Cardio Flashcards by Johannah Crumpton

What are the main EKG differences between a fib and multifocal atrial tachycardio (MAT)? What organ system is MAT associated with?

MAT:
-HR >100
-presence of at least 3 distinct P wave morphologies

P waves are NOT visible in afib

pulm conditions, especially COPD

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What is the MC PE finding in a pt with infective endocarditis?

heart murmur

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_____ condition put the patient at risk of developing nitrate-induced hypotension

aortic stenosis, volume depletion, RIGHT ventricular infarction, hypertrophic obstructive cardiomyopathy

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What is the hallmark finding of a right to left shunt?

supplemental oxygen fails to increase arterial oxygen level

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What is Eisenmenger Syndrome?

when a left to right shunt (VSD, ASD, or PDA) becomes a right to left shunt due to the change in pressure

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Which valvular heart disease most often causes syncope?

aortic stenosis

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What is the characteristic EKG finding of premature junctional contractions?

inverted P wave following the QRS

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What BP medications should be used in hypertensive emergency?

IV labetalol or nicardipine

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What is Kawasaki dz? What are the characteristics?

childhood (3 months to 5 years old) vasculitis that affects the medium-sized muscular arteries

prolonged fever and systemic inflammation

-fever for 5+ days
-bilateral nonexudative conjunctivitis
-oral changes (strawberry tongue, cracked red lips)
-peripheral extremity changes
-polymorphous rash
-cervical lymphadenopathy

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What is the tx of choice for Kawasaki dz?

IV immunoglobin

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What is the tx for acute pericarditis post-hospital?

taper off the ASA and continue colchicine for 3 months

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What 2 other conditions are commonly associated with vasospastic angina? What will their stress test reveal?

migraine headaches

raynaud phenomenon

exercise stress test is unremarkable

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What are the EKG finding during an active vasospastic angina attack?

TRANSIENT ST segment elevation or depression

can be made WORSE with IV ergonovine or acetylcholine

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Preg pt with a hx of frequent sore throats and ear infections as child with worsening dyspnea, orthopnea and lower extremity edema. What dx?

mitral stenosis

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What position is mitral stenosis best heard in? What side of the stethoscope?

best heard in the left lateral decubitus position

best heard with the BELL side of stethoscope

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What medication class should be avoided when treating cocaine induced chest pain? Why?

can have the opposite effect and may case vasoconstriction

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What HTN medication can cause hyperkalemia?

ace inhibitors

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pt at high risk for bacterial endocarditis scheduled for dental extraction. Pt is allergic to PCN. What abx?

doxy

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What are the 2 SEs of CCB?

HA and legs swelling

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What are 3 EKG findings seen with pericardial effusions?

low-voltage QRS

electrical alternans

sinus tachycardia

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Tall peaked P waves should make you think of what diagnosis?

right atrial enlargement

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What is the test of choice for a known AAA in an asymptomatic pt?

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What is the test of choice for a known AAA in a symptomatic pt?

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Boot shaped heart is associated with what dx?

tetralogy of fallot

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What are the 4 components to tetralogy of fallot?

pulm stenosis right ventricular hypertrophy overriding aorta ventricular septal defect

EKG shows diffuse ST elevations in almost all leads. What dx?

pericarditis

What EKG leads correspond to what arteries? Draw the chart

Pericardial knock is a PE finding associated with what dx?

constrictive pericarditis

What is a common complication found in pts with Brugada syndrome?

Ventricular fibrillation

inferior wall STEMI, what test should you order next?

right sided EKG

What EKG leads would you look at if you suspect a posterior MI?

to evaluate for posterior ST segment elevation if there were deep depressions in leads V1 and V2 with prominent R waves

What is pulsus alternans? What dx is it associated with?

Pulsus alternans is the presence of evenly spaced alternating strong and weak peripheral pulses. It is best appreciated by applying light pressure on the peripheral arterial pulse during blood pressure measurement. heart failure

Where is the SA node located?

right atrial wall think sick sinus syndrome

define pulsus paradoxus

fall in systolic BP by greater than 10 when the pt inhales

Describe cor pulmonale?

altered structure and function of the right ventricle

_____ is the equivalent of having a STEMI in the setting of acute chest pain

LEFT bundle branch block

_____ MC causes torsades de pointes

prolonged QT interval

Rheumatic fever is most likely to go to what valve?

mitral valve

_______ (valve abnormality) is most commonly associated with atrial fibrillation

mitral valve stenosis

Which cardiac abnormality is associated with an opening snap?

mitral stenosis

How does ASA inactive platelets?

