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UW3 (2020) > UW3 (09 CV) > Flashcards

UW3 (09 CV) Flashcards

1
Q

Stain Myopathy

  • Stop indication? 2
  • Restart indication?
A
  • Symptomatic
  • Asymptomatic + CK> x10n

• Repeat CK = n + Asymptomatic

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2
Q
  • HoloSystolic murmur
  • L 3-4 ICS
  • Thrill
A

VSD

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3
Q

Acute PeriCarditis

  • Specific PE finding?
  • EKG findings?
  • Treatment? 2
A
  • Pericardial friction rub (specific)
  • Diffuse ST elevation, PR depression
  • NSAID + Colchicine (@ virus / idiopathic), Aspirin
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4
Q

STEMI bradycardia

Management? 3

A
  • Atropine + IVF
  • Pacing
  • PCI
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5
Q

Constrictive Pericarditis

  • PE findings? 5
  • US findings?
  • Treatment? 2
A
  • JVP ↑
  • Peripheral edema
  • Clear lung
  • Ascites
  • Pericardial knock
  • Pericardial thickening / calcification
  • Atrial enlargement
  • NSAID
  • Pericardiectomy
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6
Q

AAA
• Treatment? 2
• Surgery indication? 2

A
  • Stop smoking
  • Aspirin / Statin
  • Size > 5.5cm
  • Growth > 0.5cm/6m
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7
Q

Cardiac Tamponade

  • PE findings? 4
  • EKG findings?
  • XR findings?
  • Echo findings?
A
  • JVD + BP ↓ + Heart sound ↓ + sBP ↓ > 10 @ inspiration
  • Low voltage amplitude
  • Enlarged cardiac silhouette
  • Clear lung
  • RA & RV collapse
  • IVC plethora
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8
Q

3 different P wave form
Atria > 100 bpm

  • Diagnosis?
  • Medical treatment?
A
  • MultiFocal Atrial TachyCardia

* Verapamil / Esmolol

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9
Q

CABG indication? 2

A
  • Multivessel

* DM2

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10
Q

Atrial fib

  • Target HR?
  • Treatment class? 2 each?
A

• Target HR < 110 bpm

  • Metoprolol / Atenolol
  • Diltiazem / Verapamil
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11
Q

Coronary vessel distribution

1) Anterior wall
2) Lateral wall
3) Anterior & Lateral
4) RV + inf post LV

A

1) LAD
2) Circulflex
3) Diagonal
4) RCA

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12
Q

Pulmonary Hypertension

Treatment?

A

Bosentan / Ambrisentan

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13
Q

HCM

  • Initial medical therapy? 2
  • ICD indications? 6
A

1) Beta blocker
2) Verapamil / Disopyramide

1) Cardiac arrest
2) Ventricular tachycardia
3) FH sudden cardiac death
4) Syncope
5) Hypotension
6) LV hypertrophy

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14
Q

Trastuzumab

1) Use?
2) Toxic effects?

A

1) Treatment @ Her2 breast cancer

2) Reversible cardiotoxicity (LV-EF ↓, CHF symptoms)

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15
Q

STEMI

EKG indications? 5

A

1) 1mm @ all except V2+V3
2) 1.5mm @ V2+V3 (female)
3) 2mm @ V2+V3 (male > 40y)
4) 2.5mm @ V2+V3 (male < 40y)
5) New LBBB + Symptoms

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16
Q

Aortic Dissection

Management? 4

A

1) Pain control
2) Esmolol IV
3) + NitroPrusside
4) Surgery

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17
Q

CCB edema

1) Medication cause:
2) Mechanism?
3) Management? 2

A

1) Cause: Amlodipine / Nifedipine
2) Mechanism: Arteriolar dilation
3) Change to different meds (verapamil) Or add ACE-I

18
Q

EncoCarditis

• High risk indication? 5

Prophylaxis for:
• Gingival / Respiratory
• GU / GI
• Skin / Muscle / Prosthetic cardiac

A
  • Prosthetic valve
  • Prior infective endocarditis
  • Valve abnormality @ transplanted heart
  • Unrepaired cyanotic congenital heart disease
  • Repaired congenital heart disease with residual defect
  • Amoxicillin
  • Ampicillin
  • Vancomycin
19
Q

Mitral Regurgitation

Surgery indication?

A

EF < 60

20
Q

Cocaine OD

1) 2 conditions to r/o? What test?
2) Initial treatment?
3) Medication for chest pain?
4) Medication for HTN?
5) Management for MI?
6) Medication to avoid?

A

1) MI r/o = EKG & trop
Aortic dissection r/o = CTA / MRA / TEE

2) Benzo + Nitroglycerin
3) CCB @ chest pain
4) Phentolamine (alpha blocker) @ HTN
5) PCI @ MI
6) Avoid beta blocker

21
Q

TCA OD

  • Autonomic symptoms / PE?
  • Management?
A
  • Respiratory ↓
  • HR ↑ / Arrhythmia
  • BP ↓
  • Urinary retention
  • Flushing
  • Pupil dilation

1) O2 / Intubation
2) IVF
3) Activated charcoal
4) HCO3 @
Wide QRS
Ventricular Arrhythmia
5) Mg / Lidocaine

22
Q

A-fib (treatment)

1) No CAD/HD
2) LVH
3) CAD
4) HF
5) Recurrent / Refractory

A

1) Flecainide / Propafenone
2) Amiodarone / Dronedarone
3) Sotalol / Dronedarone
4) Amiodarone / Dofetilide
5) RFA

23
Q

RV MI

1) Medications to avoid? 3
2) Medications to caution? 2
3) Main therapy?

