Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > CV > Flashcards

CV Flashcards

1
Q

Heart rate on ecg

A

300/# of large boxes between two consecutive qrs complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thumb rule for axis on ekg

A

If both leads I and II are positive (qrs up), axis is normal

If lead I is up and lead II is down, they have LEFT each other (left axis deviation)

If lead I is down and lead II is up, they are heading RIGHT for each other (right axis deviation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Each large box on ecg represents ___ seconds and ms

A

0.2seconds

200ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Each small box on ekg represents how many Seconds/milliseconds

A

0.04 s

40 ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pr interval is usually between how many msec

A

120 and 200 (3-5 little boxes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pr interval is how long in av block

A

> 200ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Qrs interval is usually how many ms? Which two patterns have a wider qrs

A

Normally <12ms

Lbbb and rbbb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal qtc interval

A

<440 ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In normal ekg, r waves ___ in size compared to S waves between leads __ and __

A

Increase

V1 and v5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Poor r wave progression in precordial leads is a nonspecific sign of

A

Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to detect right atrial enlargement on ekg?

A

P wave in lead II > 2.5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to detect left atrial enlargement on ekg?

A

P wave width in lead II is >120ms, or terminal negative deflection in v1 is >1mm in amplitude and >40msec in duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lv hypertrophy on ekg

A

Amplitude of s in v1 + r in v5 or v6 is >35mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Rv hypertrophy on ekg

A

Right axis deviation and r wave in v1>7mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

One big box on ekg is how many mm

A

Five

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is hepatojugular reflux

A

Distention of neck veins upon applying pressure to liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hepatojugular reflux is seen in what conditions

A

Heart failure or pulmonary htn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is kussmaul sign

A

Increase in jugular venous pressure with inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Kussmaul sign is seen in what two conditions

A

Cardiac tamponade and constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Systolic murmurs

A

A dashing cis (sys) mister
Aortic stenosis
Mitral regurg

Also mvp and flow murmurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe mitral regurg

A

Holosystolic murmur that radiates to the axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe mitral valve prolapse

A

Midsystolic click and then systolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diastolic murmur types

A

Aortic regurg
Mitral stenosis

A daring missus, a disreputable diastolic damsel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Are diastolic murmurs normal or abnormal

A

Always abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is pulsus paradoxus

A

Decrease in systolic bp with inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is pulsus alternans? What is it seen in

A

Alternating weak and strong pulses

Seen in cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is pulsus parvus Et tardus? What is it seen in

A

Weak and delayed pulse

Seen in aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Management options for atrial fibrillation

A

Anticoagulate
B blockers
Cardiovert/ca channel blocker
Digoxin (refractory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Chads vasc score estimates

A

Stroke risk in afib pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Anticoagulate for a Chad’s vasc score of __ or above

A

2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does Chad’s vasc stand for

A 
Chf
Htn
Age >75
Diabetes
Stroke or tia hx
Vasc diseAse
Age 65-74
Sex category (female)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Sinus bradycardia Is under how many bpm

A

60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

In first degree av block, pr interval is >

A

200ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Second degree av block is also called

A

Mobitz type I/wenckebach

Or

Mobitz type II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Define 2nd deg av block mobitz I

A

Progressive pr lengthening until a drppped beat occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Drugs that can cause second deg av block mobitz I

A

Digoxin
B blockers
Ccbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Define mobitz II

A

Unexpected dropped beats without change in pr interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Cause of mobitz II

A

Fibrotic dz of conduction system or MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Tx of mobitz II

A

Pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Tx of mobitz I

A

Atropine as needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Define third deg av block. Tx?

