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Emergency Medicine > Unit 3 Lecture 2 > Flashcards

Unit 3 Lecture 2 Flashcards

(67 cards)

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1
Q

Risk factors for ischemic heart disease

A

male sex, age >55, family hx of CAD, DM, hypercholesterolemia, HTN, tobacco use

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2
Q

sxs of angina

A

pressure, heaviness, tightness, fullness; radiate to shoulder, arms, eck or jaw

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3
Q

PE of angina

A

tachycardia, HYPERtension, S3/S4, new/changed murmur

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4
Q

what are some anginal equivalents

A

exertional dyspnea, nausea, diaphoresis, fatigue, dizziness (these are more common in the elderly and DM patients)

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5
Q

length of time for stable angina

A

substernal chest pain lasting 2-5 minutes

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6
Q

tx of stable angina

A

nitrates SL x 3 doses

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7
Q

first line for chronic angina

A

beta blockers

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8
Q

indicated for pts who dont respond to nitrates and beta blockers

A

Ca channel blockers

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9
Q

dx of angina

A

12 lead EKG, stress testing, coronary angiography

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10
Q

when is an exercise stress test stopped

A

development of chest pain, dyspnea, ST depression >2mm, decreased systolic pressure >10mmHg or ventricular dysrhythmias

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11
Q

medication used for pharmacologic stress echo

A

dobutamine

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12
Q

what is radionuclide myocardial perfusion imaging

A
  • obtain rest images
  • exercise/pharm stress induced
  • radioactive tracer administered
  • look for perfusion defect
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13
Q

gold standard for dx CAD

A

coronary angiography

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14
Q

disposition for low risk patients with normal EKG

A

observe, serial cardiac enzymes, stress test

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15
Q

what is variant angina

A

episodes of angina (5-15 min) usually at rest and often b/t midnight and early morning

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16
Q

dx of variant angina

A

coronary angiography

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17
Q

tx of variant angina

A

nitrates and Ca channel blockers

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18
Q

STEMI tx

A

ABCs, cardiac monitoring, IV access, MONA, revascularization with fibriniolytics, PCI, or CABG

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19
Q

contraindications to thrombolytics

A

hx of hemorrhagic CVA, hx of ischemic CVA in last 3mo, presence of cerevral vascular malformation or malignancy, suspected aortic dissection, active internal bleeding, significant closed-head or facial trauma within the preceding 3 mon.

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20
Q

NSTEMI/UA management

A

ABCs, cardiac monitoring, IV access, MONA, no thrombolytics!

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21
Q

peri-infarction pericarditis

A

pericarditis in the first 2-3 days

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22
Q

PE of peri-infarctin pericarditis

A

pericardial rub

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23
Q

tx of peri-infarction pericarditis

A

supportive, ASA+colchicine

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24
Q

labs for pericarditis

A

leukocytosis, elevated ESR, elevated troponin with no elevation of CK

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25
ekg of pericarditis
ST elevation, PR segment depression
26
tx of pericarditis
NSAIDs and colchicine
27
Dressler's syndrome
develops weeks to months post MI
28
tx of dressler's syndrom
NSAIDs | -corticosteroids or colcichine if refractory
29
signs/sxs of myocarditis
prodrome, fever, rigors, myalgias, chest discomfort, exertional dyspnea
30
EKG findings of myocarditis
non-specific ST/T wave changes, ST elevation, AV blocked, prolonged QT
31
gold standard for dx myocarditis
endomyocardial bx
32
tx of myocarditis
supportive, limit physical activities
33
hx of endocarditis
fever, chills, cough, dyspnea, orthopnea
34
PE of endocarditis
palatal, conjunctival or subungual petechiae, splinter hemorrhages, osler nodes, janeway lesions, roth spots, pallor, splenomegaly, new murmur
35
labs for endocarditis
blood cultures x3 at least an hour apart
36
duke criteria for definitive dx of endocarditis
2 major or 1 major and 3 minor
37
tx of endocarditis
empiric abx therapy
38
heart failure clinical presentation
dyspnea, fatigue, non productive and nocturnal cough
39
PE of heart failure
tachycardia, tachypnea, rales at the base, S3/S3, JVD, LE edema
40
CXR findings for heart failure
cardiomegaly, cephalization, kerley B line
41
tx of heart failure
ABCs, sublingual nitrates for active chest pain without hypotension, ACE-I, Lasix, sodium restriction
42
ICU admission criteria for heart failure
pulmonary edema, cardiogenic shock, concomitant MI or ischemia
43
D/c criteria for heart failure pts
mild exacerbation that responds to ED treatment and no other cardiac and pulmonary findings
44
most common type of cardiomyopathy
dilated
45
PE of DCM
S3 gallop, rales, increased JVP
46
DCM tx
abstinence from EtOH, tx underlying ds
47
PE for HCM
S4 gallop, systolic murmur, biphasic carotid pulse, jugular venous pulsations
48
tx of HCM
beta blockers or CCB, surgery
49
hx c/w RCM
decreased exercise tolerance, dyspnea
50
collagen disorders a/w RCM
amyloidosis, radiation, DM
51
heart sound heard with RCM
S3
52
tx of RCM
diuretics
53
diff between hypertensive urgency and emergency
emergency a/w acute end-organ damage
54
tx of hypertensive urgency
rest, est. pts-increase dose of current meds, new pts-reduce BP over 24-48h
55
tx of hypertensive emergency
treat end-organ damage; reduce BP
56
tx of asx carotid disease
ASA + statin
57
tx of sx carotid ds with >70%
CEA
58
tx of superficial thrombophlebitis
local heat
59
DVT tx
anticoag (heparin followed by warfarin
60
virchow's triad
stasis, hypercoagulable state, endothelial damage
61
EKG finding for PE
S1 Q3 T3
62
CXR findings for PE
hamptom's hump, westermark sign
63
Test of choice for PE in non-pregnant
Spiral CT
64
test of choice for PE in pregnancy
V/Q perfusion scan
65
gold standard for dx PE
pulm. angiography
66
what is well's criteria used for
dx of PE
67
tx of PE
O2, IV access, cardiac monitoring, anticoag (heparin, LMWH, warfarin, rivaroxaban)

Emergency Medicine (6 decks)

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