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Sp: Coexisting I > Final > Flashcards

Final Flashcards

1
Q

virchow triad

A

venous tasis
hypercoag
vascular endo disruption

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2
Q

thoracic aneurysm cause

A

genetic

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3
Q

abdominal anesurysms cause

A

lifestyle

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4
Q

peripheral vascualar disease casuse

A

smoking
lifestyl

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5
Q

coronary subclavian steal

A

sends blood from the heart to arm

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6
Q

subclavian steal

A

sends blood from brain to arm

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7
Q

BP in affected arm of subclavian steal is

A

lower

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8
Q

raynaud’s treatment

A

keep warm
avoid art line
avoid epi additive

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9
Q

3 protection mechanisms for neuro

A

SSEP/EEG
ice epidural
CSF drain

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10
Q

AAA ruptures into

A

L retroperitoneum

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11
Q

AAA rupture triad

A

pulsatile abdominal mass
severe back pain
hypotension

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12
Q

temporal arteritis risk

A

high fire risk

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13
Q

brain blood supply is ______ of CO

A

20% of CO

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14
Q

brain blood supplied by

A

internal carotids
vertebral arteries

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15
Q

vertebral arteries combine into the

A

basillar arteries

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16
Q

what combines in the circle of willis

A

basilar and internal carotids

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17
Q

innermost layer of artery

A

endothelium

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18
Q

atherosclerosis

A

response to vessel wall injury
results in endothelium dysfuntion

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19
Q

indication of vascular disease

A

claudication

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20
Q

aneurysm

A

abnormal weakening of vessel

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21
Q

dissection

A

tear in intima
false lumen

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22
Q

primary cause of thoracic aortic disease

A

genetic bicuspid aortic valve

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23
Q

stanford A

A

ascending

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24
Q

stanford B

A

no ascending

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25
Q

goal vascular ACT

A

200-300s

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26
Q

heparin dose for vascular

A

100U/kg

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27
Q

spinal cord ischemis risk increases with

A

corss clamp > 30s

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28
Q

radial art line for thoracic repair

A

right

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29
Q

BP above/below clamp

A

above: 100 mmHg
below: 50 mmHg

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30
Q

clevidipine dosing

A

2mg/hr
max: 32 mg/hr

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31
Q

highest risk of endovascular AAA repair

A

stent migration/thrombosis

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32
Q

when can you extubate carotid endarctectmy

A

when awake enough to follow commands

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33
Q

CAE damage

A

laryngeal nerve injury
carotid body injury

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34
Q

most important DVT complication

A

PE

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35
Q

best DVT prevention

A

lovenox

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36
Q

recurrent PE treatment

A

IVC filter

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37
Q

DVT prevention in pts who are CI to anticoags

A

IVC filter

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38
Q

CoW

A

protects agains ischemia/stroke
collateral circulation

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39
Q

in order for collateral flow through CoW

A

pressure must be high enough for retrograde flow
- contralateral anterior
- middle cerebral

