MKSAP questions 1 Flashcards
What is cause of stable angina?
Due to fixed atherosclerotic lesion that narrows major coronary artery = > imbalance btwn O2 in blood & need of tissue
What is worst rx fx for stable angina?
DM, other risk fx include htn, hld, smoking
Sx of stable angina?
substernal chest pain x 10-15 minutes, pain w/ activity, relieved w/ rest/nitrates
What is LDL goal in patient w/ CAD?
Ideally LDL < 100 (probably will change soon)
If ST segment or T wave chngs px w/ pain?
tx as unstable angina/ MI
How does stress test work?
Do ECG before, during, and after exercise
What is + finding on stress test?
Ischemia px w/ ST depression, also + if si/sx of heart failure, ventric arrythmia.
Do what after + stress test?
Do cardiac cath
How does dipyramidal thallium work?
Dipyramidal causes dilation of coronary vessels. obstrctd vessels already max dilated. coronary steal occurs, ischemia occurs in obstructed area
What compensations occur w/ anemia?
get incrsd CO, extraction ration, plasma volume. also Rward shift w/ incr 2,3-DPG
Si/Sx of anemia?
HA, fatigue, poor concentration, nausea, ab discomfort, pallor, hypotension, tachy
What should be assess if anemia is px?
Determine retic count, if nl then know have bone marrow response
What is ffp and when given?
contains all clotting factors w/ no RBCs/WBCs. Given if elevated PT/PTT, coagulopathy, or clotting fx deficiency
What is cryoprecip and when given?
contains VIII and fibrinogen. For hemophillia A, vWD, DIC (dcrsd fibrinogen)
What does retic >2% mean? <2%?
excessive RBC dstrxn if >2%, if <2%, then adequate response by marrow.
Causes of microcytic anemia?
iron deficiency, ACD, thalassemia, ring sideroblastic anemia
What is ringed sideroblastic anemia?
due to defective protoporphyrin synth, get buildup of iron in mitochondria.
When does ringed sideroblastic anemia occur?
lead poisoning, pyridoxine deficiency, excessive ETOH
Causes of normocytic anemia?
aplastic anemia, bone marrow fibrosis, tumor, renal failure, ACD
Most common cause of anemia in adults?
chronic blood loss.
What is RDW and when abnormal?
Measures variation in RBC size, abnml in Fe deficiency but not others
When is percutaneous intervention (cath lab) most effective for MI?
if tx w/in 12 hours of onset of chest pain
What are contraindications to thrombolytics?
prior hemorrhagic stroke, ischemic stroke w/in 3 mo, suspected aortic dissection, active bleeding
What is seen on ECG w/ acute pericarditis?
See diffuse ST elevation w/ depression of PR segment