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Cardio > Valvular Disease and Arrythmias > Flashcards

Valvular Disease and Arrythmias Flashcards

1
Q

First line treatment in sinus bradycardia

A

Atropine

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2
Q

Constant PR prolongation

Tx?

A

First degree AV block

Tx: Observe

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3
Q

Mobitz I-wenckebach

A

Progressive PR lengthening followed by dropped QRS

Symptomatic: Atropine

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4
Q

Mobitz ii

A

consistent PR lengthening followed by dropped QRS

Management: Atropine vs. peramaent pacemaker

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5
Q

P waves not related to QRS

A

peramanent pacemaker

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6
Q

Regularly irregular

A

Atrial flutter- saw tooth appearance with no P waves

Stable–> vagal, B-blocker

Unstable: synchronized cardioversion

definitive: ablation

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7
Q

Irregularly irregular with narrow QRS

A

A fib- no P waves with rate of 80-140

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8
Q

Self terminating within 7 days usually less than 24 hours

A

Paroxysmal AF

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9
Q

Fails to terminate with occurance more than 7 days

A

Persistent

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10
Q

Pt in Afib and has asthma, what is treatment?

A

Diltiazem

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11
Q

Pt has hypotension and is in Afib w/ hx of CHF

Tx for rate control?

A

Digoxin

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12
Q

When is DCC done

A

if Afib is less than 48 hrs

after 3-4 weeks with anticoacuation and TEE shows no atrial thrombi

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13
Q

CHADVASC SCORE IS USED FOR

A

to determine if anticoagulation is appropriate in Afib

CHF
HTN
Age greater than 75
DM
Vascular disease 
Age 65-74
Sex-female
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14
Q

INR GOAL FOR WARFARIN

A

2-3

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15
Q

Stable narrow complex SVT–> HR greater than 100

Tx?

A

Adenosine

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16
Q

Stable wide QRS complex with ventricular rate of greater than 100?

A

SVT–> Amiodarone

17
Q

Unstable Vtach with a pulse

A

Synchronized cardioversion

18
Q

Sustained Vtach

A

Amiodarone

19
Q

VT with no pulse

A

defibrillation

20
Q

Peopel with hypertrophic cardiomyopathy are most likely to experience what ventricular dysarrythmia leading to death

A

Vtach

21
Q

What is the first line drug for chronic management of stable angina

A

Beta bockers

22
Q

What other therapy should be included in management of stable angina

A
  1. Beta blockers
  2. Nitrates
  3. Aspirin
  4. CCB
23
Q

Leg findings for WPW

A
  1. Delta wave
  2. Wide QRS
  3. Short PR interval
    Secondary to preexcitation of ventricles through accessory pathway
24
Q

Increased JVP with normal plum exam

A

Pericardial tamponade vs constrictive pericarditis

25
Q

Acute bacterial endocarditis vs. subacute

A

Acute is usually associated with staph and IVDA occuring in normal valves vs. subacute that is infection via strep viridans and affects abnormal valves

26
Q

Criteria for infective endocarditis

A

Duke criteria must have 2 major or 1 major and 3 minor

  1. Major: 2+ blood cultures and evidence of endocardial involvement documented by echo or new valvular regurgitation (aortic or mitral)
27
Q

Treatment for acute endocarditis

A

Nafacillin plus Gentamicin for 4-6 weeks

28
Q

Pt presents with painless lesions on the hands and feet. PE shows diastolic murmur at right upper sternal border. + Fever. Reports hx of drug use. What do you order? What valve is involved? What is tx?

A
  1. Cultures-3 sets 1 hour each a part
  2. Echo

Tricuspid is MC valve affected in IV drug users- tx with Vancomycin

29
Q

A person who has ischemic heart disease may show what finding on EKG

A

ST depression

30
Q

What is significant about acute coronary syndrome/unstable angina vs. stable?

A

Pain not relieved with rest/nitroglycerin

31
Q

Pt presents with positive ASO. Sx include joint pain, myocarditis, nodules, erythema marginatum, and chorea. PE shows loud S1-opening snap w/ systolic murmur heard best in left lateral decubitus. What do you suspect?

A

Mitral stenosis

32
Q

Signs of acute MR (etiology secondary to MVP MC, but acute probably related to ruptured choradae tendinae). and tx

A

Pulmonary edema due to volume overoad on LA, hypotension, dyspnea

Ech shows hyperdynamic LV

Cardio (4 decks)

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