CV Flashcards
Thiazide AE
HyperLUGS LDL Uricemia Glucose Sulf
Alpha 1 blox
good for BPH and HTN.
AE = OH and rebound HTN
which BBlox are mixed A and B?
carvedilol and labetalol
Tx of homocystinuria
B6 and B12. Assoc with risk of MI and hi LDL
Tx of MI
MONAB Morphine O2 NG ASA BBlox. Also start statin (low INF) Clopidogrel too
Dressler syndrom
2-4 weeks s/p MI/. AI pericarditis
Most common cause of death from MI
VFib, arrhythmia
WPW tx
Amiodarone, procainamide. NOT adenosine
Magic hour for AFib
48 h, can cardiovert if it’s before 48 h onset
Reasons for Acute AFib
PIRATES Pulm dz Ischemia Rheum dz Anemia/atrial myxoma Thyrotoxicosis ETOH Sepsis
Warfarin inhibits ____ first?
Ptn C/S. give hep concurrently until INR is Tx
S3 means what?
Dilated ventricles
EKG finding in cardiac tamponade?
Electrical alternans
BBlox that decrease mortality in CHF
Bisoprolol, XR metoprolol, carvedilol
What antihypertensive not to give in CHF?
CCB - decrease cardiac contractility. SADFACE
Nitroprusside tox
Cyanide tox
ACEI AE
Cough/angioedema (increase bradyK), azotemia (acute bump in Cr), hyperK, Teratogen (fetal renal dmg)
Drug induced lupus Abs
Anti histone Abs
Narrow QRS, HR > 100
SVT
No relation b/w p and qrs
3rd degree HB
3 p wave morphologies, rate > 100
Multifocal atrial tachycardia
rate <50
bradycardia
PR > 0.2 s
1st degree HB
Early, wide QRS w/o P
PVC
Wide QRS, HR 160-240
VTach
PR long, long, drop
2nd degree HB, Mobitz I, Wenckebach
Chaotic pattern, no P, no QRS
VFib
PR normal, occasional dropped beat
2nd degree HB, Mobitz II
Saw tooth
AFlutter
No P, narrow QRS, Irregularly irregular
AFib
Sinusoidal QRS
Torsades
Drug Induced Lupus Abs
Anti histone abs
Drug of choice in cardiogenic shock?
Dobutamine - B1
Pressor of choice in septic shock?
NorE. Vasoconstricts without inotropic effect
What kind of shock is shown by vasodilation and bradycardia?
Neurogenic
Tx for WPW?
Amiodarone and or procainamine (NO ADENOSINE)
Epistaxis, HA, LVH on EKG. (increased QRS voltage and ST/T changes)
Coarctation of the aorta
Effects of NG/nitroprusside on ICP?
Increases. DO NOT GIVE WITH SAH OR ISCHEMIC STROKE
Systolic-diastolic abd bruit?
Renal AA stenosis
Biggest RF for AAA?
Atherosclerosis (HTN is dissection)
Tylenol, NSAIDS and amiodarone can potentiate effects of what drug?
Warfarin
Tx for stable vtach?
IV Amiodarone. Cardiovert only for unstable, pulseless, Sx vtach
Extra heart sound associated with MI?
S4 because of stiff LV wall
B Blox in acute heart failure?
May WORSEN! due to decreased LV fcn
TC Atresia
Cyanotic congenital lesion. Left axis deviation, decreased pulm markings. hypoplasia of r ventricle and pulmonary outflow tract
JVD, ascites after radiation therapy?
Constrictive Pericarditis. Decreased CO and decreased diastolic filling
What is the strongest influence in long-term prognosis after STEMI?
Restoring coronary blood flow
Cause of OH in the elderly?
Check drugs, but prolly just decreased response of baroceptors
Water bottle shaped heart on CXR. Diminished heart sounds, difficult to locate PMI
Think pericardial effusion
Situation syncope
LOC in elderly or middle aged male during urination. Or LOC with coughing fits. Some type of autonomic dysregulation
Torsades - tx and some associations
Tx with mag. Familial long QT/anything that causes prolonged QT can lead to it (amiodarone, sotalol/both are class III antiarrhythmics). Hypo mag can lead to it too. Also TCA’s can as well
Tx for ‘lone afib?’
None - check CHADS2, but if nothing else - dont need to treat
CHADS2 score of 1 tx?
Clopidogrel > ASA
CHADS2 >= 2 tx?
Oral anticoag with something like rivaroxiban
Pulsus Paradoxus
Seen in tamponade. large decrease in BP with inspiration. Can be thready pulses in distal extremities with inspire. Pericarditis will not give you this
Treatment for stable Vtach?
IV Amiodarone
How often to get fasting lipids in patients without RFs?
q 5 yrs
diastolic decrescendo murmur @ left sternal border
Aortic Regurg
Ovalo macrocytes, pmns with decreased segmentation. Macrocytic anemia, leukopenia, thrombocytopenia.
MDS, more common in patients over 65
Findings of hyperK on EKG
peaked t, loss of P, widened qrs with sine pattern (in order of worsening severity)
type of vasculitis with HSP?
IgA/leukocytoclastic
Low back pain in elderly/smoking hx/pain not relieved by rest/activity?
have suspicion for AAA rupture
confirmation of widened mediastinum on CXR?
use TEE or CT chest - aortic rupture
changes post splenectomy in blood?
howell jolly bodies, increased PLT
Milky blood?
HyperTGs - prolly a familial thing, esp if the kid is young. Treat with fibrates, which are best at lowering TGs
Causes of pancreatitis
Gallstone, ETOH, Hi TGs
Signs of heart failure many years after trauma? Brisk carotid upstroke, wide pulse pressure.
Think AV fistula formation at site of trauma. You get high output heart failure. This decreases systemic vascular resistance and increases cardiac preload.
Reason for murmur in HCM? as in - what gets in the way?
Mitral valve anterior systolic motion - abnormal systolic motion
most common place for abmnormal origin of beats in afib?
Think pulm veins, apparently
Tx of RV infarct
avoid NG and give fluids
Constrictive pericarditis in patients from india, africa, china?
Think TB
Temporal arteritis/PMR is assoc with what other CV abnormality?
Aortic Aneurysm. Because arteritis can affect the branches of aorta too. Need serial chest xrays
What drug should diabetics over 40 receive regardless of lipid levels?
Statins
MOA of statin drugs?
Inhibition of intracellular HMG COA reductase. also messes with coenzyme Q10, which can lead to myopathy
Nitrates decrease chest pain how?
Decreased preload, decreased LVEDV.
pain associated w dvt vs pain associated w compartment syndrome?
dvt is vague pain. compartment is exquisite pain
1 w to Months after MI. Persistent ST elevation with deep Q waves. Can have murmur at apex leading to axilla
Think ventricular aneurysm. Pap mm rupture is usually within the first few days. Dilation can also lead to mitral regurg
treatment for symptomatic sinus bradycardia?
1) Atropine. If atropine doesn’t work, then 2) transcutaneous pacing
How does hyperthyroid cause htn?
Hyperdynamic circulation
QT prolong, deafness, fam hx of sudden death. Diagnosis? Tx?
Jervell and Lange-Nielsen syndrome. It’s a Autosomal Recessive QT prolongation. Tx with bblox and pacemaker. can lead to torsades (like anything that prolongs qt)
Fevers, finger tip pain, dark urine, swollen fingers. Possible dx?
Infective endocarditis - osler nodes (finger tip pain), glomerluonephritis, arthritis.