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STEP 3 Uworld > IM cardio > Flashcards

IM cardio Flashcards

1
Q

endocarditis prophylaxis if high risk - when

A
  1. gingival manipulation or resp track incision
  2. GU or GI track procedure if active infection
  3. surgery of infected skin or muscle
  4. surgical placement of prosthetic cardiac material
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2
Q

high risk for endocarditis

A
  1. prosthetic valve
  2. previous infective endocarditis
  3. structural valve abn in transpl
  4. Certain CHD subtypes
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3
Q

constrictive pericarditis - etiology

A
  1. idiopathic or viral
  2. cardiac surgery
  3. radiation
  4. TB
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4
Q

most specific symptom for decompenstated heart failure

A

S3

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5
Q

prefered treatment for AF

A
  1. No other heart disease: flecainide or propanenone
  2. LVH: Dronedarone, amiodarone
  3. CAD without HF: sotalol, droneadrone
  4. HF: amiodarone, dofetilide
  5. refractory: radioablation
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6
Q

pulm hypertension treatment

A

combination of phosphodiestarase type 5 inh + endothelin receptor antagonist

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7
Q

hypertrophic cardiomyopathy - treatment

A

b-blockers

anternative: CCB

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8
Q

Non stemi treatment

A
  1. dual antiplatelet
  2. nitrates
  3. beta blockers
  4. statins
  5. anti-coagulants
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9
Q

when to put implantable cardioverter in hypertrophic cardiomyoparthy

A

if 1 or more RFs

  1. family history of sudden death in younger than 50
  2. personal history of Ven arrhythmia
  3. syncope due to vent arr
  4. Massive thickness
  5. LV fraction less than 50%
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10
Q

S3 vs S4 caused by

A

s3: flow sound
s4: atrial contraction

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11
Q

S4 - assoviated conditions

A
  1. LV hypertrophy
  2. restrictive cardiom
  3. Acute MI
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12
Q

Treatment of DVT or pe

A

MORE THAN 3 MONTHS ANTICOAGULATION WITH ORAL Xa INH (rivaroxaban)

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13
Q

post menop patients with flashes but history of DVT - treamtent

A

SSRI

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14
Q

pre-operative management of AF patients

A
  • stable and asympt: continue rhythm control and surgery after addressing coagulation
  • stable but uncontrol rhythm: rhythm control and surgery after addressing coagulation
  • unstable: electrical cardioversion and delay surgery
    Stop DOAC 1-3 days before
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15
Q

general management of pulm Hypertension

A
  • normoxia, euvolemia, sinus rhythm
  • contraceptive
  • immunization
  • if refractory: transplantation
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16
Q

how to reduce HF hospitalization

A
  • in-person monitoring and medication management
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17
Q

Sex in post-MI patients

A
  • low risk: can perform light intensity exercise without symptoms: start sex
  • high risk: refractory angina: wait until detailed assessment
  • intermediate: wait until the stress test
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18
Q

sudde death in young people without murmur

A

anomalous coronary artery

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19
Q

TCA oversodose

A

CNS: mental statys, seizures, resp depression
Cardio: hypotensionm arrhythmia, prolonged intervals
Anticholinergics

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20
Q

TCA toxicity treatment

A
  • o2, intubation
  • IV fluids
  • charcoal (within 2 hours)
  • IV sodium biocarbonate for QRS intereval widening or
  • Ventri arrhyth
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21
Q

treatment of cocaine induced cardio

A
  • benzo+nitro
  • never b blockers
  • CCBs
  • phentolamine for persisent
  • PCI for myoc infraction
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22
Q

role of HTN in AAA

A

not related

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23
Q

BNP - falsely low and falsely elevated

A
  • low in obesity

- elevated in entresto use

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24
Q

start amiodarone in patient on Warfarin

A

decrease warfarin by 25%

25
Q

indications of Aortic valve replacement

A
  1. onset of symptoms (angina, syncope)
  2. EF less tham 50
  3. undergoing other cardiac surgery
26
Q

Severe AS criteria

A
  1. velocity more than 4
  2. gradient more than 40
  3. valve area less than 1cm2 (not required)`
27
Q

aortic dissection treatment

A

IV b blockers (esmolol)

+ sodium nitropruside if SBP more than 120

28
Q

cyanide poisoning - common etiologies

A
  1. structure fires
  2. occupational exposure
  3. cyanide-containing medications (nitroprusside)
29
Q

cyanide poisoning - management

A
  1. decontamination
  2. supportive care
    3, empiric treatment with hydroxycobolamin + sodium thiosulfate
30
Q

what is cardiac index

A

pump function

cardiac output value based on the patient’s size.

