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Surgery EOR > CV/Hematology > Flashcards

CV/Hematology Flashcards

1
Q

retrosternal pressure >30 min NOT relieved with rest or nitroglycerin

A

unstable angina

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2
Q

no EKG changes

(-) cardiac enzymes

A

unstable angina

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3
Q

treatment for UA/NSTEMI

A

MONA
BB
+/- heparin
NO thrombolytics

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4
Q

S1 heart sound

A

AV valve closure (mitral and tricuspid)

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5
Q

S2 heart sound

A

semilunar valve closure (aortic and pulmonic)

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6
Q

systolic ejection crescendo, decrescendo murmur heard best @ RUSB
radiates to carotids

A

aortic stenosis

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7
Q

diastolic decrescendo blowing murmur @ LUSB

wide pulse pressure

A

aortic regurgitation

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8
Q

what medication is used to help treat symptoms of regurgitation murmurs and why?

A

ACE-I

vasodilators

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9
Q

diastolic rumble with opening snap @ apex

A

mitral stenosis

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10
Q

holosystolic murmur @ apex

radiates to axilla

A

mitral regurgitation

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11
Q

intermittent claudication often relieved with rest

A

peripheral arterial disease

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12
Q

diagnosis of PAD

A

ABI = 0.9

arteriography (if revascularization planned)

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13
Q

symptoms of PAD

A

dependent rubor, cyanotic leg elevation
decreased/absent pulses
atrophic skin changes without edema
lateral malleolar ulcers

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14
Q

acute arterial embolism

A 
pain
pallor
pulselessness
paresthesia
paralysis
poikilothermic
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15
Q

treatment of PAD

A

cilostazol, ASA, plavix
eliminate risk factors (HTN, DM, lipids)
revascularize (PCI)

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16
Q

MC cause of arterial ulcers

A

PAD

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17
Q

risks of venous ulcers

A

varicose veins
DVT
obesity, pregnancy, malnutrition, immobile

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18
Q

risks of arterial ulcers

A

PAD
uncontrolled DM
renal dz

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19
Q

features of arterial ulcers

A

pain improves with lowering the leg below the heart
loss of hair
minimal drainage
skin pale, shiny, taut

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20
Q

features of venous ulcers

A

pain related to edema, phlebitis –> improves with elevation
heavy drainage
superficial/shallow
more MEDIAL foot

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21
Q

dilated tortuous superficial veins secondary to defective valve structure and function

A

varicose veins

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22
Q

treatment for varicose veins

A 
conservative = leg elevation and compression stockings
cosmetic = sclerotherapy, laser ablation
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23
Q

virchow’s triad

A

intimal damage
stasis
hyper coagulability

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24
Q

test of choice for AAA

A

abd US

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25
Q

test of choice for thoracic AAA

A

CT

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26
Q

treatment for AAA

A

surgical if >5.5cm or >0/5cm growth in 6mo

BB (decreases shearing forces)

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27
Q

biggest risk for aortic dissection

A

HTN

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28
Q

diagnosis of aortic dissection

A

CXR

*CT with contrast

29
Q

increased Hct in absence of hypoxia

A

polycythemia vera

30
Q

polycythemia vera symptoms

A 
h/a, tinnitus
fatigue
pruritis
epistaxis
splenomegaly (PE)

DUE TO HYPER-VISCOSITY

31
Q

MC inherited cause of hypercoagulability

A

factor V leiden mutation

32
Q

what is factor V leiden?

A

mutated factor V resistant to breakdown by activated protein C

33
Q

role of Protein C

A

inactivates factor V and VIII

34
Q

increase in serum methylmalonic acid AND homocysteine

A

vitamin B12 deficiency

35
Q

what is pernicious anemia

A

MC type of B12 deficiency

autoimmune against parietal cells (decreased IF)

36
Q

MC anemia worldwide

A

iron deficiency

37
Q

first diagnostic sign of iron deficiency

A

decreased ferritin

38
Q

diagnosis of thalassemias

A

Hgb electrophoresis

39
Q

may progress to marrow failure or leukemia

A

sideroblastic anemia

40
Q

sxs of anemia + jaundice

A

hemolytic anemia

41
Q

low serum haptoglobin

A

intravascular hemolytic anemia

42
Q

types of intravascular hemolytic anemia

A

microangiopathic (TTP, HUS)
G6PD deficiency
paroxysmal nocturnal hemoglobinuria

43
Q

Heinz bodies

A

G6PD deficiency anemia

44
Q

+ osmotic fragility test

- Coombs

A

hereditary spherocytosis

45
Q

types of extravascular hemolytic anemia

A 
hereditary spherocytosis
sickle cell anemia
autoimmune
incompatible blood transfusion
drug-induced
46
Q

vaso-occlusive ischemic tissue injury (PAIN)
osteonecrosis of femoral and humeral heads
splenic infarcts (functional asplenia)

A

sickle cell anemia

47
Q

Howell-Jolly bodies

A

asplenia (ie. sickle cell anemia)

48
Q

diagnosis of sickle cell anemia

A

Hgb electrophoresis = HbS

49
Q

+ Coombs test

A

autoimmune hemolytic anemia

50
Q

hallmark of aplastic anemia

A

pancytopenia

51
Q

hallmark of lead poisoning anemia

A

basophilic stiplling on peripheral smear

52
Q

pentad for TTP

A 
thrombocytopenia
microangiopathic hemolytic anemia
kidney failure/uremia
neuro sxs (h/a, AMS)
fever
53
Q

antibodies against ADAMTS13

A

autoimmune TTP

54
Q

what is ADAMTS13

A

vWF cleaving protein

55
Q

diagnosis of TTP/HUS

A 
normal coags (PT and PTT - no issue with clotting factors)
thrombocytopenia
hemolytic anemia (increased reticulocytes, decreased haptoglobin)
56
Q

treatment for TTP

A

plasmapheresis

steroids

57
Q

triad for HUS

A

thrombocytopenia
microangiopathic hemolytic anemia
kidney failure/uremia

58
Q

is kidney failure/uremia MC in TTP or HUS?

A

HUS

59
Q

MC etiology of HUS

A

kids after enterohemorrhagic E. coli

60
Q

pathophys of HUS

A

platelet activation by exotoxins

61
Q

what is heparin-induced thrombocytopenic thrombosis (HITT)

A

heparin-induced platelet antibodies causes platelets to thrombose vessels

62
Q

reversal of heparin

A

protamine sulfate

63
Q

reversal of warfarin

A

FFP

vitamin K

64
Q

vitamin K dependent factors

A

II, VII, IX, X

65
Q

PT measures ?

A

VII (extrinsic pathway)

66
Q

PTT measures ?

A

VIII and IX (intrinsic pathway)

67
Q

what does warfarin inhibit?

A

vitamin K dependent factors

68
Q

what test is used to watch warfarin?

A

PT/INR

Surgery EOR (5 decks)

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