Rosh 2 Flashcards
What med is contraindicated in inferior wall STEMI
nitroglycerin
ultrasound findings are concerning for testicular cancer- what is the next step in diagnosing/
radical inguinal orchiectomy
(testicular biopsy CI due to risk of seeding into scrotum)
serum markers for seminoma testicular cancer
HCG and LDH
serum markers for nonseminoma testicular cancer
HCG and alpha-fetoprotein
Which condition commonly coexists with polymyalgia rheumatica?
giant cell arteritis
symmetric aching/stiffness about the shoulders, hip girdle, neck, and torso
Polymyalgia rheumatica
triad of:
GRADUAL ipsilateral hearing loss
ataxia
tinnitus
(also: ipsilateral sensorineural hearing loss in the high tones and a poor word discrimination score- c/o not being able to talk on the phone in that ear)
Meniere’s is LOW tones
Vestibular schwannoma
vestibular schwannomas affect what nerve
CN VII (facial)
what nerve injury causes foot drop
common peroneal
tx for BPH
- Alpha blockers (urethral relaxation, rapid sx relief): Tamsulosin
- 5 ∝ reductase (REDUCE THE SIZE) inhibitors shrink an enlarged prostate: Finasteride
Obstructive vs restrictive lung disease:
FEV1/FVC= <0.8
obstructive= <0.8
restrictive= normal
tx for chronic, stable angina
lifestyle modifications
statin
antihypertensive (BB)
antiplatelet therapies
MCC tricuspids stenosis
rheumatic heart dz
(almost always occurs with mitral stenosis)
What are Signs of more serious cardiac disease heard on auscultation
S4
grade >3/6 intensity
any diastolic murmur
fixed splitting of S2
what is seen on ekg in pericarditis
PR depression (I, II, III, aVF, aVL, V2-V6)
PR elevation (aVR)
diffuse ST-segment elevation (concave)
What is the minimum time s/p cardioversion should someone with A.fib be anticoagulated for
at least 4wks
(may be lifelong depending on CHADVASC score)
what is the most specific finding for myocardial ischemia during exercise stress test
2 mm downsloping ST-segment depression
pericardial knock
pericarditis
in patients with a myocardial infarction, which four drugs have been shown to decrease mortality?
ASA
BB
ACE
Statin
tx for endocarditis in an IV drug abuser w/ native valve
vanco + Ceftriaxone or cefepime
What 2 conditions LOWER BNP
Obesity
pericardial constriction
What is commonly hypertrophied in mitral stenosis
Right ventricular hypertrophy
(b/c MS causes “pressure backup” into pulmonary circulation and ultimately back to the right ventricle–> R vent hypertrophy +/- R HF)
(long standing MS can lead for L atrial dilation–> A.fib)
decrescendo diastolic blowing murmur at left sternal border w/ WIDE PULSE PRESSURE
water hammer pulse
AORTIC REGURG
medical tx for STABLE pts w/ WPW that have antidromic (widecomplex) tachycardia
procainamide
medical tx for STABLE pts w/ WPW that have orthodromic (narrow complex) tachycardia
adenosine
MC causative organism of endocarditis:
Tricuspid (IVDU) vs mitral valve
Tricuspid (IVDU)= S. aureus
Mitral= Strep viridans, S. aureus
what is a serious complication of Kawasaki disease
coronary artery aneurysm
Those with surgically repaired tetralogy of Fallot, with right ventricular pressure > ____ mm Hg or cardiomegaly, should not participate in rigorous or contact sports
> 50
(if RV pressure <50, no restrictions recommended)
Which of the following antiarrhythmic medications is contraindicated in the setting of coronary artery or structural heart disease?
A) Amiodarone
B) Dofetilide
C) Dronedarone
D) Flecainide
D) Flecainide
(increased risk of polymorphic ventricular tachycardia)
Which of the following medications has the greatest impact on reducing mortality in patients presenting with acute coronary syndrome?
A) Morphine
B) Beta blocker
C) Aspirin
D) Nitroglycerin
ASA
Stanford type A aortic dissections involve what part of the aorta?
Stanford type B?
Type A= Ascending
Type B= Descending