31
Q

sick sinus syncope - clues for diagnosis

A
  1. preceding fatigue or dizziness

2. sinus pauses on ECG

32
Q

antithrombotic therapy in mechanical valves

A
  1. warfarin 2-3 in aortic if no risk factors (AFib, systolic dysfunction, prior PE etc)
  2. warfarin 2.5-3.5 in mitral valve or aortic valve with RFs
  3. low dose aspirin if strong indication (CAD)
33
Q

Bicuspid aortic valve - diagnosis

A

screen ech for patients and1st degree relatives

34
Q

Bicuspid aortic valve - complications

A
  1. infective endoc
  2. severe regurgitation or stenosis
  3. Aortic root or ascending aortic dilation
  4. dissectioon
35
Q

Bicuspid aortic valve - management

A
  1. echo every 1-2 years

2. balloon valvuloplasty or surgery

36
Q

beta blocker toxicity

A
  1. iv fluids for hypotension + atropine if bradycardia
  2. glucagon for directly counteract toxicity
  3. calcium gluconate sometimes to augment BP
37
Q

apixaban in mechanical valves

A

does not work

38
Q

indications for implantable cardioverted-deffibrillator placement in HCM

A
  1. family history of scd
  2. syncope
  3. NSVT
  4. Hypotension during exercise
  5. LVH more than 3cm
  6. 2ry prevention: survivors of cardiac arrest or sustained spont ventric arrhythmuas
39
Q

ST elevation criteria

A

New ST elevation at J point in 2 or more contagious leads with :

  • more than 1 mm in all leads except V2 and V3
  • 1.5 or more mm in women and 2 or more in men age more than 40 and 2.5 or more in men age less 40 in V2+V3
40
Q

ST depression MI - TREATMENT

A
  1. Dual therapy
  2. nitrates
  3. b-blockers
  4. statis
  5. anticoagulation
41
Q

Current guidlines recomend biventricular pacing devices for patients in sinus rhythm who meet all the following criteria:

A
  1. EF less 35
  2. NYHA 2-4
  3. LBB with QRS more than 150
42
Q

Warfarin mechanism of action

A

vit K antagonist

43
Q

Warfarin - disadvantages

A
  1. therapeuitc onset 7 days
  2. requires bridging
  3. lab monitoring
44
Q

patient with DVT or PE are typically treated with

A

3 or more months anticoagulation with oral factor Xa inh (rivaroxaban)

45
Q

PE or DVT when on menopauseal hormone therapy

A

stop them and start SSRI

46
Q

when to do immediate coronary angiography in unstable angina or NSTEMI

A
  1. hemodynamic instability
  2. HF with new MR
  3. Recurrent chest pain
  4. Ventricular arrhythmua
47
Q

MR in MI

A

papillary muscle rupture

48
Q

MR in connective tissue disease

A

rupture of chordae tendineae

49
Q

Elhers-Danlos vs MARFAN - cardiac manifestations

A

Elhers: MVP
Marfan: MVP, aortic root dilation

50
Q

Elhers-Danlos vs MARFAN - skin

A

Elhers: transpartent + hyperextensible, easy bruising, atrophy
Marfan: nothing

51
Q

Elhers-Danlos vs MARFAN - musculoskeletal

A

both hypermobility, pectus excavatum, scoliosis
Elhers: arched palate
Marfan: Tall with long extr

52
Q

anti-heprtensive medications that cause periph edema (how to solve it)

A

alodipine, nifedipine

CCB with ACEi reduce it

53
Q

Afib - when to give anticoag

A

Chadvasscore
men 2 or more
women 3 or more

54
Q

CHA2 DS2 VASc

A 
CHF
HTN
Age 75
DM
STROKE
VASCU DISEASE 
AGE 65-74
SEX female
55
Q

statin causes myopathy - next step

A

wait, recheck creatinine and if back to normal restart statin

56
Q

wolf parkinson white - treatment

A

ablation

57
Q

causes of aquired long QT syndrome

A
  1. medication
  2. metabolic disorders (electrolytes, starvation, hypothyr)
  3. BRADYARRHYTHMUAS
  4. OTHER (HIV, MI, hypothermia, Intracranial disease
58
Q

revised cardiac index (cardiovasc risk of non-cardiac surgery)

A 
6 risk predictors: 
1. high risk surgery (vasc, intrathoracic)
2. ischemic heart diease
3. CHF
4, Cerebrov disease
DM treated with insulin
6. Cr more than 2
O-1 LOW RISK
2 OR MORE ELEVATED RISK
59
Q

pericarditis treatment

A

ASPIRIN

STEP 3 Uworld (14 decks)

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