Cards Flashcards
Size cutoffs for ascending aortic aneurysm where surgery would be recommended
AAA over 5.5cm, or expanding by .5cm or more in one year, meets indication for surgical repair
Which HF drugs have mortality benefit
Mortality benefit
- ACEi (or ARB)
- Beta blocker (specifically metop XL, coreg, bisoprolol)
- Spironolactone
- Hydral and long-acting nitrate in blacks w/ class III-IV HF symptoms
Choice of beta-blocker for heart failure pts
Ones w/ shown mortality benefit: metop XL, bisoprolol, coreg
How does valsalva affect murmur of HOCM?
Valsalva decreases preload => worsens HOCM murmur
Key factor in choice of antiplatelet (CYP12 inhibitor) in pt w/ recent stroke
Use clopidogrel
-don’t use prasugrel b/c contraindicated in pts w/ stroke in the past 90 days given increased risk of ICH
Guidelines AAA screen
65-75 y/o if ever smoke
High dose statin
Atorva 80
Crestor (rosuva) 40
NOT simvastatin 40! that’s moderate- can’t go higher 2/2 risk of myopathy
Why simvastatin stinks
Simva has high risk of myopathy => max dose is 20mg to use concomittantly w/ amlodipine, verapamil, dilt
Pulsus paradoxus pathophysiology
Pulsus = difference in SBP between expiration and inspiration
-inspiration = decreased preload 2/2 decreased venous return => drop in systolic pressure w/ inspiration
Severe 10-20: can sometimes even palpable disappearance of pulse w/ inspiration