PANCE Cram Flashcards
6 D’s of Dilated Cardiomyopathy
Main PE finding
Don't know (idiopathic) Drinking Drug- cocaine Dz- Coxsackie Doxorubicin Deficiency (B1)
S3 gallop: blood splashing against overly compliant, baggy ventricles
Dec mortality for Pts w/ HF using ? meds
What meds are used for Sx relief
When are ICDs considered
BASH the heart to pump harder:
BBs ACEI/ARB Spirinolactone Hydralazine-nitrate
Fuorsemide- dec fluid burden
Digoxin- inc contractility
EF <30%
Restrictive Cardiomyopathy MC has ? sided HF
? lab result indicates the MCC as the etiology
? class of medication should be given initially to Tx acute pulmonary edema during HF
R > L w/ Kussmaul sign: inhalation inc venous return to non-compliant RV, backs up into venous system
Apple-green w/ Congo red stain= Amyloidosis
Nitrates
? meds are used for HOCM Tx
Preferred anticoagulant for NSTEMI
How do you know if congenital heart defect is cyanosis or not
Non-DHP: Verapamil, Diltiazem (Dec Velocity of AV node)
UFH w/ PCI planned <48hrs
Condition starts w/ T= cyanotic
MC Type of ASD
What is seen on PE
MC congenital dz of childhood
Ostium secundum
Wide, fixed split S2:
VSD, CHOPS:
Congenital Holosystolic Observation Perimembranous (type 2) Surgery
Define Acute Bacterial Endocarditis
Define Subacute Bacterial Endocarditis
MCC of Prosthetic Valve Endocarditis
Staph A infection of normal, native valves
Strep Viridians infection of abnormal valves
Staph epidermis (early= <60day, late= >60days)
What microbe causes endocarditis after recent GI/GU exams
What microbe causes endocarditis in Pts w/ bowel Ca/UC
MC presenting c/c for endocarditis
Enterococcus
Strep bovis
Fever
Clinical manifestations of endocarditis
What are the major Duke criteria
What are the minor Duke criteria
FROM JANE:
Fever Roth spots Osler Murmu
Janeway Anemia Nail-bed hemorrhages Emboli
Two positive blood cultures
Echo proven endocardial involvement
FROM JANE,
Pos Echo/Culture not meeting major criteria,
IVDA
How is Acute Endocarditis Tx
How is Subacute Endocarditis Tx
What is used for prophylaxis
Only Native Cardiac Gears:
Oxacillin or Nafcillin w/ Ceftriax or Gentamicin
Valves Gradually Repaired:
Vanc w/ Gentamicin and days later, Rifampin
2g Amoxicillin (A: Clinda) prior to dental, respiratory tract incision/biopsy, soft tissue procedures
When are BBs used for HTN Tx
HTN Urgency/Emergency cut offs
What is the MC sign of end organ damage seen during HTN Emergencies
Pt w/ Hx of ischemic heart dz or HF w/ dec EF
≥180/120
HA
How quickly are HTN Urgencies Tx
How quickly are HTN Emergencies Tx
What are the 3 exceptions for HTN Emergency Tx time frames
Dec ≤25% in 24hrs w/ PO meds
Dec 10-20% in first hour then dec 5-15% in 23hrs w/ IV meds
Ischemic stroke
Aortic dissection
Intracerebral hemorrhage
What two meds are used in Pts w/ neurologic HTN emergencies
What two meds are used in Pts w/ CV HTN emergencies
MOA of ACEI
Nicardipine, Clevidipine
Esmolol, Labetalol
Inhibit ACE enzyme conversion of Angiotensin I to II to prevent ACE-II vasoconstriction effect
Mnemonic for s/e of ACEI
MOA of Angiotensin II Receptor Blockers
S/e of ARBS and w/ ? exception
CHAd:
Cough Hyer-K/Uricemia Angioedema Dose-1 HOTN
Blocks Angiotensin II receptor to prevent vasoconstriction effects
Hyper-K/Uricemia, Losartan- decs uric acid
? thiazide has the longest effect
What is the MOA of thiazides
? is this classes main indication for use
Chlorthalidone
Dec Na/water absorption at DCT
First line monotherapy for HTN Tx
What are the adverse effects of Thiazide diuretic use
What are the K sparing diuretics
What are their MOAs
Thiazides cause GLUCOSE to be Elevated:
Glucose Lipids Uric acid Ca Oh So Elevated
Hypo-Na/K
Spironolactone Eplerenone Amiloride Triamterene
A/T: block Na channel in collecting duct
S/E: aldosterone antagonists to dec effects leading to inc Na excretion/dec K excretion