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40
Q

SV factors

A

preload
afterload
contractility

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41
Q

contractility is independend of

A

preload
afterload

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42
Q

estimate preload

A

LV EDP ~ PAWP

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43
Q

estimate SVR

A

SVR ~ MAP or SBP

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44
Q

incr SVR ____ CO

A

incr SVR = decr CO

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45
Q

all heart disease has

A

incr VEDP

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46
Q

LVEDP ~

A

LVEDP ~ PAWP

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47
Q

LVEDV ~

A

LVEDV ~ CO = HRxSV

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48
Q

normal CI

A

2.5-4.2

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49
Q

systolic HF

A

HFrEF
LV systolic dysfunction

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50
Q

diastolic HF

A

HFpEF
poor relaxation = poor filling

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51
Q

systolic HF tachycardia

A

incr CO

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52
Q

diastolic HF tachycardia

A

decr CO

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53
Q

HF general compensation

A

decr Vmax
incr SVR
incr sympa
incr vascular tone

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54
Q

Frank starline

A

incr filling pressure needed to mx SV/CO

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55
Q

what compensates for increased pressure

A

hypertrophy

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56
Q

hypertrophy state

A

low inotropic state

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57
Q

what compensates for fluid overload

A

dilation

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58
Q

most common myocardial remodeling

A

ischemic injury

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59
Q

treat myocardial remodeling

A

ACE
aldosterone inhibitors

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60
Q

what is associated w/HF

A

elevated BNP

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61
Q

balloon pump diastole

A

inflates

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62
Q

balloon pump systole

A

deflates

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63
Q

causes of RHF

A

LV failure
PHTN
RH MI

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64
Q

most common cause of RHF

A

LV failure

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65
Q

causes of LHF

A

LH MI
chronic HTN
acute HTN
aortic/mitral dz

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66
Q

high output HF

A

good CO
poor perfusion

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67
Q

high output CO diagnosis

A

CO > 8L/min
CI> 4 L/min/m2

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68
Q

normal SVR

A

700-1200

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69
Q

normal PA

A

< 20 mmHg

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70
Q

low contractility (LOW CI), give

A

milrinone

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71
Q

low afterload, give

A

vasopressor (NE)

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72
Q

low contractility, give

A

inotrope (dobutamine)

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73
Q

low contractility, low HR, low SVR, give

A

EPI

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74
Q

transplanted heart is

A

preload dependent

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75
Q

vasopressor for transplanted heart

A

phenylephrine

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76
Q

worsen LVOT

A

incr contractility
decr preload
decr SVR
PPV
labor

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77
Q

drugs worsen LVOT

A

ephedrine
dobutamine
epi

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78
Q

improve LVOT

A

decr contractility
incr preload
incr SVR

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79
Q

drugs improve LVOT

A

BB
CCB

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80
Q

HOCM goals

A

decr LVOT
decr ischemia
avoid arrythmia

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81
Q

HOCM pregnancy labor analgesia

A

epidural

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82
Q

HOCM pregnancy vasopressor

A

phenylephrine
fluids

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83
Q

dilated CM

A

LV dilation

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84
Q

preipartum CM

A

type of dilated CM

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85
Q

peripartum CM treatment

A

give diuretics
give vasodilators

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86
Q

treat restrictive CM

A

ketamine
no PPV
avoid brady

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87
Q

cor pulmonale

A

RV enlargement
can turn into RHF

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88
Q

cor pulmonale management

A

avoid hypoxia
avoid hypercarbia
avoid overnarcsq

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89
Q

open diastole

A

T
M

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90
Q

open systole

A

P
A

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91
Q

starling

A

incr preload = incr SV

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92
Q

starling overstrethcing

A

decr contractility
decr SV

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93
Q

concentric hypertrophy

A

incr P

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94
Q

eccentric hypertrophy

A

incr V

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95
Q

LV failure

A

pulm edema

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96
Q

RV failure

A

lower edema

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97
Q

stenosis

A

normal HR
mx preload
mx afterload
avoid myocardial depression

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98
Q

regurge

A

fast HR
full mx preload
forward SV
decr SVR

99
Q

outer pericardium

A

fibrous

100
Q

inner pericardium

A

serous

101
Q

small effusion stretfches

A

elastin

102
Q

large effusion stretches

A

stiff collagen

103
Q

inspiration causes (IVS shift)

