New perls from AMBOSS Flashcards
what is the rate control target on AFib?
The target resting heart rate for patients with Afib is < 110/minute for asymptomatic patients and < 80/minute for symptomatic patients
Tx for asthmatic patient that presents with a SVT or an AVnRT
1st line valsalva
2nd line is adenosine BUT this can cause bronchosmasm.
that’s why you’ll better give:
3°.-BBlockers /CCB.
chronic nitrate therapy Side effect and how to avoid it
tolerance . The most effective strategy to prevent this is intermittent therapy with nitrate-free intervals of at least 8 hours, which would be accomplished by avoiding isosorbide dinitrate at night.
beta blocker intoxication. Clinical features
Bradycardia, hypotension, wheezing, confusion, hypoglycemia, and prolonged PR intervals
beta blocker intoxication Treatment
1st IV fluids and atropine.. and dextrose?
2°line: glucagon
pulmonary embolism (PE) + hemodynamic instability (e.g., SBP < 90 mm Hg) Treatment
thrombolysis with alteplase or other recombinant tissue plasminogen activators (tPA) is indicated.
ARBs effects over: urinary sodium excretion Vessel tone Renin activity Angiotensin II level Aldosterone Level
urinary sodium excretion ↑ Vessel tone ↓ Renin activity ↑ Angiotensin II level ↑ Aldosterone Level ↓
what does an Echo reveals at pericardial effusion.
anechoic space between the pericardium and epicardium,
pulmonary hypertension Dx
Right heart catheterization
Amiodarone SE
pulmonary fibrosis, treated by stoping amd >glucocorticoid
Blue-gray skin discoloration
elevation in AST and ALT =stop amd
Sick sinus syndrome synonym ?
Sinus bradycardia with sinus pause and junctional escape rhythm
S4 gallop. is a common sign of
Decreased compliance of the left ventricle
hyperviscosity syndrome
triad of mucosal bleeding, neurological symptoms, and visual changes
polycythemia vera (PV) Patho
mutation in the Janus kinase 2
mutation in the Janus kinase 2 is also seen in
polycythemia vera (PV) essential thrombocythemia (ET) and primary myelofibrosis (PMF).
PV Dx Cx
all 3 major criteria
or
1 minor + 2 major
PV major criteria
1 evidence of increased RBCs (↑ Hb, ↑ Hct)
2 bone marrow biopsy showing hypercellularity with trilineage growth
3 evidence of a mutation in the JAK2 gene.
PV minor criteria
decreased EPO levels.
primary Raynaud phenomenon Tx
Calcium channel blockers
Small Kidney + hypertension =
should raise concern for renal artery stenosis
should raise concern for renal artery stenosis Important sign
Abdominal bruit
Scarlet fever signs
Sore throat and fever followed by a diffuse maculopapular rash, an erythematous tongue (strawberry tongue), and perioral pallor
Abciximab main use
Glycoprotein IIb/IIIa antagonists such as abciximab are mainly used in high-risk patients with myocardial infarction undergoing percutaneous coronary intervention (PCI).
wide pulse pressure with elevated systolic blood pressure and normal diastolic pressure. common finding of
A decrease in arterial compliance secondary to reduced arterial elasticity and increased stiffness is a common occurrence in the elderly population (> 60 years). It results in isolated systolic hypertension,
most common cause of unexpected mortality after diagnostic or interventional cardiac catheterization.
retroperitoneal hemorrhage
most common cause of mitral valve degeneration and subsequent mitral valve prolapse.
in developed countries
Myxomatous valve degeneration
most common cause of mitral valve degeneration and subsequent mitral valve prolapse.
in undeveloped countries
Inflammatory valve degeneration, due to rheumatic fever
The accumulation of fluid and protein in the lungs from ARDS disrupts alveolar surfactant and increases the force needed to maintain open alveoli. An increase in the pressure required to inflate the lungs is the result of a ________ in lung compliance,
decrease
most important factor for cyanosis at Fallot T
Degree of right ventricular outflow obstruction.
When there is a high degree of RV outflow obstruction, blood will flow through the VSD instead of through the pulmonary artery for oxygenation in the lungs.
Renal artery stenosis Cx Fx
Hypertension that is difficult to control, hypokalemia, and a significant increase in creatinine after adding an ACE inhibitor
HOCM Echo findings
systolic anterior motion of the anterior mitral valve leaflet, asymmetrical septal hypertrophy, and septal wall thickness of >15 mm
Not exactly Reduced left ventricular ejection fraction. that’s why young guys can have this with no hypotension
Idiopathic APBs 1st L treatment
avoid triggers,(caffeine +- alcohol consumption, stress, and smoking)
Idiopathic APBs unstable treatment
electrophysiological evaluation with concurrent ablation or medical therapy with beta blockers can be considered
