Random Cards!

Question 1

MONA

Answer 1

morphine, O2, nitroglycerin, aspirin

“Mona”
Morphine for pain and to relieve anxiety
O2, especially if O2 saturation <90%
Nitroglycerin to vasodilate coronaries
Aspirin for its antiplatelet effect

Outpatient medications for unstable angina: Bblocker, CCB, long acting nitrate

Question 2

unstable angina

Answer 2

new onset
present at rest
crescendo pattern

Question 3

rule of three

Answer 3

take one angina, wait five minutes, see if it goes away, take another angina, five minutes, take third angina (then call an ambulance!)

Question 4

celecoxib

Answer 4

COX-2 selective NSAIDs, i.e., celecoxib is associated with an increased risk of serious adverse CV events

o celecoxib: is COX2 selective inhibitor, they do not effect platelets and bleeding time, less GI ulcers – used for tx of arthritis

o ALL COX2 selective NSAIDS (ibuprofen, neproxib) generate higher cardiovascular risk with long term tx

Question 5

precordial heave?

Answer 5

directly under sternum = right ventricular hypertrophy

Question 6

what does holosytolic 4/6 murmur better with valsalva indicate?

Answer 6

aortic stenosis

Question 7

pulsus parvus et tardus

Answer 7

indicates aortic stenosis: have faint and delayed pulse - with a low and weak diastolic pressure

Question 8

valsalva maneuver

Answer 8

causes increased intra-thoracic pressures and decrease in venous return of blood thus decreasing EDV –> makes aortic stenosis quieter

Question 9

LVH measured?

Answer 9

V1 + V5: if greater than 35 mm (or seven boxes then there is LVH)