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USLME Step 1 > Cardiovascular- First Aid > Flashcards

Cardiovascular- First Aid Flashcards

1
Q

Treatment of STABLE angina (ABCDE)

A 
A- aspirin and antianginals
B- beta blocker and control of BP
C- cigarretes and cholesterol reduction
D- diet and diabetes
E- education
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2
Q

Prinzmetal angina (Definition, Causes, Findings)

A
  • coronary artery spasm with complete coronary artery occlusion
  • tobacco, cocaine, triptans
  • ST elevation due to transmural ischemia
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3
Q

Left circumflex coronary artery supply

A

lateral and posterior walls of left ventricle

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4
Q

Left anterior descending coronary artery

A

anterior 2/3 of interventricular septum, anterior papillary muscle, and anterior surface of left ventricle

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5
Q

Posterior descending artery

A

supplies posterior 1/3 of interventricular septum and posterior walls of ventricles

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6
Q

Microscopic changes in MI

A

coagulative necrosis (no nuclei)–> neutrophils–> macrophages–> granulation tissue (heart is permanent tissue)–> fibrosis

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7
Q

Pathophysiology of Hemosiderin laden macrophages in the lungs

A
  • secondary to left sided heart failure
  • increased hydrostatic pressure in the pulmonary vasculature leads to rupture of pulmonary capillaries
  • blood leaks into alveolar space
  • alveolar macrophages consumes the blood
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8
Q

Features of Eisenmenger’s syndrome

A
  • RVH
  • Polycythemia (hypoxemia-induced erythropoietin release)
  • Clubbing (cyanosis)
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9
Q

Paradoxical Embolus

A
  • Seen in ASD that has reversed (R–>L) shunt
  • DVT enters into right heart, gets shunted to the left, and enters the systemic circulation
  • embolus either in brain or lower extremities
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10
Q

Jones criteria for Rheumatic fever

A
  • migratory polyarthritis
  • valvular damage (mitral>mitral+aortic»tricuspid)
  • subcutaneous nodules
  • erythema marginatum
  • sydenham chorea
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11
Q

Pathophysiology behind and findings for WIDENED PULSE PRESSURE in aortic regurgitation

A
  • increased stroke volume and decreased cardiac output secondary to regurg increases SP and decreases DP respectively
  • bounding pulses, head bobbing, pulsating nail bed
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12
Q

Complications of atherosclerosis (thickened intima of medium/large vessels)

A
  • PVD (popliteal artery)
  • Angina/MI (coronary)
  • Ischemic bowel disease (mesenteric artery)
  • Stroke (middle cerebral)
  • Atherosclerotic emboli
  • aneurysm (abdominal aorta)
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13
Q

Class 1A Antiarrhythmics

A
  • Quinidine, Procainamide, Disopyramide
  • increase AP duration, increase effective refractory period
  • increase QT interval
  • use for both atrial and ventricular arrhythmias, especially re-entrant and ectopic SVT and VT
  • cinchonism (quinidine), reversible SLE-syndrome (procainamide), heart failure (disopyramide), thrombocytopenia, torsades de pointes due to increased QT inerval
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14
Q

Class 1B Antiarrhythmics

A
  • lidocaine, mexiletine
  • decrease AP duration, preferentially affect ischemic or depolarized tissue
  • use for both acute ventricular arrhythmias (post-MI) and digitalis-induced arrhythmias
  • CNS stimulation/depression, cv depression
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15
Q

Class 1C Antiarrhythmics

A
  • flecainide, propafenone
  • significantly prolongs refractory period in AV node, minimal effect on AP duration, negative inotropy
  • use for SVT’s, atrial fibrillation, refractory VT
  • proarrhythmic, contraindicated in structural and ischemic heart disease
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16
Q

Class 2 Beta blockers

A
  • metoprolol, propranolol, esmolol, atenolol, timolol, carvedilol
  • decrease SA and AV nodal activity by decreasing cAMP, Ca currents, decrease slope of phase 4 (Na funny channels)
  • use for SVT
  • impotence, bronchospasm, bradycardia, AV block, CHF,sedation, sleep alterations, hypoglycemia, dyslipidemia (metoprolol), vasopasm in Prinzmetal angina
17
Q

Class 3 K channel blockers

A
  • amiodarone, ibutilide, dofetilide, sotalol
  • increase AP duration, increased ERP, increased QT interval
  • Afib, atrial flutter, v-tach
  • torsades, excessive beta blockade (sotalol), torsades (ibutilide), pulmonary fibrosis, hepatotoxicity, hypothyroidism, hyperthyroidism, corneal deposits, skin deposits–> photodermatitis, neurologic effects, constipation, bradycardia, heart block, CHF (amiodarone)
18
Q

Class 4 Calcium Channel Blockers

A
  • verapamil, diltiazem
  • decreased conduction velocity, increased ERP, increased PR interval, prolong phase 4 in AVN, SAN
  • Prevention of nodal arrhythmias (SVT), rate control
  • constipation, flushing, edema, CHF, AV block, sinus node depression

USLME Step 1 (16 decks)

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