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Cardio > MTB 1 > Flashcards

MTB 1 Flashcards

1
Q

What makes the S4 gallop

A

Atrial systole as blood is ejected from atrium into a stiff ventricle
- seen in ischemia w noncompliant LV

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2
Q

What is Kussmaul sign?

Ass’d with?

A

Increase in JVP w inhalation

Constrictive pericarditis or Restrictive Cardiomyopathy

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3
Q

What condition do we see with displaced PMI

A

LVH

Dilated Cardiomyopathy

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4
Q

When do we see triphasic scratchy sound on auscultation

A

Pericardial Friction Rub

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5
Q

Leads in Anterior Wall MI

A

Leads V2-V4

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6
Q

Leads in Inferior wall MI

A

II, III, aVF

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7
Q

PR interval > 200 msec?

A

First-degree AV block

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8
Q

ST depression in Leads V1 and V2

A

Posterior wall MI

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9
Q

Pt w substernal chest pain arrives at ED. EKG shows ST elevation in V2, V4. Next best step?

A

Admin ASA

Angioplasty

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10
Q

How long is ST elevation present on EKG

A

1-6 weeks

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11
Q

Pt w new episode of pain a few days after first cardiac event - next step?

A
  1. EKG for new ST changes

2. Check CK-MB

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12
Q

MCC death first few days after MI

A

Ventricular Arrhythmia

- V tach, V fib

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13
Q

When do we use thrombolytics in NSTEMI

A

Never

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14
Q

Complications of PCI

A
  1. Rupture of coronary artery on balloon inflation
  2. Restenosis of vessel after angioplasty
  3. Hematoma at site of entry
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15
Q

Important in reducing recurrent stenosis after PCI

A

Drug-eluting stents inhibit T cell response

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16
Q

Which thrombolytic cannot be given repeatedly and why

A

Streptokinase causes allergenic response

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17
Q

Which thrombolytics are given as IV infusion

A

Streptokinase

Alteplase

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18
Q

Which thrombolytics are given as rapid bolus injection

A

Retaplase

Tenecteplase

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19
Q

Absolute CI to thrombolytics

A 
CNS bleed
Major bleeding into bowel
Recent surgery - past 2 weeks
Active peptic ulcer - bleeding
Severe HTN, >180/110
Nonhemorrhagic stroke past 6 months
Hemorrhagic stroke
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20
Q

Pt presents to ED with chest pain for past 1 hour, crushing, non-positional. EKG shows ST depression in V2, V4. ASA is given. Next best step?

A

LMW Heparin can prevent a clot from forming in coronary arteries

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21
Q

Which pts do GIIb/IIIa inhibitors reduce mortality

A

Pts with ST depression

Best for non-STEMI, PCI and stenting

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22
Q

With what pathology are TPAs beneficial

A

ONLY with STEMI

23
Q

Which heart pathology is heparin used in

A

BEST for non-STEMI

24
Q

Drugs that Increase bleeding with warfarin/Potentiate warfarin effect

A 
NSAIDs
Acetomenophen
Amiodarone
Cranberry Juice
Ginkoba
Vit E 
Thyroid hormone
SSRI
25
Q

Drugs that Decrease bleeding with warfarin/lower warfarin effect

A 
Rifampin
Carbamezapine
OCPs
Ginseng
St Johns Wort
Spinach
26
Q

EKG of First Degree AV block

A

Prolonged PR interval

27
Q

Third Degree AV block

A

Cannon A waves = atrial systole against closed tricuspid valve.
- cannon is bounding JV wave bouncing in neck

28
Q

TX for symptomatic bradycardia

A
  1. Atropine

2. Pacemaker if ineffective

29
Q

Right Ventricular Infarction

A

New inferior wall MI

Clear lungs

30
Q

What does the right coronary artery supply

A

RV
AV node
Inferior wall of heart

31
Q

Most specific EKG finding for Right Ventricular Infarction

A

ST elevation in V4R

32
Q

TX for RV Infarction

A

High volume fluid replacement

33
Q

TX for stable V tach

A

Amiodarone

Lidocaine

34
Q

TX for Unstable V tach

A

Shock/Cardioversion/Defibrillation

35
Q

TX for V Fib

A

Shock/Cardioversion/Defibrillation

36
Q

When do we see tamponade/free wall rupture

A

Several days after infarction

37
Q

Presentation of tamponade/free wall rupture

A

Sudden loss of pulse
Clear lungs
One cause of PEA

38
Q

TX for tamponade/free wall rupture

A

Emergency pericardiocentesis on way to OR

39
Q

How to distinguish V tach and V fib

A

EKG

40
Q

Best long term therapy for V tach and V fib

A

Beta blockers

41
Q

Presentation of valve or septal rupture

A

SOB, HypoTN, tachycardia
New onset of murmur
Pulmonary congestion

42
Q

Step up in O2 sat from RA to RV

A

Septal Rupture

43
Q

Most accurate test for valve rupture?

Septal rupture?

A

Echo

44
Q

3 major mechanical complications of MI

A
  1. MR due to papillary m. rupture
  2. LV Free wall rupture
  3. Interventricular septum rupture
45
Q

TX for mural thrombi

A

Heparin followed by Warfarin

46
Q

Sudden loss of pulse, JVD?

A

Tamponade/wall rupture

47
Q

IWMI in hx, clear lungs, tachycardia, hypoTN w nitroglycerin?

A

RV Infarction

48
Q

New murmur + rales/congestion

A

Valve Rupture

49
Q

New murmur + increase in O2 sat in RV

A

Septal Rupture

50
Q

Postinfarction routine medications

A

ASA
Beta Blocker
Statin
ACE-I

51
Q

Anterior wall infarctions have high likelihood of developing what?

A

Systolic Dysfunction

52
Q

Nitrates and Sildenafil?

A

Causes HypoTN

4 hour interval in DM patients

53
Q

MC cause of ED postinfarction

A

Anxiety

54
Q

How long do pts have to wait post MI to engage in sexual activity

A

They do not have to wait.

Can resume immediately

Cardio (6 decks)

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