Brainscape's Knowledge GenomeTM

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


See full index

cardio and pulm > LA cardiac pt 1 > Flashcards

LA cardiac pt 1 Flashcards

1
Q

dilated CM
-vent wall
-dysfunction
-etio
-EF
-murmur

A

-vent wall: thin, decreased contractility
-dysfunction: systolic
-etio: A B C C D (alcohol, beriberi(thiamine), cocaine, chagas, coxsackie B(enterovirus), doxorubicin
idiopathic most common
-EF: under 40%
-S3 gallop, MR or TR

avoid CCB

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

kussmaul sign

A

lack of inspiratory decline or increase in JVP.

restrictive CM, pericarditis

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

HOCM
-vent wall
-dysfunction
Most common sx

-EF
-murmur

A

-vent wall: thick, small ventricle
-dysfunction: diastolic
-most common symptom: dyspnea
-EF: preserved
-murmur: S4 loud, MR, S3, pulsus bisferens

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

increase LV volume how

A

squatting, leg raise

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

decrease LV volume how

A

valsalva, standing

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

what movement will accenuated HOCM

A

standing

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

3rd degree heart block first line tx

A

transcutaneous pacing

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

sinus rhythm with inspiration and expiration

A

rhythm increases with inspiration

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

1st degree AV block

A

PR interval prolonged (>0.20).

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

wenkebach

A

mobitz 1

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

mobitz 1 vs 2

A

1: wenkebach: progressive PR lengthening then dropped qrs

2: constant prolonged PR interval then dropped qrs

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

which av block seen in pts with structural hrt disease

A

mobitz 2

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

sawtooth pattern on ekg

A

atrial flutter

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

a flutter
-rate
- ecg picture

A

300 beats/min

sawtooth

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

most common chronic arrhythmia

A

a fib

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

afib vs aflutter

A

aflutter has one irritable atrial foci, afib has multiple

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

4 types of a fib

A

paroxysmal, persistant, permanent, lone

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

ashman’s phenomenon

A

occasional abberrantly conducted beats (wide QRS) after short R-R cycles

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

Afib tx

A

stable: rate control with BB or CCD(D/V)

digoxin is BB/CCB contraindicated

unstable: direct current synchronized CV

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

anticoagulation and cardioversion

A

AF > 48 hours: anticoagulation at least 3 weeks before CV

AF < 48 hours: anticoagulation for 4 weeks after CV

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

CHA2DS2-VASc

A

chronic oral anticoagulation for score of or higher

CHF, HTN, Age>75(2), DM, Stroke/TIA/Thrombus(2), Vascular disease(prior MI, aortic plaque, PAD), age 65-74, sex(female)

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

dabigatran

A

direct thrombin inhibitor(binds and inhibits thrombin)

non vitamin K antagonist oral anticoagulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

rivaroxaban, apixaban, edoxaban

A

factor 10a inhibitors

non vitamin K antagonist oral anticoagulant

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

pts for warfarin

A

severe CKD, contraindicated to use carbamazepine, phenytoin, cost issue

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

PSVT most common type

A

AV node re-entrant tachycardia

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

PSVT common finding on ECG

A

orthodromic: regular narrow complex tachycardia.

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

PSVT tx
-stable(narrow and wide)
-unstable
-definitive

A

stable, narrow: adenosine and vagal manuevers

stable, wide: amiodarone. Procainimide if WPW suspected.

unstable: direct current synchonized CV

definitive: radiofrequency catheter ablation

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

multifocal atrial tachycardia classically associated with what.

