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PANCE > high yield > Flashcards

high yield Flashcards

1
Q

H influ pne associated with

A

COPD

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2
Q

Staph Aureus pne associated with

A

post viral

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3
Q

tx for CAP

A

3rd gen cephlasporin + macrolide
OR
moxifloxin

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4
Q

tx for HAP

A

Pip/Tazo + Vanc

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5
Q

tx for lung absecess

A

3rd gen cehp + clinda

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6
Q

tx for PCP, TB or fungal PNE

A

Bactrim

+/- steroids

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7
Q

worst risk factor for CAD

A

DM

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8
Q

MONA BASHC

A

tx for CAD

Morphine, O2, Nitro, ASA, BB, ACE-i, statin, heparin, clopidogrel

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9
Q

ACE-i benifits in CAD

A
  1. stops remodeling

2. reduces afterload

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10
Q

drug that reduces mortality MOST in CAD

A

ACE-i

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11
Q

tx of CAD long-term

A
  1. BB &ACE-i
  2. Dual anti-platlet therapy: ASA (81mg) + Clopidogrel (75mg)
  3. statin- atorvastatin, rosuvatatin
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12
Q

when in tPA used in CAD

A

when transport time is >60 min away for PCI (per cutaneous cath intervention_

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13
Q

how much time does a hospital have to stent STEMI

A

door–>90 min balloon inflation

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14
Q

pt has increase ACE-i

A

sarcoidosis

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15
Q

normal ejection fraction of heart

A

55%

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16
Q

diuretics used for CHF

A

hydralazine OR spironolactone

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17
Q

EF <35%, HF NOT class VI tx

A

AICD

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18
Q

tx of CHF

A

ACEi + BB

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19
Q

tx CHF exacerbation

A 
LMNOP
L-lasix (forosemide)
M-morphine
N-nitrates
O- O2
P-position
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20
Q

murmur grade

A

1: S1, S2 > murmur
2: S1, S2= murmur
3: S1, S2 < murmur
4: palpable thrill
5: hear murmur w/ stethscope half of chest
6: hear murmur w/o stethoscope

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21
Q

1st step after hearing mumur

A

echo

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22
Q

rheumatic heart disease is associated w/ which mumur

A

mitral stenosis

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23
Q

younger pt with
afib (atrial stretch)
CHF

A

rheumatic heart dz

mitral stenosis

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24
Q

mitral stenosis murmur location & time

A

diastolic

Apex

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25
Q

rumbling diastolic murmur w/ an opening snap

A

mitral stenosis

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26
Q

tx for mitral stenosis

A

balloon valvuloplasty

** different from other murmurs b/c vegitations

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27
Q

what causes valve insufficiency

A

infection or infarction

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28
Q

major complication of aortic valve insufficiency

A

aortic dissection

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29
Q

aortic insufficiency murmur

location & time

A

diastole
blowing
decresendo
L upper sternal border

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30
Q

tx of aortic insufficiency

A

replacement

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31
Q

Aortic Stenosis causes

A

Calcium buildup OR bicuspid valve

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32
Q

old man with CP, CHF syncope + systolic cresendo decresendo murmur at base

A

aortic stenosis

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33
Q

aortic stenosis

location & time

A

systolic
R upper sternal border
cresendo-decresendo
radiates to cartoid artery

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34
Q

mitral insufficiency

tx

A

replacement

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35
Q

mumur that radiates to carotid artery

A

aortic stenosis

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36
Q

mumur that has bounding pulses and increased pulse pressure due to increased stroke volume

A

aortic insufficiency

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37
Q

signs associated w/ wide pule pressure in chronic aortic regurg

A

water hammer pulse: radial pulse upstroke
corrigan’s pulse: carotid upstroke
hill’s sign: popliteal atery pressure > brachial artery by >60 *MOST sensitive
de mussets: head bobbing
qunickes: fingernail bed pulse

38
Q

mitral facies

A

ruddy (flushed cheeks w/ facial palor

39
Q

MC cause of mitral regurg

A

MVP- US

rheumatic fever- developing

40
Q

marfan syndrome is related to which mumur

A

mitral regurg

41
Q

blowing hollosystolic mumur best heard at apex

A

mitral regurg

42
Q

murmur radiates to axilla

A

mitral regurg

43
Q

left lateral decubits increases this murmur

A

mitral stenosis

44
Q

MC systemic vasculitis

A

Giant Cell Arteritis

45
Q

Valsalva increase or decrease blood flow

A

decrease

46
Q

HCOM tx

A

avoid dehydration

BB

47
Q

MVP tx

A

avoid dehydration

BB

48
Q

moves that increase venous return

A

supine
leg lift
squat

49
Q

moves that decrease venous return

A

Valsalva

standing

50
Q

inspiration increases sound of which mumurs

A

right sided

51
Q

diastolic murmurs

A

AR MS rest

52
Q

causes of dilated cardiomyopathy

A
  1. ETOH
  2. virus
  3. ischemia
53
Q

causes of restrictive cardiomyopathy

A
  1. sarcoidosis- pulm dz
  2. amyloid- neuropathy
  3. hemachomatosis- cirrhosis or DM bronze dz
54
Q

