onlinemeded Flashcards
Why would you not use a drug eluding stent?
unreliable or homeless patient, b/c drug eluding stents require 1 year of clopedigrel
otherwise ALWAYS use drug eluding stents
how long do you use clopedigrel in drug eluding stents? bare metal stents?
1 year
1 month
after STEMI has been ruled out, what is the next step?
Give ASA
diagnosis with troponins comes AFTER ASA
first line treatment for R sided infarct?
fluids
What medications are NOT given in R sided infarct & why?
Nitroglycerin & morphine b/c they are venodilators which would decreased preload to R heart, making situation worse
What is the limit for transport to PCI center?
60 minutes
what is the door to balloon time?
90 minutes
In class III heart failure, what medication is added?
spironolactone OR combination hydralazine & isosorbide dinitrate
first step in diagnosing HF?
BNP, then echo, then catheterization
What can hide HF via BNP?
obesity artificially lowers BNP
when do you refer for AICD in HF?
Class I with EF less than 30%
Class II or III with EF less than 35%
tx of flash pulmonary edema
IV nitrates
What medication in important for long term HF mortality, but reduces EF in acute setting?
beta blockers
possible sign of posterior MI?
depression in V1-V4
cardiogenic PCWP
greater than 12
L atrial enlargement can cause?
atrial fibrillation
mitral stenosis sound
opening snap w/diastolic decrescendo murmur
earlier the snap, worse the disease
aortic stenosis sound
aortic region, systolic crescendo-decrescendo murmur
mitral regurgitation sound
holosystolic murmur radiating to axilla
heard best at apex
aortic insufficiency sound
diastolic decrescendo systolic murmur at aortic region
valsalva improves which murmurs
MS, AS, MR, AR
valsalva worsens which murmurs
HCOM & MVP
Leg raise worsens which murmurs
MS, AS, MR, AR
Leg raise improves which murmurs
HCOM & MVP
HOCM sound
systolic crescendo-decrescendo, young person, improves with increased venous return
what patients are most likely to respond to cardioversion?
young with NO structural heart disease
when do you get a cardiac MRI?
when sarcoid or hemachromatosis is suspected
Beck’s triad
pericardial tamponade:
JVD, hypotension, decreased heart sounds
T or F: intubation is dangerous in setting of pericardial tamponade.
T: induction medication decrease preload too much & positive pressure ventilation further reduces preload
What antihypertensives cause hypokalemia?
thiazides and loop diuretics
What antihypertensives cause hyperkalemia?
ACE-inhibitors
tx of A fib in the setting of heart failure?
digoxin or amiodarone
when can chest compressions be skipped?
witnessed loss of pulse in shockable rhythm