A

No electrical communication between Atria and ventricles

Tx-pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Define sick sinus/yacht Brady syndrome

A

Intermittent supraventricular tachy and Bradyarrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Most common indication for pacemaker

A

Sick sinus/tachy Brady syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Sinus tachy is above

A

100 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

For chronic afib, rate control with

A

B blockers
Ccbs
Digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

For chronic afib, anticoagulate with

A

Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

For unstable/chronic afib,

A

Cardiovert if onset <2 days

If >2 days or unclear duration,get a tee to rule out atrial clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Etiology of aflutter

A

Circular movement of electrical activity around the atrium at rate of 300X per minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Etiology of avnrt

A

Reentry circuit in av node that depolarizes atrium and ventricle nearly simultaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Rate in avnrt

A

150-200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

P wave in avnrt

A

Often buried in qrs or shortly after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Etiology of avrt

A

Ectopic connection between Atria and ventricle that causes a reentry circuit

Example: wpw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Etiology of paroxysmal atrial tachy

A

Rapid ectopic pacemaker in atrium (not sinus node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How to unmask underlying atrial activity in paroxysmal atrial tachy

A

Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Define systolic dysfunction

A

Ef <50% and increased lv end diastolic volumes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Systolic dysfunction is caused by

A

Inadequate lv contractility it increased afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Bnp levels in chf

A

> 500pg/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Creatinine in chf

A

Sometimes high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Sodium levels in chf

A

Low in later stages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Class III chf

A

Limitation of activity. Comfort only at rest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Class IV chf

A

Symptoms present at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Class I chf

A

No limitation of activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Acute chf pulmonary congestion management

A 
Lmnop
Lasix
Morphine
Nitrates
Oxygen
Position (upright)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

B blockers should be ___ during decompensated chf

A

Avoided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Why avoid ccbs in chf

A

Can worsen edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

B Blockers and arbs in chf help

A

Help prevent remodeling of heart and decrease mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Low dose spironolactone does what for chf pts

A

Decrease mortality risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Loops ___ calcium, thiazides ___

A

Loose

Take in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

In nonsystolic dysfunction, ventricle has either

A

Impaired active relaxation or impaired passive filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

If you send a guy out after chf exacerbation on lasix and bblocker, what else should you add

A

Acei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Potassium levels with loops

A

Cause hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Thiazides cause hyper__

A 
Gluc
Glycemia
Lipidemia
Uricemia
Calcemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Side effects of spironolactone

A

Hyperkalemia
Gynecomastia
Sex dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

S3 signifies

A

Rapid ventricular filling in setting of fluid overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

S4 gallop signifies

A

Stiff non compliant ventricle and increased atrial kick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

S4 May be associated with

A

Hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Key pe finding in hocm

A

Systolic ejection crescendo-decrescendo murmur that increased with decreased preload (valsalva, standing) and decreases with increased preload (passive leg raise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Tx of hocm

A

B blockers for symptomatic relief, ccbs second line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is angina pectoris

A

Substernal chest pain secondary to ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Prinzmetal angina is caused by

A

Vasospasm of coronary vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Prinzmetal angina classically affects

A

Young women at rest in early morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

St elevation in absence of cardiac enzyme elevation

A

Prinzmetal angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Tx of stable angina

A

Asa
B blockers
Nitroglycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Ck comes down _ days after mi, tropinin comes down after _ days

A

Two

4-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Inferior mi involves what coronary vessels

A

Rca/pda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Anterior mi involves what coronary vessels

A

Lad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Lateral mi involves what coronary vessels

A

Lca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Ecg changes in inferior mi

A

St elevation in leads II, III, aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Ekg changes in anterior mi

A

St elevation in leads v1-v4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Ekg changes in lateral mi

A

St elevation in leads I, aVL, and v5-v6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

In ___ Wall mis, avoid nitrates due to

A

Inferior

Risk of severe hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Post mi complications: first day

A

Heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Post mi complications: 2-4 days

A

Arrhythmia, pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Post mi complications: 5-10 days

A

Lv Wall rupture, papillary muscles rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Post mi complications: weeks to months

A

Ventricular aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is dressler syndrome

A

Autoimmune process 2-10 weeks post mi, presents with fever, pericarditis, pleural effusion, leykocytosis, elevated esr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Start getting lipid levels at age

A

35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Effect on lipid profile:

Gemfibrozil

A

Low triglycerides

High hdl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Effect on lipid profile:

Ezetimibe

A

Lowers ldl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Effect on lipid profile:

Niacin

A

Elevated hdl

Lowers ldl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Effect on lipid profile: choles tyramine

