MKSAP Flashcards
How do you treat RV Infarction?
1) Volume–0.9% Saline
then maybe inotropic agents.
Describe the murmur of aortic stenosis. Associated symptoms?
Systolic, crescendo-decrescendo heard best at the R sternal border w radiation to carotids.
S4 may be present due to LV hypertrophy.
Assoc w exercise intolerance, dyspnea.
Describe the murmur of aortic insufficiency. Associated symptoms?
High pitched diastolic murmur best heard at L sternal border in leaning forward position at end of respiration.
S3 may be present bc of LV dilation.
Wide pulse pressure–>head bob, nail blanch w diastole.
Dyspnea on exertion, Parox Noct Dysp, Orthop
Describe the murmur of mitral stenosis. Associated symptoms?
Low pitched, rumbling diastolic, heard best at the L lateral decubitus position w bell. +Opening snap.
Signs of right side heart fail–JVD, edema, hepatomegaly.
Dyspnea, Parox Noct Dysp, Orthopnea
Describe the murmur of mitral regurgitation. Associated symptoms?
Holoystolic, heard best at the L Lateral decubitus position w diaphragm. Radiates to L axilla.
+S3 and/or S4
Dyspnea.
Major risks within 1 day of MI, 3 days, 3-14 days post MI, 2 weeks +?
w/in 1 day–Arrythmia
1-3 days–fibrinous pericarditis
3-14 days–VSD, Papillary muscle rupture, Free wall rupture.
2 weeks +–Dressler syndrome–fever, pleuritic pain and pericard effusion.
How should you treat AFib?
Beta blocker/Cardiovert, Consider implantable defib, Warfarin if CHADS2>3.
How to treat heart failure by NYHA Class?
All–Beta blocker, ACE inhib. Add diuretic (loop) to achieve euvolemia.
III–add spironolactone
III+Black–add isosorbide dinitrate and hydralazine
IV–add digoxin.
How can you test for hypertrophic cardiomyopathy
Murmur increases on a) Valsalva, b) Squat-to-Stand.
How do you treat diabetic ketoacidosis?
Insulin drip
What should you do if a pt on L-thyroxine comes in pregnant?
Recheck TSH, adjust up thyroid meds.
Pt comes in w tachycardia, lo TSH, hi T4. Tx?
Methamizole PLUS Beta blocker for HR.
How can the thyroid activity change after pregnancy?
Postpartum thyroiditis can cause 1) thyrotoxicosis, 2) hypothyroidism, 3) periods of both.
What is the appropriate management of an accidentally discovered adrenal mass?
Plasma metanephrine and dexamethasone suppression tests. (examine for glucocorticoids and catecholamines)
In the presence of drug-resistant hypertension with high urine K, low serum K, what is the likely diagnosis?
What screening test should be used?
Primary hyperaldosteronism.
Aldosterone to renin ratio.
