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CV Flashcards

1
Q

MCC distributive shock

A

septic shock

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2
Q

normal urine output

A

0.5 mL/kg/hr

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3
Q

HTN Tx with diuretics

A
  • thiazides.

- loop diuretics only if renal dysfn

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4
Q

ACE MOA

A

incr bradykinin, incr prostaglandins (vasodilator)

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5
Q

Kerley B lines

A

CHF

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6
Q

Tx HTN urgency/emergency

A
  • nitroprusside.

- with MI: nitroglycerin, BB.

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7
Q

Tx aortic dissection

A

nitroprusside + BB + urgent surgery

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8
Q

S3 gallop

A

CHF

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9
Q

Elderly with suspected CHF. What else to order?

A

TSH (thyrotoxicosis causing CHF)

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10
Q

Acute & Chronic angina Tx

A

Acute: SL nitroglycerin, SL isosorbide.
Chronic: BB.

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11
Q

NSTEMI Tx

A

Antiplatelet (ASA, clopidogrel) + Anticoagulant (heparin, enoxaparin)

BB

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12
Q

STEMI Tx

A

ASA + clopidogrel

PCI or thrombolytics

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13
Q

Thrombolysis contraindications

A
  • Absolute: hemorr stroke previously, stroke within 1yr, intracranial neoplasm, active bleed, aortic dissection
  • Relative: trauma within 3-4wks, sure within 3wks, cardiopulm resuscitation, pre, PUD, anticoag use, BP>180, diabetic retinopathy
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14
Q

Tetralogy of Fallot

A

VSD, RV outflow obstruction (pulm stenosis), overriding aorta, RVH

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15
Q

widened pulse pressure

A

AR

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16
Q

midsystolic/ejection click

A

MVP

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17
Q

opening snap

A

MS

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18
Q

Holiday heart

A

A. fib with incr ETOH

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19
Q

Tx PSVT

A

adenosine, verapamil (CCB)

prevention: CCB, BB

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20
Q

Tx chronic A flutter

A

amiodarone

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21
Q

Brugada’s

A

asians, male, syncope, VF, sudden death

EKG: RBBB, ST elevation V1-3

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22
Q

Tx VT

A

cardioversion (unstable), amiodarone, procainamide, lidocaine (stable)

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23
Q

electric alternans

A

pericardial effusion (pathognomonic)

-cyclic shift in amplitude

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24
Q

pulsus paradoxus

A

cardiac tamponade, constrictive pericarditis, COPD

> 10mmHg decr SBP with inspiration

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25
Q

narrow pulse pressure

A

cardiac tamponade, AS

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26
Q

Endocarditis Dx

A

Duke

  1. 2 BC
  2. echo+
  3. new regurgitant murmur

minor: fever, petechiae, splinter hemorrhages, Osler, Janeway, Roth spots, glomerulonephritis

2major, 1+1, 3 minor

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27
Q

Tx endocarditis

A

Vanco + ceftriaxone
Vanco + gentamicin

NO anticoag

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28
Q

endocarditis prophylaxis

A

for invasive dental/surg and infected skin/I&D with:

  1. prosthetic valves
  2. previous endocarditis
  3. congenital heart dz/ HCM
  4. heart transplant/ heart repairs

-Amoxicillin

NOT for GI/GU, valvular dz

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29
Q

Rheumatic heart dz Dx

A

Jones
erythema marginatum
minor: fever, polyarthralgia, PR prolong, CRP

2major, 1+2

AND pos cult/rapid strep and strep Ab titer (ASO)

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30
Q

Tx rheumatic heart dz

A

IM PCN, bed rest, salicylates, corticosteroids

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31
Q

intermittent claudication

A

PAD

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32
Q

PAD of the iliac artery (Leriche’s syndrome) leads to what?

A

erectile dysfunction

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33
Q

ABI

A

PAD

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34
Q

PAD Tx

A

Cilostazol (antiplatelet for intermittent claudication)

no smoking, exercise, lipid lowering, sildenafil, thromboendarterectomy

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35
Q

Tx venous ulcers

A

leg elevation, compression bandage/boot

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36
Q

DVT definitive Dx

A

venography

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37
Q

DVT Tx

A

lovenox (LMWH)

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38
Q

Giant cell arteritis highly associated with what?

