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Path 2 SJSM > PDI Material > Flashcards

PDI Material Flashcards

1
Q

Twaves:

What does it mean is a T wave is peaked?

A

Hyperkalemia

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2
Q

Twaves:

What does it mean is a T wave is flattened?

A

Hypokalemia

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3
Q

QRS:

What does a higher amplitude QRS mean?

A

Left ventricular hypertrophy

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4
Q

QRS:

What does a fast, fat, & irregular QRS mean?

A

Ventricular fibrillation

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5
Q

QRS:

What does a fast, fat, & regular rhythmed QRS mean?

A

Ventricular tachycardia

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6
Q

QRS:

What does a wide QRS mean?

A

Conduction issue

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7
Q

What is the normal width & height of a QRS complex

A

Height up to 5 big squares
Width ~3 small squares

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8
Q

ST segment:

What does a flat ST segment mean?

A

normal

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9
Q

ST segment:

What does a depressed ST segment mean?

A

Angina/ischemia

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10
Q

ST segment:

What does a elevated ST segment mean?

A

Prizmetal angina or MI

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11
Q

ST segment:

What does a elevated ST segment in leads II, III, & aVF mean?

A

Inferior infarct

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12
Q

ST segment:

What does a elevated ST segment in leads V1-V4 mean?

A

Anterior infarct

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13
Q

ST segment:

What does a elevated ST segment in leads I, aVL, & V6 mean?

A

Lateral infarct

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14
Q

Describe 3rd degree heart block:

pathophysiology?

A

The ventricles will beat independently of each & there’s no relationship between the p wave & the QRS complex

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15
Q

The ventricles will beat independently of each & there’s no relationship between the p wave & the QRS complex

A

3rd degree heart block:

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16
Q

Describe 2nd degree heart block:

Type 1 pathophysiology?

A

Type 1 or Wenckebach/moblitz type 1) results in progressive prolongation of the PR interval until a QRS complex is dropped or missed (Usually asymptomatic)

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17
Q

results in progressive prolongation of the PR interval until a QRS complex is dropped or missed (Usually asymptomatic)

A

Type 1 or Wenckebach/moblitz type 1, 2nd degree HB

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18
Q

Describe 2nd degree heart block:

Type 2 pathophysiology?

A

aka moblitz type 2 results in the QRS complex being dropped/missed without any prior PR prolongation (This is pathological!)

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19
Q

results in the QRS complex being dropped/missed without any prior PR prolongation (This is pathological!)

A

moblitz type 2, 2nd degree HB

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20
Q

Describe 1st degree heart block:

pathophysiology?

A

Results in prolonged PR interval due to a delayed AV conduction

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21
Q

Results in prolonged PR interval due to a delayed AV conduction

A

1st degree heart block

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22
Q

Describe the features of sinus bradycardia

Bpm
ECG
Etiology

A

HR <60Bpm
Normal ECG
Normal in athletes & plp on B-blockers

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23
Q

HR <60Bpm
Normal ECG
Normal in athletes & plp on B-blockers

A

sinus bradycardia

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24
Q

Describe a the features of a left bundle branch block:

QRS complex changes

A

QRS in v1 = W shaped
QRS in v6 = M shaped

“WiLLiaM”

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25
Q

QRS in v1 = W shaped
QRS in v6 = M shaped

“WiLLiaM”

A

left bundle branch block:

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26
Q

Describe a the features of a right bundle branch block:

QRS complex changes

A

QRS in v1= M shaped
QRS in v6= W shaped “MaRRoW”

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27
Q

QRS in v1= M shaped
QRS in v6= W shaped “MaRRoW”