A

Lowers ldl

102
Q

Side effect of statins

A

Myositis

103
Q

Side effect of niacin

A

Skin flushing

104
Q

Tx of primary htn

A 
Abcd
Aceis/arbs
B blockers
Ccbs
Diuretics (thiazides)
105
Q

Ekg findings on pericarditis

A

Diffuse st segment elevation and pr segment depressions

106
Q

Beck triad of cardiac tamponade

A

Jvd
Hypotension
Distant heart sounds

107
Q

Electrical alternans is diagnostic of

A

Large pericardial effusion

108
Q

Aortic aneurysms are most commonly associated with

A

Atherosclerosis

109
Q

> 90% of aortic aneurysms originate below the

A

Renal arteries

110
Q

Who to screen for aaa and how

A

Men 65-75 with hx of smoking at any point, once by ultrasound

111
Q

Blowing diastolic murmur is likely

A

Aortic regurg

112
Q

You see head bob with which murmur

A

Aortic regurg

113
Q

Virchow triad

A

Risk factors for dvt:

Venous stasis
Endothelial trauma
Hypercoag states

114
Q

What is homans sign

A

Calf tenderness with passive foot dorsiflexion

115
Q

Inflammation from surgical cardiac intervention can lead to

A

Pericarditis, pericardial effusion, cardiac tamponade

116
Q

Why in a normal fetus is the r v bigger than the lv

A

In fetus blood is shunted away from lungs through pda, so systemi circulation relies primarily on rv

117
Q

Newborns have what on ekg

A

R axis deviation due to larger rv

118
Q

Ekg findings in tricuspid valve atresia

A

Left axis deviation and peaked p waves

Small or absent r waves in precordial leads

119
Q

What happens to tricuspid valve in tricuspid valve atresia

A

It’s absent

120
Q

What happens to rv in tricuspid valve atresia

A

It’s hypoplastic

121
Q

Complete av canal defect is associated with what syndrome

A

Downs

122
Q

Primary problem in ebsteins anomaly

A

Malformed tricuspid valve into right ventricle

123
Q

Ekg findings in ebsteins anomaly

A

Tall p waves and right axis deviation on ecg

124
Q

Truncus arteriosus is strongly associated with ___ syndrome

A

Digeorge

125
Q

What is truncus arteriosus

A

Single blood vessel (truncus arteriosus) comes out of the right and left ventricles instead of the normal two vessels (aorta and pulm artery)

126
Q

What remodeling can occur in heart after mi

A

Dilation of lv and thinning of ventricular walls

127
Q

What meds can limit ventricular remodeling following MI

A

Aceis

128
Q

Can hyperthyroid cause afib with rvr

A

Yep

129
Q

Tx of tachycardia and afib in hyperthyroidism

A

Beta blockers

Propranolol also decreases conversion of t4 to t3 in peripheral tissues

130
Q

How does adenosine work?

A

Induced transient block at av node

131
Q

When is adenosine used

A

Often in pts with svt in whom the dx is unclear

132
Q

Why do you get a decrescendo diastolic murmur in aortic dissection

A

Due to aortic regurg due to proximal extension of dissection into aortic valvular annulus

133
Q

Why might you get elevated creatinine in aortic dissection

A

Due to distal extension into renal arteries

134
Q

Heart failure with preserved lv ejection fraction is also known as

A

Lv diastolic dysfunction

135
Q

___ stenosis is found in 45% of pts with severe htn and 30% of pts with pad

A

Renal artery

136
Q

Continuous abdominal bruit is suggestive of

A

Renovascular diseAse

137
Q

__ is associated with rib notching on X-ray

A

Coarctation of aorta

Due to enlarged collateral intercostal vessels

138
Q

Direct current cardio version is indicated with ___ whereas defibrillation is indicated with __

A

Persistent tachyarrhythmia causing clinical instability (eg afib)-synchronized with qrs

Unsynchronized, used in vfib

139
Q

Proteinuria, hepatomegaly, restrictive cardiomyopathy, peripheral neuropathy, waxy thick skin and easy bruising. What am I?

