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Cardiovascular > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Shock

A

Lack of perfusion

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2
Q

Pump problem

A

cariogenic shock

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3
Q

Cardiogenic shock - History Findings

A
  • massive MI
  • dilated cardiomyopathies
  • tamponade
  • myocarditis
  • CHF
  • Toxin
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4
Q

Cardiogenic shock - physical exam

A

pulmonary edema = wet lungs

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5
Q

Cardiogenic shock - treatment

A

ICU and cardiology

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6
Q

Plumping - pipe problems

A

Distributive

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7
Q

Types of distributive

A

septic, neurogenic, anaphylaxis

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8
Q

Septic - history

A

fever, infection, gram-negative

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9
Q

Septic - physical findings

A

bounding pulses

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10
Q

Septic - later stages

A

urine output goes down, pulse quickly goes to crap, body shutting down

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11
Q

Septic - treatment

A

treat the infection

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12
Q

Neurogenic

A
  • head or cervical or spine injury
  • lose of SNS tone to everything below the level of the injury
  • poor profusion below injury
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13
Q

Neurogenic - physical findings

A

bradycardia

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14
Q

Neurogenic - treatment

A

neurosurgery

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15
Q

Anaphylaxis - history

A

bee sting, food, penicillin

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16
Q

Anaphylaxis

A
  • IgE cause of initial part of reaction
  • airway starting to close down
  • kill people is the cardiovascular collapse
  • airway is second most common cause of death
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17
Q

Anaphylaxis - physical findings

A

from anaptyctic shock blood pressure is going to crap

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18
Q

Anaphylaxis - treatment

A
  • epinephrine causes vasodilation
  • Benadryl and xanax
  • steroids = longer benefit
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19
Q

Fluid problems = not enough

A

Hypovolemic

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20
Q

Hypovolemic - history

A
  • trauma
  • dehydration
  • burns
  • sweating
  • urinating a lot
  • vomiting
  • diarrhea
  • bleeding
  • third space in fluids
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21
Q

Hypovolemic - physical findings

A
  • dry lungs

- respiratory rate and heart rate are elevated

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22
Q

Aortic stenosis - common causes

A 
senile degeneration and calcification 
-calcified after age 65
congenitally bicuspid aortic valve
-calcified around age 30
rheumatic fever 
-commissure calcify in 3rd or 4th decade
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23
Q