A

right bundle branch block

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28
Q

Describe the features of sinus tachycardia:
HR
ECG

A

HR >100Bpm
Normal ECG
Normal response to stress

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29
Q

HR >100Bpm
Normal ECG
Normal response to stress

A

sinus tachycardia

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30
Q

Describe the features of ventricular fibrillation:
ECG

A

Broad QRS & irregular rhythm

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31
Q

Broad QRS & irregular rhythm

A

ventricular fibrillation

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32
Q

Describe the features of atrial fibrillation:
ECG

A

No p waves & irregular rhythm

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33
Q

No p waves & irregular rhythm

A

atrial fibrillation:
ECG

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34
Q

Describe the features of supra-ventricular tachycardia:
ECG

A

Narrow QRS & regular rhythm

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35
Q

Narrow QRS & regular rhythm

A

supra-ventricular tachycardia

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36
Q

Describe the features of ventricular tachycardia:
ECG

A

Broad QRS & regular rhythm

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37
Q

Broad QRS & regular rhythm

A

ventricular tachycardia

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38
Q

Describe the pathophysiology of constrictive/restrictive pericarditis:

patho?
Causes?
Symptoms?

A

Patho:
Constriction of heart leads to diastolic dysfunction (poor filling)

Causes:
Amyloidosis
Endocardial fibroelastosis (kids)
Loeffler syndrome (eosinophilia)

Symptoms:
1) CHF
2) Low voltage EKG with diminished QRS amplitude

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39
Q

Patho:
Constriction of heart leads to diastolic dysfunction (poor filling)

Causes:
Amyloidosis
Endocardial fibroelastosis (kids)
Loeffler syndrome (eosinophilia)

Symptoms:
1) CHF
2) Low voltage EKG with diminished QRS amplitude

A

pathophysiology of constrictive/restrictive pericarditis

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40
Q

Describe the features of an atrial myxoma:

Signs

Risk

A

A benign cardiac tumor that is made of mesenchymal made up of ground substance

Symptoms:
1) Syncope

Risk:
Obstruct the mitral valve

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41
Q

Describe the features of restrictive/constrictive cardiomyopathy

patho?
Causes?
Signs?

A

Patho:
Diastolic dysfunction (reduced ventricular filling)

Causes:
Amyloidosis
Endocardial fibroelastosis (children)
Loeffler syndrome

Symptoms:
1) CHF
2) Low voltage EKG with reduced QRS amplitude

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42
Q

Patho:
Diastolic dysfunction (reduced ventricular filling)

Causes:
Amyloidosis
Endocardial fibroelastosis (children)
Loeffler syndrome

Symptoms:
1) CHF
2) Low voltage EKG with reduced QRS amplitude

A

Describe the features of restrictive/constrictive cardiomyopathy

patho?
Causes?
Signs?

43
Q

JVP changes:

a waves represent what?

Absent a waves mean what?

Large a waves mean what?

Cannon a waves mean what?

A

a waves represent Atrial contraction

absent = a fibrillation

large = pulmonary HTN or stenosis

Cannon = Complete heart block or ventricular arrythmias

44
Q

JVP changes:

C waves represent what?

A

Contraction of the right ventricle & Closure of the triCuspid

45
Q

JVP changes:

X waves represent what?

A

relaXation of atria

46
Q

JVP changes:

v waves represent what?

large v wave means what?

A

v wave represents Venous filling

Large = tricuspid regurgitation

47
Q

JVP changes:

y waves represent what?

A

emtYing of the right atrium into the right ventricle

48
Q

Pulses:

Describe Pulsus paradoxus

A

Decrease in pulse during inhalation (10+mmHg) & increase in pulse on exhalation (10mmHg)

49
Q

Decrease in pulse during inhalation (10+mmHg) & increase in pulse on exhalation (10mmHg)

A

Pulsus paradoxus

50
Q

Pulses:

Describe Corrigan pulse

A

The pulse is forceful & then it suddenly collapse

ass: aortic regurgitation

51
Q

The pulse is forceful & then it suddenly collapse

ass: aortic regurgitation

A

Corrigan pulse

52
Q

Pulses:

