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Cardiology Med-Study > Lecture 1: Diagnostic Studies > Flashcards

Lecture 1: Diagnostic Studies Flashcards

1
Q

when is exercize ECG testing not useful

A
  1. patient can’t exercize 2. baseline ECG is abnormal (LVH, LBBB, paced rhythm, WPW syndrome, >1 mm ST-segment depression
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2
Q

contraindications to dobutamine

A

Dobutamine contraindications are severe baseline hypertension, unstable angina, and arrhythmia

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3
Q

contraindications to adenosine stress

A

bronchospastic airway disease, theophylline use, sick sinus syndrome, and high-degree AV block

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4
Q

best test for LBBB

A

vasodilator stress (septal perfusion abnormality that may occur with exercise)

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5
Q

adequate work load for exercise stress

A
  1. rate pressure product (heart rate × systolic blood
    essure) of at least 25,000
  2. 85% of PMHR
  3. (5 metabolic equivalents [METs on Bruce Protocol
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6
Q

CAC utility

A

Coronary calcium scores greater than 400 are associated with a higher incidence of abnormal perfusion on SPECT imaging
used in framhingam intermediate 10-20%

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7
Q

wide aortic knob

A

aortic dissection

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8
Q

water bottle heart

A

pericardial effusion

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9
Q

skull heart

A

constrictive pericarditis

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10
Q

nephrogenic sclerosis eGFR

A

< 30

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11
Q

when should you not do an echo

A

Benign murmurs, such as grade 1/6 or 2/6 midsystolic murmurs, are common with pregnancy, anemia, and other high-flow states
continuous flow over breast

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12
Q

features of coarctation of aorta

A
  1. lack of aortic knob + rib notching
  2. hypertension, radiofemoral delay
  3. bicuspid aortic valve
  4. associated with turner’s syndrome
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13
Q

when to treat coarcation

A
  1. Hypertension
  2. Heart failure
  3. peak to peak gradient > 20
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14
Q

cardiac extramanifestation coartcation

A

berry anyeursms

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15
Q

surveilllance timing of echo in valve

A

mild - q 3 years

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16
Q

daily symptoms arrythmia

A

Holter

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17
Q

infrequent but lasting 1-2 minutes

A

patient triger event

18
Q

infrequent, < 1 minute or syncope

A

looping event

19
Q

very infequent

A

implanted loop

20
Q

medication that need to be held when doing stress ehco

A
  1. BB
  2. nitrates
  3. non-pyradamine CCB
  4. digoxin
21
Q

ECG changes that are considered positive

A

> 1 mm ST depression in contingous leads or elevation

22
Q

primary cardiac tumors

A
  1. atrial myxoma
  2. papillary fibroelastoma (papillary fronds)
  3. atrial septal lipomas (thickening of septum)

RA-angiosarcoma - malignant

23
Q

arrytjhmia monitor for syncope

A

looping event recorder is useful for recording episodes of palpitations that are accompanied by syncope or presyncope

24
Q

Attrituble risk factors

A

Cholesterol, smoking, stressors, diabetes, hypertension, obesity, alcohol, exercise, fruits and vegetables

25
Q

Moderate intensity Staten and diabetics

A

40 to 75 years old, risk less than 7.5.

26
Q

HSCRP

A

Elevated level may used to restart a phi intermediate risk score a.k.a. 10 to 20.

27
Q

Low-dose aspirin guidelines

A

50 to 59, 10 year CVD risk greater than 10%. And have a life expectancy at least 10 years.

28
Q

equalization of diastolic pressures

A

cardiac tamponade and constrictive pericarditis

29
Q

normal RA pressure

A

5

30
Q

normal RV pressure

A

20

31
Q

normal PCWP pressure

A

10

32
Q

physiologically split

A

A-P slightly seperated during inspiration

33
Q

widely split S2

A

early closure A valve -severe mitral valve stenosi or P2 late - pulmonary stenosis

34
Q

fixed slpit

A

ASD

35
Q

reasons to fix ASD

A

RV enalrgement without PAH
> 2:1 L-shunt
symptoms

36
Q

HYPER FAT HIP

A 
physiological S3
hyperdynamic states
F: Fever
A: anemia/AV fistual
T: Thiamine (wet berry berry)
Hyperthyroidism
Infection
Pagets/Pregnancy
37
Q

Louder murmors with valsalva

A

MVP, HCM (Valsalva+ Amyl nitrate + Standing)

38
Q

Pulsus paradoxus -

A 
inspiratory fall in systolic in pressure, > 10 mmHg
CAAT: 
Cardiac tamponade
Constrictive perist
Asthma
Tension
39
Q

Beck’s triad

A

pulsus paradoxus, heart sounds muffled, and hypotension, elevated JVD

40
Q

RCRI risk variables

A
  1. Ischemic heart Disease
  2. Congestive Heart Failure
  3. Cerebrovascular Disease
  4. Diabetes Mellitus (Use of Insulin Therapy)
  5. Renal Insufficiency (Serum Cr >2.0mg/dL)

2 or more varaibles gets you > 1%.

41
Q

preoperative risk testing

A

emergency or urgent surgery - go ahead

if elective, then >1% risk and poor METS (< 4 aka symptoms with aDLS), then preoperative testing

42
Q

tx angioedema related to ACE

A

~ aCE inhibitor to ARB

Cardiology Med-Study (9 decks)

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