A

Amyloidosis

140
Q

Amyloidosis can cause what heart pathology

A

R sided heart failure

141
Q

Mitral valve leaflet motion in hocm

A

Systolic anterior motion towards iv septum

142
Q

Dilated mitral valve annulus is seen in pts with

A

Dilated cardiomyopathy or ischemic cardiomyopathy

143
Q

Recent uri followed by sudden onset of cardiac failure in otherwise healthy pt is suggestive of

A

Dilated cardiomyopathy likely secondary to acute viral myocarditis

144
Q

Viral or idiopathic myocarditis is most commonly seen with what virus

A

Coxsackie b

145
Q

Tx of vfib

A

Immediate defibrillation

146
Q

First step in acute limb ischemia from arterial occlusion

A

Echo because most come from lv thrombi

147
Q

Pulm side effect of amiodarone

A

Chronic interstitial pneumonitis

148
Q

Treatment of claudication (non emergent)

A

Low dose aspirin
Statin
Exercise

149
Q

Can asthma and copd cause pulsus paradoxus

A

Yes

150
Q

Aortic regurg prevents or causes pulsus paradoxus

A

Prevents- causes increase in lv end diastolic pressure. That precludes iv septum from shifting towards lv cavity during inspiration

151
Q

What abnormal heart sound can be heard in pts during acute mi

A

S4 due to lv stiffening and dysfunction

152
Q

Premature atrial complexes are largely

A

Benign

153
Q

Premature ventricular complexes in presence of st elevation may indicate

A

Reentrant ventricular arrhythmia secondary to mi

154
Q

Ekg findings in aortic coarctation

A

Consistent with lv hypertrophy (high voltage qrs complexes, lateral st segment depression, lateral t wave inversion)

155
Q

Pulsatile groin mass below the inguinal ligament is likely a

A

Femoral artery aneurysm

156
Q

Anterior thigh pain with a femoral artery aneurysm is due to

A

Compression of the femoral nerve that runs lateral to the artery

157
Q

First and second most common peripheral artery aneurysms

A

First: popliteal aneurysm
Second: femoral artery aneurysm

158
Q

Effect on preload: valsalva

A

Decreased

159
Q

Effect on preload: abrupt standing from sitting or supine position

A

Decrease

160
Q

Effect on preload: nitroglycerin administration

A

Decreased

161
Q

Effect on preload: squatting

A

Increased

162
Q

Effect on preload: passive leg raise

A

Increased

163
Q

Effect on afterload: sustained hand grip

A

Increased

164
Q

Effect on afterload: squatting

A

Increased

165
Q

What congenital heart defect is common with trisomy 18 pts

A

Vsd

166
Q

Can ocps cause hypertension

A

Yes

167
Q

Three common etiologies of aortic regurg

A

Congenital bicuspid aortic valve

Postinflammatory (rheumatic heart dz, endocarditis)

Aortic root dilation (marfan, Syphillis)

168
Q

Murmur of aortic regurg

A

Diastolic decrescendo murmur

169
Q

Exertional dyspnea, pounding heart sensation, uncomfortably aware of heartbeat while laying on left side, and widened pulse pressure is likely due to

A

Chronic aortic regurg

170
Q

Other than wt loss what is the most effective behavioral intervention to decrease bp

A

Dash diet

171
Q

Spect scan: decreased uptake at rest and during exercise indicates

A

Scar tissue with decreased perfusion and cad

172
Q

Spect scan: decreased tracer uptake with stress but normal uptake at rest indicates

A

Reversible defect, inducible ischemia and likely cad

173
Q

Tx of inducible ischemia/likely cad

A

Antiplatelet therapy (aspirin) for prevention of mi

174
Q

Tx of dressler syndrome

A

NSAIDs

175
Q

Murmur in hocm

A

Crescendo-decrescendo systolic murmur along left sternal border without carotid radiation