Describe a Dicrotic pulse

Ass conditions

A

2 palpable pulses in aortic

Ass:
Decreased cardiac output
Increased resistance 2nd diastole

53
Q

2 palpable pulses in

Ass:
Decreased cardiac output
Increased resistance 2nd diastole

A

Dicrotic pulse

54
Q

Describe a pulsus bisferiens

A

2 palpable pulses in systole

ass aortic insufficiency/regurgitation & hypertrophic cardiomyopathy

55
Q

2 palpable pulses in systole

ass aortic insufficiency/regurgitation & hypertrophic cardiomyopathy

A

pulsus bisferiens

56
Q

Describe parvus et tardus

A

a low amplitude pulse with delayed up stroke

ass with aortic stenosis

57
Q

a low amplitude pulse with delayed up stroke

ass with aortic stenosis

A

parvus et tardus

58
Q

Describe Pulsus bigeminus

A

2 heart beats close together then a longer pause

Ass:
Hypo/hyperkalemia
HYpothyroidism
MI
B-Blocker

59
Q

2 heart beats close together then a longer pause

Ass:
Hypo/hyperkalemia
HYpothyroidism
MI
B-Blocker

A

Pulsus bigeminus

60
Q

Describe pulsus alternans

A

A regular alternating pulse amplitude

Ass
Severe left ventricular disease

61
Q

A regular alternating pulse amplitude

Ass
Severe left ventricular disease

A

pulsus alternans

62
Q

Describe Quincke pulse

A

pulse in the nail bed

ass aortic regurgitation

63
Q

pulse in the nail bed

ass aortic regurgitation

A

Quincke pulse

64
Q

Describe a hypokinetic pulse

A

A low amplitude pulse with low voltage

ass:
MI
Shock

65
Q

A low amplitude pulse with low voltage

ass:
MI
Shock

A

hypokinetic pulse

66
Q

Heart sounds:

Aortic regurgitation

Sound

Associated conditions

Symptoms

A

A high-pitched blowing early diastolic decrescendo murmur

Ass:
Acute (endocarditis)
Chronic (Bicuspid aortic valve & CT disease)

Symtoms:
1) Water hammer pulse (wide pulse pressure)
2) deMussets (head bobbing)

67
Q

A high-pitched blowing early diastolic decrescendo murmur

Ass:
Acute (endocarditis)
Chronic (Bicuspid aortic valve & CT disease)

Symtoms:
1) Water hammer pulse (wide pulse pressure)
2) deMussets (head bobbing)

What’s the condition?

A

Aortic regurgitation

68
Q

Heart sounds:

VSD

Sound

Associated conditions

A

A HARSH holosystolic murmur

Ass:
Down syndrome (ostium primum)

69
Q

A HARSH holosystolic murmur

Ass:
Down syndrome (ostium)

A

VSD

70
Q

Heart sounds:

MVP

Sound

Associated symptoms

Complications

A

Late systolic crescendo-decrescendo murmur & midsystolic click.

Ass:
Elher-Danlos
Marfans
Rheumatic heart disease
Infect endocarditis (s.viridians)

Comp:
Severe mitral regurgitation

“MVP click”

71
Q

Late systolic crescendo-decrescendo murmur & midsystolic click.

Ass:
Elher-Danlos
Marfans
Rheumatic heart disease
Infect endocarditis (s.viridians)

Comp:
Severe mitral regurgitation

A

MVP

72
Q

Heart sounds:

Mitral regurgitation

sounds

associated condition

location

A

Holocystolic high-pitched blowing murmur

Ass:
Post MI syndrome
rheumatic heart disease
endocarditis (s. viridians)
IHD

location: apex radial to axilla

73
Q

Holocystolic high-pitched blowing murmur

Ass:
Post MI syndrome
rheumatic heart disease
endocarditis (s. viridians)
IHD

location: apex radial to axilla

A

Mitral regurgitation

74
Q

Heart sounds:

Tricuspid regurgitation

Ass conditions/risks

location

A

Holosystolic high-pitched blowing murmur

ass:
IV drug abuse (s. aureus endocarditis)
Marfans
EDS
Pulmonary HTN

Location:
tricuspis

75
Q

Heart sounds:

Aortic stenosis

Ass conditions

Symptoms

Causes

A

Systolic crescendo-decrescendo murmur ejection murmur (louder -> softer)

Ass:
Pulsus parvus et tardus (weak & delayed carotid upstroke)

Ass:
1) Syncope
2) Angina
3) Dsypnea

Causes
Aortic valve sclerosis
Bicuspid aortic valve (ass with turners)
Rheumatic fever

