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Cardiology > Week 6 > Flashcards

Week 6 Flashcards

1
Q

What maneuvers increase the sounds of aortic stenosis

A

Squatting, leaning forward and valsalva release

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2
Q

What does aortic stenosis sound like and what confirms diagnosis

A

Systolic high pitched cresendo decresendo

Transthroacic doppler echo

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3
Q

What point should valve replacement be considered in aortic stensosi

A

Valve area <0.7cm
Valve gradient >50mmHg
Sx present
S4 sound heard

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4
Q

What is the only drug approved by the FDA for anticoagulation in valve replacement

A

Warfarin

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5
Q

What is the most common congenital heart anomaly in the US.

What is happenin?

A

Biscupid aortic valve

-aneurysm at the root of the valve

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6
Q

Most common cause of aortic stenosis

A

aortic sclerosis

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7
Q

What does mitral regurg sound like

A

high pitched, blowing, holosystolic

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8
Q

When is MR hemodynamically significant

A

S3 gallop present, rumble at apex

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9
Q

When to consider surgical repair for MR

A

when LV ESD >4.5 on echor EF <55%

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10
Q

Acute MR sx

A

NO LONGER HOLOSYSTOLIC! No is systolic decresencdo

abrupt pulmonary edema, severe hemodynamic compromise (tachypnea, dyspnea s4 gallop)

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11
Q

What is the most comon heart valve abnormality What does it sound like

A

MVP

Mid sysolic click, high pitched, blowing, cresendo decresendo

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12
Q

What are the 2 syndromes of MVP

A

Women 20-50 thin, atypical chest pain with palpitations and anxiety, no MR on echo

-Men 20-40 with valve leaftlet thickening and more likely to develop hemodynamically significant MR

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13
Q

What maneuvers allow you to hear MVP better

A

Valsalva, isometric handgrip, standing from squatting

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14
Q

What maneuver causes a derease in MVP sounds

A

squatting from standing and passive leg raise

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15
Q

What is the main treatment for MVP

A

Beta blockers, magnesium with tauren, CoQ10 with carnitine

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16
Q

What are the high risk patients for primary htn

A

HTN +DM+ Chronic kidney disease

17
Q

What is the #1 cause of secondary hypertension

what are some other causes

A

1: Renal artery Stenosis

  • meds(nsaids,thyroxine,snri,ndsri, amphetanmine,hrt,steroird,ginseng,licorice)
  • obstructive sleep apnea
  • endocrine disorders
18
Q

When to evaluate for secondary hypertension

A
  • onset prior to puberty
  • acute rise in well controlled patient
  • -svere and nonresponsive to therapy
  • age<30, not obsese,noFhx, non AA
  • malignant htn
19
Q

According to the JNC8 what are blood pressure goals

A

<140/90 for pts <60yo
<150/80 for pts >60yo
<130/80 for pts with DM and Kidney disease

20
Q

What is the formula to lower blood pressure safely

A

2/3 diastolic + 1/3 systolic, reduce MAP by 20-25% in 24 hours to avoid hemodynamic compramise

21
Q

What is the ER diagnosis to lower bp

A

30mg propanolol BID

22
Q

What medication decreases preload and afterload on the ventricles

A

Ace Inhibitors

23
Q 
List the follow blood pressures
Optimal
Pre htn
Stage 1 
Stage 2
A

Optimal: 120/80
Prehtn: 120-139/80-89
Stage 1: 140-159/90-99
Stage 2: >160/>100

24
Q

What is malignant HTN

A

Hypertensive retinopathy

Usually at diastolic >120

25
Q

Name some supplements for HTN

A 
Arginine
EFA
Coq10
B-complex
bonita fish peptids: ace inhibitor
garlic
capsicum
niacin
L-citroline
mangesium glycinate: calcium channel blocker
26
Q

First line acents for HTN

A

Thiazide diuretic
ACEI
Calcium Channel Blocker
Angiotension Receptor Blocker

27
Q

Dont uses ACEI with what?

A

ARBS

28
Q

Why dont oyu use CCB and BB together

A

bradycardia

29
Q

What drug use in African Americans

A

Thiazide duretic or CCB unless they have chrnic kidney disease then use ACE or ARB to protect the kidney

30
Q

What is first line in diabetcs and why

A

ACEI protect against protenuria or Angiotension receptor blockers

31
Q

What do BB increase risk of and when

A

stroke in older pts

32
Q

No comorbidities use

A

HCTZ, then EI or ARB then CCB

33
Q

African americans

A

HCTZ or CCB

34
Q

Chronic kidney disease

A

ACEI or ARB

35
Q

Stable angina

A

BB

36
Q

BPH

A

prazosin, otherwise never as first line dt increased risk of heart failure

37
Q

PCOS

A

spiranolactone

Cardiology (8 decks)

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