  • ST segment depressions in leads V1, V2, and V3
  • Tall, broad R waves in V2-V3
  • Dominant R wave in V2 (R/S ratio > 1)

On posterior leads -> elevations in leads V7 and V8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Sgarbossa Criteria

A
  1. Concordant ST elevation > 1mm in leads with a positive QRS (5pts)
  2. Concordant ST depression > 1mm in V1-V3 (3pts)
  3. Discordant ST elevation 5mm in leads with a negative QRS (2pts)
    3pts = STEMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What medications require increased dose of adenosine?

A
  • Methylxanthines
  • Caffeine
  • Theophylline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What medications require a lower dose of adenosine?

A
  • Carbamazepine
  • Dipyridamole
  • Cardiac transplant
33
Q

What are mycotic aneurysms?

A

Focal arterial dilatations

34
Q

Etiology of mycotic aneurysms?

A
  • Direct bacterial inoculation
  • Bacteremic seeding
  • Contiguous infection
  • Septic emboli
35
Q

Typical presentation of mycotic aneurysm

A
  • Painful, pulsatile, enlarging mass associated with systemic symptoms of infection (fever, malaise, myalgias)
  • At deeper sites, a palpable mass may not be appreciated
  • When in femoral arteries, frequently associated with acute limb ischemia due to thrombosis within the aneurysm
36
Q

Typical microbiology of mycotic aneurysm

A
  • Staph aureus
  • Staph epidermidis
  • Salmonella
  • Strep pneumo
    Occasionally syphilis or Mycobacterium
37
Q

Dx of mycotic aneurysm

A

CTA or MRA

38
Q

Tx of mycotic aneurysm

A

Abx and aggressive surgical debridement

39
Q

Diagnostic criteria for pulmonary hypertension

A

Mean pulmonary arterial pressure greater than 25 at rest or greater than 30 during exertion

Also with decreased cross-sectional area of the pulmonary vascular bed, increased pulmonary blood flow, increased pulmonary venous pressure

40
Q

Physical exam findings of pHTN

A

Initially cyanosis

S1 followed by ejection click
S2 narrowly split
Increased intensity of pulmonary component of S2

As progresses, JVD, hepatomegaly, peripheral edema from RHF

41
Q

What is first line tx for torsades?

A

Mg sulfate

42
Q

Most common causes of prolonged QT

A
  • Drug interactions (procainamide, quinidine, propafenone, flecanide, TCAs, droperidol, phenothiazines, erythromycin, fluoroquinolones, methadone)
  • Myocardial ischemia
  • Electrolyte disturbances (hypomagnesemia, hypokalemia)
43
Q

Other than Mg sulfate and defibrillation, what is another tx for torsades?

A

Increase HR to shorten ventricular repolarization, also known as overdrive pacing

Avoid amiodarone as this can cause QT prolongation itself

44
Q

What is the most common dysrhythmia following commotio cordis?

A

Ventricular fibrillation

45
Q

Risk window on ECG for commotio cordis

A

Upstroke of T wave

46
Q

Medications to avoid in aortic stenosis

A

Nitroglycerin, diuretics, or anything that reduces preload

47
Q

Murmurs

A

Remember to study them and how they increase/decrease with maneuvers

48
Q

What is the initial tx for symptomatic congenital long QT syndrome?

A

beta-blockers - most effective being propranolol and nadolol

49
Q

What conditions can multifocal atrial tachycardia be present?

A

Common in elderly patients with chronic lung disease

Also seen in heart failure and sepsis

50
Q

Time troponin is detectable from onset of ischemia

A

3-12 hours

51
Q

Peak of troponin after ischemia

A

24-48 hours

52
Q

Time for troponin to return to baseline

53
Q

Time CK is detectable from onset of ischemia

A

3-12 hours

54
Q

Peak of CK after ischemia

55
Q

Time for CK to return to baseline after ischemia

A

48-72 hours

56
Q

What is the role of beta-adrenergic blocking agents in acute MI?

A

Given within 24 hours of presentation reduce risk of developing ventricular dysrhythmias

57
Q

What cardiac biomarker has highest sensitivity and specificity?

58
Q

When is the cardiac biomarker CK useful?

A

Useful for diagnosis of reinfarction

59
Q

Absolute contraindications to anticoagulation

A
  • NSGY within past 10 days
  • Active bleeding
  • Severe bleeding diathesis
  • Platelet count <20,000
  • Severe allergy
60
Q

Relative contraindications to anticoagulation

A
  • Mild-moderate bleeding diathesis
  • Platelet count >20,000 but less than normal
  • Brain mets
  • Recent major trauma
  • Major abdominal surgery in last 2 days
  • GI or GU bleeding in past 14 days
  • Endocarditis
  • Severe hypertension
61
Q

When anticoagulating a patient with DVT with enoxaparin and warfarin, when is it safe to have the patient stop enoxaparin

A

When INR is greater than 2.0 for 2 consecutive days

62
Q

Etiology of acute MR

A

ISCHEMIC:

  • Acute MI with papillary muscle displacement
  • Trauma

NONISCHEMIC:

  • Ruptured mitral chordae tendineae (flail leaflet) due to myxomatous disease (MVP)
  • Infective endocarditis
  • Blunt chest trauma
  • Rhematic heart disease
  • Spontaneous
63
Q

Clinical presentation of acute MR

A
  • Sudden onset and rapid progression of pulmonary edema, hypotension, and s/s of cardiogenic shock
  • Systolic murmur is often soft, harsh, low-pitched, and decrescendo, often ending well before A2; best heard along left sternal border and base of heart
64
Q

Types of Wellens Syndrome

A 
Really a continuum, but need to recognize both
In leads V1-V2...
Type A: Biphasic T wave
Type B: Deeply inverted T wave
Q143890
65
Q

What is the most common symptom of cardiac ischemia in patients older than 85 years?

66
Q

What initial anti-hypertensive should be initiated in African American population (including those with diabetes)?

A

Thiazide or CCB

67
Q

What is the most likely cardiac arrest rhythm in someone who arrests in public (as opposed to at home)?

68
Q

What diagnostic test has the highest sensitivity for diagnosing a DVT?

A

Venography (Duplex US still first-line imaging)

69
Q

What antibiotic is recommended as prophylaxis for high-risk patients undergoing a dental extraction?

A

Amoxicillin (2g by mouth)

70
Q

What affect will atropine have on third degree heart block?

A

It alters conduction ratios without changing the appearance of the ventricular escape rhythm

71
Q

What entities may cause a falsely large E-point septal separation?

A

Mitral stenosis and aortic stenosis

72
Q

Mechanism of action of atropine

A

Competitively inhibits acetylcholine at the AV node from the vagus nerve

73
Q

What medication should be avoided in myocarditis

A

NSAIDs (can exacerbate disease and increase mortality)

74
Q

What medication is contraindicated in the tx of a child younger than 12 months old with SVT? In what other situations is this medication contraindicated?

A

CCB due to poor calcium reserves in the sarcoplasmic reticulum in infants
(Also contraindicated in children with heart failure, suspected WPW, or wide QRS complex)

75
Q

What is the most common significant dysrhythmia in pediatrics?

76
Q

What is the most common cause of tricuspid valve stenosis?

A

Rheumatic heart disease

77
Q

Murmur with VSD

A

Harsh, holosystolic murmur heard best at left lower sternal border
Murmur may no longer be present later due to reversal of shunting and a loud S2 caused by pulmonary hypertension

78
Q

What is an epsilon wave?

A

Small positive deflection at end of QRS complex that is most specific finding for arrhythmogenic right ventricular dysplasia

Rosh Review (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions