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Cardiology > EOM > Flashcards

EOM Flashcards

1
Q

What polymyalgia Rheumatica ?

A

Inflammation disorder that causes muscle pain

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2
Q

What are key sxs of Polymyalgia Rheumatica (PMR)?

A

morning stiffness lasting 48 hours. Aching/pain in neck, bilateral shoulders, low back, hips & thighs.
SXS MUST BE ONGOING FOR 2WKS

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3
Q

What Dx finding will be seen in PMR?

A

Elevated ESR >100

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4
Q

How do you tx PMR?

A

Prednisone 15 mg/day

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5
Q

What is Giant Cell Arteritis or Temporal Arteritis ?

A

Immune Mediated damage to the carotid arteries. Damage lead to inflammation and thrombus formation + instability of the vessels walls prone to aneurysms.

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6
Q

Which artery is most commonly affected in Giant Cell Arteritis or Temporal Arteritis?

A

Temporal artery is commonly affected

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7
Q

SXS of Giant Cell Arteritis or Temporal Arteritis ?

A

New HA (unilateral in temporal area)
Pain when brushing hair.
·Vision loss (ophthalmic artery blockage) Pain/stiffness in hips & shoulders
Fever & weight loss
Pain w chewing food (jaw claudication)

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8
Q

Dx for Giant Cell Arteritis or Temporal Arteritis?

A

Temporal Artery Biopsy
Elevated ESR >100
Bruit heard w temporal accusation

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9
Q

Tx for Giant Cell Arteritis or Temporal Arteritis?

A

Vision intact-> prednisone -> 40-60mg/day
Vision loss-> methylprednisolone 500-1000 IV/day for 3 days

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10
Q

What is Hypertrophic Cardiomyopathy ?

A

Asymmetric thickening of the myocardium. Septum thicker >3omm than the rest of the ventricle

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11
Q

What causes Hypertrophic Cardiomyopathy ?

A

Autosomal dominant mutation of the protein that encodes sarcomere.
–> Beta-myosin heavy chain
–> myosin-bindin protein C

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12
Q

Which pts with Hypertrophic Cardiomyopathy should get a ICD?

A

1) septal wall thickness >30mm
2)unexplained syncope
3) fail to increase or decrease BP by 20 mm Hg
4) LVEF is less than or equal to 35%

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13
Q

SXS of Hypertrophic Cardiomyopathy

A

dyspnea on exertion, presyncope,syncope, fatigue, edema, orthopnea, paroxysmal nocturnal dyspnea

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14
Q

Dx for Hypertrophic Cardiomyopathy?

A

ECG
Echocardiogram

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15
Q

Tx Hypertrophic Cardiomyopathy?

A

B Blockers (avoid meds that decrease preload & afterload)
implantable cardioverter-defibrillator
abalation of septum
anticoag w A fib

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16
Q

Hypertophic cardiomyopathy can cause which type of arrhythmia?

A

Ventricular arrhythmias

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17
Q

What is Restrictive Cardiomyopathy ?

A

Restrictive filling & reduced diastolic volume of LV &/or RV
* Stiff heart-> diastolic dysfunction
Systole remains normal

18
Q

What are 4 major causes of Restrictive cardiomyopathy?

A

Endomyocardial fibrosis (collagen)
Amyloidosis (protein)
Sarcoidosis (granulomas)
Hemochromatosis (iron)

19
Q

What are SXS of Restrictive cardiomyopathy?

A

Kussmaul sign -> JVP increase w inspiration
Venous congestion, exterional dyspnea, paroxysmal noctural dyspnea
apical impluse not displaced-> S4 mitral & tricuspid reguritation murmur

20
Q

Dx Restrictive cardiomyopathy?

A

Biopsy & tissue analysis w fat pad, transrectal or myocardial
ECHO
ECG
Low voltage QRS complex

21
Q

What is Dilated cardiomyopathy?

