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Mixed > UW 4 > Flashcards

UW 4 Flashcards

1
Q

EKG for Complete AV block?

A

Regular P waves
Unrelated to QRS
Consistent of R-R wave

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2
Q

Tx for symptomatic complete AV block?

A

Temporary pacemaker insertion

Assess for cause

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3
Q

Complications for untreated complete heart block

A

Ventricular arrhythmias

Asystole

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4
Q

Causes of complete AV block?

A

Myocardial ischemia
Increased vagal tone
Metabolic changes (HyperKalemia)
AV nodal blockers

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5
Q

What does Adenosine do?

A

Inhibits L-type calcium channels ->decreases conduction velocity at AV node

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6
Q

When is adenosine used in tx?

A

termination of AV node dependent reentrant tachycardia

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7
Q

Most beneficial therapy to reduce progression of diabetic nephropathy

A

Strict BP control to maintain GFR

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8
Q

Tx for stroke in sickle cell pt in acute setting

A

Exchange transfusion

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9
Q

Hepatic hydrothorax

A

Causes transudative pleural effusion in cirrhosis pts w/underlying cardiac or pulm dz
- usually right sided

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10
Q

Tx for hepatic hydrothorax

A
  1. Salt restriction + Diuretics

2. TIPS if refractory

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11
Q

Supraventricular tachycardia (SVT)

A

Regular

Narrow-complex tachycardia

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12
Q

Tx for pts with persistent tachyarrhythmia causing hemodynamically unstable

A

Immediate synchronized DC cardioversion

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13
Q

SVT pt that is hemodynamically stable management?

A
  1. Vasovagal maneuvers - carotid sinus massage
    OR
    IV Adenosine/CCBs
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14
Q

When are IV antiarrhythmics like amiodarone and procainamide used?

A

Stable recurrent or refractory wide-complex tachycardia

- they can worsen hypoTN

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15
Q

Electrolyte abnormalities in heart failure

A

Hyponatremia = severe HF - Neurohumoral activation

Low Na = High renin, aldosterone, vasopressin, NE

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16
Q

Causes of QT Prolongation

A

Electrolytes
Meds
Inherited

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17
Q

Electrolyte derangements - QT Prolongation

A

Hypocalcemia
Hypokalemia
Hypomagnesemia

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18
Q

Meds that cause QT Prolongation

A 
Macrolides
Fluoroquinolones
Antipsychotics
TCAs
SSRIs
Opiods
Antiarrhythmics - Quinidine, Sotalol, Procainamide, Flecainide, Amiodarone
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19
Q

Jervell and Lange-Nielsen syndrome

A

Congenital sensorineural deafness + long QT (600 ms) + FHx of sudden death
Defect in K channels

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20
Q

PTs w Prolonged QT at risk for?

A

Syncope
Life threatening ventricular arrhythmias = Torsade des pointes
Sudden death

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21
Q

Tx for QT prolongation

A
  1. Avoid vigorous exercise
  2. Maintain normal levels of calcium, potassium, magnesium
  3. Meds: Beta blockers
  4. long term control w pacemaker
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22
Q

Medication of choice for QT Prolongation?

A

Beta blockers

  • blunt exertional heart rate
  • shorten QT interval
23
Q

Variable decelerations?

A

Umbilical cord compression
Oligohydramnios
Cord Prolapse

24
Q

What is the relationship bt PRL and thyroid hormone

A

TRH and Serotonin stimulate PRL

Dopamine inhibits PRL

25
Q

What antihypertensive limit ventricular remodeling

A

ACE Inhibitors

26
Q

Most effective parameter to estimate fetal weight in suspected Fetal Growth Restriction

A

Abdominal Circumference

27
Q

What will Biparietal Diameter be in FGR?

A

Asymmetric - Normal

Symmetric - Decreased

28
Q

Dx study for esophageal perforation

A

Contrast Esophagram shows leakage of contrast outside of esophagus

29
Q

How does esophageal perforation present

A

Sudden onset
Severe pain
Located retrosternally in neck, back, abdomen
Worse with swallowing

30
Q

What does CXR look like in esophageal perforation

A

Widened Mediastinum
Air in paraspinal muscles
Pneumomediastinum
Pleural effusions

31
Q

What does accuracy of a test measure

A

The true value of the test

32
Q

What does validity measure

A

Measures what it is supposed to measure

33
Q

What does precision measure

A

Reproducibility

34
Q

What are si/sx’s of dilated CM secondary to alcoholism

A

Thrombocytopenia
Macrocytosis
Elevated transaminases

35
Q

What can reverse CHF from Dilated CM

A

Alcohol abstinence

36
Q

How does digitalis work in Heart failure?

A

Systolic Dysfnc and rapid ventricular rates

  • Positive inotropic effect
  • Negative dromotropic - slows AV conduction
37
Q

What survival benefit does digitalis have in CHF

A

None.

Only tx for sx’s

38
Q

What are the MCC of neonatal jaundice

A

Breastfeeding jaundice
Breast milk jaundice
Heme conditions
Sepsis

39
Q

Presentation of neonatal sepsis

A 
Temp instability 
Poor feeding
Irritability/lethargy
Resp distress
Vomiting
Seizures
Jaundice 
Apnea
Cyanosis 
Bulging fontanelle
40
Q

Next step in management for suspected neonatal jaundice after CBC and BR levels

A

Blood cultures

LP

41
Q

What labs are seen in HUS

A 
MAHA
Thrombocytopenia
PS - schistocytes, giant platelets
Intravscular hemolysis= High LDH, Indirect BR, Retic count
High BUN/Cr
42
Q

When is BNP secreted

A

In response to ventricular stretch and wall tension when cardiac filling pressures are elevated

43
Q

What are high BNP levels indicative of

A

CHF
Level of correlates with:
- severity of LV filling pressure elevation
- mortality

44
Q

What is an S3 and when do we hear it

A

Soft
Diastolic
Tensing of papillary chordal apparatus when rapid influx of blood into ventricle in early diastole
Ass’d with elevated ventricular filling pressures

45
Q

Presentation of stress/hairline fx

A

Athletes - second metatarsal common

  • slow onset foot pain first with activity -> then with rest
  • Point tenderness over affected metatarsal
46
Q

What are Turner syndrome pts at risk of developing?

Why

A

Osteoporosis

  • Increased bone fx
  • Low estrogen from gonadal dysgenesis
  • Increased risk from one X
47
Q

How to differentiate follicular cancer from adenoma?

A

Follicular cancer = early hematogenous spread to lung, brain, bone
- demonstrate invasion of tumor capsule and blood vessels

48
Q

What does FNAB show in follicular cancer?

A

Large numbers

Normal appearing follicular cells

49
Q

Are papillary cancer and follicular cancers encapsulated?

A

Follicular cancer is

Papillary Not

50
Q

Which thyroid cancer secretes calcitonin

A

Medullary cancer of the thyroid

51
Q

Where do we see Hurthle cells

A

Both Follicular and Papillary cancer

- Hurthle cell carcinoma is a variant of follicular cell ca.

52
Q

What is the MC thyroid malignancy

A

Papillary thyroid cancer

53
Q

How does papillary thyroid cancer present

A

Slow, infiltrative spread

Psammoma bodies

54
Q

Papillary thyroid cancer - FNAB what is seen?

A

Large cells
Ground glass cytoplasm
Pale nuclei w inclusion bodies and central grooving

Mixed (19 decks)

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