Restrictive Cardiomyopathy dx AFTER echo

  1. sacoidosis=
  2. amyloidsis
  3. hemachromatosis=
A
  1. sacoidosis= cardia MRI, endo cardio biopsy
  2. amyloidsis= fat pad biopsy/gingiva
  3. hemachromatosis= elevated ferritin + genetic test
55
Q

electrical alternans

A

pericardial effusion

56
Q

pericarditis
1st test
best test

A

1st test: ECG

best: MRI

57
Q

pericarditis tx

A

NSAIDS + colchicine

58
Q

when can NSAIDs not be used

A
  1. CKD
  2. PUD
  3. low platelets
59
Q

tx for uremic pericarditis

A

dialysis

60
Q

MC cause of pericarditis

A
  1. VIRAL

2, uremia

61
Q

pericardial effusion

-cause

A

pericarditis

62
Q

pericardial effusion

dx

A

echo

63
Q

pericardial effusion

tx

A

pericardial window

64
Q

Becks triad

A

pericardial tamponade

  1. decreased heart sound
  2. JVD
  3. hypotension
65
Q

pericardial knock

A

constrictive pericarditis

66
Q

constrictive pericarditis

tx

A

pericardectomy

67
Q

MAP

A

COx SVR
CO= HR X SV
SV= contractility & preload

68
Q

S1

S2

A 
S1= tri & bicuspid valves
S2= aortic & pulmonic
69
Q

vasovagal causes

A
  1. stimulate visceral organs
  2. carotid bodies
  3. psych
70
Q

vasovagal

tx

A

BB

71
Q

+ orthostatics

A

systolic 20
diastolic 10
HR 15

72
Q

cardiac causes of syncope

A
  1. valve– AS-old person over exert OR HOCM -young athlete

2. arrhythmia (no prodrome)

73
Q

base line labs before starting statins

A
  1. lipids (yearly)
  2. A1C 1x (unless DM)
  3. CK –> rhabdo (sxs)
  4. LFT–> hepatitis (sxs)
74
Q

Niacin

-bad effect

A

flushing

–> tx w/ ASA

75
Q

ezetimibe

A

decrease LDL

causes diarrhea

76
Q

fibrates

A

decrease Trigs

increase HDL

77
Q

hypertension classes

A

normal <120/ <80 (lifestyle)
elevated >120/>80 (lifestyle)
stage I <130/ <90 (1 MED)
stage II >140/>90 (2 MEDS)

78
Q

HTN tx

comorbid: HF or CAD

A

ACEi and BB

BB= metropolol, carvadilol

79
Q

HTN tx

comorbid: stroke

A

ACEi & thiazide

80
Q

HTN tx

comorbid: CKD

A

ACEi

EXCEPT STAGE 4

81
Q

HTN tx

comorbid: DM

A

ACEi

82
Q

ONLY HTN tx

A

choose one:

ACEi, CCB (dihydropyridine), thiazide

83
Q

dCCB
S/E
notes

A

“dipines”
S/E: peripheral edema
notes: anti-anginal (CAD)
NOT useful in HFrEF

84
Q

ACEi & ARB

S/E

A

S/E: increase Cr & K (work collecting duct via aldosterone)

ACEi only: angioedema, dry cough

85
Q

thiazides
S/E
Note:

A

distal collecting duct
decreased K & urinary Ca
Note: help with kidney stone from decrease urinary Ca

86
Q

BB

S/E

A

Hypotension

87
Q 
Aldosterone antagonists 
spironolactone
epleronone 
S/E
notes
A

hyperkalemia
only spiro: gynecomastia
notes: hyperladosterone or CHF

88
Q

hydralazine

S/E

A

dilator
reflex tachy
drug induced Lupus

89
Q

alpha- antagonist

S/E

A

Doxazosin, Prazosin
othrostatic hypo
for BPH

90
Q

clonidine

S/E

A

rebound HTN

91
Q

non dyhydropyridine CCB

A

RATE CONTROL in afib

diltiazam & verapamil

92
Q

HTN urgency

A

> 220/120

PANCE (5 decks)

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