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72 Cards in this Set
- Front
- Back
silent MIs often occur in
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diabetic patients
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criteria for family history of CAD
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MI before age 40 in men
MI before age 55 in women |
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max heart rate =
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220 - patient's age
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inferior wall MI on EKG
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ST elevation in II, III, and avF
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cor pulmonale on EKG
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ST depression in II, III, and avF
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anteroseptal MI
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ST elevation in V1, V2, and V3
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lateral wall MI
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ST elevation in V4, V5, and V6
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Posterior wall MI
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ST depression in V1 and V2
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heparin does not
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dissolve clots already present;
rather, it prevents future ones from forming |
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LMW heparin is given
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SubQ every 12 hrs
PT/PTT does not need to be checked |
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Streptokinase
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is highly immunogenic
can't be used in the same pt twice within a 6 month period |
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58 y/o man who was discharged from the hospital after MI 2 weeks ago presents with fever, chest pain, and generalized malaise. EKG shows diffuse ST-T wave changes. Think:
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Dressler's syndrome
treat with NSAIDs |
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a 62 y/o smoker presents complaining of 3 episodes of severe heavy chest pain this morning. Each episode lasted 3 to 5 minutes, but now he has no pain. He has never had this pain before. Think:
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unstable angina
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A 62 year old man presents with frequent episodes of dull chest pain on and off for 8 months. He says the pain wakes him from sleep. Think:
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prinzmetal's angina
coronary vessels are angiographically normal |
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CO =
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SV * HR
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diastolic dysfunction
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accounts for 40-60% of heart failure
signs/symptoms of heart failure with normal EF more common in women ass. with HTN, left vent. hypertrophy, dilated cardiomyopathy, and ischemia treat the HTN |
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most common cause of RHF is
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LHF
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rule of 1/3s for viral or pregnancy-induced dilated cardiomyopathy
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1/3 get worse
1/3 stay the same 1/3 improve |
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RHF vs. cirrhosis
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signs are similar
pts with cirrhosis usually do not have trouble lying flat and will not have JVD |
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1st line therapy for acute pulmonary edema
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Nitro
Oxygen Morphine Aspirin Diuretic |
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restrictive cardiomyopathy vs. constrictive pericarditis
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do biopsy
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causes of paradoxical splitting (P2 occurs before A2)
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conditions that delay LV empyting
hypertrophic cardiomyopathy LBBB aortic stenosis |
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very few murmurs decrease with squattin
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hypertrophic CM does
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most common cause of viral myocarditis
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Coxsackie B
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pulsus paradoxus
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transient fall in measure BP > 10 mm Hg ass. with inspiration (due to reached SV during inspiration)
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tamponade physiology
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during inspiration, venous return to the RA increases. in tamponade, the transiently enlarged RA bulges leftward, reducing left ventricular volume and output, causing BP to fall with inspiration
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pericardiocentesis yielding clotting blood probably came from
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the RV, not the pericarial sac
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Kussmaul's sign
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failure of jugular venous pressure to fall during inspiration
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dilation of the LV is a major cause of
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a-fib
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balloon valvuloplasty in mitral stenosis
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is an effective intervention; it has a low incidence of restenosis, in contrast to aortic stenosis
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patient with mitral regurg has a good prognosis if
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LV function is preserved
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a young woman presents with atypical chest pain and mid-systolic click. Think:
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mitral valve prolapse
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Mean survival for patients with aortic stenosis and:
Angia --> Syncope --> Heart Failure --> |
Angina --> 5 years
Syncope --> 2-3 years HF --> 1-2 years |
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LV strain pattern on EKG
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ST segment depression and T wave inversion in I, avL, and left precordial leads (V5, V6)
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patients with aortic stenosis should be considered for valve replacement for:
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persistent symptoms
aortic orifice < 0.7 cm^2 body surface area gradient > 70 mm Hg |
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conditions with wide pulse pressure
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aortic regurgitation
hyperthyroidism anemia wet beriberi hypertrophic subaortic stenosis HTN |
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Acute valvular disorders (acute MR or AR) result in
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severe decompensation into CHF due to the absence of hemodynamic compensation; emergent surgery is required
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a rumbling diastolic murmur can be due to
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mitral or tricuspid stenosis; TS will increase with inspiration
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pt with a DVT has a stroke. he has a fixed S2 split. Think:
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ASD, right-to-left embolization
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right-sided bacterial endocarditis is most frequently associated with
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nonsterile technique in IV drug abusers
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a holosystolic murmur can be due to
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mitral or tricuspid regurg
VSD |
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#1 cause of death in patients with CHF is
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arrhythmia
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v-fib usually occurs after
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v-tach
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pt has hyperkalemia and peaked T waves: 1st step? why?
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calcium because is stabilizes cardiac membranes
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causes of prolonged QT
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QT WIDTH
WPW Infarction Drugs Torsades Hypokalemia, hypocalcemia, hypomagnesemia |
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cause of short QT
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hypercalcemia
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causes of Torsades
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POINTES
Phenothiazines Other meds (tricyclics) Intracranial bleed No known cause Type I antiarrhthymics Electrolyte abnormalities Syndrome of prolonged QT |
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causes of a-fib
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PIRATES
Pulmonary disease Ischemia Rheumatic heart disease Anemia, atrial myxoma Thryotoxicosis Ethanol Sepsis |
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this can be used to temporarily slow a rapid supraventricular rhythm
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adenosine
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Don't give these to someone with WPW. Do give this...
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don't give ABCD
adenosine beta blockers calcium channel blockers dig do give procainamide |
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causes of mobitz I
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inferior wall MI
dig toxicity increased vagal tone |
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causes of mobitz II
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inferior wall or septal MI
conduction system disease |
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causes of 3rd degree heart block
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inferior wall MI
dig toxicity conduction system disease |
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Bradycardia (one INCH)
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overmedication
inferior wall MI increased intracranial pressure normal variant carotid sinus hypersensitivity hypothyroidism |
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over 90% of HTN is
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essential or idiopathic
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HTN due to pheo
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is characterized by ectopic production of epi and NE causing wide swings in BP
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a 24 y/o woman with preeclampsia treated with IV drip of magnesium complains of difficulty breathing and has diminished reflexes. next step?
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stop magnesium and give IV calcium
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MAP =
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(2/3) (dBP) + (1/3) (sBP)
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nitroprusside can cause
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cyanide toxicity
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Type A aortic dissection
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involves ascending aorta and can extend to descending
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Type B aortic dissection
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involves only the descending aorta
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aortic dissection due to syphilis occurs because
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treponema infect the vaso vasorum of the aorta
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causes of arotic dissection
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PATC^3H
pregnancy aortic coarctation trauma cocaine, congenital, connective tissue HTN |
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always do this when you suspect MI
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get a chest film; some of these patients will have aortic dissection and thrombolysis may kill them
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strong association between strep bovis and
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colon cancer
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endocarditis prophylaxis is given to patients with valvular heart disease and those with a previous history of endocarditis 30 minutes prior to
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dental procedures
GI procedures urologic procedures |
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IV drug users:
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right-sided ABE most often affects the tricuspid valve, septic pulmonary emboli are common
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most common valve affected by rheumatic heart disease is
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mitral > aortic > tricuspid
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JONES criteria for Rheumatic fever
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Joints - arthritis
o - carditis Nodules- subQ nodules Erythema marginatum Syndenham's chorea |
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HDL level > 60
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is cardioprotective
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all isolated hypercholesterolemia is
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type IIa
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patients with very high TG levels (> 1,000) are at risk of
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developing pancreatitis
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