Aortic Stenosis

A
  • systolic ejection murmur - throughout

- NARROW pulse pressure

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24
Q

Aortic insufficiency (regurgitation) - common cause - infection

A

bacterial endocarditis

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25
Aortic insufficiency (regurgitation) - common cause - congenital
bicuspid AoV
26
Aortic insufficiency (regurgitation) - common cause - increased afterload
systemic hypertension (poorly controlled)
27
Aortic insufficiency (regurgitation)
- soft high pitched diastolic murmur - widened pulse pressure - no beta blockers = increased diastolic time and preload
28
Mitral stenosis - common cause
-rheumatic valve disease
29
Mitral stenosis
- opening snap | - low-pitched rumbling diastolic murmur
30
Mitral stenosis - ECG changes
- left atrial enlargement | - right ventricular hypertrophy
31
Mitral regurgitation - common cause
- myxomatous changes (MVP) | - rheumatic heart disease
32
Mitral regurgitation
- mid-systolic click | - pansystolic blowing/harsh murmur
33
Mitral valve prolapse - common cause
- idiopathic - Marfan's - Ehler's Danlos
34
Friction rub, global ST elevation, flu before, chest pain worse with deep breath, chest pain better while leading forward
pericarditis
35
Muffled heart beat
pericardial effusion
36
Muffles heart beat, JVD, hypotension
cardiac tamponade
37
Fixed split A2
ASD
38
opening snap
mitral stenosis
39
Mid-systolic click
mitral prolapse with mitral regurgitation
40
Valve is supposed to be open
stenosis
41
Valve is supposed to be close
regurgitation
42
ASD
- fixed S2 | - patent foamed ovale (PFO)
43
VSD - most common
perimembranous - acyanotic congenital heart defect
44
VSD - auscultation
left lower sternal border | -increase during expiration
45
AV Canal Defect
40% occurrence in Down syndrome
46
PDA - auscultation
continuous machinery-like murmur best at LUSB
47
PDA - treatment
indomethacin
48
Treatment of valvular issues
surgery
49
diagnosis of valvular issues
echo
50
Complications
mitral valve prolapse and bunch of PVCs | -beta-blocker
51
Pulmonary vascular resistance - fetal to neonatal
goes down
52
Ductus arteriosus
closes to ligament arteriosus
53
Foramen ovale
closes to fossa ovale
54
Terta fallot
- most common cyanotic congenital heart defect - PROM - Squatting = increase systemic vascular resistance - boot-shaped heart
55
PROM
pulmonic stenosis right ventricular hypertrophy overriding aorta massive/malalinged VSD
56
Transposition
- parallel circuit | - have to have ASD, PAD, or VSD to sustain life
57
Keep PAD open
prostaglandins
58
Close PAD
indomethacin
59
Still Murmur
most common innocent murmur in early childhood
60
Still Murmur - loudest
between the apex and LLSB with patient supine
61
Pulmonary Ejection Murmur
most common innocent murmur in older children and adults
62
Pulmonary Ejection Murmur -auscultated
LUSB | -soft systolic ejection murmur with I-II/VI intensity
63
Chest pain - most common cause
musculoskeletal
64
Syncope - most common cause
vasovagal syncope
65
Red flags they have this than oh crap
syncope during exercise
66
Kawasaki disease
- most common types of vasculitis in pediatric population | - multisystem inflammatory condition of medium-sized blood vessels
67
Kawasaki disease - Crash and burn
``` Conjunctivitis Rash Adenopathy Strawberry tongue Hand (swelling or erythema) Burn (5 days of fever) ```
68
Kawasaki disease - Coronary aneurysms
- affects 30 to 50% of patients | - usually 10 days after onset of fever
69
Kawasaki disease - treatment
aspirin and immunoglobins
70
Acute Rheumatic fever - bug
immunologic reaction (delayed) to infection with group A beta-hemolytic streptococcal (GABHS) pharyngitis
71
Acute Rheumatic fever - major criteria
``` Polyarthritis* Carditis Chorea Subcutaneous nodules Erythema marginatum ```
72
First-degree AV block
- constant prolonged PRI | - QRS follow every P wave
73
Second Degree AV Block Type I | AKA: Wenckebach
progressive prolonged PRI | -dropped QRS
74
Second Degree AV Block Type II | AKA: Classic
constant/prolonged PRI | -dropped QRS
75
Third Degree AV Block
- P waves not related QRS - All P waves not followed by QRS = decrease CO - dropped QRS
76
Unifocal
each PVC has the same morphology due to one ectopic site
77
Multifocal
more than one PVC appearance due to multiple ectopic sites within the ventricles
78
Bigeminy
Pattern of one PVC followed by a normal intrinsic beat
79
Trigeminy
pattern of one PVC followed by two normal intrinsic beats
80
Couplets
Two PVC's occurring in sequence
81
Triplets
Three PVC's occurring in sequence
82
Idioventricular Rhythm
- no p waves | - 20 to 40 rate
83
Accelerated Idioventricular Rhythm
- no p waves | - 40 to 100
84
Monomorphic Ventricular Tachycardia
- rate >150 - no p waves - wide QRS
85
Polymorphic ventricular tacycardia
