Cardiovascular FA > Uw 2 > Flashcards

Uw 2 Flashcards

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1
Q

Cholysterol crystal embolism - diagosis

A

Labs: leveated creatinine, eosinophylia, low complement
Eosinophiluria
Skin or renal biopsy

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2
Q

Approximate decrease in BP with life style modification

A
  1. Weight loss: 5-20 per 10 kg loss
  2. Diet with fruit + vegetables + low fat: 8-14
  3. Exercise: 30 min / d 5 days per week: 4-8
  4. Less than 3 g sodium /day: 2-8
    Less than 2 drinks in men and 1 in women : 2-4
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3
Q

Congenital artiriovenous fistula

A
  1. PDA
  2. Angiomas
  3. Pulmonary AVF
  4. CNS AVF
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4
Q

Medication withhold prior to cardiac stress

A

Hold for 2 days: b-blockers, CCB, nitrates
Hold 2 days prior to vasodilatory test: dypirodamole
Hold 12 h prior to vasodilatory test: caffeine
Continue: ACEi, digoxin, diuretics,statins

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5
Q

Classification of angina

A
  1. Classic: typical location quality and duration, provoked by emotional stress or exercise, relieved by rest or NO
  2. Atypical: 2/3
  3. Nonanginal: less than 2/3
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6
Q

Pretest probability for coronary artery disease

A
  1. Low: asynptomatic in all ages, atypical in women under 50
    Intermediate: atypical in men all ages,, atypical in women over 50, typical in women 30-50
    High: typical in men over 40 or men over 60
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7
Q

poor prognostic factors in systolic HF

A
  1. Qrs more than 120

2. LBBB

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8
Q

Characteristics of infectious endocarditis in IV drug users

A
  1. Increase risk in HIV +
  2. Fewer peripheral manifestations
  3. HF more common in aprtic valve involvement (rare in tricuspid)
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9
Q

Diagnosis of hypercholestermia requires

A

total cholesterol of > 200 mg/dL on two occasions.

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10
Q

Metabolic syndrome

A

increased waist circumference ≥94 cm (men) or ≥80 cm (women) plus any two of the following: increased triglycerides (>150 mg/dL), HDL cholesterol <40 mg/dL, hyperglycemia (fasting plasma glucose >100 mg/dL), and blood pressure >130/85 mm Hg or drug treatment for hypertension.

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11
Q

Screening tests for patients average risk - Breast cancer

A

mammo every 2 years at women 50-75

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12
Q

Screening tests for patients average risk - cervical cancer

A

pap every 3 years at 21-65

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13
Q

Screening tests for patients average risk - colon cancer

A

fecalt occult yearly or colonoscopy every 10 years at 50-75

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14
Q

Screening tests for patients average risk - HIV

A

antibody screen 1 time at 15-65

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15
Q

Screening tests for patients average risk - hyperlipidemia

A

men 35+ every 5 years

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16
Q

Screening tests for patients average risk - hypertension

A

BP measurements every 2 years at 18+

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17
Q

Screening tests for patients average risk - osteoporosis

A

DEXA (interval uncertain) at women 65+

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18
Q

lymphedema - clinical presentation

A

swelling, pain, heaviness
ear;y: soft skin, pitting edema
late: firm + thickened skin nonpitting edema

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19
Q

lymphedema - treatment

A
  1. weight loss
  2. limb elevation + compression
  3. physiotherapy
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20
Q

flu vaccine - recommendation

A

after 6 months in eveyy patient and should be given as soon as it is available in the fall

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21
Q

Mitral stenosis - heart sounds

A

loud S1, LOUD s2 IF PULM HYPERETENSION

- MID-DIASTOLIC RUMBLSE

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22
Q

vasovagal syncope - treatment

A

reassurance, avoid tigers, counter-pressure techniques for recurrent episodes (eg. leg crossing, handgrip)

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23
Q

supportive evidence for rnovascular disease

A

asymmetric renal size, abdominal bruit (diastolic + systolic)

  • Unexplained rise in serum Cr afte starting ACEi
  • unexplained atrophic kidney
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24
Q

