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مطالعات من > Heart❤️ > Flashcards

Heart❤️ Flashcards

1
Q

The first best appropriate test in investigating the chest pain is …

A

𝑬𝑪𝑮

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2
Q

What are three main criteria to diagnose ACS (Acute
Coronary Syndrome)?

A

1）𝑇𝑦𝑝𝑖𝑐𝑎𝑙 𝑐ℎ𝑒𝑠𝑡 𝑝𝑎𝑖𝑛
2）𝑃𝑜𝑠𝑖𝑡𝑖𝑣𝑒 𝐸𝐶𝐺 𝑓𝑖𝑛𝑑Ings
3）𝐸𝑙𝑒𝑣𝑎𝑡𝑒𝑑 𝑙𝑒𝑣𝑒𝑙 𝑜𝑓 𝑐𝑎𝑟𝑑𝑢𝑎𝑐 𝑚𝑎𝑟𝑘𝑒𝑟𝑠

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3
Q

𝑊ℎ𝑎𝑡 𝑎𝑟𝑒 𝑡𝑦𝑝𝑖𝑐𝑎𝑙 𝑠𝑖𝑔𝑛𝑠 & 𝑠𝑦𝑚𝑝𝑡𝑜𝑚𝑠 𝑜𝑓 MI？

A

．𝑅𝑒𝑡𝑟𝑜𝑠𝑡𝑒𝑟𝑛𝑎𝑙 𝑐ℎ𝑒𝑠𝑡 𝑝𝑎𝑖𝑛 𝑟𝑎𝑑𝑖𝑎𝑡𝑖𝑛𝑔 𝑡𝑜 𝑙𝑒𝑓𝑡 (𝑤𝑖𝑡ℎ 𝑜𝑟 𝑤𝑖𝑡ℎ𝑜𝑢𝑡 𝑟𝑖𝑔ℎ𝑡）， 𝑠ℎ𝑜𝑢𝑙𝑑𝑒𝑟， 𝑎𝑟𝑚， 𝑛𝑒𝑐𝑘， 𝑗𝑎𝑤
． 𝐴𝑠𝑠𝑜𝑐𝑖𝑎𝑡𝑒𝑑 𝑤𝑖𝑡ℎ 𝑑𝑖𝑎𝑝ℎ𝑜𝑟𝑒𝑠𝑖𝑠，𝑛𝑎𝑢𝑠𝑒𝑎， 𝑎𝑛𝑥𝑖𝑒𝑡𝑦

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4
Q

𝑾𝒉𝒂𝒕 𝒂𝒓𝒆 3 𝑬𝒔 𝒕𝒉𝒂𝒕 𝒄𝒂𝒖𝒔𝒆 𝑨𝑪𝑺?

A

𝑬𝒙𝒆𝒓𝒕𝒊𝒐𝒏
𝑬𝒎𝒐𝒕𝒊𝒐𝒏
𝑬𝒂𝒕𝒊𝒏𝒈

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5
Q

Duration of ACS is …and usually relieves by … and …

A

< 10-15 min
rest- nitrates

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6
Q

What is Levine’s sign?

A

Clutchung fist over sternum when describing chest pain
.

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7
Q

What are anginal equivalents?

A

Dyspenea, acute LV failure, flash pulmonary edema.

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8
Q

Close to … of MIs are
“silent” or unrecognized due to atypical symptoms.

A

30%

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9
Q

Silent MIs are more common in …

A

• Females
• Diabetics
• Seniors
• Post-heart transplant

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10
Q

𝑾𝒉𝒂𝒕 𝒂𝒓𝒆 𝒄𝒂𝒓𝒅𝒊𝒂𝒄 𝒎𝒂𝒓𝒌𝒆𝒓𝒔?

A

CPK / LDH / CK-MB / Troponin I

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11
Q

The physical findings that are most highly associated with cardiac disease include …

A

hypotension, diaphoresis, and a new S3 gallop

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12
Q

… of patients with cardiac disease will have their pain reproduced by chest wall pressure.

A

15%

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13
Q

کدام خصوصیات در درد سینه احتمال منشأ قلبی را کم می‌کند؟

A
  • Sharp quality pain
  • Continuous pain for
    days or lasting fewer than 2 minutes
  • If a patient can pinpoint with one finger the localized painful area and is found tender on palpation.
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14
Q

A normal troponin and/or CPK-MB do not rule out cardiac disease; except in cases where the chest pain has been continuous for over…

A

12 hours

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15
Q

… of all patients with an MI will have a normal ECG in the ED.

A

9%

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16
Q

Only…% of those with an Ml have a diagnostic ECG in the
ED. Additionally, those with … may have a normal ECG.

A

50

angina

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17
Q

….is more sensitive in the first … hours than is the troponin (about … versus …).

A

CK- MB
6
84% 74%

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18
Q

An increased … is associated with increased short term and in-hospital mortality.

A

troponin

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19
Q

Patients with … disease may have a mildly elevated troponin at baseline due to poor clearance,

A

renal

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20
Q

… like MI, can elevate the serum troponin.