A

incr RV filling
shift IVS Left

104
Q

pericarditis classified by

A

duration
recurrence

105
Q

acute peri

A

2-4 weeks

106
Q

incessant peri

A

1-3 mo

107
Q

chronic peri

A

> 3 mo

108
Q

recurrent peri

A

4-6 weeks asymptomatic

109
Q

pericarditis S+S

A

ST elevation
PR depression
chest pain
incr inflammation

110
Q

is pericarditis responsive to NTG

A

no

111
Q

exudative

A

incr permeability

112
Q

transudative

A

incr pressure to drive fluids

113
Q

pulsus paradoxus

A

decr SBP on inspiration
incr SBP on expiration

114
Q

pleural effusion S+S

A

SoH
orthopnea
cough
chest pain

115
Q

pleural effusion primary diagnosis

A

echo

116
Q

small pleural effusion

A

< 10 mm

117
Q

mod pleural effusion

A

10-20 mm

118
Q

large pleaural effusion

A

> 20 mm

119
Q

tamponade S+S

A

pulsus paradoxus
becks triad

120
Q

becks traid

A

muffled heart sounds
incr jugular distension
hypotension

121
Q

tamponade induction

A

ketamine

122
Q

hemopericardium primary diagnosis

A

CVP
TEE

123
Q

treat hemopericardium

A

pericardiocentesis
surgical drain w/window

124
Q

pericardial decompression S+S

A

hypotension
severe HF
pulm edema

125
Q

management pericardial effusion and constrictive pericarditis

A

avoid hypovolemia
avoid PPV
avoid decr SVR
avoid hypoxemia
min PIP/PEEP

126
Q

commotio cordis

A

impact trauma
R on T phenomena

127
Q

who has increased ischemic risk

A

males

128
Q

angina S+S

A

retrosternal chest pain
screscnedo decrescendo pain

129
Q

angina gold std diagnosis

A

coronary angiography via femoral

130
Q

angina dermatomes

A

C8-T4

131
Q

stable angina

A

no change over 2+ months

132
Q

stable angina most common cause

A

atherosclerosis

133
Q

stable angina diagnosis

A

stress test

134
Q

what might be normal in stable angina

A

EKG

135
Q

coronary steal drugs

A

adenosine
dipyridamole

136
Q

acute coronary syndrome common cause

A

focal disruption of plaque

137
Q

STEMI S+S

A

incr CRP
incr fibrinogen
ST changes
incr troponin C

138
Q

when does troponin C elevate

A

w/in 3 hrs of MI

139
Q

troponin I

A

> 40 ng/L

140
Q

troponin T

A

men > 22 ng/L
female > 14 ng/dl

141
Q

when do yo unot need an ECHO for stemi diagnosis

A

with EKG diagnosis

142
Q

treat stemi

A

BB
reperfusion
PCI

143
Q

reperfusion starts within

A

30 mins of hospital
(12 hrs of symptoms start)

144
Q

PCI starts within

A

90 mins of hospital
(12 hours of symptoms)

145
Q

treat chronic NSTEMI

A

statins

146
Q

treat acute NSTEMI

A

BB
anithrombotics
supp O2

147
Q

drug eluting stent decreases

A

neointimal hyperplasia

148
Q

reendothelialization takes

A

2-3 weeks

149
Q

BMS reendothelialization

A

12 weeks

150
Q

DES reendo

A

1 year

151
Q

angioplasty wait for surgery

A

2-4 weeks

152
Q

BMS wait for surgery

A

1-3 month

153
Q

DES wait for surgery

A

6-12 mo

154
Q

CABG wait for surgery

A

6-12 weeks

155
Q

MACE risk 4 weeks post PCI

A

10%

156
Q

MACE risk 31-90 days post PCI

A

4%

157
Q

MACE risk > 90 days post PCI

A

3%

158
Q

aspirin increase bleeding risk

A

1.5x

159
Q

plavix + aspirin increases bleeding risk

A

2.25x

160
Q

stop clopidogrel/ticagrelor

A

5 days

161
Q

stop prasugrel

A

7 days

162
Q

stop rivaroxaban

A

3 days

163
Q

stop aspirin

A

6 days for high bleeding risk only

164
Q

when can you give plts after clopidogrel

A

4 hrs

165
Q

platelets are most effective given ____ hrs after clopidogrel

A

24+ hrs

166
Q

DAPT

A

aspirin + Plavix

167
Q

DAPT after angioplasty

A

2 weeks

168
Q

DAPT after BMS

A

6 weeks

169
Q

DAPT after DES

A

1 year

170
Q

wait ____ days after MI for surgery

A

60+ days

171
Q

MI with normal/high BP, give

A

NTG

172
Q

MI w/normal/high BP and high HR, give

A

esmolol

173
Q

obstructive

A

incr TLC
incr RV
decr FEV1
decr FVC
decf FEV1/FVC ratio

174
Q

obstructive ex

A

asthma
CF
bronchiectasis
URI

175
Q

URI are

A

viral

176
Q

wait ____ from URI symptoms start for surgery

A

6 weeks

177
Q

compliance =

A

C = V/P

178
Q

severe asthma FEV1

A

FEV1 < 60%

179
Q

severe asthma FEV1/FVC

A

decr > 5% FEV1/FVC

180
Q

treat asthma on vent

A

incr I:E ratio
(incr expiration time)