176
Q

Meds to withhold prior to cardiac stress testing

A

Beta blockers
Ccbs
Nitrates

177
Q

Do you have to withhold aceis and arbs before cardiac stress testing

A

No

178
Q

In acute mitral regurg post mi, there is ___ lv end diastolic pressure

A

Increased

179
Q

Persistent st segment elevations and deep q waves in a pt with a previous mi

A

Ventricular aneurysm

180
Q

Do you see htn and pulm edema with a post mi ventricular aneurysm

A

Yes

181
Q

Do you see htn and pulm edema with a post mi pericarditis in dressler syndrome

A

No

182
Q

Tx of post surgical mediastinitus

A

Drainage of pus in mediastinum, surgical debridement, prolonged abx therapy

183
Q

In adults, s4 is an indicator of __ which could be due to what two things

A

Blood striking a Stiff left ventricle

Restrictive cardiomyopathy or lv hypertrophy from prolonged htn

184
Q

Does synchronized cardio version help in a patient with pulseless electrical activity

A

No

185
Q

If a baby is cyanotic, what kind of shunt do they have

A

Right to left

186
Q

Tetralogy is associated with what syndrome

A

Downs

187
Q

Four things of tetralogy?

A

Vsd
Overriding aorta
Pulm stenosis
Rv hypertrophy

188
Q

Transposition in babies occurs when moms have

A

Diabetes (not gestational)

189
Q

Pda is required for survival in what congenital heart defect

A

Transposition

190
Q

How to keep pda open

A

Prostaglandin

191
Q

Vsd is diagnosed before age

A

One

192
Q

Vsd is associated with what syndrome

A

Downs

193
Q

Multiphasic murmur May refer to

A

Pda

194
Q

Cyanide poisoning causes what four things

A

Slac

Seizures
Lactic acidosis
Ams
Coma

195
Q

What is mech of nitroprusside and why is it used?

A

Vasodilator with quick onset and offset. Commonly used for rapid blood pressure control in pts with hypertensive emergency.

196
Q

Risk of using prolonged nitroprusside in pts with renal insuff

A

Cyanide poisoning

197
Q

Decreased co in pts with decompensated chf leads to activation of ____ and increased secretion of ____

A

Raas

Adh

198
Q

Increased ang II causes ___ renal blood flow due to ___ of afferent and efferent glomerular arterioles

A

Decrease

Vasoconstriction

199
Q

Pe findings in transposition of great vessels

A

Single s2

+/- vsd murmur

200
Q

Pe findings in tetralogy

A

Harsh pulmonic stenosis murmur, vsd murmur

201
Q

Cxr of transposition of great vessels

A

Egg on a string appearance

202
Q

Primary anti-ischemic effects of nitrates

A

They cause systemic vasodilation and decrease preload, which decreases left ventricular systolic Wall stress and decrease in oxygen demand

203
Q

Is vasodilatory effect of nitrates on coronary vasculatre the reason they are beneficial

A

No

204
Q

Septic shock causes ___ svr, ie ___ afterload

A

Decreased, reduced

205
Q

Intermittent claudication due to pad is a strong predictor of future

A

Cv morbidity mortality

206
Q

Do you have full peripheral pulses in coarctation of aorta

A

No, diminished distal. Get le claudication

207
Q

How do vagal maneuvers fix paroxysmal supraventricular tachycardias (avnrt)

A

Increases parasympathetic tone in heart thus slowing conduction in av node and increasing av node refractory period, terminating avnrt

208
Q

Aspirin provides anti___ therapy not anti___ therapy. Which do you need for a Chad’s vasc score above 2?

A

Platelet not coagulant. Need coagulant (warfarin, apixaban). Antiplatelet isn’t strong enough.

209
Q

Middiastolic sound heard with constrictive pericarditis is also known as

A

Pericardial knock

210
Q

Can you have hypoalbuminemia with constrictive pericarditis

A

Yes

211
Q

What is cor pulmonale

A

Rv failure due to pulm htn

212
Q

Mech of adenosine

A

Inhibits L type calcium channels, decreasing conduction velocity in av node. Used in termination of avnrt.