76
Q

Systolic crescendo-decrescendo murmur ejection murmur (louder -> softer)

Ass:
Pulsus parvus et tardus (weak & delayed carotid upstroke)

Ass:
1) Syncope
2) Angina
3) Dsypnea

Causes
Aortic valve sclerosis
Bicuspid aortic valve (ass with turners)
Rheumatic fever

A

Aortic stenosis

77
Q

Heart sounds:

S1/S2 Splitting

Heart sounds

A

S1 Mitral & tricuspid valves closing
S2 Aortic pulmonic valves closing

78
Q

Heart sounds:

Wide split s2

ass conditions

A

Pulmonic stenosis
RBBB

79
Q

Heart sounds:

Fixed splitting S2

ass conditions

A

Ass with left-right shunt (ASD)

80
Q

Heart sounds:

Paradoxical splitting S2

A

Delayed aortic valve closure

ASS:
Aortic stenosis
LBBB

81
Q

Heart sounds:

Mitral stenosis

Sound

Ass condition

What mimics it

A

Diastolic open-snap followed by a delayed diastolic rumbling

Ass:
Rheumatic fever
SLE
RA

Mimicers:
L. atria myxoma
Bacterial endocarditis

82
Q

Diastolic open-snap followed by a delayed diastolic rumbling

Ass:
Rheumatic fever
SLE
RA

Mimicers:
L. atria myxoma
Bacterial endocarditis

A

Mitral stenosis

83
Q

Heart sounds:

PDA

Sound

Ass condition

Treatment

A

Continuous machine-like murmur

Ass:
Congenital rubella
FAS
Fetal hytoin syndrome (phenytoin)

Rx:
Prostaglandins (open if sugery later)
Indomethacin (close)

84
Q

Continuous machine-like murmur

Ass:
Congenital rubella
FAS
Fetal hytoin syndrome (phenytoin)

Rx:
Prostaglandins (open if sugery later)
Indomethacin (close)

A

PDA

85
Q

Key words:
LOC
Feeling unwell
Drinks alot
Recovers quickly

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
Orthostatic hypotension

Differentials:
Hypovolemia
Medication side effects
Hypoglycemia

Tests:
Electrolytes
Blood glucose
ECG

Rx:
Glucose replacement
Fluid & electrolyte replacement

86
Q

Differentials:
Hypovolemia
Medication side effects
Hypoglycemia

Tests:
Electrolytes
Blood glucose
ECG

Rx:
Glucose replacement
Fluid & electrolyte replacement

What’s the diagnosis

A

Diagnosis:
Orthostatic hypotension

87
Q

Key words:
Dizzy
Chest hurts
Swollen legs

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
CHF (due to aortic stenosis)

Differentials:
Valvular disease
Atrial myxoma
MVP

Tests:
CBC
Electrolytes
Kidney function test
BNP/ANP
ECG
ECHO
Chest x RAY

Rx:
lifestyle changes (WL, diet, exercise)
Diuretics
ACE inhibitors
Restrict fluid
B-blockers

88
Q

Differentials:
Valvular disease
Atrial myxoma
MVP

Tests:
CBC
Electrolytes
Kidney function test
BNP/ANP
ECG
ECHO
Chest x RAY

Rx:
lifestyle changes (WL, diet, exercise)
Diuretics
ACE inhibitors
Restrict fluid
B-blockers

What’s the condition?

A

Diagnosis:
CHF (due to aortic stenosis)

89
Q

Key words:
Hard to breath
High fever
IV user

Diagnosis?

Differentials?

Tests?

Rx?

A

Tricuspid regurgitation (bacterial endocarditis via s. aureus)

Diff:
Pulmonary HTN
Pulmonary stenosis
Pulmonary emboli

Tests:
CBC
ESR
CRP
ECHO

Rx:
Antibiotics
Monitoring
Diuretics
Antiarrhythmics
Eventual valve replacement

90
Q

Diff:
Pulmonary HTN
Pulmonary stenosis
Pulmonary emboli

Tests:
CBC
ESR
CRP
ECHO

Rx:
Antibiotics
Monitoring
Diuretics
Antiarrhythmics
Eventual valve replacement

Diagnosis?

