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MTB 4 Flashcards

(55 cards)

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1
Q

Presentation of Cardiomyopathy

A

SOB worsened on exertion
Edema
Rales
JVD

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2
Q

Best initial test for Cardiomyopathy

A

Echo

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3
Q

Most accurate test for Cardiomyopathy

A

Echo

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4
Q

TX for Cardiomyopathy

A

Diuretics

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5
Q

Etiology of Dilated Cardiomyopathy

A 
Previous MI 
Ischemia (MCC) 
Alcohol (2nd MCC) 
Postviral myocarditis
Radiation 
Doxorubicin
Chagas
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6
Q

MC Indication for heart transplant

A

Dilated Cardiomyopathy

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7
Q

TX for Dilated Cardiomyopathy that lowers mortality

A

ACEi/ARBs
Beta blockers - Metoprolol, Carvedilol
Spironolactone

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8
Q

TX for Dilated Cardiomyopathy to control Sx’s

A

Digoxin

Diuretics

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9
Q

TX for Dilated Cardiomyopathy if Wide QRS > 120

A

Biventricular Pacemaker

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10
Q

Hypertrophic Cardiomyopathy Etiology

Presentation

A

HTN
- Heart hypertrophies to carry excess load but has difficulty relaxing in diastole -> SOB - MC presentation
S4 Gallop
Fewer si’s of RSHF

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11
Q

HOCM Pathophys

A

Genetic - Chromosome 14
Abnormal septum shape
Asymmetrically hypertrophied septum obstructs bt septum and valve leaflet, blocking blood leaving the heart

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12
Q

What kind of motion is seen in HOCM

A

SAM - Systolic Anterior Motion

Abnormal MV leaflet motion

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13
Q

Presentation of HOCM

A 
Dyspnea - MC
Chest pain
Syncope/light headedness
Sudden death in athletes
Palpable S4 gallop
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14
Q

What increases HR

A

Exercise
Dehydration
Diuretics

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15
Q

HOCM sx’s are worse with

A

Increased HR

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16
Q

HOCM worse with

A

Decreased LV chamber size

  • ACEi/ARBs
  • Digoxin
  • Hydralazine
  • Valsalva and standing suddenly
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17
Q

Which population is HOCM more common in

A

African Americans

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18
Q

Murmur of HOCM

A

Same as MR
Palpable S4 gallop
Holosystolic obscures S1 and S2
Radiates to axilla

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19
Q

Best initial test HCM and HOCM

Findings

A

Echo

Septum is 1.5X thickness of posterior wall

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20
Q

TX for HCM and HOCM

A
  1. Beta blockers best initial tx
  2. Negative inotropes - verapamil, disopyramide
  3. Diuretics HCM ONLY
    - CI In HOCM
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21
Q

When do we use implantable defibrillators in HOCM

A

Any pt with syncope

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22
Q

When do we ablate septum in HOCM

A

Failure with meds

  • Catheter placed absolute alcohol in muscle causing infarctions
  • Surgical myomectomy if sx’s persist
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23
Q

EKG findigns in HOCM

Study These Flashcards
A

Septal Q waves - inferior and lateral leads

24
Q

Wrong answers for TX for HCM, but used in DCM

Study These Flashcards
A

Digoxin

Spironolactone

25
Difference bt HCM and HOCM
ACEi and diuretics do NOT help
26
Causes of Restrictive Cardiomyopathy
``` Sarcoidosis Amyloidosis Hemochromatosis Endomyocardial fibrosis Scleroderma ```
27
Pathophys of Restrictive Cardiomyopathy
Heart neither contracts nor relaxes normally | Immobility
28
Presentation of Restrictive Cardiomyopathy
``` Dyspnea RSHF si/sx's - Ascites - Edema - JVD - HSM ```
29
What sign is commonly seen in Restrictive Cardiomyopathy
Kussmaul sign - increase in JVP on inhalation
30
Best initial test Restrictive Cardiomyopathy
Echo
31
Most accurate test Restrictive Cardiomyopathy
Endomyocardial BX
32
TX for Restrictive Cardiomyopathy
Treat underlying cause | Diuretics for Pulm HTN, RSHF si's
33
What maneuvers decrease venous return to heart
Standing | Valsalva
34
What drug has similar effects as Standing and Valsalva
Diuretics
35
What maneuvers increase venous return to heart
Squatting | Leg raising
36
What impact does handgrip have on heart
Increases Afterload = Fuller LV = Decreased LV emptying Arm muscle contraction compresses arteries of UE - Brachial, Radial, & Ulnar. Obstructs ability of blood to empty the heart
37
MOA Amyl Nitrate
Direct Arteriolar Vasodilator = Increases LV emptying Like ACEi/ARBs Emptier LV
38
Etiology of Pericarditis
``` Infxn Inflamm Dz Connective tissue Dz Truam Cancer ```
39
MC Infxn in Pericarditis
Viral - Coxsackie B Strep Staph Fungal
40
MC Connective tissue Cause of Pericarditis | Others?
``` SLE Others: Wegener's Goodpasture RA PAN ```
41
Presentation of Uremic Pericarditis
Renal Failure pts BUN > 60 Diffuse STE NOT seen on EKG Inflammatory
42
TX for Uremic Pericarditis
Hemodialysis | Dialysis
43
EKG findings in Pericarditis
Diffuse, low voltage STE in all leads | PR depression = most specific
44
Pericardial Friction Rub
Scratching High-pitched sound 3 parts Heard best w diaphragm w pt sitting fwd at forced end expiration
45
TX for Pericarditis
Treat underlying cause Viral - NSAIDs, Ibu, naproxen, indomethacin Steroids if no improvement
46
Is Pericardial Tamponade an emergency
Yes. | Super Emergency
47
Etiology of Pericardial Tamponade
Causes of pericarditis Fluid extravasates and compresses chambers Starts on right side b/c walls are thinner
48
TX for Pericardial Tamponade
Emergent thoracotomy Needle pericardiocentesis Subxiphoid surgical drainage
49
Presentation of Pericardial Tamponade
``` HypoTN Tachycardia Distended neck veins Clear lungs Pulsus Paradoxus ```
50
How to differentiate bt Pericardial Tamponade and Pulmonary emboli?
Pericardial Tamponade has JVD. | Pulm. Emboli does not.
51
EKG of Pericardial Tamponade
Electrical alternans - varying heights of QRS complexes
52
CXR of Pericardial Tamponade
Enlarged cardiac shadow | Globular heart
53
Echo of Pericardial Tamponade
RA and RV diastolic collapse
54
Right heart catheterization of Pericardial Tamponade
Equalization of pressures in diastole
55
TX for Pericardial Tamponade
Pericardiocentesis IVF Hole/window placed in pericardium if recurrent
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