Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GK- IM EOR > IM Cardio > Flashcards

IM Cardio Flashcards

A-fib

1
Q

EKG of A-fib

A

narrow QRS complex

no P wave

chaotic activity of atria

irregular R-R intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 types of a-fib

A
  1. Paroxysmal: <7days
  2. Persistent: >7days, requires termination
  3. Permanent: AF > 1 yr
  4. Lone: any of the above w/o evidence of hrt dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mgmt of stable a-fib rate control

A

B-Blockers: metoprolol

CCB: Diltiazem

Digoxin: pts w/hypotension or CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Options for A-fib rhythm control

A

DCC: direct current cardioversion (synchronized cardioversion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When would you use DCC over pharm tx?

A

AF <48hrs

OR

post 3-4 wks of anticoag & TEE showing no atrial thrombi

OR

If you dont want to use DCC: **start IV Heparin, cardiovert w/in 24hrs & anticoag for 4 wks**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pharma rhythm control meds

IFSA

A

Ibutilide

Flecainide

Sotalol

Amiodarone

“IFSA”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Main focus of A-fib meds

A

control Heart rate

reduce clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other tx options for a-fib

A

Pacemaker

RF ablation(Av node ablation): maze–> need pacemaker with this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CHA2DS2-VASc Criteria topics

A

Congestive Hrt failure

HTN

Age >75y/o

DM

Stroke, TIA, Thrombosis

Vascular Dz: prior MI, aortic plaque, peripheral art dz

Age 65-74

Sex F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which 2 categories of CHA2DS2-VASc Criteria have 2 points?

A

Age >75 y/old

Stroke, TIA, thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

tx for greater than or equal to 2 on CHAD2DS2-VASc criteria

A

mod-high risk = chronic anticoag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

anti-coag agents used for a-fib

A

NOAC: lower rates of major bleeding, dec. risk of ischemic stroke, do not need to check INR

Ex: Dabigatran, “abans”

Warfarin indications: severe CKD, CI to NOAC (HIV pts), monitor INR goal of 2-3

Dual A-platelet therapy: ASA + clopidogrel –> only ise if pts annot be tx with anti-coag.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Class I Angina Pectoris

A

angina with unusually strenuous activity

no limitations on activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Class II Angina Pectoris

A

W/prolonged/rigorous activity

slight limitation of physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Class II Angina Pectoris

A

angina with usual daily activity

Marked limitation of Phys. activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Class IV Angina Pectoris

A

angina at rest

unable to carry out any physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stable angina

A

relieved by rest /nitroglycerine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

unstable angina

A

more frequent sxs, increasing sxs, present at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Any new onset murmur w/fever is…

A

infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

IVDA w/endocarditis will affect which valve and what bacteria?

A

staph aureus tricuspid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

non IVDAs will affect which valve and what bacteria is it?

A

strep viridans and mitral valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What 3 things do you see in infective endocarditis?

A
  1. Roths spots: hemorrhage in the retina with a white center
  2. Janeway lesions: arise from infected microemboli
  3. Osler Nodes: small tender subcutaneous nodules on digits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the INITIAL study for infective endocarditis?

A

TTE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the diagnostic method of choice for infective endocarditis?

A

echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

infective endo tx

A

IV PCN and ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

leading cause of mitral valve stenosis and valve replacement

A

rheumatic heart dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Major Jones criteria

A

carditis

polyarthritis

chorea, subcutaneous nodules, erythema marginatum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

minor jones criteria

A

fever

arthralgia

elevated ESR

ASO titer test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

pts with rheumatic heart may develop what?

A

a fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

cpx of aortic stenosis

A

right 2nd ICS radiates to carotids and down to border of apex

syncope

dyspnea

angina on exertion

CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

dx of PAD

A

A-B Index

doppler US

angiography (if surg required)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is ABI?

A

ratio of systolic ankle BP/brachial systolic BP

if <0.9 = PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

tx of PAD

A

anti-platelets

if severe: stent placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ABI <0.9 indicates what?

ABI < 0.4 indicates what?

A

< 0.9 = > 50% stenosis

<0.4 = ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

can present with lower extremity edema, varicosities, increased pigmentation, and venous stasis ulcers

A

Venous Insuff

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

normal range of ABI

A

0.91–1.3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

MCC of PAD

A

atherosclerotic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

gold standard for PAD

A

If limb is threatened - contrast arteriography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

PE: cool extremity with absent or diminished pulses

What dz

A

PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

classic triad of AS

A

chest pain, dyspnea, and syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

crescendo descrescendo

systolic ejection murmur

delayed/diminished carotid pulses

paaradoxically split S2

narrow pulse pressure

Associated with what dz?

A

Aortic Stenosis

42
Q

Complaining of sudden “ripping” or “tearing” CP radiating to back

CXR will show widened mediastinum

Diagnosis is made by CT or transesophageal echocardiogram (TEE)

Treatment is reduce BP, surgery

What dz?

A

aortic dissection

43
Q

What populations are recommended to start screening for Lipid disorders?

