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MEDI > CR IV MEDI Cardio > Flashcards

CR IV MEDI Cardio Flashcards

1
Q

What are causes of hypertonic hyponatremia?

A

Hyperglycemia or hypertonic infusion

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2
Q

How is isotonic hyponatremia similar to hypertonic hyponatremia

A

Similar to hypertonic hyponatremia but slow onset time so body has time to adjust

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3
Q

What are non-renal and renal causes of hypovolemic hypotonic hyponatremia?

A

Non-renal - GI (UNa <20)

Renal - Thiazide diuretics, low aldosterone (UNa >20)

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4
Q

What are two causes of euvolemic hypotonic hyponatremia? How can you tell them apart?

A

SIADH and Psychogenic polydipsia
SIADH - Urine concentrated
Psychogenic polydipsia - urine dilute

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5
Q

If Na is increased too quickly, what is caused?

A

Osmotic Demylination Syndrome

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6
Q

What three labs are needed for hyponatremia?

A

Urine Na
Urine Osmolarity
Plasma osmolarity

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7
Q

How is the water deprivation test performed? What does each point tell you?

A

Restrict water - if urine osm improves = polydipsia
Give ADH - if urine osm improves = neurogenic
If ADH does not improve = nephrogenic

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8
Q

What diuretics do you use to treat hypervolemic hyponatremia? Hypervolemia hypernatremia?

A

Loop diuretics - hyponatremia

Thiazide diuretics - hypernatremia

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9
Q

What should be ordered immediately when K >5.5?

A

EKG

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10
Q

What ECG abnormalities can be seen with hyperkalemia?

A

High T-wave, widened QRS

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11
Q

What should be given immediately to stabilize a patient with hyperkalemia if symptomatic?

A

IV calcium gluconate

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12
Q

What should be given to treat someone with hyperkalemia?

A

Insulin and glucose

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13
Q

If a patient is hyperkalemic and in metabolic acidosis, what should be given?

A

IV bicarb

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14
Q

What should be checked when a person is truly hypokalemic?

A

Magnesium

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15
Q

What is the most common cause of hypercalcemia?

A

Hyperparathyroidism

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16
Q

What three things should be given to treat hypercalcemia?

A

Saline
Loop diuretics
IV bisphosphanates

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17
Q

What is the treatment for hyperphosphatemia?

A

Oral phosphate binders

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18
Q

What regulates the movement of calcium into SMC?

A

MAgnesium

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19
Q

What helps stabilize hypermagnesia? What is the treatment of choice?

A

Stabilize - IV calcium gluconate

Hemodialysis - treatment of choice

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20
Q

What test is good at showing myocardial viability, better than eCHO and stress EKG?

A

Nuclear scintigraphy - MPI

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21
Q

What test is still used in oncology and is useful for identifying EF?

A

MUGA scan

22
Q

What is the best test for congenital heart disease?

A

MRI with gadolinium contrast

23
Q

What is the most popular drug for cardiac stress testing? What can be used if BMI > 50?

A

Lexiscan

Adenosine - if BMI > 50

24
Q

What is the first goal of treatment for Afib? Second goal? Long term use?

A

Rate
Rhythm
Amiodarone - lone term use

25
Q

What is the most common symptom of LHF?

A

Orthopnea

26
Q

What is a major cause for Afib, not procedure related?

A

Obstructive Sleep Apnea

27
Q

What is hypokensis? Akinesis? Diskinesis?

A

Hypokenesis - ischemia, low oxygen, can be reversed
Akinesis - dead tissue thins wall
Dyskinesis - anneurysm

28
Q

What is the angiographic hallmark of prinzmetal’s angina?

A

Coronary spasm w/ ST elevating during chest pain, goes away when pain goes away

29
Q

What is the treatment order for angina?

A 
Aspirin 1st
BB 2nd
long-acting nitrate
CCB
Statin
30
Q

What should be used for IHD in a hypotensive patient?

A

Ranolazine

31
Q

What did the Courage trial show?

A

Medical treatment vs PCI no different in long term for asymptomatic patient
PCI still wins when symptoms present

32
Q

What does 3rd heart sound indicate? 4th heart sound?

A

3rd - dilation because of ischemia

4th - diastolic dysfunction because of ischemia

33
Q

What is the cornerstone of treatment for a person with Acute coronary syndrome?

A

BB and Nitrates

34
Q

What score is used to evaluate chest pain in the ER?

A

HEART score

35
Q

What is the gold standard enzyme for diagnosing MI?

A

Troponin

36
Q

What is mandatory treatment after PCI?

A

P2Y12 inhibitor/ASA dual treatment

37
Q

Is treatment for STEMI and nonSTEMI different?

A

No

38
Q

What complication has occured if you hear a loud harsh systolic murmur?

A

Interventricular septal rupture

39
Q

If a person keels over after lifting or straining after an MI, what most likely has happened?

A

Free wall rupture

40
Q

What should be done if Right ventricular infarction occurs?

A

Volume expansion

41
Q

What should not be given in Dressler’s Syndome?

A

Steroids

42
Q

What is the most important diagnostic measure for HF?

A

ECHO

43
Q

What is the corner stone of treatment for HF? What should be added if EF <35?

A

ACEI or ARB

Spironolactone

44
Q

What BB is great for HF, particular diabetes?

A

Carvedilol

45
Q

What is an a-wave mean? V-wave? Cannon a-waves? Large V-waves?

A

A-wave - pressure in atria during atrial contraction
V-wave - pressure in atria during ventricular systole
Cannon a-wave - atrial contraction against closed tricuspid (v.tach, junctional rhythms)
Large v-waves (tricuspid regurg)

46
Q

What two things are required for diagnosis of pulmonary hypertension?

A

Righ heart cath

PA resting pressure > 25 mmhg

47
Q

What calculator is used for risk of serious complication before/after surgery?

A

NSQIP calculator

48
Q

What is 1 MET? 4 MET? >10 MET?

A

1 MET - eat, dress, use toilet
4 MET - can walk up 1 flight of stiars
>10 - can do physical exercise

49
Q

When is resynchronization therapy (biventricular pacer used)?

A

QRS >120
Symptomatic (NYHA III or IV)
EF < 35

50
Q

What is a defibrilator used?

A

Class II or III with reduced EF

Already on max therapy

MEDI (11 decks)

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