ECG

tx

A

COPD

heart rate >100, 3 or more P wave morphologies

verapamil or BB

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

WPW

what pathway

tx

avoid what

A

bundle of kent

procainimide preferred. amiodarone

lupus like syndrome

avoid AV nodal blocking agents

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

Etiologies of myocarditis

A

Infectious, viral most common, especially in tarot, viruses and coxsackievirus b and toxoplasmosis, Lyme disease

Auto immune think of Lupus and rheumatoid arthritis, polymyositis

Clozapine

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

Myocarditis symptoms

A

Fever, myalgia, malaise for a few days, followed by symptoms of systolic dysfunction, ( dilated cardiomyopathy)

S3 gallop

Megacolon, pericarditis

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

Myocarditis gold standard diagnostic test, and other tests

A

Gold standard is the endomyocardial biopsy

Echo; vent systolic dysfunction

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

Saddle shaped ST elevation

A

Myocarditis

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

Vent tachycardia is usually due to what

A

Underlying heart disease, ischemic heart disease

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

V tachycardia treatment

Stable
Unstable with pulse
No pulse

A

Stable: amio, lido, procainimide

Pulse: synchronized cv

No pulse: defib, unsynchronized cv + cpr

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

What electrolyte abnormalities can cause VTEC and torsades

A

Low magnesium, low, potassium, and low calcium

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

V fib, patient presentation and management

A

Unresponsive, pulse, syncope

Un synchronized cardioversion (defib) + cpr

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

Brugada

A

Rt bbb

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

Prostaglandins

PDA and ductus arteriosis

A

They keep ductus open and close pda

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

Most common innocent murmur

A

Still murmur

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

Most common innocent murmur

A

Still murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Systolic and diastolic pediatric murmurs, which are innocent and concerning

A

Systolic or innocent and diastolic are pathological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Murmur that may develop paradoxical emboli

A

Asd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Describe murmur for ASD

A

Systolic ejection crescendo de crescendo at pulmonic area

Wide, fixed S2 split that does not vary with respirations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Systolic ejection crescendo de crescendo at pulmonic area

Wide, fixed S2 split that does not vary with respirations

A

Asd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Systolic ejection crescendo de crescendo at pulmonic area

Wide, fixed S2 split that does not vary with respirations

A

Asd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Describe the PDA murmur

A

Continuous machine like murmur loudest at the pulmonic area

Wide pulse pressure/bounding, peripheral pulses, S2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Continuous machine like murmur loudest at the pulmonic area

Wide pulse pressure/bounding, peripheral pulses, S2

A

Pda

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

pathophys of pda

A

continued prostanglandin E1 production and low arterial oxygen content promotes patency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

congenital heart defect often associated with bicuspid aortic valve

A

coa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

narrowing occurs where in coa in adult and infants

A

adult: occurs distal to the ductus arteriosum

infants: occurs proximal to ductus arteriosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

s/s coa

A

claudification bilateral, DOE, syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

neonatal presentation of coa

A

failure to thrive, poor feeding 1-2 weeks after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

describe murmur of coa

A

systolic murmur radiating to the back, scapula, or chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

coa cxr

A

posterior rib notching; 3 sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

failure to thrive, poor feeding 1-2 weeks after birth

A

coa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

coa confirmatory test and gold standard

A

confirmatory test: echo(narrowing of aorta)

gold standard: angiography

57
Q

CXR: posterior rib notching; 3 sign

A

coa

58
Q

systolic murmur radiating to the back, scapula, or chest

A

coa

59
Q

tetrology of fallot constellation

A
  1. overiding aorta
  2. rv outflow obstruction
  3. RVH
  4. large unrestrictive VSD
60
Q

associated with chromosome 22 deletion

A

tet of fallot

61
Q

most common cyanotic congenital heart disease

A

tet of fallot

62
Q

blue baby syndrome

A

tet of fallot

63
Q

squatting with tet spells do what

A

decreases the right to left shunting, improving oxygenation

64
Q

tet of fallot murmur

A

harsh systolic murmur at left mid to upper sternal border, rt ventricular heave.

65
Q

harsh systolic murmur at left mid to upper sternal border, rt ventricular heave.

A

tet of fallot

66
Q

CXR: boot shaped heart

A

tet of fallot, prominent rt ventricle

67
Q

tet of fallot test of choice

A

echo.