181
Q

COPD FEV1/FVC

A

> 70%

182
Q

mild COPD

A

FEV1 >=80%

183
Q

mod COPD

A

50-80% FEV

184
Q

sev FEV1

A

30-50% FEV1

185
Q

very sever COPD

A

FEV1 < 30%

186
Q

what BODE is bade

A

high BODE

187
Q

BODE

A

BMI
obstruction
Dyspnea
exercise

188
Q

what decreases risk for intraop COPD

A

preop incentive spirometry

189
Q

COPD on monitor

A

upslope capnography
doesnt return to baseline

190
Q

restrictive

A

normal - incr FEV1/FVC
decr TLC
decr RV
decr RFEV1
decr FVC

191
Q

mild restrictive

A

65-80% TLC

192
Q

restrictive ex

A

pulm edma
pneumo

193
Q

mod restrictive

A

50-65% TLC

194
Q

sev restrictive

A

< 50% TLC

195
Q

DLCO in restrictive

A

decreased DLCO

196
Q

pulm edema goal

A

optimize cardiorespiratory function

197
Q

mild ARDS

A

paO2/FiO2 > 200

198
Q

mod ARDS

A

paO2/FiO2 > 100

199
Q

scoliosis

A

lateral

200
Q

kyphosis

A

anterior

201
Q

severe kyphoscoliosis

A

> 100 deg

202
Q

lordosis

A

posterior

203
Q

GHTN

A

BP > 139/89

204
Q

preeclampsia treatment

A

delivery at term
mild delivery at 37 weeks

205
Q

HELLP

A

deliver at 34 weeks

206
Q

ecclampsia

A

deliver if seizures dont stabilize

207
Q

triad of death

A

hypothermia
acidosis
coagulopathy

208
Q

previa

A

painless vaginal bleeding > 32 weeks

209
Q

previa delivery

A

C section at 37 weeks

210
Q

vasa previa

A

low lying fetal vessels

211
Q

vasa previa management

A

bedrest: 30-32 weeks
delivery: CS at 35 weeks

212
Q

accreta

A

asymptomatic

213
Q

accreta management

A

CS at 34 weeks

214
Q

abruption managment

A

epidural if no fetal distress
GETA for severe hemorrhage

215
Q

most common cause of hemorrhage

A

uterine atony

216
Q

uterine rupture

A

severe abdominal pain w/referred shoulder

217
Q

uterine rupture management

A

immediate laparotomy

218
Q

dehiscence

A

incomplete uterine division

219
Q

dehiscence treatment

A

most likely c section

220
Q

HOCM w/LVOT management

A

early epidural w/slow titration

221
Q

HTN stage 1

A

130-139/80-89

222
Q

HTN stg 2

A

140+/90+

223
Q

ANP

A

atrial

224
Q

BNP

A

ventrical

225
Q

CNP

A

vasculature

226
Q

secondary HTN causes

A

Cushings
Hyperaldo
Aorta coarctation
Pheochromatoma
S

227
Q

1 kg = _____mmHG BP

A

1 kg = 1 mmHg

228
Q

primary HTN treatment

A

thaizide
CCB
ACE
ARB

229
Q

secondary HTN treatment

A

loop diuretics
K= sparing
aldo antag
BB
alpha blocker

230
Q

hold before surgery

A

ACE
ARB

231
Q

continue before surgery

A

CCB
BB
clonidine

232
Q

how much fluid is bowel prep

A

1L

233
Q

cancellectomy

A

180+/110+

234
Q

surgeries with high risk acute post op HTN

A

CAE
AAA
neck dissection
craniotomy

235
Q

mPAP

A

> 20 mmHg

236
Q

1 wu

A

80 dynes/s/cm5

237
Q

PVR =

A

PVR = (mPAP - PAWP)/CO

238
Q

phtn management

A

avoid hypoxia
avoid hypercarbia

239
Q

hypercarbia causes

A

incr PVR

240
Q

inotropy

A

contractility

241
Q

chronotropy

A

HR

242
Q

dromotropy

A

conduction

243
Q

bathmotropy

A

excitability

Sp: Coexisting I (11 decks)

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