Reversible RF for premature atrial contractions / treatment

A
  • tobacco + alcohol + caffeine + stress

- beta blockers are helpful in symptomatic

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25
wide complex tachycardia
AV dissociation? Fusiin/ ca[ture beats - YES: VT --> if stable give amiodarone, if unstable (hypotension, resp distress, alterend mental) --> synch cardioversion - NO --> SVT with abbereancy --> stable make maneuvers, unstable the same as VT
26
essential diagnostic sign for sustained monomorphic VT
fusion beats
27
chronic stable angina treatment
1. beta blockers 2. CCBs nondihydro 3. Dihydr CCB 4. Nitrates 5. Ranolazine
28
pericardiocentesis is indicated in
Pleural effusion and UNSTABLE
29
indications for synchronized cardioversions
hemodynamic instability deu to narrow or wide QRS complex tachyarrhytmia (AF, atrial flatter, VT with pulse)
30
drug that enlarge QRS if fast HR
class IC
31
malignant HTN?
more than 180.120 + retinal hemorrhage, exudatesor papilledema
32
hypertensice emergency?
Severe HTN with end organ complications
33
CHA2DS2-VASc score
``` IN NONVALVULAR: CHF (1) HTN (1) Age more than 74 (2) DM (1) Stroke/TIA/Thromboemb (2) Vasc disease (prior I. PAD, aortic plaque) (1) Age 65-74 (1) Sex: female (1) if 0 --> low risk, no antithromb therapy, 1 --> interm risk --> none or aspirin or antithromb 2 or more --> oral anticoagulatns ```
34
Aortic fibrilation - aware of pounding
left lateral decubitus --> brings the enlarged LV closer to the chest wall and causes pounding sensation and increased awareness of heartbeat
35
ascending vs descenting aneurysms are due to
asc: cystic medial necrosis desc: atheroscl
36
constrictive pericarditis - etiology
1. idioathic or viral pericarditis 2. cardiac surgery or radiation therapy 3. TB pericarditis (in endemic
37
constrictive pericarditis - diagnostic findings
1. ECG: nonspecific 2. Image: pericardial thickening and calcification 3. prominent x & y
38
adult tachycardia algorithm (with pulse)
assess appropriateness for clinical condition (HR more than 150) --> identify + treat underlying cause (maintain airway, assists breathing, O2, cardiac monitor) --> unstable (hypotension, mental, shock, ischemic, acute HF)??? YES --> sync cardioversion NO --> QRS more than 0.12 - if yes --> adenosine, antiarrhythmic infusion - no --> vagal, adenosine (if regular), beta block, CCB
39
prinzmental angina - treatment
preventive: CCB abortive: sublingual NO
40
labs evidence of poor prognostic Systolic HF
1. low Na+ 2. eelvated proBNP 3. Renal failure
41
ECG evidence of poor prognosis in Systolic HF
long WRS | LBBB
42
Reversible causes of asystole/PEA
5H: hypovolemia, hypoxia, Hydrogen ions (acidosis), hypo/hyperkalemia, hypothermia 5T: tension pneumothorax, temponade, toxins, thrombosis, trauma
43
predisposition for atypical symptoms at MI
1. women 2. elderly 3. MI
44
MI in right artery with Lung findings and apex murmur - think for .....
right MI and acute MR
45
adenosine in Wolf park white
NEVER
46
fibromuscular dysplasia - treatment
1. antihypertensive (ACEi) 2. percutaneous translumination angioplasty 3. surgery (if PTA son successful)
47
aortic stenosis in patients under 70
bicuspid valve | if older 70 --> senile calcification
48
HyperTG - management
- evaluation of 2ry causes - if less 150-500: lifestyle modification (and statin in cardiovascular risk) - if more than 1000: pancreatitis prevention (fibrates, fish oil, no alcohol) --> if drop more than 500 -> lifestyle modif
49
The most specific ecg finding in pericarditis
PR segment depression
50
Constrictive pericarditis - clinical signal
1. Kussmaul sign 2. Knock: extra heart sound in diastole from ventricular filling (the heart fioos to its maximum --> it hits the rigid pericaridum)
51
Leriche syndrome - manifestation
triad of erectile dysfunction, buttock + hip pain, absent femoral pulse
52
Vasovagal syncope - prodrome symptoms
nausea, pallor, diaphoresis
53
Guidelines for lipid-lowering therapy (general)
1. LDL more than 190 2. Clinically significant atherosc disease (ASC, angina, mi, stoke, TIA, PAD: if younger than 75: high intenisity, moderate for older than 75 3. age 40-75 with DM 40-75 4. estimated 10 years ASCVD risk 7.5% or more: moderate to high
54
LDL more than 190 - statin?
high-intensity statin
55
Statin in Clinically significant atherosc disease
ASC, angina, mi, stoke, TIA, PAD: - 75 or younger: high intenisity - older than 75: moderate
56
DM - statin?
if age 40-75: - 10 years ASCVD risk 7.5% or more: high intensity - 10 years ASCVD risk less than 7.5%: moderate
57
exertional heat stroke- clinical manifestation
core Q more than 40 immediately after collapse AND - CNS dysfunction - additional organ or tissue damage (Renal/hepatic failure/ DIC, ARDS)
58
exertional heat stroke - management
1. rapid cooling (ice immersion preferred) 2. fluids 3. electrolyte correction 4. management of end organ complications 5. NO ROLE FOR ANTIPYRETICS
59
AS - early vs late peaking of pulse
in moderate: early | in severe: late
60
murmur in severe AS
mid to late peaking
61
Sclerodermal renal crisis
- acute renal failure (without kidney disease) and malignant hypertension (eg. headache, blurry vision, nausea) (HIGH RENIN) - urinalysis: mild proteinuria - peripheral: microangiopathic hemolytic anemia + schistocytes and thrombocytopenia)
62
types of arrhythmia at 1st hour after MI
1. - immediate or phase 1a ventricular arrhythmias in first 10 mins 2. - delayed or phase 1b arrhythmias in 10-60 mins (reetrant arrhythmias)
63
anticoagulation in pericarditis
never --> hemorrhagic pericardial effusion
64
ventricula aneurysm - what else beside ST elevations
Q waves in the same leads
65
doctor - gifts form 3rd person?
only small gifts that benefits patients are acceptable
66
adult with meningitis wants to leave -->
hospitlize him and isolate
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