68
Q

what to do prior to tet of fallot surgery

prophylaxis for what

A

prostaglandin infusion

bacterial endocarditis

69
Q

most common cyanotic heart d/s presenting in neonatal period

A

TOGA, dextro

70
Q

difference between dextro and levo TOGA

A

dextro: parallel circuits, most common

levo: acyanotic

71
Q

egg on a string CXR

A

toga

72
Q

TOGA primary means of diagnosis

gold standard

A

echo

cardiac cath

73
Q

most common type of congenital heart disease in childhood

A

vsd

74
Q

congenital heart defect that eisenmenger can occur

A

vsd

75
Q

most common type of vsd

A

perimembraneous 80%; hole in the outflow tract near tricuspid valve

76
Q

swiss cheese pattern

A

vsd

77
Q

s/s of moderate vsd

A

excessive sweating or fatigue, especially during feeds, lack of adequate growth, frequent respiratory infections

78
Q

excessive sweating or fatigue, especially during feeds, lack of adequate growth, frequent respiratory infections

A

s/s of moderate vsd

79
Q

large vsd pressure in ventricles

A

no differences

80
Q

vsd murmur

A

high pitched harsh holosystolic murmur best heard at the LLSB

81
Q

vsd testing

A

echo finds location and size

echo usually preferred over cath

82
Q

congenital cyanotic heart diseases

A

5 Ts

truncus arteriosus
TOGA
tricuspid atresia
tet of fallot
total anomalous pulm venous return

83
Q

hypoplastic left heart syndrome is often associated with what

A

mitral valve and/or aortic valve atresia

84
Q

pulm atresia def

A

complete obstruction to rt ventricular outflow; blood if unable to flow from the rt ventricle into pulm artery and lungs

85
Q

pulm atresia s/s

improved survival …

A

cyanosis

improve survival if there is a PDA

single heart sound(due to semilunar valve-aortic valve)

systolic murmur of TR

86
Q

tricuspid atresia

incidence

leads to what

s/s

A

2%

leads to hypoplastic rt ventricle.

single heart sound S2

87
Q

tricuspid atresia CXR and ECG

A

nml or enlarged cardiac silhouette with DECREASED pulm flow

LVH ECG

88
Q

single heart sound(due to semilunar valve-aortic valve)

systolic murmur of TR

A

pulm atresia

89
Q

nml or enlarged cardiac silhouette with DECREASED pulm flow

LVH ECG

A

tricuspid atresia

90
Q

what is hypoplastic left heart syndrome

incidence

A

failure of the development of the mitral valve, aortic valve, or aortic arch then small ventricle unable to supply the nml systemic circulation requirements.

1% of all congenital heart diseases

91
Q

failure of the development of the mitral valve, aortic valve, or aortic arch then small ventricle unable to supply the nml systemic circulation requirements.

A

hypoplastic left heart syndrome

92
Q

CAD and angina def

A

inadequate tissue perfusion due to imbalance between increased demand and decreased coronary artery blood supply

93
Q

CAD major risk factors

A

DM worst, smoking modifiable.

94
Q

classic EKG for angina

A

ST depression

95
Q

angina initial test of choice

most important non-invasive testing

definitive diagnostic test

A

angina initial test of choice: EKG

most important non-invasive testing: stress testing

definitive diagnostic test: coronary angiography

96
Q

angina tx

A

4 drugs: asa qd, bb, nitro, qd statin

ccb if bb contraindicated

97
Q

4 classes of angina

A
  1. angina only with strenuous activity. no limitations.
  2. angina with more prolonged or rigorous activity. s.ight limitations with activity.
  3. angina with usual daily activity. marked limitation of physical activity.
  4. angina at rest. often unable to carry out any physical activity.
98
Q

most useful non-invasive test in CAD

A

stress testing

99
Q

definitive diagnosis/gold standard in CAD

A

coronary angiography

100
Q

ACS silent MI pt population

atypical S/s

A

women, elderly, DM, obese

abd pain, jaw pain, dyspnea without CP

101
Q

what artery supplies the AV node

A

RCA

102
Q

triad of rt ventricular infarction (ACS)

