Medi-misc Flashcards
Anteroseptal wall
Leads
Artery
V1-V6
LAD
Lateral wall
Leads
Artery
I, aVL, V5, V6
LCX
Posterior wall
Leads
Artery
V1, V2
LCX
Inferior wall
Leads
Artery
II, III, aVF
RCA
Right ventricular wall
Leads
Artery
RV1-RV6
RCA
The ___ feeds the anterior wall and apex of the heart
LAD (and diagonal)
The ___ feeds the lateral and part of the posterior wall of the heart (in 15% of people it also supplies all of the inferior wall because it gives rise to the ___)
LCX (and obtuse marginals)
Posterior descending
He ___ feeds the inferior wall, RV wall, and SA/AV nodes
RCA
Sounds likely to be heard in a STEMI patient
Paradoxically splitting of S2
Apical systolic murmur
S4
Friction rub
Stage of MI with tall and narrow T waves?
Early
ST depression occurs in leads ___
Facing an ischemic area (1-2 mm lasting 0.08 seconds)
Normal values for CO and SVR
4-8 L/min
900-1300 dynes/sec/cm
Type of shock:
High CO
low SVR
normal PAOP
Distributive
Type of shock:
Low CO
high SVR
high PAOP
Cardiogenic
Type of shock:
Low CO
High SVR
Low PAOP
Hypovolemic
Type of shock:
Low CO
High SVR
high or normal PAOP
Obstructive
Thwart are two of the physiological causes of extracardiac obstructive shock?
Impaired systolic emptying
Impaired diastolic filling
Common causes of distributive shock
Anaphylaxis
Shock
Drug overdose
TSS
- What is directly measured by a PA catheter?
2. Indirectly?
- CVP, PA pressure, PAOP/wedge pressure, CO, SvO2
2. SV, CI, SVR, PVR, Oxygen delivery
PAOP reflects pressure in which chamber of the heart?
Left atrium
- What is the drug of choice for septic shock?
- Medication related shock?
- Cardiogenic shock?
- NE (increases BP)
- Phenylephrine (selective alpha 1 agonist)
- Dobtamine (increases contractility and CO, vasodilator)
- Best fluid for MVA shock? (Or any trauma)
2. For septic patients?
- Saline
2. Albumin
Colloid is ___
Dosing?
Albumin HES Pentastarch *expensive *500-1000 mL of IVS expansion per 1L
Crystalloid is ___
Dosing?
Lactated ringers
- cheap, but can give interstitial edema
- 100-200mL IVS expansion per 1L (so less effective than colloid)
Normal MAP
70-110 mmHg
72 y/o male Left calf claudication with exertion Relieved with rest Predictable after 2 blocks of walking 102 pack year smoker What drug will best reduce risk of CV event
Clopidogrel
72 y/o male Left calf claudication with exertion Relieved with rest Predictable after 2 blocks 102 pack year smoker Which artery is likely stenosed?
Superficial femoral
Symmetric and painful dysregulated adipose
Weight loss will not help
Lipedema
Virchows triad
Stasis
Hypercoagulability
Endothelial injury
Cirrhosis can cause ___ which leads to pitting edema
Anasarca
Which causes of edema are pitting?
Venous HTN
Anasarca
Lymphedema (non pitting at some stages)
Gold standard for dx of DVT?
Venography
-rarely used due to invasiveness
What are 2 causes of venous HTN
AV fistula
Thrombophlebitis
Filariasis can result in ___ which leads to edema
Lymphedema
Venous cath evaluates what?
Venous pressure
Right heart pressure
CO
Possible shunts
Which artery is likely responsible if the anterior interventricular sulcus area is not functioning correctly?
Posterior IV sulcus?
LAD
RCA
