USMLE step2 > Cardiovascular > Flashcards

Cardiovascular Flashcards

(67 cards)

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1
Q

Best initial test for valvular disease

A

Echo

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2
Q

Most acurate test for valvular disease

A

Catheterization

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3
Q

Murmurs that do not inclease with expiration

murmurs thar increase with a decrease in preload(standing and valsalva)

A

HOCM

MVP

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4
Q

Drugs that decrease mortality in dilated cardiomyopathy

A

ACEi
ARBs
B-blokers(metoprolol,bisoprolol,carvidelol)
spironolactone(only in III-IV class)

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5
Q

drugs that decrease mortality in HTN

A

Diuretics
CCB
ACEIs
B-blockers

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6
Q

drugs that decrease mortality in ANGINA

A

ASA and B blokers

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7
Q

decrese preaload

A

standing

valsalva

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8
Q

increase afterload

A

hand grip

squad

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9
Q

cannon A waves

A

III degree block

right ventricle infarction

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10
Q

LBBB

A

QRS>200msec
deep S in V1 ,Tall R in I, V5,V6
NEW LBBB COULD BE ISCHEMIA

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11
Q

RBBB

A

QRS>200
RSR´ with wide R in V1
wide S in I,V5,V6

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12
Q

P Pulmonale

A

right atrial

P-amplitude >2.5mm in lead II

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13
Q

P mitrale

A

left atrial
wide P>120 msec in lead II
notched P waves in lead II

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14
Q

LVH EKG findings

A

S in V1 + R in V5 or V6>35mm

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15
Q

RVH EKG findings

A

right axis deviation

R wave in V1>7mm

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16
Q

holosistolyc murmur that increase with inspiration

A

tricuspid regurgitation

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17
Q

holosistolyc murmur ,radiates to axilaincreases with hand grip

A

mitral regurgitation

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18
Q

midsystolic murmur

A

Mitral valve prolapse

it increases with decrease in preload

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19
Q

CHADS

anticoagulation criterai for patients with AF

A 
WARFARIN IF CHADS>2
CHF(1 point)
HTN(1 point)
Age >75(2 points)
DM(1 point)
Stroke or ITA history(2 points)
Vascular disease(1 point)
Age 65-74(1 point)
Sex (female)(1 point)
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20
Q

Aacute AF causes:

PIRATES

A

PIRATES

  • pulmonary disease
  • Ischemia
  • Rheumatic heart disease
  • Anemia/Atrial mixoma
  • Thyrotoxicosis
  • Ethanol
  • Sepsis
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21
Q

most common cardiomyopathy

A

dilated cardiomyopathy

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22
Q

systolic ejection crescendo decresendo murmur that increases with standing or valsalva

A

HOCM

HCM

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23
Q

PCI critaria in unstable angina (TIMI)

A

TIMI>3

  • Age>65
  • Three or more CAD risk
  • known CAD(>50%)
  • ASA use in past 7 days
  • severe angina(2 or more episodes in 24 hours)
  • ST elevatio>0.5mm
  • positive cardiac markers
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24
Q

inferior MI

A

obtain a right-sided ECG

AVOID NITRATES

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25
posterior MI
obtain posterior ECG leads(V7-V8)
26
indications for CABG
unable to perform PCI left main CAD triple-vessel diase} depressed ventricualr function
27
2 hypertension mnemonic
CHAPS ``` cushing syndrome Hyperaldosteronism aortic coarctation pheochromocytoma Stenosis of renal arteris OCP ```
28
Hypertensive emergency tx
(>180/120 with end-organ damage) | IV labetalol, nitroprusside ,nicardipine)
29
Hypertensive urgency
PO medication B-blockers clonidine ACEIs
30
AAA Tx
>5.5cm Cx
31
Aortic disection Tx
A= Cx | B=B-blokers
32
PAD Dx
chronic= ABI(ankle-brachial index)
33
CAD risk factors
- DM(WORTS) - Tabacco - HTN(MOST COMMON) - Hyperlipidemia - Famili history(only parents and brothers)male45, women>55)
34
tako-tsubo cardiomyopathy
MI after overwhelming emotionally stressful event. angiography is normal echo=apical left ventricular balloning
35
drgs that decrease mortality in chronic angina
- ASA - B blockers(metoprolol,bisoprolol or cavedilol[non especific]) - nitroglycerin
36
most common cause of dead in CHF
arrhythmia/sudden death ( prevented with b-blockers)
37
worst CAD risk factor
DM
38
most common coronary disease risk factor
Hypertention
39
most dangerous hyperlipidemia
increse LDL
40
elevation of troponing following a overwhelming emotional stress
tako-tsubo diseae
41
p2Y12 inhibitor for angiplasty
ticagrelor or prasugrel
42
most common cause of death in ACS
ventricular arrhythmia(tachychardia or fibrillation)
43
inferor wall MI with sudden drop in BP after nitrates
IT IS A RIGTH VENTRICULAR INFARCTION | -give high volume fluid and avoid nitroglycerin.
44
most accurate test for CHF
multiple-gated acquisition scan (MUGA) or nuclear venticulography
45
implantable defibrilaltor indication inCHF
ischemic cardiomyopathy and ejection fraction below 35%
46
biventricular pacemarker indication in CHF
EF under 35% dilated cardiomyopathy and QRS above 120 milliseconds
47
most common cause of death in CHF
arrhythmias(sudden death)
48
dyastolic disfunction treatment
BB and diuretics
49
best inital test in pulmonary edema
``` EKG -AF -atrial flutter -Ventricular tachycardia DO SYNCHRONIZED CARDIOVERSION ```
50
valvualr disease best inital step and most accurate
best inital: echocardiogram | most accurate:catheterization
51
valvualr desease ¨general medical treatment
- All get better with diuretics | - REGURGITATION respong better to ACEIs or ARBS
52
surgical replasmetn indication for Mitral regurgitation
BIGGER HEART | LVESD above 40mm or EF below 60%
53
surgical replasment indication for Aortic regurgitation
EF less thatn 55% or LVESD greater than 55mm
54
increase mortality in CAD
``` CCB only used in special situations: -bblockers contraindicated(severe asthma) -princemetal angina -cocaine induced chest pain ```
55
auscultation association with ACS
S4 gallop | ischemia leading to nocompliance of the left ventricle
56
ST depressions in leads V1 and V2
suggestive of a posterior wall myocardial infarction
57
ABSOLUTE contraindications for thrombolytics
- mayor bleedin into the bowel or brain - recen surgery(within the last 2 weeks - severe hypertension(above 180/110) - Nonhemorrhagic stroke within the last 6 months
58
medication contraindicated in HOCM
Diuretics | will increase the obstruction
59
endocartis profilaxis with amoxicilin indication
- previous endocarditis - uncorrected cyanotid congenital heart disease - prostethis valves - repaired congenital heart disease with residual defect - valvulopathy in a transplanted heart MVP DOES NOT NEED
60
posterior stroke
- ipsilateral sensory loss of the face, ninth and 10th creneal nerve(VII,XI,X) - contralateral sensory loss of the limbs - limb ataxia
61
patient already on ASA during stroke
- add dipyridamole or switch to clopidogrel
62
magraine medicaitions contraindicated to convine
DO NOT CONVINE triptans with ergotamine
63
most single effective treatment for cluster headache
100% oxigen
64
SAH treatmetn
EMBOLIZATION its not present amoung teh answers chose clipping
65
most accurate test for guillian barre
nerve conduction studies/electromyography
66
msota ccurate test for miastenia gravis
alectromyography
67
best initial test for myastenia gravis
acetylcholine receptor Ab
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