A

pulmonary emboli

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21
Q

𝑾𝒉𝒊𝒄𝒉 𝒄𝒐𝒏𝒅𝒊𝒕𝒊𝒐𝒏𝒔 𝒐𝒕𝒉𝒆𝒓 𝒕𝒉𝒂𝒏 𝑴𝑰, 𝒄𝒂𝒏 𝒆𝒍𝒆𝒗𝒂𝒕𝒆 𝒕𝒓𝒐𝒑𝒐𝒏𝒊𝒏?

A

CHF, PE, burns, sepsis or
other critical illnesses,
stroke.

22
Q

What is the role of ECG in therapeutic
decisions in MI?

A

Presence or absence of
elevation in ST segment of
ECG

23
Q

Aspirin given within half an hour of chest pain is similar to … treatment.

A

thrombolytic

24
Q

patient with chest pain that may be cardiac in origin, current use of warfarin or aspirin should not prevent the … in the emergency department.

A

administration of aspirin

25
Q

….and … from NSAIDs, are reversible platelet inhibitors that do not give adequate platelet inhibition.

A

Iboprofen
Maproxen

26
Q

…. and ….. can block the effect of aspirin by making binding sites
on platelets unavailable.

A

Ibuprofen
Naproxen

27
Q

stopping … is considered good practice for any patient who is admitted for possible CAD.

A

NSAIDs

28
Q

In ACS percentage of Unstable Angina (UA) is … %
NSTEMI … %
STEMI: plaque rupture and thrombus formation … %

A

38

25

30

29
Q

The microemboli breaks away from the ruptured plaque and causes … or …

A

subendocardial infarction NSTEMI

ischemia UA

30
Q

The microemboli breaks away from the ruptured plaque and causes … or ….

A

subendocardial infarction NSTEMI

ischemia UA

31
Q

𝑰𝒏 𝒄𝒉𝒆𝒔𝒕 𝒑𝒂𝒊𝒏, 𝒏𝒆𝒙𝒕 𝒔𝒕𝒆𝒑 𝒂𝒇𝒕𝒆𝒓 𝑬𝑪𝑮 & 𝒉𝒆𝒂𝒓t 𝒆𝒏𝒛𝒚𝒎𝒆𝒔 𝒘𝒊𝒍𝒍 𝒃𝒆 …

A

𝒔𝒕𝒓𝒆𝒔𝒔 𝒕𝒆𝒔𝒕

32
Q

If stress test shows ischemia, the next step will be ..

A

angiography

33
Q

… is the most alarming
thing a stress test could show.

A

Reversible ischemia

34
Q

… is the most alarming
thing a stress test could show.

A

Reversible ischemia

35
Q

… is a defect that remains unchanged between exercise

A

Fixed defect

36
Q

The best initial test to evaluate valve function or ventricular wall motion is …

A

Echocardiography

37
Q

The most accurate method for evaluating ejection fraction is …

A

Nuclear ventriculogram
(MUGA scan)

38
Q

…. is the only one that have resulted in lower mortality in chest pain.

A

Low molecular weight Heparin (LMWH)

39
Q

… is the most useful intervention to improve functional capacity and reduce symptomatic claudication in patients with peripheral arterial disease.

A

A supervised graded exercise program

40
Q

… reduce overall cardiovascular mortality.

A

Antiplatelet agents (e.g., aspirin,
clopidogrel)

41
Q

… should also be given to all patients with clinically significant atherosclerotic cardiovascular
disease.

A

Lipid-lowering therapy with statins

42
Q

What is Vincent Angina?

A

Chest pain because of pharyngitis and tonsillitis, kind of referred pain from the infection location

43
Q

… is a type of severe cellulitis of the floor of the mouth, in which pus can trickle down to the chest cavity.

A

Ludwig’s angina

44
Q

Pain in … is related to activity, occasionally it occurs at rest as well and is linked with rupture of atherosclerotic plaque.

A

unstable angina

45
Q

A chest pain that happens after an episode of MI (post MI), after PCI or after CABG is also referred to as …

A

unstable angina

46
Q

Based on Canadian Cardiovascular Society (CCS), angina caused with strenuous, rapid, or prolonged activity if indicated as class … angina.

A

I (one)

47
Q

According to CCS angina that occur during walking > 2 blocks (same level) or
> 1 flight of stairs with slight imitation of ordinary activity is referred to class …

A

II (two)

48
Q

According to CCS, angina that occurs while walking < 2 blocks (same level) or climbing <1 flight of stairs, i.e., limitation of ordinary household activity is referred to class …

A

III (three)

49
Q

In class … angina, no physical activity is possible without discomfort
OR
Angina occurs at rest.

A

IV (four)

50
Q

چه مقدار LDL در فرد دیابتی پرخطر محسوب می‌شود؟

A

بالاتر از mg/dl ۷۰ یا ۱/۸ mEq/L

51
Q

چه بیمارانی برای آسپرین Eligible هستند؟

A

1- coronary artery diseases
2- peripheral artery diseases (e.g leg cramp)

(Not just diabetic)

52
Q

نسبت ankle/brachial در حد …. نشانه‌ی آترواسکلروزِ moderate است و باید … شروع شود.

A

۱:۵ - ۱:۸
آسپرین

مطالعات من (14 decks)

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