A

Polymyalgia Rheumatica

  • elderly female
  • severe stiffness: neck, shoulders, upper back, pelvic girdle
  • ESR incr
  • Tx: NSAIDS, prednisone/steroids
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39
Q

Giant cell arteritis Tx

A

high dose prednisone, low dose ASA

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40
Q

MCC aortic aneurysm

A

atherosclerosis

others: Marfans, Ehlers Danlos

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41
Q

Indications for AAA repair

A
  1. > 5.5 cm
  2. growth >0.5 cm in 6mo
  3. symptomatic
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42
Q

AAA study of choice

A

US

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43
Q

BB and HF

A

BB Tx chronic CHF

BB contraindicated in acute CHF

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44
Q

Digoxin toxicity

A

Bradycardia
Heart block, ectopy (PVC, VT, PAC)
Hyperkalemia

predisposing to dig toxicity: hypoK, hypoMg

Tx: Fab Ab

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45
Q

Beck’s triad

A

pericardial tamponade

  1. muffled/distant heart sounds
  2. HOTN
  3. incr JVP
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46
Q

pericardial knock

A 
constrictive pericarditis
(pericardial thickening/calcification)

3rd heart sound

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47
Q

Kussmaul’s sign

A

pericardial tamponade, constrictive pericarditis

-incr JVP with inspiration

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48
Q

MCC acute pericarditis and myocarditis

A

viral

Enteroviruses (COXSACKIE B, echovirus)

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49
Q

Mobitz I

A

Wenckebach

progressive PR lengthening

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50
Q

Mobitz II, where?

A

bundle of HIS
constant prolonged PR
to 3rd AV block

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51
Q

Tx bradycardia

A

ATROPINE

epi, dopamine, pacemaker

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52
Q

location of MI: lat, ant, inf

A

lat: circumflex
ant: LAD
inf: right coronary

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53
Q

incr aldosterone does what?

54
Q

Dx ACS with baseline ECG abnorm

A

pharmacologic stress test (adenosine, dipyridamole)

55
Q

contraindication to treadmill stress test

A

baseline ECG abnorm, too fat

56
Q

contraindication to pharmacologic stress test

A

bronchospastic dz

57
Q

Tx Prinzmetal’s, cocaine use MI

A

Prinzmetal’s: CCB

Cocaine: CCB, nitrates, benzos

58
Q

S3, S4

A

S3: systolic HF
S4: diastolic HF

59
Q

Cheyne Stokes

A

L-sided CHF

60
Q

normal EF

61
Q

CHF Tx: Na restriction, fluid restriction

62
Q

ADR loop diuretics, thiazides

A

hypoNa, hypoK, hyperuricemia, hyperglycemia

63
Q

ADR K sparing diuretic

A

gynecomastia, hyperK

64
Q

pos inotropic

A

digoxin, dobutamine, epi

65
Q

batwing on CXR

66
Q

MCC dilated cardiomyopathy

A

idiopathic

other: enterovirus, ETOH, cocaine, preg, doxorubicin

67
Q

MCC restrictive cardiomyopathy

A

amyloidosis

68
Q

incr/decr HCM murmur

A

decr: squatting
incr: standing, valsalva

69
Q

Tx HCM

70
Q

erythema marginatum

A

rheumatic fever

71
Q

MCC rheumatic fever

A

GABHS (S pyogenes)

72
Q

squatting in murmurs

A

increases

decr HCM

73
Q

standing, valsalva in murmurs

A

decreases

incr HCM

74
Q

handgrip in murmurs

A

incr AR, MR, MS

75
Q

holosystolic murmurs

A

VSD (harsh), MR/TR (blowing), PDA (continuous machinery), Tetralogy of Fallot (harsh)

76
Q

widely split S2

77
Q

Rheumatic heart dz associated with what murmur?

78
Q

Tx regurgitation murmurs

A

vasodilators

79
Q

Rib notching

A

coarctation of aorta

80
Q

Coarctation of aorta: gold standard Dx

81
Q

HTN retinopathy findings

A

arterial narrowing, AV nicking, hemorrhages, soft exudates

Stage IV: papilledema

82
Q

Tx HTN emergency

A

1st line: Nitroprusside IV

enceph: Nitroprusside
Cerebral infarction/hemorr, aortic dissection: labetalol
Nitro IV, Hydralazine

83
Q

Tx HTN urgency

A

Clonidine PO

84
Q

LDL goals: CAD/DM, RF for CAD, everyone else

A

CAD/DM: 130

RF for CAD (HTN, smoking, HDL50y/o): 160

everyone else: 190

85
Q

Drug for LDL

86
Q

Drug for TG

87
Q

Drug for HDL

A

Niacin

HDL is NIce

88
Q

lipid lowering drug to avoid in DM

A

Niacin (hyperglycemia)

89
Q

Lipid screening start at what age?