Aspirin inhibits the synthesis of thromboxane A2, a potent stimulator of platelet aggregation.

sudden profound right heart failure and shock (jugular venous distention, hypotension and muffled heart sounds) after MI. What dx?

left ventricular free wall rupture

Pts with mitral stenosis and afib what medication?

warfarin with INR between 2-3 due to stroke risk of 7-15% per year

U waves present in an EKG, should instantly think ????

hypokalemia

What are the EKG changes seen in patients with hyperkalemia?

Symmetrical peaked T waves with a shortened QT interval and ST-T segment depression are the earliest ECG changes seen in patients with hyperkalemia. Worsening hyperkalemia results in progressive lengthening of the PR interval and QRS duration, disappearance of the P wave, and ultimately, widening of the QRS complex into a sinusoidal pattern

What dysrhythmia are patients with prolonged QT interval at risk for?

Torsades de pointes

What is the "classic" way to describe Prinzmetal angina?

chest pain in the early morning

Describe pericardial knock. What dx is it associated with?

heard after the aortic valve closes, caused by a sudden cessation of ventricular filling constrictive pericarditis

cocaine induced MI, what medication is CI?

What is the leading cause of dilated cardiomyopahty in central and south america?

chagas disease A protozoan infection with Trypanosoma cruzi.

What cardiac abnormality is associated with lithium or BZD use in first trimester of pregnancy?

Ebstein anomaly

What is Ebstein anomaly?

congenital cardiac malformation that occurs during fetal development, there is a failure of the tricuspid valve to form properly, resulting in downward displacement of the leaflets and incompetency of the valve. This leads to a relatively small functional right ventricle, tricuspid regurgitation, and eventually symptoms of heart failure.

What heart arrthymia is associated with Ebstein Anomaly?

Wolff-Parkinson-White Syndrome

What is the definition of first degree heart block?

PR interval greater than 200 msec

What is the MC type of primary cardiac tumor?

Atrial myxoma

What dx? No symptoms, what treatment?

second-degree type I atrioventricular (AV) block no symptoms, no treatment

Which three biomarkers, when elevated, increase the risk of death in unstable angina fourfold?

High-sensitivity troponin, C-reactive protein, and B-type natriuretic peptide.

What is the daily prophylaxis treatment for prinzmetal angina?

amlodipine

What does lying supine change about a still vs venous hum murmur?

when lying supine: still's murmurs get louder when lying supine: venous hum decrease (will be LOUDER when sitting)

how do you calculate cardiac index?

stroke volume × heart rate) / body surface area; < 2.2 L/min/m2 normal is 2.6-4.2

What congenital kidney condition predisposes patients to aortic dissection?

polycystic kidney disease

What ECG abnormalities are associated with hypokalemia?

T wave flattening and prominent U waves.

hallmark finding is increased left ventricular wall thickening (often asymmetric) in the absence of a hemodynamic cause (e.g., valve disease). Systolic anterior motion of the mitral valve and a hyperdynamic left ventricle are other findings that may be seen. What dx?

HCMO (this question in particular mentioned an infant when was sweating during feedings)

Where is the HCMO murmur best heard?

The murmur is usually best heard at the left sternal border or apex and is a harsh crescendo-decrescendo systolic murmur that increases in intensity with Valsalva maneuver and decreases with squatting.

_______ and ____ are associated with lower BNP levels

obesity and pericardial constriction

What is diagnostic criteria for POTS?

Diagnostic criteria for POTS include a sustained increase in heart rate of at least 30 beats per minute or heart rate ≥ 120 bpm within 10 minutes of standing up

What 2 beta blockers have the shortest half life?

