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MTB 4 Flashcards

1
Q

Presentation of Cardiomyopathy

A

SOB worsened on exertion
Edema
Rales
JVD

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2
Q

Best initial test for Cardiomyopathy

A

Echo

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3
Q

Most accurate test for Cardiomyopathy

A

Echo

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4
Q

TX for Cardiomyopathy

A

Diuretics

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5
Q

Etiology of Dilated Cardiomyopathy

A 
Previous MI 
Ischemia (MCC) 
Alcohol (2nd MCC) 
Postviral myocarditis
Radiation 
Doxorubicin
Chagas
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6
Q

MC Indication for heart transplant

A

Dilated Cardiomyopathy

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7
Q

TX for Dilated Cardiomyopathy that lowers mortality

A

ACEi/ARBs
Beta blockers - Metoprolol, Carvedilol
Spironolactone

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8
Q

TX for Dilated Cardiomyopathy to control Sx’s

A

Digoxin

Diuretics

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9
Q

TX for Dilated Cardiomyopathy if Wide QRS > 120

A

Biventricular Pacemaker

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10
Q

Hypertrophic Cardiomyopathy Etiology

Presentation

A

HTN
- Heart hypertrophies to carry excess load but has difficulty relaxing in diastole -> SOB - MC presentation
S4 Gallop
Fewer si’s of RSHF

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11
Q

HOCM Pathophys

A

Genetic - Chromosome 14
Abnormal septum shape
Asymmetrically hypertrophied septum obstructs bt septum and valve leaflet, blocking blood leaving the heart

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12
Q

What kind of motion is seen in HOCM

A

SAM - Systolic Anterior Motion

Abnormal MV leaflet motion

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13
Q

Presentation of HOCM

A 
Dyspnea - MC
Chest pain
Syncope/light headedness
Sudden death in athletes
Palpable S4 gallop
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14
Q

What increases HR

A

Exercise
Dehydration
Diuretics

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15
Q

HOCM sx’s are worse with

A

Increased HR

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16
Q

HOCM worse with

A

Decreased LV chamber size

  • ACEi/ARBs
  • Digoxin
  • Hydralazine
  • Valsalva and standing suddenly
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17
Q

Which population is HOCM more common in

A

African Americans

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18
Q

Murmur of HOCM

A

Same as MR
Palpable S4 gallop
Holosystolic obscures S1 and S2
Radiates to axilla

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19
Q

Best initial test HCM and HOCM

Findings

A

Echo

Septum is 1.5X thickness of posterior wall

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20
Q

TX for HCM and HOCM

A
  1. Beta blockers best initial tx
  2. Negative inotropes - verapamil, disopyramide
  3. Diuretics HCM ONLY
    - CI In HOCM
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21
Q

When do we use implantable defibrillators in HOCM

A

Any pt with syncope

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22
Q

When do we ablate septum in HOCM

A

Failure with meds

  • Catheter placed absolute alcohol in muscle causing infarctions
  • Surgical myomectomy if sx’s persist
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23
Q

EKG findigns in HOCM

A

Septal Q waves - inferior and lateral leads

24
Q

Wrong answers for TX for HCM, but used in DCM

A

Digoxin

Spironolactone

25
Q

Difference bt HCM and HOCM

A

ACEi and diuretics do NOT help

26
Q

Causes of Restrictive Cardiomyopathy

A 
Sarcoidosis
Amyloidosis
Hemochromatosis
Endomyocardial fibrosis
Scleroderma
27
Q

Pathophys of Restrictive Cardiomyopathy

A

Heart neither contracts nor relaxes normally

Immobility

28
Q

Presentation of Restrictive Cardiomyopathy

A 
Dyspnea
RSHF si/sx's
- Ascites
- Edema
- JVD
- HSM
29
Q

What sign is commonly seen in Restrictive Cardiomyopathy

A

Kussmaul sign - increase in JVP on inhalation

30
Q

Best initial test Restrictive Cardiomyopathy

31
Q

Most accurate test Restrictive Cardiomyopathy

A

Endomyocardial BX

32
Q

TX for Restrictive Cardiomyopathy

A

Treat underlying cause

Diuretics for Pulm HTN, RSHF si’s

33
Q

What maneuvers decrease venous return to heart

A

Standing

Valsalva

34
Q

What drug has similar effects as Standing and Valsalva

35
Q

What maneuvers increase venous return to heart

A

Squatting

Leg raising

36
Q

What impact does handgrip have on heart

A

Increases Afterload = Fuller LV = Decreased LV emptying
Arm muscle contraction compresses arteries of UE - Brachial, Radial, & Ulnar. Obstructs ability of blood to empty the heart

37
Q

MOA Amyl Nitrate

A

Direct Arteriolar Vasodilator = Increases LV emptying
Like ACEi/ARBs
Emptier LV

38
Q

Etiology of Pericarditis

A 
Infxn
Inflamm Dz
Connective tissue Dz
Truam
Cancer
39
Q

MC Infxn in Pericarditis

A

Viral - Coxsackie B
Strep
Staph
Fungal

40
Q

MC Connective tissue Cause of Pericarditis

Others?

A 
SLE
Others: 
Wegener's
Goodpasture
RA
PAN
41
Q

Presentation of Uremic Pericarditis

A

Renal Failure pts
BUN > 60
Diffuse STE NOT seen on EKG
Inflammatory

42
Q

TX for Uremic Pericarditis

A

Hemodialysis

Dialysis

43
Q

EKG findings in Pericarditis

A

Diffuse, low voltage STE in all leads

PR depression = most specific

44
Q

Pericardial Friction Rub

A

Scratching
High-pitched sound
3 parts
Heard best w diaphragm w pt sitting fwd at forced end expiration

45
Q

TX for Pericarditis

A

Treat underlying cause
Viral - NSAIDs, Ibu, naproxen, indomethacin
Steroids if no improvement

46
Q

Is Pericardial Tamponade an emergency

A

Yes.

Super Emergency

47
Q

Etiology of Pericardial Tamponade

A

Causes of pericarditis
Fluid extravasates and compresses chambers
Starts on right side b/c walls are thinner

48
Q

TX for Pericardial Tamponade

A

Emergent thoracotomy
Needle pericardiocentesis
Subxiphoid surgical drainage

49
Q

Presentation of Pericardial Tamponade

A 
HypoTN
Tachycardia
Distended neck veins
Clear lungs
Pulsus Paradoxus
50
Q

How to differentiate bt Pericardial Tamponade and Pulmonary emboli?

A

Pericardial Tamponade has JVD.

Pulm. Emboli does not.

51
Q

EKG of Pericardial Tamponade

A

Electrical alternans - varying heights of QRS complexes

52
Q

CXR of Pericardial Tamponade

A

Enlarged cardiac shadow

Globular heart

53
Q

Echo of Pericardial Tamponade

A

RA and RV diastolic collapse

54
Q

Right heart catheterization of Pericardial Tamponade

A

Equalization of pressures in diastole

55
Q

TX for Pericardial Tamponade

A

Pericardiocentesis
IVF
Hole/window placed in pericardium if recurrent

Cardio (6 decks)

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