A

increased JVP, clear lungs, positive kussmaul sign

103
Q

CK/CK-MB marker

A

appears 4-6 hours

peaks 12-24 hours

baseline 3-4 days

104
Q

troponin 1 and T

A

appears 4-8 hours

peaks 12-24 hours

baseline 7-10 days

105
Q

Myoglobin

A

appears 2-4 hours

peaks 4-6 hours

baseline 1 day

106
Q

quickest cardiac enzyme

A

myoglobin

107
Q

most sensitive and specific cardiac enzyme

A

troponin

108
Q

STEMI tx

A

BB, nito, asa, heparin, ACE, reperfusion

109
Q

avoid what in cocaine induced MI

A

BB

do CCB, MONA, heparin

110
Q

O2 in NSTEMI and STEMI

A

NSTEMI: low O2

STEMI: no O2

111
Q

proximal LAD

A

V1 and V2 anterior and septal wall

112
Q

LAD

A

V1 -V4 anterior wall

113
Q

circumflex artery

A

lateral wall

114
Q

RCA

A

inferior wall

115
Q

leads in anterior wall/septal wall

A

V1-V4

116
Q

leads in lateral wall

A

1, avL, V5, V6

117
Q

leads in anterolateral wall

A

1, avL, V4-V6

118
Q

leads in inferior wall

A

11, 111, avF

119
Q

posterior wall leads

A

ST depressions in V1-V2

120
Q

avoid what in inferior/posterior MI

A

nitro and morphine

121
Q

dressler syndrome

A

post MI pericarditis + fever + pulm infiltrates

122
Q

to form a clot, factor __

A

factor Xa converts prothrombin II to thrombin(IIa).
Thrombin activates fibrinogens to fibrin clot.

123
Q

cheap and least chance of intracranial bleeding:

A

streptokinase

124
Q

MOA of rTPA

A

dissolves clot by activating tissue plasminogen to plasmin

125
Q

initial tests of choice for suspected CHF

A

CXR, BNP

126
Q

Kerley B lines

A

linear lucencies in the peripheral lung fields

127
Q

most common cause of pleural effusions

A

CHF

128
Q

BNP in CHF

A

over 100

129
Q

cheyne stokes breathing

A

deeper, faster breathing in gradual decrease and periods of apnea, cyanosis

130
Q

cephalization

A

increased vascular flow to the apices as a result of increased pulmonary venous pressure. occurs with PCWP of 12-18.

131
Q

bat wings

A

PCWP over 25

132
Q

HTN urgency tx medications

A

clonidine, captopril, furosemide, labetalol, nicardipine

133
Q

avoid cerebral hypoperfusion if ischemic

list bps

A

> 220/120 (not a thrombotic candidate)

> 185/110 ok

134
Q

avoid what in acute HF

A

hydralazine and BB

135
Q

when to not use nitro

A

if suspected right ventricular infarction

136
Q

orthostatic hypoTN

workup
tx
avoid what

A

tilt table test: BP reduction at a 60 degree angle

fludrocortisone

avoid flat position, sleeping with the head of the bed raised to 30-45 degrees

137
Q

left BBB EKG

A

WILLIAM
wide qrs
rsr in V5,6
deep S wave in V1
ST elevations in V1-V3

138
Q

Extra cranial branches of carotid artery

A

Temporal, occipital, opthalmic, posterior ciliary artery

139
Q

Temporal arteritis

R/F

Triad symptoms

A

Women, >50 yo, NE Europeans

Ha, jaw clarification with mastication, visual changes . Poss scalp tenderness

140
Q

Right BBB

A

MARROW

wide qrs
rsr in V1, 2
wide S wave in V6

141
Q
A

cardio and pulm (22 decks)

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