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Family med > deck 10 > Flashcards

deck 10 Flashcards

1
Q

learn murmurs

A

…

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2
Q

most common cause of mitral regurg

A

mitral valve prolapse

- occurs due to myxomatous degeneration of the mitral valve leaflets and chordae

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3
Q

new term for variant angina

A

vasospastic angina

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4
Q

cause of vasospastic angina

A

vascular smooth muscle hyperreactivity

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5
Q

RF’s for vasospastic angina

A

cigarette smoking

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6
Q

ECG for vasospastic angina

A

contiguous ST elevation during episodes of chest discomfort

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7
Q

hemodynamic features of septic shock

A
  • Low SVR (and thus after load)
  • low normal or decreased pulmonary capillary wedge pressure
  • increased CO
  • high mixed venous O2 saturation
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8
Q

chest pain algorithm for stable patient

A

1) Obtain ECG + CXR
2) Administer aspirin ASAP if risk for aortic dissection is low
3) O2, IV access

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9
Q

mgmt of patient with chest pain + ECG findings of ACS

A

heparin

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10
Q

features of venous stasis

A
  • pain worse in evening or following prolonged standing
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11
Q

initial treatment of chronic venous insufficiency

A

Leg elevation, exercise, compression stockings

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12
Q

main RF’s of aneurysm expansion and rupture

A
  • large diameter
  • rate of expansion
  • CURRENT cigarette smoking (unknown mechanism but thought to be associated with degeneration of connective tissue in the aortic wall)
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13
Q

med all patients with MI should be discharged home with

A

ACE inhibitors within 24 hours of MI. Following MI, ventricles of heart undergo remodeling, causing dilation of LV + thinning of ventricular was, resulting in CHF.

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14
Q

most common focus of afib

A

pulmonary veins

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15
Q

STEMI management

A
  • full-dose aspirin + cath lab
  • PCI recommended within 90 minutes.
  • additional stabilization measures = 02, platelet receptor blockers, nitroglycerin for pain control, beta-blockers, anticoagulation
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16
Q

treatment of choice for Dressler’s syndrome

A

NSAIDs

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17
Q

alcohol and cardiovascular disesae

A
  • excessive alcohol intake is associated with increased incidence of HTN
  • moderate alcohol intake is associated with decreased incidence of coronary heart disease
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18
Q

meds that can reduce response to antihypertensive agents

A
  • NSAIDs, decongestants, glucocorticoids
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19
Q

presentation of septic emboli

A

cough + chest pain + hemoptysis

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20
Q

atypical angina can present as

A
  • epigastric burning provoked by exercise
21
Q

other sequela of lupus

A

known RF for accelerated atherosclerosis and premature coronary heart disease

22
Q

recommended test for patients with suspected stable ischemic heart disease

A

exercise ECG

23
Q

hyponatremia and CHF

A
  • hyponatremia parallels severity of HF + is an independent predictor of adverse clinical outcomes.
24
Q

treatment of hyponatremia in CHF

A
  • fluid restriction, ACEi’s, loop diuretics
25
Q

protein/gamma gap

A
  • gap between total protein and albumin
26
Q

causes of gamma gap

A

MM, HIV, autoimmune inflammation (due to acute-phase proteins), amyloidosis

27
Q

advair

A

salmeterol + fluticasone

28
Q

CHADS-VAS cutoff for managing with anticoagulation

A

greater than 2

29
Q

NOAC’s used reduce systemic embolization in patients with AFib/eg at high risk of thromboembolic events

A

apixaban, dabigatran, rivaroxaban, edoxaban

30
Q

clopidogrel is…

A

antiplatelet therapy

31
Q

clinical presentation of constrictive pericarditis

A
  • fatigue + dyspnea on exertion
  • peripheral edema and ascites
  • increased JVP
  • pericardial knock
  • pulsus paradoxus
  • kussmaul’s sign
  • pericardial calcifications on CXR
32
Q

Causes of clubbing

A

1) lung malignancies
2) CF
3) Right to left cardiac shunts
* hypoxemia in COPD alone does not cause clubbing.

33
Q

problem with LMWH (enoxaparin) and Xa inhibitors (fondaparinux, rivaroxaban)

A

reduce renal clearance

34
Q

PE presentation

A

sudden-onset chest pain + dyspnea + tachycardia

35
Q

common finding associated with PE

A

Small pleural effusions due to hemorrhage or inflammation

- effusions tend to be exudative and grossly bloody, and can be associated with PAIN due to pleural irritation.

36
Q

treatment for hypersensitivity pneumonitis from birds

A

avoid responsible antigen (eg birds)

37
Q

pleural effusion management

A
  • if CHF, nothing. If no CHF, US for mass, then thoracentesis to determine if transudate or exudate.
38
Q

How to test for c-spine radiculopathy

A

spurning’s test
- turns the patient’s head to the affected side while extending and applying downward pressure to the top of the patient’s head.

39
Q

shoulder exam special tests

A

Neers –> Hawkins –> cross arm –> biceps

40
Q

first step in workup of chronic cough in smoker

A

CXR. Always need to rule out malignancy.

41
Q

only treatment hasn’t been shown to decrease mortality

A

CPAP, O2, tobacco cessation

42
Q

meds that can exacerbate asthma/COPD

A

beta-blockers, NSAIDs

43
Q

asthma mimis

A

**vocal cord dysfunction
Chung-Strauss
Allergic bronchopulmonary aspergillosis

44
Q

asthma step up from SABA + low-dose ICS

A
  • uptitrate steroid before starting LABA.

- anyone on LABA, must always be on corticosteroid. LABA can mask symptoms.

45
Q

DLCO is not reduced in…

A

asthma
It is in emphysema, ILD, and anemia (think about as carrying blood out). You have destruction of lung parenchyma in these conditions.

46
Q

chronic cough defined as

A

8 weeks

47
Q

most common causes of chronic cough

A

RAD (usually young w/ allergies)
GERD
Postnasal drip

48
Q

percentage of people who get cough on ACEI’s

A

20%

49
Q

bicarb in COPD patients

A

elevated due to chronic compensation.

Family med (48 decks)

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