A

Men greater than or equal to 35

Men 20-35 yrs at inc. risk for coronary heart dz

women greater than or equal to 45 at inc. risk for CAD

women 20-45 yrs old at inc, risk for CAD

44
Q

Causes of mitral stenosis

A

rheumatic heart dz

atrial myxoma

45
Q

mitral stenosis murmur

A

low pitched, rumbling diastolic apical murmur (LRDA)

Loud S1 & opening snap

46
Q

acute mitral regurg causes

A

endocarditis, myocardial infartion, trauma

47
Q

chronic mitral regurg causes

A

rheumatic heart dz

48
Q

mitral regurg murmur

A

loud holosystolic heard best at apex, with radiation to base

49
Q

mitral valve prolapse cause

A

congenital

50
Q

mitral valve prolapse murmur

A

early to mid systolic click with late systolic mumur heard best at left lateral heart border

51
Q

aortic stenosis cause

A

calcific valve degeneration

bicuspid aortic valve

52
Q

aortic stenosis murmur

A

crescendo-decrescendo systolic murmur radiating to neck

53
Q

acute aortic regurg cause

A

endocarditits, aortic dissection

54
Q

chronic aortic regurg cause

A

rheumatic heart disease, bicuspid aortic valve

55
Q

aortic regurg murmur

A

high pitched, blowing, diastolic murmur heard best at left sternal border (HBD)

56
Q

what is the most commonly associated complication of mitral valve stenosis?

A

A FIB

57
Q

What meds lower TGLs the best?

A

FIBRATES: gemfibrozil, fenofibrate

58
Q

Can you use gemfibrozil in pts with biliary dz?

A

NO

59
Q

Xanthomas

Tendinous xanthomas

Corneal arcus

CPx of what dz?

A

hypertriglyceridemia

60
Q

What are the 1st line antihyeprtensives for AA?

A

thiazide type diuretics

61
Q

Dx of HTN

A

elevated BP greater on 2 or more reading on 2 or more different visits

greater or equal to 140/90

62
Q

When should you suspect 2ry hypertension?

A

if BP is refreactory to anti-HTN drugs or severely elevated

63
Q

what signifiies an adv stage of malignant HTN?

A

papilledema

64
Q

Grades of Retinopathy

A
  1. arterial narrowing
  2. A-V nicking
  3. 1 + 2 and hemorrhages + soft exudates
  4. papilledema
65
Q

main side effects of HCTZ

A

hypercalcemia

hyperuricemia

hyperglycemia

**avoid in pts with gout & DM**

66
Q

main SES of loop diuretics (furosemide, bumetanide)

A

hypokalemia

hyperglycemia

metabolic alkalosis

ototoxicity

_** avoid in pts with sulfa allergy**_

67
Q

main SES of K+ sparing diuretics (spironolactone, amiloride, eplerenone)

A

hyperkalemia

gynecomastia with spironolcatone

68
Q

SES of ACE-I (prils)

A

1st dose hypotensio, azotemia/renal insuff

hyperkalemia

cough & angioedema (inc bradykinin)

hyperuricemia

_**avoid in preggo pts**_

69
Q

Hypertensive Urgency

A

Inc. BP + NO acute end organ damage

70
Q

Hypertensive Urgency Mgmt

A

Captopril

Clonidine (short term use)

71
Q

Hypertensive Emergency

A

inc. BP + acute end organ damage**

>180/>120

72
Q

HTN emergency Mgmt

A

use IV agents

When to not use IV agents:

  • acute phase of an ischemic stroke
  • acute aortic dissection
73
Q

Neurologic hypertensive emergency

A

nicardipine/clevidipine/labetolol

74
Q

CV hypertensive emergency

A

Esmolol/Labetolol

Nitroglycerin/BB (ACS)

Nitro/Furosemide (acute heart failure)

75
Q

Four groups that benefit from statins

A
  1. patients with ASCVD,
  2. patients with LDL levels greater than or equal to 190 mg/dL,
  3. patients aged 40-75 years with DM and an LDL level of 70-189 mg/dL,
  4. patients with an LDL level of 70-189 mg/dL and a 10-year ASCVD risk of greater than or equal to 7.5%
76
Q

What 2 choices are 1st line tx for AA for HTN?

A

HCTZ & CCB

77
Q

Indications for ARB for HTN

A

pts not able to tolerate BB/ACEI

78
Q

indication for non-dihydropyridine (verapamil,diltiazem) use in HTN

A

HTN w/a-fib

79
Q

What should you use for a pt with HTN + BPH?

A

alpha 1 blockers (zosins)

80
Q

What is the main SES of Alpha 1 blockers?

A

1st dose syncope

81
Q

Best HTN med for a fib

A

BB or CCB (non-D)

82
Q

best med for HTN + angina

A

BB, CCB

83
Q

Best meds for HTN + post-MI

A

BB, ACE

84
Q

HTN + systolic HF

best HTN meds?

A

ACE, ARB, BB, diuretics

85
Q

Best HTN meds ?

HTN + DM/CKD

A

ACE, ARB

86
Q

Best HTN for pt w/isolated systolic HTN in elderly

A

Diuretics

87
Q

best HTN med for pt w/OP

A

Thiazides

88
Q

Best HTN med for pts with BPH

A

A-blockers (zosins)

89
Q

Best HTN meds for young, caucasian males

A

thiazides –> ACE/ARB –> BB

90
Q

Best HTN med for pt w/gout

A

CCB or Losartan (only ARB allowed)

91
Q

What is considered HTN in pregnancy?

A

acute onset of BP 160/110 for > 15 mins

92
Q

Best meds to increase HDL

A

Niacin

93
Q

Which Hyperlipidemia meds should be used in T2DM?

A

fibrates, statins

94
Q

What hyperlipidemia med should be avoided in T2DM?

A

Niacin

95
Q

Optimal cholesterol levels

A

LDL <100

Total chol <200

HDL >60

96
Q

Main SES of niacin

A

flushing

HA

warm sensation

pruiritis

hyperuricemia

hyperglycemia

97
Q

main SE of statins

A

hepatitis

98
Q

Which cholesterol meds are safe in pregnancy?

A

bile acid sequestrants:

Cholestyramine

Colestipol

Colesevelam

99
Q

SES of bile acid sequestrants

A

GI: inc. LFTs

inc. TGL

100
Q
A

GK- IM EOR (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions