Cardiovascular System 1 Flashcards
When might you suspect congenital long QT syndrome?
Cardiac syncope; sudden cardiac death in kids
What’s the tx for congenital long QT syndrome?
Propranolol and pacemaker
Which antibiotics can cause long QT syndrome (2)?
- Macrolides
2. Fluoroquinolones
Which psych drugs can cause long QT syndrome (3)?
- Antipsychotics
- TCAs
- SSRIs
Which antiemetics can cause long QT syndrome (2)?
- Ondansetron
2. Granisetron
Which antiarrhythmics can cause long QT syndrome (5)?
- Quinidine
- Procainamide
- Flecainide
- Amiodarone
- Sotalol
What 2 types of drugs can be used in hypertrophic cardiomyopathy?
- B-blockers
2. Ca channel blockers
In patients with CHF, what does the RAAS system do to the efferent arteriole?
Causes preferential vasoconstriction of it to maintain adequate GFR
What’s the PCWP in PE?
Normal or low
What’s the PCWP in MI?
High
What does acute limb ischemia after MI suggest?
Possible embolus from L ventricle thrombus; order echo
What’s Beck’s triad for cardiac tamponade?
- Hypotension
- Distended neck veins
- Muffled heart sounds
What might be a question stem for cardiac tamponade?
Patient who recently had a viral illness; now has weakness and dyspnea
What medication can prevent ventricular remodeling after an MI?
Enalapril (or other ACE inhibitors)
What might be the etiology of a young adult with decompensated HF findings?
Viral myocarditis
The development of new Afib with rvr during pregnancy likely stems from which childhood illness?
Rheumatic fever
What’s a common cause of exertional syncope in elderly patients?
Aortic stenosis
What’s “pulsus parvus et tardus?”
Delayed and weak carotid pulse
What drugs can stable Afib patients take to stabilize the ventricular rate (3)?
- B-blockers
- Diltiazem
- Digoxin
What are the changes to the following parameters after an AV fistula?:
- Afterload
- Preload
- CO
Afterload: decreased
Preload: increased
CO: increased
What’s the most common cause of calcifications around the heart in developing countries?
TB
What are some features of benign murmurs?
Early or mid-systolic, grade I/II, decrease when standing
What are some features of pathologic murmurs?
Harsh, holosystolic, diastolic, grade III, increase with standing/valsalva
What post-MI complication can occur acutely?
Right ventricular failure
“That’s a cute RV”
What 2 post-MI complications can occur acutely or within 3-5 days?
- Papillary muscle rupture
2. IV septum rupture
What post-MI complication can occur between 5 days-2 weeks?
Free wall rupture
What post-MI complication can occur up to several months later?
Left ventricular aneurysm
How can you tell the difference between a papillary muscle rupture vs an IV septum rupture?
Papillary has a softer murmur without a thrill
“nasal septum holes are harsh”
What underlying disorder is a risk factor for <40 aortic dissections?
Marfan’s
How do you differentiate between acute abdominal aortic dissection vs renal infarction?
Aortic: hypotension
Renal: hypertension
What drug can cause interstitial pneumonitis?
Amiodarone
T/F: clonic jerks can occur during any syncopal episode that is associated with cerebral hypoxia?
True
What’s the initial tx for wide complex tachycardia?
Amiodarone
When should you suspect Printzmetal (vasospastic) angina?
Young patients with recurrent chest pain during sleep
Which 2 types of shock have increased central venous pressure?
- Obstructive
2. Cardiogenic
T/F: constrictive pericarditis can cause hepatomegaly and ascites?
True
What’s a pericardial knock?
Mid-diastolic sound
Which 6 drugs are CYP450 inhibitors and therefore increase warfarin effect?
- Metronidazole
- Macrolides
- Azoles
- Amiodarone
- Cimetidine
- Grapefruit juice
Which 5 drugs are CYP450 inducers and therefore decrease warfarin effect?
- Carbamazepine
- Phenytoin
- Phenobarbital
- Rifampin
- St. John’s wort
What test is contraindicated in patients with severe AS?
Exercise stress test
What causes exertional sx, pulsus parvus et tardus, soft S2, loud S4, and harsh systolic ejection murmur?
AS
What test has the highest sensitivity for CHF?
BNP
What’s the cause of cor pulmonale (impaired R ventricle function)?
Pulmonary HTN (usually due to chronic lung disease)
What medication is a good initial treatment for bradycardia and hypotension?
Atropine
Which 4 antihypertensives are first-line during pregnancy?
- Labetalol
- Nifedipine
- Hydralazine
- Methyldopa
Which 5 types of antihypertensives are contraindicated during pregnancy?
- ACE inhibitors
- Angiotensin II receptor blockers
- Direct renin inhibitors
- Nitroprusside
- Mineralocorticoid receptor antagonists (spironolactone)
What might a “water bottle” shaped heart and recent URI illness indicate?
Pericardial effusion/cardiac tamponade
Can you palpate the point of maximal apical impulse with a large pericardial effusion?
No
What condition is fixed splitting heard in?
ASD
The OS is ___?
MS
Which type of HF can be caused by chronic, severe tricuspid regurgitation?
RHF
Which device can cause tricuspid regurgitation?
Pacemaker
