PANCE- Cards Flashcards

1
Q

? is the MC form of cardiomyopathy

This MC is a ? type of dysfunction

What PE finding is the hallmark for this MC

A

Dilated, involving all four chambers

Systolic

S3 gallop

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2
Q

Dilated cardiomypathy is the MCC of ?

What are the two MCCs of dilated cardiomyopathy

What will CXR show

A

Transplant

Idiopathic > Alcohol (B1 thiamine deficient)

Balloon-heart: megaly w/ pulm congestion

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3
Q

How is dilated cardiomyopathy Tx

What med is used to increase contractility

What are the indications for ICD

A

Loop ACEI BB Spironolactone

Digitalis

EF <35%

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4
Q

HOCM is ? type of dysfunction

How does this condition develop

What will be seen/heard on PE

A

Diastolic

Autosomal dominant sarcomere defect

S4 w/ apical lift, Prominent A-wave

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5
Q

HOCM is made softer by ?

HOCM is made louder by ?

What meds are used upon Dx

A

Inc venous return/preload: squat/hand grip

Dec venous return: stand, valsalva

Metoprolol and/or Verapamil to dec contractility and HR

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6
Q

What meds are avoided in HOCM

What med is c/i

When are ICDs considered

A

Dec preload: ACEI/ARB Nitrate Diuretic

Digoxin- inc contraction worsens obstruction

Syncope, Sudden arrest

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7
Q

HOCM is the MCC of young athlete death d/t ?

? surgical procedure is used for Tx

What non-surgical procedure is used for Tx

A

V-Fib

Myomectomy- young Pt refractory to meds

Alcohol septal ablation

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8
Q

Define Restrictive Cardiomyopathy

What side of the heart is MC affected

What is the MCC

A

Resistance to diastolic filling

L > R

Amyloidosis, half are idiopathic

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9
Q

What PE finding may be seen w/ Restrictive Cardiomyopathy

What would be seen on Dx Echo

What would be seen on lab results if etiology was from Amyloidosis

A

Kussmaul’s: inc JVP w/ inhalation

Atrial dilation w/ diastolic dysfunction

Apple-green birefringence w/ Congo-red stain

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10
Q

How is restrictive cardiomyopathy Tx

Define Myocarditis

What two other manifestations can this present w/

A

Diuretic- congestion
Chelation- hemochromatosis
GCCS- sarcoidosis

Inflamed heart muscle MC from Coxsackie B leading to SHF Sxs

Pericarditis, Megacolon

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11
Q

How is Myocarditis definitively Dx

How is it Tx

How do R/L atrial enlargements appear on EKG

A

Endomyocardial Biopsy

Loop ACEI BB

L: M-shape in lead 2 w/ large terminal part
R: P-wave >3mm in lead 2 w/ larger initial part

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12
Q

R/L VH EKG characteristics

Two MC Peds murmurs

MC type of ASD

A

R: R>S or >7mm in V1
L: V1-S+V5-R= >35mm

MC: Stills
MC continuous: cervical venous hum

Ostium secundum

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13
Q

How do ASDs present on PE

What EKG sign can these show

When do these need surgical interventions

A

Wide, fixed split S2 w/out inspiration variance

Crochetage: notchig at peak of R wave in inferior leads

> 1cm/Sx/Volume overload- closed at 2-4y/o

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14
Q

ASDs are definitively Dx by ? but ? is best

Define PDA

? does this sound like on PE

A

Cardiac cath, Echo is best test

Patent ductus arteriosus between aorta and Pulm Artery

Bounding pulse,
Machinery murmur, Wide pulse pressure, Low DBP

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15
Q

How are PDAs Dx

What two factors allow these to remain patent after birth

How are these Tx in premature infants

A

Initial: Echo
Best: cardiac cath

Prostaglandin E1 production, Low arterial O2 content

Indomethacin + fluid restriction

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16
Q

MC congenital heart Dz of childhood

When are medical interventions indicated

Define Katz-Watchel Phenomenon

A

VSD- MC type is perimembranous

HF, Growth retardation= Digoxin+Diuretics

VSD EKG finding w/ RVH+LVH

17
Q

Coarctation of Aorta MC occurs where

What are the two types

Older Pts may present w/ ? c/c

A

Insertion of Ductus Arteriosus distal to LSV origin

Post-duct: adult, narrowing distal to arteriosum

Pre-ductal: infant, narrowing proximal to arteriosum

Bilateral claudication

18
Q

Gold standard to Dx Aortic Coarctation

Best confirmatory test

? is used pre-op for Tx

A

Angiography

Echo

Alprostadil- Prostaglandin E1

19
Q

What are the 4 indications for emergent coarcation correction

Four parts of Tetrology

Why is this the only cyanotic heart Dz on blue print

A

HTN Megaly CHF Shock

PS RVH Overiding VSD

R-L shunt through VSD

20
Q

Define Tet Spell

Tetrology of Fallot is associated w/ ? chromosome deletion

MCC of essential and secondary HTN

A

Hypercyanotic episode d/t inc systemic pressures

Chrom 22

E: Idiopathic, S: renovascular

21
Q

Preferred, initial management of newly Dx HTN

MCC of cardiogenic shock and unique fact about Tx

How is Cardiogenic Shock Dx

A

WADE:
Weight loss Alcohol ≤2/d, ≤1/d DASH diet, Exercise ≥30min/day

Acute MI; only time Tx of shock does not use large amounts of fluids

Pulmonary wedge pressure >15mmHg

22
Q

First line medical Tx for O-HOTN

What two meds can be added if additional therapy is needed

MCC of Acute MI

A

Fludrocortisone

Midodrine: alpha agonist
Droxidopa: pressor

Atherosclerosis

23
Q

AV node received blood supply from ?

What is the Triad of an RV infarct

Door to EKG, PCI and Thrombolytics

A

RCA= during MI, brady/heart block

JVP w/ Clear lungs and Kussmaul sign

EKG: <10min
Thrombo: <30min
PCI: <90min