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Clin Med > Cumulative - Cardio > Flashcards

Cumulative - Cardio Flashcards

1
Q

halo sign

A

temporal artery thickening on temporal US

-giant cell arteritis

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2
Q

tx: giant cell arteritis

A

high dose prednisone + low dose aspirin (immediately)

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3
Q

tx: DVT

A

LMWH (enoxaparin) followed by warfarin

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4
Q

diagnostic test for DVT

A

duplex US

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5
Q

diagnostic test for PE

A

CT angiography

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6
Q

vein that is most commonly varicosed

A

great saphenous

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7
Q

mechanism of varicose veins

A
  1. superficial venous insufficiency

2. valvular incompetence

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8
Q

sx: PAD

A

intermittent claudication (foot/lower leg pain resolved w/ rest)

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9
Q

tx: PAD

A
  • modify risk factors: smoking cessation; tx HTN, DM, hyperlipidemia
  • beta blocker, ACEI, statins, antiplatelet (if not contraindicated)
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10
Q

roth spots - what are they and what do they indicate

A
  • exudative lesions on retina

- infective endocarditis

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11
Q

janeway lesions - what are they and what do they indicate

A
  • painless red lesions on palms/soles

- infective endocarditis

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12
Q

osler nodes - what are they and what do they indicate

A
  • osler nodes

- infective endocarditis

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13
Q

dx endocarditis

A
  • 3 blood cultures, spaced 1 hour apart

- transesophageal echo - vegetation

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14
Q

causative organisms endocarditis

  • native valve
  • IV drug users (tricuspid valve)
  • prosthetic valve
A
  • native: Strep viridans, S. aureus
  • IV: S. aureus
  • Prosthetic: S. aureus, gram negs, fungi
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15
Q
  • cough + dyspnea
  • electrical alternans EKG
  • low voltage Q waves
A

pericardial effusion

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16
Q
  • narrow pulse pressure
  • tachycardic/tachypnic
  • JVD
  • pulsus paradoxus
A

cardiac tamponade

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17
Q

Friction rub
Substernal chest pain relieved by leaning forward
- what is it
- what EKG changes

A

acute pericarditis

diffuse ST elevation

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18
Q

tx: restrictive cardiomyopathy

A

diuretics

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19
Q

tx: hypertrophic cardiomyopathy

A

beta-blocker, CCB
disopyramide (neg inotropic effects)
possible ablation/pacing

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20
Q

tx: dialated cardiomyopathy

A

avoid EtOH

supportive

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21
Q

MC type of cardiomyopathy:

MCC?

A

dialated

  • genetics
  • excessive alcohol
  • postpartum
  • chemo tox
  • endocrinopathy
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22
Q

Takotsubo cardiomyopathy - what is this?

A

“broken heart syndrome”

  • extreme stress releases catecholamines; resulting in hypOcontractility of LV apex
  • clinically, looks like an MI
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23
Q

Cardiomyopathy that is usually genetic, found in otherwise healthy young ppl?

A

Hypertrophic

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24
Q

Cause of restrictive cardiomyopathy?

A
  • fibrosis of ventricular wall due to collagen defect dz (amylodosis, radiation, postop, DM)
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25
Q

Hypertrophic cardiomyopathy sx?

A

dyspnea, angina, syncope, S4

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26
Q

2nd degree heart block, Mobitz 2: where is the block in the conduction system

A

within His Bundle

intermittent non-conducted beings

27
Q

3rd degree heart block: where is the block in the conduction system

A

distal to His bundle

28
Q

tx: sick sinus syndrome

A

permanent pacing

29
Q

sick sinus syndrome - what is the heartbeat like?

A
  • sinus brady/pause/arrest

- alternating sinus tachy/sinus brady

30
Q

indication for ICD

A
  • recurrent vtach (w/o reversible cause)
  • congential long qt
  • brugada
31
Q

vtach: tx

A
  1. amiodarone
  2. lidocaine
  3. procainamide
32
Q

what is brugada syndrome?