A

Dilation of the LV (thin myocardium) -> ejection fraction <40. normal diastolic filling but impaired systolic

22
Q

What causes Dilated Cardiomyopathy

A

Chagas diease
drug (cocaine) or alcohol use
Doxorubicin (chemotherapy drug)
Thiamine deficieny (Ber Beri)-> vitamin B1 defincney

23
Q

Sxs of Dilated Cardiomyopathy

A

S3 gallop
cough & frothy sputum
anasarca (swelling of the whole body)
Abdominal distention
Cheyne-stokes breathing (gradually deeper and faster breathing until breathing stops)

24
Q

Dx of dilated cardiomyopathy?

A

Enlarged heart on CXR
LBBB pattern on ECG
decreased efection fraction

25
Q

Tx for dilated cardiomyopathy?

A

diuretics
reduce afterload (ACE/ARBs)
cardiac transplant

26
Q

What causes takotsubo cardiomyopathy and how do you tx it?

A

enlargement of ventricles triggered Intense emotional or physical stress
sxs CP, dizziness, syncope, dyspnea, pulmoanry edema
Tx nitrates, labatolol
——————–> aviod anticoag = risk for ventricular rupture

27
Q

What is unstable angina ?

A

Supply & demand mismatch-> myocardial ischemia but not infarction (cells has not died)
-> no alleviation with rest
No troponin elevation
->ST depression, T wave inversion or no changes
Persistent for 20 mins & not relieved by nitroglycerin

28
Q

What is Stable Angina?

A

progressive narrowing of the vessel. Familiar chest pain on exertion. Alleviates w rest.

29
Q

What is Non ST elevation Myocardial Infraction (NSTEMI)

A

Supply & demand mismatch -> non-transmural subendocardial infract
§ ST depression & T-wave inversion
§ Elevated troponin

30
Q

What is ST Elevation Myocardial Infraction (STEMI)

A

Complete blockage to coronary artery -> transmural infract of wall supplied by artery
ST elevation
Elevated Troponin

31
Q

What does HEART stand for and when do you decided hospital admittance vs home w f/u?

A

History
Ecg
Age
Risk
Troponin
Heart score greater than 4 = hospital stay
Heart score less than 3 w neg work up -> home

32
Q

What medications do you give for an MI?

A

Asa, nitroglycerin
antiplatelet-> clopidogrel, ticagrelor
Heparin bollus
send to cath lab where they receive IIb/IIIa inhibitor
* Epitfibatide (preferred), Abcixamab

33
Q

What is Peripheral Arterial Diease ?

A

Claudication-> pain w excertion that resolves at rest

34
Q

In Peripheral Arterial Diease what are the 6 P’s that indicate critical limb ischemia?

A

Pain
Pulseless
Poikilothermic
Pallor
Paresthesia
Paralysis

35
Q

What is a major risk factor for Peripheral Arterial Diease?

A

Tobacco use. has CVD

36
Q

What is pseudoclaudication and how does it differ from Peripheral Arterial Diease claudication?

A

narrowing of spinal canal causing pain, numbness, weakness when standing. Allievated by leaning forward on a shopping cart (positional pain)
Peripheral Arterial Diease claudication-> exertional pain that allivates with rest.

37
Q

What is a normal and abnormal pulse grade?

A

2= normal
3= abnormal
0 = absent

38
Q

Ankle brachial index measure?

A

Highest systolic BP at Brachial artery
Highest systolic BP in PT or DP
Calculate using valves from left leg & right leg

0.9 = abnormal
normal = 1.0-1.4

39
Q

Tx for PAD

A

Asprin 81 mg Po qd -> CVD & amputation risk decrease
High does statin (atorvastatin 80 mg & rosuvastatin 40 mg)
Cilostazol -> suppress platelet aggreg
Excercise program
Quit smoking

40
Q

When is it recommended for men to be screened for abdominal aortic aneurysm?

A

Screen b/w aged 65-75 y/o 1 time

41
Q

When is AAA diagnosed via U/S

A

when the aorta has grown 5.0 cm
surgery is indicated if growth is 5.5 cm or 1/2 cm growth in 6 months

Cardiology (1 decks)

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