Joe Gilboy Review Flashcards
What diabetic medication is highly associated with heart failure
Actos (Pioglitazone); Glitazones/TZD’s
DPP4 inhibitors/Gliptins
Brand name of Methimazole
Tapazole
ADR of sulfonylureas
hypoglycemia
What diabetic medication can HELP with heart failure
SGLT2I's/Gliflozin's eg Jardiance (empagliflozin)
What electrolyte does glucose flow with?
K+
What test should you always order with A fib?
TSH
Which method of echo is the best?
Transesophageal (transthoracic is only for INITIAL)
What Tx is contraindicated in WpW (wolff-parkinson-white)
CCB
What do you tx WpW with?
Procainamide (during acute)
MC valvular murmur
Aortic Stenosis
2nd MC valvular murmur
Mitral Regurgitation
Which murmurs increase with valsalva and standing
mitral valve prolapse
HCM
Which murmurs increase with squating
all murmurs except mitral valve prolapse and HCM
“Water-hammer pulse”
aortic regurgitation
What drug is first line if there is A fib caused by Graves Dz
beta blockers
thyroxine caused overstimulation of beta n.
Pseudomonas Pneumonia cases
ventilators
cystic fibrosis
COPD
malignancy
What organism is the cause of pneumonia in alcoholics?
Klebsiella
Causes of Legionella pneumonia
ice machines: bacteria + protozoa (gyms for bacteria)
How to diagnose Legionella pneumonia
- IFA
2. THEN DFA
MC cause of viral pneumonia in kids
RSV
MC cause of viral pneumonia in adults
Flu
Who/what circumstances gets Staph aureus pneumonia?
POST-viral flu, esp in NURSING HOMES
What causative organism usually goes along with H. influenza pneumonia?
Moraxella catarrhalis
“Lobar” pneumonia is usually
strep pneumoniae 85%
Serevent is the brand name for
Salmeterol (LABA)
“Massage therapists” of atria (medications) and what can they treat
flecainide (outpt)
Ibutilide
procainamide
Tx: WpW
ASA v Plavix
ASA is quick but not strong
Plavix is stronger
When can you not treat a fib?
young (<60yo) and controlled rate
Tx of isolated A fib with no other comorbidities
plavix
Amiodarone toxicity
thyroid tox
lung tox
liver tox
High Risk comorbidity with A fib
DM, treat with Xa inhibitors (DOAC)
What jacks everything up?
Carbamazepine
Azoles
Tx of A flutter
CCB + flecainide or ibutilide
CARDIOVERT
SVT Tx
Vagal Maneuver Adenosine CCB Cardiovert flecainide or ibutilide (outpt) bc problem in atria
Tx: VTach, pulse, stable BP
amiodarone, procainamide
Tx: VTach, pulse, unstable BP
cardiovert
Tx: VTach, no pulse
defibrillate
Tx: V fib
defibrillate ASAP
What should you think with PEA, no pulse, no BP
H’s and T’s: (consider in pulseless arrest)
Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hyper-/hypokalemia, Hypoglycemia, Hypothermia.
Toxins, Tamponade(cardiac),Tension pneumothorax, Thrombosis (coronary and pulmonary), and Trauma.
Asystole Tx
CPR, epi
Brugada Syndrome
very wide QRS. ST elevation + downward slope
will go into V fib
the wider, the worse
tx: implantable defibrillator
When does atria contract?
diastole
ASD murmur
split S2, pulmonic ejection murmur
RVH, pulmonic HTN
blood moves from LA to RA
S3
"Ken Tuc KY", ventricular gallop early diastole, COMPLIANT LV can be sign of systolic HF NORMAL in children, pregnancy early diastole, COMPLIANT LV
S4
“TE Nuh See”, atrial gallop
late diastole, always PATHOLOGIC, NONcompliant LV
can be sign of diastolic HF
occurs in Aortic Stenosis
S3 v Split S2
S3 is LOW pitch at APEX (bell)
Split S2 HIGH pitch at PULMONIC (diaphragm)
syncope with exercise
hypertrophic cardiomyopathy
chronic LVH can lead to
LBBB
Coarctation of aorta
kink in aorta causing blood to back up in LV
LVH
Why is NSAID avoided in pregnancy
miscarriage, malformation, premature closure of ductus arteriosus
Patent ductus arteriosis Tx
indomethacin
MC congenital heart defect
VSD, blood moves L to R during systole
leads to pulm HTN
HOLOsystolic murmur
PDA murmur
continuous machinery murmur, loudest at aortic
Tetralogy of Fallot
Overriding aorta
RVH
Pulmonic stenosis
VSD
What artery is affected in INFERIOR lead MI
RCA, MC
Best BB for CHF
Carvedilol
U wave
repolarization of purkinje fiber
only present is T wave absent/abnormal
in HYPOkalemia
What drug should be avoided in AV Block T2 M1 Wenckebach
CCB
Spiriva
tiotropium bromide, long acting anti-cholinergic
Tx COPD
Atrovent
ipratropium bromide, short acting anti-cholinergic
even short acting takes longer than albuterol (Beta2 antag)
Tx COPD
What can you get with using steroids in COPD
steroid dependence, inc glu, suppress immune
get DMII, high mortality
want to PREVENT use of oral steroids
When does COPD need O2 supplement
PaO2 <55, PaCO2 >55
“can’t drive below 55”
Organisms in COPD exacerbation
H Flu
M. Catarrhalis
Tx pneumonia in COPD
Fluoroquinolones (Levaquin)
COPD Tx
- albuterol
- anti-cholinergics
- inhaled steroids
- oral steroids
small cell lung ca
rare
more likely with smokers
endocrine
everywhere
non-small cell lung ca types
adenocarcinoma: MC