213
Q

Htn has a ___ association with aaa

A

Weak

214
Q

What behavior is associated with high rate of aneurysm expansion and rupture

A

Smoking

215
Q

Tx for pts with wpw who develop afib with rapid ventricular rate

A

Cardioversion or antiarrhythmics such as procainimide

216
Q

Why avoid av node blockers such as b blockers, ccbs, digoxin and adenosine In wpw pts with afib

A

Can cause increased conduction through accessory pathway

217
Q

Inheritance of hocm

A

Autosomal dominant

218
Q

Old man with acute onset of severe back pain, syncope, and hypotension is worrisome for

A

Abdominal aortic aneurysm rupture

219
Q

If you have uremia + pericarditis what do you have? What is the treatment?

A

Uremic pericarditis, usually bun>60mg/dL

Tx is dialysis. Use NSAIDs if not responding to dialysis.

220
Q

Mobitz type I is due to impaired conduction of

A

Av node

221
Q

Confirm dx of cardiac tamponade

A

Urgent echo

222
Q

Large amount of blood flowing through a fistula will __ svr, ___ preload and ___ co

A

Decrease
Increase
Increase

223
Q

Brisk carotid upstroke also indicates

A

Strong peripheral arterial pulse

224
Q

Can mitral stenosis present with dyspnea, orthopnea, pnd and hemoptysis

A

Yes

225
Q

Can mitral stenosis present with hoarseness

A

Yes

226
Q

Sx of digoxin tox

A

Arrhythmias, anorexia/n/v, color vision alterations, weakness and confusion

227
Q

Amiodarone ___ levels of digoxin

A

Increases

228
Q

Coarctation of aorta results from thickening of

A

Tunica media near junction of ductus arteriosus and aortic arch

229
Q

First step in a pt with normal mental status after blunt abdo trauma

A

Focused bedside ultrasound

230
Q

Which arrhythmia is most specific for digoxin toxicity

A

Atrial tachycardia with av block

231
Q

Atrial tachycardia bpm? Aflutter bpm?

A

Tachy: 150-250
Flutter: 250-350

232
Q

Pts who have delayed presentation of appendiceal rupture likely have

A

Appendiceal rupture with contained abscess

233
Q

Valvular complication of aortic dissection

A

Retrograde extension of intimal tear to involve aortic valve and cause acute aortic regurgitation

234
Q

How to screen for aaa

A

Abdo ultrasound

235
Q

After mi pts should be on __ antiplatelet therapy consisting of __

A

Dual

Aspirin and p2y12 receptor blocker (eg clopidogrel)

236
Q

What kind of murmur is associated with tricupsid regurg

A

Holosystolic murmur that increases in intensity with inspiration

237
Q

Pts with persistent tachyarrhythmia causing hemodynamic instability should be managed with

A

Immediate synchronized cardioversion

238
Q

Acute inferior and posterior wall mis are caused by occlusion of

A

Rca

239
Q

Most common congenital heart defect in pts with downs

A

Complete av septal defect

240
Q

Dobutamine mechanism

A

Adrenergic agonist with predominant activity on beta 1 receptors

241
Q

What is dobutamine used for

A

Mgmt of severe heart failure associated with lv systolic dysfunction and cardiogenic shock

242
Q

Dobutamine causes an increase in myocardial contractility which causes a __ in

A

Lv end systolic volume

243
Q

Livedo reticularis and blue toe syndrome should make you suspect

A

Cholesterol embolization

244
Q

How is angiotensin I converted to angiotensin II

A

Ace (from the lung) cleaves c terminal peptides on ang I

Acei blocks this

245
Q

Pda is associated with congenital ___

A

Rubella

246
Q

More than 2/3 of pts with coarctation of the aorta also have a

A

Bicuspid aortic valve

247
Q

Bad complication of giant cell arteritis is ___. How do you screen?

A

Aortic aneurysms

Serial cxrs

248
Q

Other than bradykinin cough, what is a side effect of aceis?

A

Angioedema (edema in face, mouth, lips, larynx)

249
Q

If you get angioedema from acei what should be done

A

Stop acei immediately

250
Q

> 90% of acute pes originate where

A

Proximal led/thigh (iliac, femoral, popliteal veins)

251
Q

On cxr for transthoracic aortic aneurysm, you see what three things

A

Tracheal deviation
Widened mediastinum
Widened aorta

Step 2 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions