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Cardiovascular FA > Uw 2 > Flashcards

Uw 2 Flashcards

1
Q

Cholysterol crystal embolism - diagosis

A

Labs: leveated creatinine, eosinophylia, low complement
Eosinophiluria
Skin or renal biopsy

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2
Q

Approximate decrease in BP with life style modification

A
  1. Weight loss: 5-20 per 10 kg loss
  2. Diet with fruit + vegetables + low fat: 8-14
  3. Exercise: 30 min / d 5 days per week: 4-8
  4. Less than 3 g sodium /day: 2-8
    Less than 2 drinks in men and 1 in women : 2-4
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3
Q

Congenital artiriovenous fistula

A
  1. PDA
  2. Angiomas
  3. Pulmonary AVF
  4. CNS AVF
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4
Q

Medication withhold prior to cardiac stress

A

Hold for 2 days: b-blockers, CCB, nitrates
Hold 2 days prior to vasodilatory test: dypirodamole
Hold 12 h prior to vasodilatory test: caffeine
Continue: ACEi, digoxin, diuretics,statins

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5
Q

Classification of angina

A
  1. Classic: typical location quality and duration, provoked by emotional stress or exercise, relieved by rest or NO
  2. Atypical: 2/3
  3. Nonanginal: less than 2/3
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6
Q

Pretest probability for coronary artery disease

A
  1. Low: asynptomatic in all ages, atypical in women under 50
    Intermediate: atypical in men all ages,, atypical in women over 50, typical in women 30-50
    High: typical in men over 40 or men over 60
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7
Q

poor prognostic factors in systolic HF

A
  1. Qrs more than 120

2. LBBB

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8
Q

Characteristics of infectious endocarditis in IV drug users

A
  1. Increase risk in HIV +
  2. Fewer peripheral manifestations
  3. HF more common in aprtic valve involvement (rare in tricuspid)
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9
Q

Diagnosis of hypercholestermia requires

A

total cholesterol of > 200 mg/dL on two occasions.

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10
Q

Metabolic syndrome

A

increased waist circumference ≥94 cm (men) or ≥80 cm (women) plus any two of the following: increased triglycerides (>150 mg/dL), HDL cholesterol <40 mg/dL, hyperglycemia (fasting plasma glucose >100 mg/dL), and blood pressure >130/85 mm Hg or drug treatment for hypertension.

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11
Q

Screening tests for patients average risk - Breast cancer

A

mammo every 2 years at women 50-75

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12
Q

Screening tests for patients average risk - cervical cancer

A

pap every 3 years at 21-65

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13
Q

Screening tests for patients average risk - colon cancer

A

fecalt occult yearly or colonoscopy every 10 years at 50-75

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14
Q

Screening tests for patients average risk - HIV

A

antibody screen 1 time at 15-65

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15
Q

Screening tests for patients average risk - hyperlipidemia

A

men 35+ every 5 years

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16
Q

Screening tests for patients average risk - hypertension

A

BP measurements every 2 years at 18+

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17
Q

Screening tests for patients average risk - osteoporosis

A

DEXA (interval uncertain) at women 65+

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18
Q

lymphedema - clinical presentation

A

swelling, pain, heaviness
ear;y: soft skin, pitting edema
late: firm + thickened skin nonpitting edema

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19
Q

lymphedema - treatment

A
  1. weight loss
  2. limb elevation + compression
  3. physiotherapy
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20
Q

flu vaccine - recommendation

A

after 6 months in eveyy patient and should be given as soon as it is available in the fall

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21
Q

Mitral stenosis - heart sounds

A

loud S1, LOUD s2 IF PULM HYPERETENSION

- MID-DIASTOLIC RUMBLSE

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22
Q

vasovagal syncope - treatment

A

reassurance, avoid tigers, counter-pressure techniques for recurrent episodes (eg. leg crossing, handgrip)

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23
Q

supportive evidence for rnovascular disease

A

asymmetric renal size, abdominal bruit (diastolic + systolic)

  • Unexplained rise in serum Cr afte starting ACEi
  • unexplained atrophic kidney
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24
Q

Reversible RF for premature atrial contractions / treatment

A
  • tobacco + alcohol + caffeine + stress

- beta blockers are helpful in symptomatic

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25
Q

wide complex tachycardia

A

AV dissociation? Fusiin/ ca[ture beats

  • YES: VT –> if stable give amiodarone, if unstable (hypotension, resp distress, alterend mental) –> synch cardioversion
  • NO –> SVT with abbereancy –> stable make maneuvers, unstable the same as VT
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26
Q

essential diagnostic sign for sustained monomorphic VT

A

fusion beats

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27
Q

chronic stable angina treatment

A
  1. beta blockers
  2. CCBs nondihydro
  3. Dihydr CCB
  4. Nitrates
  5. Ranolazine
28
Q

pericardiocentesis is indicated in

A

Pleural effusion and UNSTABLE

29
Q

indications for synchronized cardioversions

A

hemodynamic instability deu to narrow or wide QRS complex tachyarrhytmia (AF, atrial flatter, VT with pulse)

30
Q

drug that enlarge QRS if fast HR

31
Q

malignant HTN?

A

more than 180.120 + retinal hemorrhage, exudatesor papilledema

32
Q

hypertensice emergency?

