Clinical Questions - Cardiology Flashcards
Treatment for acute exacerbation of CHF
“NO LIP”
Nitrates: dilate peripheral vasculature (veins) to reduce preload
Oxygen
Loop diuretics
Inotropic drugs - dobutamine, milrinone, amrinone
Positioning - with legs down
LHC findings that indicate CABG needed
Major indications for CABG
severe 3 vessel disease
Left main with >50% stenosis
Precautions taken for cardioversion in stable afib
Afib > 48 hr or unknown onset: obtain a TEE
- No thrombus can cardiovert
- a/c for 3 weeks then repeat TEE if thrombus seen on initial TEE
Afib less than 48 hr: cardiovert +/- a/c depending on risk
Treatment classes for AR (decrescendo diastolic murmur, wide pulse pressures…) s/p infective endocarditis
ACE-I or CCB: decrease afterload and slow progression of AR
If significant sxs - AV replacement
Territory for anterior wall STEMI
V2-V5 - LAD
territory for inferior wall STEMI
II, III, aVF
Territory for lateral wall STEMI
I, aVL
Sharp, left sided chest pain that is relieved by sitting forward - work up to r/o or r/I acute pericarditis
- ECG - diffuse ST segment elevation, diffuse PR depression, later diffuse inverted T
- ECHO: normal unless pericardial effusion
- CXR normal unless large pericardial effusion
- +/- elevated ESR, CRP, WBC
Vasculitis of the kidney, upper airway, lungs
Granulomatosis with polyangiitis (Wegeners)
Vasculitis of he kidney and GI tract, but spares the lungs
Polyarteritis nodosa
Vasculitis associated with Palpable purpura on the legs, associated with IgA nephropathy
Henoch-Schonlein purpura
Vasculitis in a young asthmatic
Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)
Vasculitis in a young male smoker
Thromboangiitis obliterans (Buerger)
Vasculitis associated with 2 yo Asian girl with strawberry tongue and desquamation of the hands/feet
Kawasaki disease
Vasculitis associated with 20 yo Asian woman with weak pulses in the upper extremities
Takayasu arteritis