A

1) Nitrate / Diuretics / Opioids
2) Beta blocker / CCB
3) IVF

24
Q

HF w/o decomp or hypotension

1) Diuretic med?
2) Vasodilator med?

A

1) Furosemide

2) Nitroglycerin / Nitroprusside / Nesiritide

25
Q

Bicuspid Aortic Valve

  • XR findings? 3
  • Complications? 3
  • Follow up? 2
  • Balloon Valvuloplasty indication? 4
  • Valve replacement indication? 3
A
  • AV calcification
  • Aortic enlargement
  • Rib notching
  • Aneurysm
  • EndoCarditis
  • Regurgitation / Stenosis
  • screen @ family
  • FU echo q1-2y
  • Symptomatic
  • Asymptomatic
    • Aortic stenosis
    • No significant calcification
    • Gradient < 50
  • Severe symptoms
  • Aortic regurgitation
  • LV dysfunction
26
Q

Acute Limb Ischemia

1) Immediate complication?
2) Treatment? 2

A

1) Irreversible MyoNecorsis @ 4-6h

2) Heparin / Surgery

27
Q

Digoxin Toxicity

Synergic meds? 4

A
  • Quinine
  • Amiodarone
  • Spironolactone
  • Verapamil
28
Q

Hypertension

BP reduction impact? 5

A

1) Weight
2) DASH diet
3) Exercise
4) Na restriction
5) Alcohol reduction

29
Q

Varicose Vein

Management? 4

A

1) Leg elevation
2) Compression stocking (avoid @ PAD)
3) Weight ↓
4) Sclerotherapy (failed treatment 3-6m)

30
Q

Tachycardia + Palpitation
EKG: Narrow QRS

  • Diagnosis?
  • Management? 2
A

• SVT

  • Valsalva
  • Adenosine
31
Q

Cardiac risk for these surgery types?

  • Aortic
  • Major vessel
  • Vascular
  • Carotid
  • Head & Neck
  • Abdominal
  • Thoracic
  • Orthopedic
  • Prostate
  • Ambulatory
  • Endoscope
  • Breast

• When to do stress test prior to surgery?

A
  • High cardiac risk surgery
  • Intermediate cardiac risk surgery
  • Low cardiac risk surgery
  • High & Intermediate risk = cardiac eval (stress test)
32
Q

Unstable angina / NSTEMI

  • EKG finding?
  • Medical management? 5
A

• EKG: ST ↓ @ 2 + aVF + V3-V6

1) Aspirin + Clopidogrel / Prasugrel / Ticagrelor
2) Nitrates
3) Beta blocker
4) Statin
5) Heparin / Enoxaparin / Bivalirudin / Fondaparinux

33
Q

VTE @ post menopausal HRT

Management? 2

A

1) Stop: HRT

2) Start: SSRI / Escitalopram (symptom treatment)

34
Q

Cardiogenic Syncope
Types?

1) Exertional syncope / Systolic murmur
2) No prodromal symptom / Cardiomyopathy / Prior MI
3) Prodromal (fatigue / dizziness) / Sinus pause
4) Bifasicular block / ↑ PR + QRS drop
5) No prodromal symptom / QT ↑ / K↓ / Mg ↓

A

1) Aortic Stenosis / HOCM
2) Ventricular tachycardia
3) Sick sinus
4) AV block
5) Torsades

35
Q

Mechanical Valve

  • Targe INR 2-3? 2
  • Target INR 2.5-3.5? 5
A
  • AV valve replacement
  • No other risk Mitral valve replacement
  • fib
  • EF < 30%
  • Prior VTE
  • HyperCoag state
36
Q

Bi-Vent

Pacing indication? 3

A
  • EF < 25%
  • HF symptoms
  • QRS > 150ms + LBBB
37
Q

Peri-Op med
Complications?

1) Beta blocker
2) Alpha 2 blocker
3) CCB
4) Statin
5) Diuretics
6) ACE-I
7) SERM (Raloxifene, Tamoxifen)

A

1) Hypertension @ withdrawal
2) Hypertension @ withdrawal
3) ↑ Bleed
4) Myopathy
5) BP ↓ (stop @ AM surgery)
6) BP ↓ / Continue @ HF (stop @ PM before surgery)
7) Stop for 4 weeks

38
Q

Rheumatic Heart Disease

1) PE finding? Consistent with?
2) Complication at pregnancy?

A

1) Low pitch, Diastolic murmur, Loud S1 = mitral stenosis

2) Atrial fibrillation

39
Q

Aortic Coarctation

Xray finding? 2

A
  • Rib notch

* 3 sign @ aortic narrowing

40
Q

Warfarin interaction

  • Increases warfarin? 5
  • Decreases warfarin?
  • No changes to warfarin effect?
A
  • Metronidazole
  • Quinine
  • Antifungal – azoles
  • Amiodarone
  • Acetaminophen
  • Rifampin
  • Phenytoin
  • OCP
  • Green leaf veggie
  • NSAID
  • Clopidogrel
  • Ginko
41
Q

Aortic Stenosis

  • Severe indication? 3
  • Replacement indication? 3
A
  • Velocity > 4m/s
  • Press Grad > 40mmHg
  • Valve opening < 1cm2
  • Severe AS
    • symptom
    • EF < 50%
    • Future cardiac surgery
42
Q

Nitroprusside

1) Mechanism?
2) Indication? 2
3) Complication? S/s?
4) Increased risk?
5) Management?

A

1) Vasodilation @ artery & vein
2) Aortic dissection / Hypertensive emergency
3) Cyanide toxicity = flushing, cyanosis / headache / AMS seizure / Arrhythmia / metabolic acidosis
4) Nitroprusside @ kidney problem
5) ↓ infusion rate / Short term use
Stop use
Sodium ThioSulfate

UW3 (2020) (19 decks)

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