A

Severe HTN with end organ complications

33
Q

CHA2DS2-VASc score

A 
IN NONVALVULAR: 
CHF (1)
HTN (1)
Age more than 74 (2)
DM (1)
Stroke/TIA/Thromboemb (2)
Vasc disease (prior I. PAD, aortic plaque) (1)
Age 65-74 (1)
Sex: female (1)
if 0 --> low risk, no antithromb therapy, 
1 --> interm risk --> none or aspirin or antithromb
2 or more --> oral anticoagulatns
34
Q

Aortic fibrilation - aware of pounding

A

left lateral decubitus –> brings the enlarged LV closer to the chest wall and causes pounding sensation and increased awareness of heartbeat

35
Q

ascending vs descenting aneurysms are due to

A

asc: cystic medial necrosis
desc: atheroscl

36
Q

constrictive pericarditis - etiology

A
  1. idioathic or viral pericarditis
  2. cardiac surgery or radiation therapy
  3. TB pericarditis (in endemic
37
Q

constrictive pericarditis - diagnostic findings

A
  1. ECG: nonspecific
  2. Image: pericardial thickening and calcification
  3. prominent x & y
38
Q

adult tachycardia algorithm (with pulse)

A

assess appropriateness for clinical condition (HR more than 150) –> identify + treat underlying cause (maintain airway, assists breathing, O2, cardiac monitor) –>
unstable (hypotension, mental, shock, ischemic, acute HF)???
YES –> sync cardioversion
NO –> QRS more than 0.12
- if yes –> adenosine, antiarrhythmic infusion
- no –> vagal, adenosine (if regular), beta block, CCB

39
Q

prinzmental angina - treatment

A

preventive: CCB
abortive: sublingual NO

40
Q

labs evidence of poor prognostic Systolic HF

A
  1. low Na+
  2. eelvated proBNP
  3. Renal failure
41
Q

ECG evidence of poor prognosis in Systolic HF

A

long WRS

LBBB

42
Q

Reversible causes of asystole/PEA

A

5H: hypovolemia, hypoxia, Hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia
5T: tension pneumothorax, temponade, toxins, thrombosis, trauma

43
Q

predisposition for atypical symptoms at MI

A
  1. women
  2. elderly
  3. MI
44
Q

MI in right artery with Lung findings and apex murmur - think for …..

A

right MI and acute MR

45
Q

adenosine in Wolf park white

46
Q

fibromuscular dysplasia - treatment

A
  1. antihypertensive (ACEi)
  2. percutaneous translumination angioplasty
  3. surgery (if PTA son successful)
47
Q

aortic stenosis in patients under 70

A

bicuspid valve

if older 70 –> senile calcification

48
Q

HyperTG - management

A
  • evaluation of 2ry causes
  • if less 150-500: lifestyle modification (and statin in cardiovascular risk)
  • if more than 1000: pancreatitis prevention (fibrates, fish oil, no alcohol) –> if drop more than 500 -> lifestyle modif
49
Q

The most specific ecg finding in pericarditis

A

PR segment depression

50
Q

Constrictive pericarditis - clinical signal

A
  1. Kussmaul sign
  2. Knock: extra heart sound in diastole from ventricular filling (the heart fioos to its maximum –> it hits the rigid pericaridum)
51
Q

Leriche syndrome - manifestation

A

triad of erectile dysfunction, buttock + hip pain, absent femoral pulse

52
Q

Vasovagal syncope - prodrome symptoms

A

nausea, pallor, diaphoresis

53
Q

Guidelines for lipid-lowering therapy (general)

A
  1. LDL more than 190
  2. Clinically significant atherosc disease (ASC, angina, mi, stoke, TIA, PAD: if younger than 75: high intenisity, moderate for older than 75
  3. age 40-75 with DM 40-75
  4. estimated 10 years ASCVD risk 7.5% or more: moderate to high
54
Q

LDL more than 190 - statin?

A

high-intensity statin

55
Q

Statin in Clinically significant atherosc disease

A

ASC, angina, mi, stoke, TIA, PAD:

  • 75 or younger: high intenisity
  • older than 75: moderate
56
Q

DM - statin?

A

if age 40-75:

  • 10 years ASCVD risk 7.5% or more: high intensity
  • 10 years ASCVD risk less than 7.5%: moderate
57
Q

exertional heat stroke- clinical manifestation

A

core Q more than 40 immediately after collapse AND

  • CNS dysfunction
  • additional organ or tissue damage (Renal/hepatic failure/ DIC, ARDS)
58
Q

exertional heat stroke - management

A
  1. rapid cooling (ice immersion preferred)
  2. fluids
  3. electrolyte correction
  4. management of end organ complications
  5. NO ROLE FOR ANTIPYRETICS
59
Q

AS - early vs late peaking of pulse

A

in moderate: early

in severe: late

60
Q

murmur in severe AS

A

mid to late peaking

61
Q

Sclerodermal renal crisis

A
  • acute renal failure (without kidney disease) and malignant hypertension (eg. headache, blurry vision, nausea) (HIGH RENIN)
  • urinalysis: mild proteinuria
  • peripheral: microangiopathic hemolytic anemia + schistocytes and thrombocytopenia)
62
Q

types of arrhythmia at 1st hour after MI

A
    • immediate or phase 1a ventricular arrhythmias in first 10 mins
    • delayed or phase 1b arrhythmias in 10-60 mins (reetrant arrhythmias)
63
Q

anticoagulation in pericarditis

A

never –> hemorrhagic pericardial effusion

64
Q

ventricula aneurysm - what else beside ST elevations

A

Q waves in the same leads

65
Q

doctor - gifts form 3rd person?

A

only small gifts that benefits patients are acceptable

66
Q

adult with meningitis wants to leave –>

A

hospitlize him and isolate

Cardiovascular FA (8 decks)

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