Brainscape's Knowledge GenomeTM

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


See full index

Internal Medicine > CV: Ischemic, Myocardia, Pericardial, and Valvular Heart Dz > Flashcards

CV: Ischemic, Myocardia, Pericardial, and Valvular Heart Dz Flashcards

1
Q

Management of stable angina?

A

EKG

  • if nml, do stress test and then cath (if stress test is positive)
  • if ST/T abn = unstable angina (no need for stress test)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A positive stress test =

A

chest pain, ST depression, hypotension, or significant arrhythmias

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

Coronary steal during stress test:

A

dipyridamole causes blood flow redistribution to nondiseased veins in stress test

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

Management of angina:

  1. Mild angina (1 vein)
  2. Moderate (2 veins)
  3. Severe (3 veins)
A
  1. mild (1 vx) → Tx β-blocker + aspirin + nitrates
  2. moderate (2 vx) → Tx (above) vs. PTCA/CABG
  3. severe (3 vx) → Tx CABG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Unstable angina + biomarkers =

treatment?

A

NSTEMI

medical management

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

NSTEMI + EKG changes =

treatment?

A

STEMI

cath lab for PTCA or CABG

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

Tx of Acute coronary syndrome?

*Which reduce mortality?

A
  • Morphine (analgesia)
  • O2
  • Nitrates (analgesia)
  • Aspirin* ± clopidogrel
  • β-blockers*
  • ACE inhibitor* (remodeling)
  • Statins
  • Heparin vs. enoxaparin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q 
EKG leads:
Lateral = 
Inferior = 
Anterior = 
Posterior =
A

Lateral: I, aVL
Inferior: II, III, aVF
Anterior: V1-V4
Posterior: V1-V2

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

Prinzmetal (variant) angina:
dx?
inducible by?

A

EKG (ST-elevation during episode)

inducible by IV ergonovine

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

Defn and Management of CHF:
Class I?
Class II/III?
Class IV?

A
  • class I sx only w/ vigorous activity → Tx loop diuretic + ACE inhibitor
  • class II-III (II= sx with mod activity and III sx w/ ADLs)→ add β-blocker
  • class IV (sx at rest) → add digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adenosine toxicity sx:

Nitrate toxicity:

Digoxin toxicity:

A

Adenosine toxicity: HA, flushing, nausea, SOB, chest pressure

Nitrate toxicity: headache, orthostatic hypotension, tolerance, syncope

Digoxin toxicity: atrial tachycardia w/ AV block

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

What enhances the murmur in HCM?
Symptoms?
Management?
Etiology?

A

↓preload (e.g. handgrip, Valsalva)

exertional dyspnea, angina,
syncope, sudden death in young athlete

dx with ECHO; if symptomatic, B blockers vs myomectomy vs pacemaker

Autosomal dominant, few are sporadic

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

How soes dialted cardiomyopathy presnet?
Dx o?
Tx?
Etiology?

A

presents as decr contractility with CHF symptoms
Dx: echo+CXR

Tx for CHF + heart txp (MC indication)

MI (MCC), infx, alcohol, doxorubicin (Adriamycin), etc.

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

Presentation of restrictive cardiomyopathy?
Dx
Tx?
Etiology?

A

presents as infiltration of myocardium → ↓compliance → CHF sx

Dx echo + endomyocardial bx to find cause

Tx underlying cause

Etiology: CASHES – carcinoid syndrome, amyloid, sarcoid, hemochromatosis, endocardial fibroelastosis (kids), scleroderma

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

Presentation of mycarditis?
dx?
etiology?

A

usually asx, can present w/ fever, chest pain, pericarditis

Dx ↑cardiac enzymes, ↑ESR

Etiology: coxsackie B virus (MCC)

*tx underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q 
Acute pericarditis:
EKG findings?
tx?
MCC? Other etiologies?
complications?
A

diffuse ST elevation + PR dePRession

Tx NSAIDs

coxsackie B virus > Dressler

pericardial effusion and tamponade

17
Q

Tx of pericarditis + uremia?

A

hemodialysis

18
Q

Dressler syndrome =

tx?

A

post-MI pericarditis, “feels like a second heart attack”

Tx NSAIDs

19
Q

Constrictive pericarditis:
a/w increased…
s/s?

A

↑systemic venous pressure (due to fibous pericardial scarring)

edema, ascites, hepatic congestion, JVD, pericardial knock, Kussmaul sign

20
Q

Constrictive pericarditis:
dx?
tx?

A
  • EKG shows AFib
  • cardiac cath shows “square root sign”

pericardiectomy

21
Q

Constrictive pericarditis vs. tamponade?

A

pericarditis fills rapidly then stops suddenly, tamponade fills slowly through-out diastole

22
Q

muffled heart sounds, soft PMI,
±pericardial friction rub

dx?
management?
mcc?

A

Pericardial Effusion

echo (gold standard)
CXR shows “water bottle” silhouette

small/asx → repeat echo in 1-2 wks
rapidly developing → pericardiocentesis

acute pericarditis

23
Q

pulsus paradoxus + Beck’s triad (hypotension, JVD, muffled heart sounds)

dx?
etiology?

A

Cardiac tamponade

echo (gold standard)
EKG shows electrical alternans

trauma, pericarditis, post-MI w/ free wall rupture

24
Q

Cardiac tamponade:
management of hemorrhagic vs non-hemorrhagic?

**most important factor in determing severity/how quick to act?

A

nonhemorrhagic, stable → close monitoring

nonhemorrhagic, unstable → pericardiocentesis

hemorrhagic → ER thoracotomy

Rate vs. amount: rate is more
important than amount b/c
pericardium has ability to stretch

25
Q

All vavular diseases require..

A

warfarin (anticoagulate) + amoxicillin (SBE ppx)

26
Q

loud S1, opening snap w/ late diastolic rumble

A

Mitral stenosis (rheumatic heart dz)

27
Q

holosystolic blowing murmur

A

Mitral regurgitation (think MVP, ischemic heart dz)

Tricuspid regurgitation (+ pulsatile liver, think IV drug user)

28
Q

systolic crescendo-decrescendo murmur following opening snap

A

Aortic stenosis

29
Q

high-pitched blowing diastolic murmur

A 
Aortic regurgitation (Etiology: bicuspid aortic valve,
syphilitic aortitis, rheumatic fever)
30
Q

midsystolic click, late systolic crescendo murmur

A

Mitral valve prolapse

31
Q

What are the MI biomarkers? When do they appear and how long do they last?

A

CK-MB: peaks in 24 hrs and lasts 2-3 days (therefore good to detect reoccurance)

Troponin 1: peaks un 24 hrs and lasts 1-2 weeks (most specific)

32
Q

EKG changes seen with MI

A 
peaked T waves
ST-elevation
ST-depression
Q waves
T wave inversion
33
Q

Complications of MI

A 
CHF, arrhythmias,
recurrent infarction, free wall
rupture, papillary muscle
rupture, acute pericarditis,
tamponade, Dressler syndrome
34
Q

transient coronary vasospasm

→ episodic angina at rest

A

prinzmetal angina

35
Q

suspect CHF, next steps?

A

EKG + cardiac enzymes (r/o MI) + ↑BNP + echo (best test, estimates EF)

36
Q

what kind of CHF does MI cause? HTN?

A

MI: systolic
HTN: diastolic (LVH impairs filling)

Internal Medicine (15 decks)

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