A

Tricuspid regurgitation (bacterial endocarditis via s. aureus)

91
Q

Key words:
Weight loss
Poor sleep
Fast heart rate
Swollen neck

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
Hyperthyroidism

Diff:
Arrythmia
Pheochromocytoma

Tests:
Thyroid functions & Ultrasound
Urine test
ECG
Holter/monitor

Rx:
Antithyroid drugs (methimazole or PTU)

92
Q

Diff:
Arrythmia
Pheochromocytoma

Tests:
Thyroid functions & Ultrasound
Urine test
ECG
Holter/monitor

Rx:
Antithyroid drugs (methimazole or PTU)

Diagnosis?

A

Diagnosis:
Hyperthyroidism

93
Q

Key words:
Chest pain rad from front to back
Hard to breath
Dizzy
Light headedness
Abnormal sweating

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
Aortic dissection

Diff:
MI
Pericarditis

Tests:
Cardiac enzymes
ECG
CT
Chest X ray
ECHO

Rx
Surgery
Nitrates
B-blockers
ACE inhibitors
Sup O2
Aspirin & HEPARIN

94
Q

Diff:
MI
Pericarditis

Tests:
Cardiac enzymes
ECG
CT
Chest X ray
ECHO

Rx
Surgery
Nitrates
B-blockers
ACE inhibitors
Sup O2
Aspirin & HEPARIN

Which condition?

A

Diagnosis:
Aortic dissection

95
Q

Key words:
Lots of stress
Dizzy
poor sleep
Chest pain

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
Stable angina

Diff:
MI
Anxiety

Tests:
Cardiac enzymes
Lipid profile
ECG
Cardiac stress test

Rx:
Lifestyle changes
B-blockers
Nitrates

96
Q

Diff:
MI
Anxiety

Tests:
Cardiac enzymes
Lipid profile
ECG
Cardiac stress test

Rx:
Lifestyle changes
B-blockers
Nitrates

What’s the condition?

A

Diagnosis:
Stable angina

97
Q

Key words:
Cold-intolerant
Losing hair
Weight gain
No appetite
Constipation
Fatigue

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
Hypothyroidism

Diff:
Iron deficiency anemia
Depression

Tests:
CBC
Thyroid pannel & ultrasound
Iron studies

Rx:
L-Thyroxine replacement (thyroid replacement)
Follow up at regular intervals

98
Q

Diff:
Iron deficiency anemia
Depression

Tests:
CBC
Thyroid pannel & ultrasound
Iron studies

Rx:
L-Thyroxine replacement (thyroid replacement)
Follow up at regular intervals

What’s the condition?

A

Diagnosis:
Hypothyroidism

99
Q

Key words:
Splitting headache
Jaw pain
Blurry vision

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
GC temporal arteritis

Diff:
Migraine
Transient ischemic attack

Tests:
Elevated ESR
Elevated CRP
Segmental biopsy
CT/MRI

Rx: Glucocorticoids

100
Q

Diff:
Migraine
Transient ischemic attack

Tests:
Elevated ESR
Elevated CRP
Segmental biopsy
CT/MRI

Rx: Glucocorticoids

What’s the condition?

A

Diagnosis:
GC temporal arteritis

101
Q

Key words:
Calf pain when active
Foot goes numb
Chest pain
Discolored leg

Diagnosis?

Differentials?

Tests?

Rx?

A

Diagnosis:
Acute limb ischemia

Diff:
Buegers disease
Compartment syndrome

Tests:
ABI (ANKLE BRACHIAL INDEX)
Angiography

Rx:
Anticoagulants
Angiography

102
Q

Diff:
Buegers disease
Compartment syndrome

Tests:
ABI (ANKLE BRACHIAL INDEX)
Angiography

Rx:
Anticoagulants
Angiography

What’s the diagnosis

A

Diagnosis:
Acute limb ischemia

103
Q
A

Path 2 SJSM (17 decks)

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