A

Genetic d/o in Asian men

  • syncope
  • V. fib
  • sudden death in sleep
33
Q

long QT: sx

A
  • congential
  • recurrent syncope
  • ventricular arrhythmia
  • sudden death
34
Q

Possible causes of torsade de pointes

A
  • hypokalemia
  • hypomagnesemia
  • QT- prolonging drugs
35
Q

Tx: Torsade de Pontes

A
  • IV magnesium
  • tx other electrolyte abnormalities
  • isoproternol after initial correcting treatment
36
Q

PVCs - when to worry

A

3+ can lead to V.tah

possible causes: electrolyte abnormalities, MI, dilated CM

37
Q

Major complication of Afib

A

MCC of embolic cerebrovascular accident

38
Q

Difference in treating stable arrhythmia v. unstable arrhytmia

A
  • unstable: electricity

- stable: meds

39
Q

Midsystolic click
Late systolic murmur

What valve d/o

A
  • mitral valve prolapse

- thin females

40
Q

D/o of these valves present in childhood

A

Pulmonic and tricuspid

41
Q

D/o of these valves present in adults

A

Aortic and mitral

42
Q

What would be appropriate tx for someone with unstable bradycardia?

A

Atropine or epi/dopa (+ chronotropes) or pacing

43
Q

difference in carotid pulses

  • aortic stenosis
  • aortic regurg
A

AS: thready
AR: bounding

44
Q

MC valve d/o in US?

A

aortic stenosis

45
Q

What pt should NOT get CCBs for treating their HTN?

A

Those w CHF

46
Q

Tx: hypertensive emergency

A
  • Sodium nitroprusside
  • if myocardial ischemia: nitro/BB
  • if pg: hydralazine

Avoid dec. BP too fast - risk of cerebral ischemia

47
Q

Tx: HTN in pregnancy

A

methyl-dopa

48
Q

What drug class reduces mortality in both pt w/ CHF and post-MI pts?

A

Beta-blockers

49
Q

Beta-blocker affect on heart

A

Reduce HR and CO

50
Q

L-sided HF - clinical sx

A
  • exertional dyspnea
  • cough
  • fatigue
  • orthopnea, paroxsymal nocturnal dyspnea
  • gallps
  • exercise intolerance

Think of as “pulmonary vascular congestion”

51
Q

R-sided HF - clinical sx

A
  • pitting edema

- hepatomegaly

52
Q

Kerley B lines - what are they

A

CXR finding indicative of CHF

53
Q

tx: CHF

A

ACEI/ARB, some BB

54
Q

BB used for CHF (3)

A

bisoprolol, metoprolol, carvedilol

55
Q

MCC of ischemic heart dz

A

artherosclerotic narrowing

56
Q

Which gender dies more from CVD?

A

women

57
Q

maintenance tx: unstable angina

A

ACEI/BB + antiplatelet

58
Q

STEMI EKG criteria

A

ST elevation in 2+ contiguous leads

59
Q

STEMI: tx

A
  • aspirin + clopidogrel immediately
  • coronary angiography + PCI
  • if PCI unavailable, thrombolysis
60
Q

UA: tx

A
  • low risk: aspirin + clopidogrel immediately, then LMWH (enoxaparin) long term
  • if high risk; same as STEMI (angio+PCI)
61
Q

Tetrology of Fallot - what are 4 things

A

VSD
Aortic orignation over defect
RV outflow obstruction
RV hypertrophy

62
Q

ASD - PE findings

A
  • heave @ LLSB
  • S2 w/ fixed wide splitting
  • mid-systolic murmur at LUSB
63
Q

ASD - sx

A

usually asymptomatic

- DOE, fatigue

64
Q

ASD - tx

A

surgical repair to prevent cor pulmonale

Clin Med (12 decks)

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