torsades de pointes
86
Ventricular Fibrillation
- no rate | - chaotic rhythm
87
Pulseless Electrical Activity (PEA)
activity on ECG monitor but no palpable pulse
88
Inferior wall MI - treatment
right sided EKG | -no nitro
89
Right Atrial Enlargement
- tall peaked P wave in inferior leads (especially in lead II) - P wave amplitude greater than 2.5 mm in inferior leads - Tall initial upstroke of the P wave in V1 and a terminal negative deflection
90
Left Atrial Enlargement
- notched or "m" shaped P wave in lead II | - small initial upstroke of P wave in V1 with deep terminal negative deflection
91
Right Ventricular Hypertrophy
- right axis deviation (aVF up, Lead I down) | - R>S in lead V1
92
Left Ventricular Hypertrophy
-S in V1 or V2 and R in V5 or V6 >35
93
LBBB
down in V1
94
RBBB
up in V1
95
WPW
delta wave: slurring of the initial portion of QRS complex
96
Pericarditis
global ST elevation
97
Pericardial effusion
small then big then small
98
Anterior Wall
- V3 and V4 | - left anterior descending
99
Septal Wall
- V1 and V2 | - septal branches off LAD
100
Lateral Wall
- Leads 1, aVL, V5, V6 | - Left circumflex artery
101
Inferior Wall
- Lead II, III, aVF | - right coronary artery
102
Posterior Wall
V1 and V2 put your posterior in it
103
Complications with Inferior MI
papillary muscle rupture
104
Complications with MI
- ventricular aneurysm - free wall rupture - ventricular arrhythmias - AV blocks
105
Cardiac arrest most common
V fib
106
PEA common case
hypoxia | hypovolemia
107
Asystole - causes that you will survive
- hypothermic - drug overdose - struck by lightening
108
Asystole - causes that you will die from
- trauma and related complications - Massive MI - Massive PE
109
Venous insufficiency
- severe manifestation of venous hypertension - commonly follows history of DVT - history of leg trauma or surgery
110
Venous insufficiency - physical findings
- swelling of legs - brownish or reddish hyperpigmentation of skin - dry flakiness - cool and clammy - pitting edema
111
Venous insufficiency - treatment
- elevate legs - sodium restriction - compression stockings
112
Arterial insufficiency - physical findings
- poor pulses - lack of hair - shinning skin
113
Arterial insufficiency - treatment
- quit smoking - Stain drug - Aspirin
114
Six Ps for acute arterial occlusion
``` Pain Pallor Polar (cold) Paralysis Paresthesia Pulselessness Purple toes ```
115
Aortic Dissection
- tearing sensation - tear in the intimal lining of the aorta at a weakened point - splitting of the layers of the vessel wall - diaphoresis - most are hypertension - BP or pulse asymmetry between limbs
116
Aortic Dissection - CXR
widening of mediastinum
117
Aortic Dissection - Medical Mangement
- beta-blockers | - sodium nitroprusside
118
Aneurysms - most common site for AAA
intarenal-superilliac | men > women
119
Aortic Aneurysm - saccular
bulging out of one specificities are of vessel
120
Aortic Aneurysm - fusiform
circumferential dilation of all layers of a segment of the aorta
121
Aortic Aneurysm - false/pseudoaneurysm
only involves one or two of the layers of the arterial wall
122
Aortic Aneurysm
- usually asymptomatic - incidental finding on abdominal examination, AXR< or ultrasound - sense of "fullness"
123
AAA
- hypertesion | - rupture
124
AAA Triad
- abdominal pain - hypotension - palpable pulsatile abdominal mass
125
AAA - test of choice
ultrasound
126
AAA - gold standard
open repair
127
Varicose Veins
dilation and tortuosity of superficial veins
128
Varicose Veins - risk factors
- prolonged standing - heavy lifting - pregnancy - obesity
129
Varicose Veins - presentation
dull, aching heaviness in the lower extremities or increase east of fatiguability associated with prolonged standing
130
Pericarditis - common cause
- viral - tumor - uremia - after MI
131
Pericarditis - symptoms
- lean back = worse | - lean forward = better
132
Pericarditis - Labs
ESR
133
Pericarditis - Treatment
- anti-inflammatory | - indomethacin
134
Pericarditis - EKG
global ST elevation
135
Endocarditis
mitral than aortic valve
136
Endocarditis - IV user
tricuspid valve
137
Mechanical or damage valve - bug
strep virdans
138
IVD user - bug
Staph aureus
139
Duke Criteria - major
- two sets of blood cultures | - new or chaining murmur
140
Endocarditis - see vegetation
on transesophageal
141
Treatment - IV
-cillin
142
Treatment - Mechanical or damaged valve
ceftriaxone with gentamycin
143
Treatment - MRS
vancomycin with gentamycin
144
Endocarditis - Physical Findings
- janeway lesions - osler nodes - splinter hemorrhages - roth spots
145
Cardiac Tamponade - Beck's Triad
- hypotension - JVD - muffled heart sounds
146
Cardiac Tamponade - treatment
pericardiocentesis
147
Cardiac Tamponade
Gout

Cardiovascular (10 decks)

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