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the begining=ddx, meds, sa+contra, red flags, ss > PANCE Cardiology #3 Ischemic heart dz > Flashcards

PANCE Cardiology #3 Ischemic heart dz Flashcards

1
Q

Deficiency of oxygen getting to the heart is a function of 3 things.

A

Cardiac output
hct, hg
%sat
and carbon monoxide poisoning

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2
Q

MCC of ischemic heart dz?

A

coronary atherosclerotic dz

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3
Q

What is a major risk factor for CAD?

A

HTN

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4
Q

Whats most important to lower, systolic or diastolic?

A

both

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5
Q

Typical pain duration with stable angina and important defining factor?

A

5-15 minutes

relieved by rest.

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6
Q

What does ST-segment depression indicate?

What does ST-segments elevation mean?

A

Ischemia

Infarction

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7
Q

Criteria for positive stress test, 2 things.

A

> 2mm ST-segment depression

hypotension of > mmhg in systolic pressure.

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8
Q

When do you use angiogram?

A

when you suspect CABG

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9
Q

What is the criteria for CABG?

A

3 vessel dz or left main coronary

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10
Q

When do you place a stent?

A

1 or 2 vessel dz

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11
Q

70 yo male presents with chest pain and ST elevation. What works best,

A

MONA and beta blockers.

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12
Q

whats proven to decrease mortality with acute MI?

A

aspirin, bblockers, tpa, angioplasty

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13
Q

What if you cant use aspirin?

A

plavix

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14
Q

what 3 things do you se to treat CAD; unstable angina, NSTMI?

A

ASA, clopidogrel, BBlocker (Metoprolol, Atenolol)

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15
Q

What 6 things can you use for acute MI and what whill decrease mortality?

A

M.O.N.A.
Tpa and BBlockers
(aspirin and betablockers are the only things that decrease motality)

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16
Q

What test do yo order to tell the difference between unstable angina and NSTMI?

A

CK-MB, Troponins

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17
Q

What does not decrease mortality with MI tx?

A

m.o.n

18
Q

Do you need CK-MB/troponins to dx a STEMI?

A

No, its a STEMI

19
Q

Tell me the leads affected with inferior wall MI?
The leads for lateral MI?
the leads for anterior MI?
The posterior wall MI?

A

2,3,avf
1, AVL, V4, V5, V6
V2-V4
V1-V2, ST-segment depression

20
Q

difference between RBBB, LBBB.

A

LBBB assoc with ischemia

RBBB no big deal

21
Q

Post MI care? (a,b,c,d,e)

A

aspirin, betblockers, cholesterol, DM, exercise

22
Q

MCC of abnormal AV conduction of heart?

A

ischemia

23
Q

what do you do for symptomatic 3rd degree av block?

what do you give for asymptomatic 3rd degree av block?

A

atropine (1st)

pacemaker (2nd)

24
Q

whats dressler syn?

A

post MI the dead heart muscle gives off antigens and an immune response is initiated=pericarditis

25
Q

how do you tell the difference between valve rupture and septal rupture?

A

septal rupture has an increase in saturation from RA to RV.

26
Q

Inferior wall MI associated with?
best initial test?
best therapy?

A

right vent=hypotension
right vent chest leads
IV fluids

27
Q

most sensitive test for prinzmetal angina

A

angiogram

28
Q

how do you differentiate prinzmetal from unstable?

A

stress test, angiogram are normal with prinzmetals

29
Q

Definative dx for prinzmetal?

tx?

A

ergonovine during angiography

CCB

30
Q

chest pain, SOB, hypotension and confusion?

A

means yor not getting enough profusion

31
Q

treatment for CHF in order of importance

A 
O2
diuretics
nitrates
morphine
lower pre-load
32
Q

Whats the test of choice for CHF?

what do you see?

A 
chest x-ray
prominent pulmonary vessels
cardiac silhoulette
kerley B-lines
effusions
33
Q

sx’s of pulmonary edema from CHF

A 
increased R.R
productive cough
cyanosis
PND
rales, rhonchi, wheezing
34
Q

which tx is acute

which is chronic

A

dobutamine

digoxin.

35
Q

how do you tell if the pt is in systolic or diastolic heart failure?
whats the difference in management?

A

echocardiagraphy

systolic gets digoxin, and ace inh

36
Q

what drug lowers mortality in CHF?

A

BBlocker, ACE, arb, spirolactone (K+sparing diuretic) pacemaker

37
Q

what is the MC symptom of digoxin toxicity?

A 
GI upset (n/v)
gynecomastia
blurred vision, yellow halo
arrhythmias (atrial tachycardia most common)
HYPERKALEMIA
38
Q

what is 1st line therapy for any CHF pt with systolic dysfunction..increases survival!!!

A

ACE!

39
Q

when do the coronary arteries fill?

A

in diastolie

40
Q

how do you die from CHF?

A

ischemia

41
Q

tell me some nitrate drugs?

A

isosorbide=long term drug for CHF

hydralazine

the begining=ddx, meds, sa+contra, red flags, ss (7 decks)

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