Landiolol, with a half-life of about 3-4 minutes Esmolol, which has a half-life of approximately 9 minutes

_________ are preferred first-line antianginal therapy

beta-blockers

What two electrolyte imbalances are most commonly associated with torsades de pointes?

hypoK hypomagnesemia

What dx? What is the first line treatment?

torsades de pointes magnesium sulfate

What dx?

AV nodal reentrant tachycardia which is a type of supraventricular tachycardia

What dx? Pt has a pulse with unstable vital signs, What should you do next?

vent tachy synchronized cardioversion

What is the compression to breath ratio for high-quality adult CPR?

30:2

What dx? What is the most likely location of pathophysiologic conduction in this patient?

2nd degree heart block, type II His-Purkinje system

What PE findings are associated with HCM?

Physical examination may reveal a loud S4 gallop and a harsh midsystolic crescendo-decrescendo murmur

_______ antineoplastic medications is most likely to cause cardiac toxicity and precipitate heart failure?

doxorubicin

What is it called when the blood vessels are distended and the ventricles contract?

systole

An adult with a high risk for bacterial endocarditis is scheduled for a dental extraction. The patient has a history of penicillin allergy. What is the next abx of choice?

doxy

What is the initial treatment of calcium toxicity?

IV normal saline

Tall peaked P waves should make you think of what diagnosis?

right atrial enlargement

______ is the MC and most important predisposing risk factor for aortic dissection

hypertension

What common OTC pain medication is CI in pts with heart failure?

ibuprofen

What finding is shown in this xray?

calcified wall of an abdominal aortic aneurysm (AAA)

What is the another EKG finding in pericarditis besides diffuse elevated ST segment?

PR depression in II, aVF, V4-6

Inferior rib notching in a patient with coarctation is called the ______.

Roesler sign

What echocardiogram finding is common to see with mitral stenosis?

right ventricular hypertrophy The intracardiac narrowing of this condition hampers outward flow from the left atrium, causing a “pressure back-up” into the pulmonary circulation and ultimately the right heart which causes right ventricular hypertrophy

The ______ is a low-frequency, brief vibration occurring in early diastole at the end of the rapid diastolic filling period of the right or left ventricle. systolic or diastolic heart failure?

third heart sound (S3) associated with systolic heart failure

the most common cause of native valve endocarditis in a patient who does NOT use intravenous drugs is ________ especially in those with dental disease, as this organism is normally present in the oral cavity.

streptococcus viridans

Which of the following is the most common cause of tricuspid regurgitation?

elevated right heart pressure

Physical exam of a 1 day old infant reveals a loud, continuous murmur that is best heard at the left infraclavicular area and bounding, symmetric femoral pulses. What is the most likely diagnosis?

patent ductus arteriosus may also have widened pulse pressure

What is the MC complication of Kawasaki disease?

coronary artery aneurysm

What are the features associated with innocent murmurs?

grade ≤ 2 intensity, softer intensity when the patient is sitting compared with when the patient is supine short systolic duration, minimal radiation musical or vibratory quality

What is the MOA of nitrates?

reduces both preload and afterload

What are the features of Ebstein anomaly?

tricuspid regurg (a congenital heart defect in which the tricuspid leaflets attach to the right ventricular wall) large right atrium and small right ventricle

Ebstein anomaly is associated with what syndrome?

Wolff-Parkinson-White syndrome

What 3 PE findings are super super correlated with CHF?

presence of a third heart sound or S3 gallop hepatojugular reflux jugular venous distention

What is the most common side effect following administration of IV amiodarone?

hypotension

3 day old boy, cyanosis without exertion. What dx?

transposition of the great arteries

What is the MC complication of arterial switch operation?

pulm artery stenosis

What 3 electrolyte disturbances can cause torsades de pointes?

hypokalemia hypomagnesemia hypocalcemia

Does mitral regurg or tricuspid regurg increase with inspiration?

tricuspid regurg increases with inspiration

Which of the following antiarrhythmic medications is contraindicated in the setting of coronary artery or structural heart disease?

flecainide

What is the treatment for congenital long QT syndrome?

propanolol

His ECG shows consecutive large and wide QRS complexes. P waves cannot be appreciated. His pulse is 188 bpm. What dx?

ventricular tachycardia

Cardio Flashcards

(105 cards)