Brainscape's Knowledge GenomeTM

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


See full index

Internal Medicine > MKSAP Cardiovascular > Flashcards

MKSAP Cardiovascular Flashcards

1
Q

Diagnosis of non-ST-elevation MI

A

Characteristics: chest pain at rest, absence of ST elevation on ECG, and elevated MI biomarkers

  • ST depression is often seen.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of acute pericarditis

A

Three classic features: 1. pleuritic chest pain, 2. friction rub, 3. diffuse concordant ST-segment elevation on ECG

  • Chest pain that’s worse when supine.
  • Often can see PR segment depression.
  • Fever is often present.

Friction rub: 3 components - atrial systole, ventricular contraction, and rapid ventricular filling; squeaky, scratchy and high-pitched

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

ST-elevation MI treatment

A
  • PCI is the preferred treatment above thrombolytics.

- Most effective if completed within 12 hours of the onset of chest pain.

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

Contraindications to thrombolytic therapy

A
  1. prior intracerebral hemorrhage
  2. ichemic stroke within 3 months
  3. suspected aortic dissection
  4. active bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aortic dissection

A
  1. severe-onset chest pain radiating to the back
  2. BP differential between arms
  3. Murmur of aortic regurgitation
  4. Widened mediastinum of CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treating RVMI

A
  • Volume expansion with normal saline

Physical exam findings: Classic triad - 1. hypotension, 2. clear lung fields, 3. elevated estimated central venous pressure

ECG: ST-segment elevation of right-sided leads

Treatment: Reperfusion therapy, IV fluids, possibly inotropic support with dobutamine if IV fluids are not sufficient (second-line due to risk of worsening infarction due to increased O2 demand)

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

Noncardiac, GERD chest pain

A
  • Symptoms can present with radiation and can last minutes to hours (even 18 hrs)
  • Stress test pretty much r/o cardiac ischemia making an empiric trial of PPIs reasonable.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diagnosis of Third degree AV block

A
  • Complete absence of atrial impulses to the ventricle
  • Most common caused of marked bradycardia w/ ventricular rates usually 30-50.

Causes: Lyme carditis (acute-onset, high-grade AV conduction defects occasionally associated with myocarditis)

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

First-degree AV block

A

PR interval greater than 0.2 sec

- Often associated with a soft S1

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

Diagnosis of panic disorder

A
  • Symptoms peak within 10 minute of onset and usually last from 15-60 minutes

Treatment: CBT and SSRI

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

Pheochromocytoma

A

Classic triad: 1. sudden severe headaches, 2. diaphoresis, and 3. palpitations

Other symptoms: pallor, hyperglycemia, weight loss, arrhythmias, catecholamine-induced cardiomyopathy

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

Mobitz type II second-degree heart block

A
  • Associated with disease of the conduction system (bundle-branch block, etc.)

Treatment: pacemaker

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

Treatment of worsening symptoms of chronic stable angina

A
  • Increase beta blocker dosage
  • Beta blockers should be titrated to achieve a resting HR of approximately 55 to 60 bpm and approximately 75% of the HR that produces angina w/ exertion.
  • consider coronary angiography only after angina persists despite maximal medical therapy.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ranolazine

A
  • Used to treat chronic stable angina

- Only added to baseline therpy that includes a beta-blocker, calcium channel blocker, and long-acting nitrate.

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

Diagnosis of PE

A

Symptoms: chest pain, dyspnea, asymmetric leg edema, elevated CVP, tachypnea, and tachycardia

Diagnosis: CT pulmonary angiography

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

Echocardiogram during chest pain

A
  • Normal wall motion excludes coronary ischemia or infarction.
17
Q

Ascending aortic dissection

A
  1. acute aortic regurgitation
  2. MI
  3. cardiac tamponade
  4. hemopericardium
  5. hemothorax or exsanguination
18
Q

Descending aortic dissection

A
  • Splanchnic ischemia, renal insufficiency, lower extremity ischemia, or focal neurologic deficit due to spinal cord ischemia
19
Q

Evaluation os suspected CAD

A
  • Exercise stress test

- Especially useful in pts w/ intermediate probability of CAD w/ a normal baseline ECG, who are able to exercise

20
Q

Adenosine nuclear perfusion stress test contraindication

A
  • Significant bronchospastic disease.
21
Q

Atrial flutter

A
  • multiple P waves in a sawtooth pattern w/ 2:1 ventricular conduction.
  • Most noticeable in inferior leads.
  • Sawtooth patternshows negative deflections in inferior leads, but positive deflection in V1.
22
Q

SA node dysfunction

A
  • AKA sick sinus syndrome
  • Symptomatic sinus bradycardia (in between episodes of tachycardia due to a fib) and tachycardia-bradycardia syndrome
  • A. fib is the most common tachyarrhythmia observed

Can be due to sinus arrest, sinus exit block, and sinus bradycardia

Treatment: pacemaker implantation

23
Q

Ventricular tachycardia

A
  • Wide-complex QRS tachycardia

- Rate 140-250

24
Q

LDL cholesterol in CAD

A
  • Below 100
25
Q

Atrial fibrillation

A

Rate between 350 and 600

26
Q

Multifocal atrial tachycardia

A
  • Associated with chronic lung disease w/ three of more P-wave configurations on ECG.
27
Q

Atrioventricular reentrant tachycardia

A

AKA Wolff-Parkinson White syndrome

- Short PR interval (

28
Q

Indications for coronary revascularization

A

Pt has chronic stable angina + one or more of these:

  1. Angina pectoris refractory to medical therapy
  2. a large area of ischemic myocardium
  3. high-risk coronary anatomy (left main stenosis or 3 vessel disease)
  4. Significant stenosis w/ reduced LV systolic function
29
Q

Unstable angina treamtment

A

Admission to the CCU and IV heparin and nitroglycerin

30
Q

Torsades de pointes

A

polymorphic ventricular tachycardia

- Rate of 200-300

31
Q

Ventricular tachycardia

A
  • Any wide complex QRS should be considered to be this unless proven otherwise
32
Q

Cannon waves

A
  • large a waves in jugular pulsations

- Signifies AV dissociation

33
Q

Indications for inta-aortic balloon pump

A
  1. ACS w/ cardiogenic shock unresponsive to medical therapy
  2. acute mitral regurgitation secondary to papillary muscle dysfunction
  3. ventricular septal rupture
  4. refractory angina
34
Q

Pathologic Q waves

A

-Width greater than 1mm and depth >25% the heighth of the QRS.

35
Q

Always comes before CABG

A

Coronary angiography

36
Q

Increased vagal tone

A
  • Associated with inferior wall MI
37
Q

Ventricular septal defect

A
  • New systolic murmur, hypotension, and respiratory distress 1-3 days following an MI.
  • Palpable thrill.
38
Q

New onset murmur following MI

A

mitral regurgitation or ventricular septal defect

Internal Medicine (12 decks)

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