90
Q

Niacin ADR

A

hyperglycemia, hyperuricemia (gout), hepatotoxicity

91
Q

Fibrates ADR

A

gallstones, myositis/myalgias

92
Q

Omega 3 for?

93
Q

What to give prior to Niacin to decr flushing?

A

ASA or ibuprofen

94
Q

Leriche syndrome

A

PAD

Claudication, impotence, decr femoral pulses

95
Q

Areas of PAD sx in aortic bifurcation/iliac, femoral A, popliteal A.

A

iliac: buttock, hip, groin
femoral A: thigh, upper calf
popliteal A: lower calf

96
Q

MC PAD location

A

femoral A: thigh, upper calf

97
Q

MC AAA location

A

infrarenal

98
Q

thoracic aneurysm test of choice

99
Q

AAA >4cm and >3cm management

A

> 4: monitor with US Q6mo

>3: monitor Q1yr

100
Q

aortic aneurysm gold standard test

A

angiography

101
Q

MC aortic dissection site

A

ascending aorta (type A)

102
Q

aortic dissection gold standard test

A

MRI angiography

103
Q

Tx types of aortic dissection

A 
type A (proximal/ascending): surgery
type B (distal/descending): medical (BB)
104
Q

Amaurosis fugax

A

Giant cell arteritis

anterior ischemic optic neuritis
central retinal artery occlusion

105
Q

Giant cell arteritis Bx findings

A

Temporal artery Bx: mononuclear lymphs infiltration, multinucleate giant cells

106
Q

Giant cell arteritis Tx

A

high dose corticosteroids (60mg/day x 6wks)

107
Q

Giant cell arteritis - arteries involved?

A

external carotid A. -> temporal, occipital, ophthalmic

108
Q

Polymyalgia Rheumatica associated with what?

A

Giant cell arteritis

109
Q

Tx Raynaud’s

110
Q

Thromboangiitis obliterans / Buerger dz: Sx, Tx, population

A

Sx: thrombophlebitis, claudication, Raynauds
**population: young, tobacco

Tx: tobacco cessation

111
Q

hypercoagulability etiologies

A

malignancy…

112
Q

Trousseau’s sign

A

Superficial thrombophlebitis

migratory thrombophlebitis
= malignancy, vasculitis

113
Q

most specific DVT sx

A

unilat edema

114
Q

abnormal Allen test

A

thromboangiitis obliterans (Buerger dz)- nonatherosclerotic dz of sm/med vessels

115
Q

cerulea alba, cerulea dolens

A

Alba: white milky pallor ->
Dolens: cyanosis, swelling of limb with sudden pain

-DVT

116
Q

false pos D-dimer

117
Q

DVT gold standard Dx, Tx

A

gold standard Dx: venography

Tx: heparin, LMWH -> warfarin x 3-6 mo

118
Q

extrinsic factors

A

II, VII, IX, X, protein C/S

119
Q

heparin, warfarin pathways

A

heparin: intrinsic (in a relationship), PTT
warfarin: extrinsic (exes at war), PT

120
Q

Medial/Lateral malleolus ulcer

A

Medial: venous
Lateral: arterial

121
Q

Venous ulcer Tx

A

wet to dry dressings, hyperbaric O2, edema Tx

122
Q

shock physiology

A

metab acidosis, LA, sympathetic stim, RAAS stim

123
Q

MAP goal

124
Q

fluid loss sx 40%

A

40%: no UOP

125
Q

PCWP (pulm cap wedge pressure) shock

A

hypovol: decr
cardio: incr
obstructive: incr

distrib: decr SVR (Sys vasc resistance)

126
Q

neuro shock sx

A

HOTN, bradycardia

127
Q

septic shock sx

A

INCR CO*** (only one) = warm extrem

decr SVR

128
Q

when to use mechanical valve replacement

129
Q

MC mets to heart

A

malignant melanoma

130
Q

SLE assoc with what cardiac dz?

A

pericarditis

131
Q

early morning hrs CP

A

Prinzmetal’s

132
Q

pos tox screen (cocaine, ETOH), CHF (dyspnea)

A

dilated cardiomyopathy

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