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12 Cards in this Set
- Front
- Back
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What is tumor lysis syndrome? Which cancers are high risk? When does it occur? What special labs should be ordered? |
Acute renal failure that occurs after recent chemo. Most common with hematologic malignancies. BMP will show renal failure with an elevated URIC ACID & PHOSPHORUS.
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"SVT" encompasses multiple diagnoses...what are they (general explanation & then x2 specific)?
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1. SVT = any tachycardia resulting from above the AV node.
2. AVnRT (Atrioventricular nodal re-entry tachycardia) ~ 60% 3. AVRT (Atrioventricular re-entry tachycardia) 20% 4. Other: 20% |
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Describe the top three "20% other" supraventricular tachycardia accessory pathways (i.e. the rare ones)
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1. Kent bundle pathway (WPW--complete bypass of node & infranodal systems)
2. Mahaim bundle pathway (1/2 normal conduction & 1/2 accessory myocytes) 3. James fiber pathway (Lown-Ganong-Levine syndrome--intranodal pathway) |
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Verapamil is a 2nd line agent for supraventricular tachycardias, including WPW. (1) What is the dose and (2) what drug should you always have available when using verapamil? (3) Contraindications to verapamil?
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1. Dose = 2.5-5.o mg IV over 2 mins.
2. Always have Calcium chloride 500-1000mg IV available to treat the infamous verapamil induced hypotension. 3. Do not use in VT, Hypotension, severe CHF or severe COPD/Asthma. |
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Differentiate between Orthodromic and Antidromic AV nodal re-entrant tachycardias.
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All accessory pathways have the proper AV nodal tract and an accessory tract that are connected by cardiac myocytes...it all depends on how the re-entry occurs.
Orthodromic (narrow complex)= AV node entry & accessory path re-entry (80%) Antidromic (wide complex--looks like VT) = Accessory path entry and AV node re-entry (20%) |
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My ventricular rate is > 300; what is my EM physician's primary concern? What does he want to avoid at all costs?
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Oh crap, this isn't VT, this guy has a pre-excitation syndrome (i.e. WPW with 1:1 conduction--this could definitely convert into VF and should be cardioverted with procainamide 17mg/kg or electricity)
Avoid using Bblockers, Diltiazem / Verapamil or Adenosine |
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Why does procainamide treat a pre-excitation syndrome? |
It prolongs the refractory period of the accessory tract and breaks the cycle.
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Aflutter should trigger you to search for what?
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Underlying heart disease--usually ischemia but ddx should include PE, cardiomyopathy, myocarditis, blunt cardiac injury. (Note: AFlutter is sometimes a transitional rhythm when someone is developing Afib)
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List the 5 Congenital Cyanotic Heart Diseases and the hand mnemonic. |
Cyanotic = R-->L physiology; Recall the 5 T's.
1. Truncus arteriosis = Vessels join to make ONE 2. Transposition of the great vessels = TWO major vessels switched 3. Tricuspid atresia = THREE (tri-cuspid) 4. Tetrology of fallot = FOUR defects 5. Total anomalous pulmonary vascular return = FIVE letters (TAPVR) |
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List the 4 Congenital Acyanotic Heart Diseases.
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L-->R Physiology
1. Atrial septal defect (ASD) 2. Ventricular septal defect (VSD) 3. Patent ductus arteriosus (PDA) 4. Coarctation of the aorta (CoA) |
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What are the 5 kidney stones and which are most-->least radio opaque? |
The order of decreasing radiopacity is: 1. Calcium Phospate (most visible on Xray) 2. Calcium Oxalate 3. Struvite 4. Cysteine 5. Uric Acid (least visible) |
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What is the order to give drugs in thyroid storm and how does each drug work? |
Order: Propranolol-->PTU-->Iodine-->Dexamethasone
1) Glucocorticoids blocks the peripheral conversion of T4 to T3. 2) Iodine blocks the release of both T3 and T4 from the thyroid gland. 3) Thionamides, such as PTU or methimazole, block de novo thyroid hormone synthesis. 4) PTU (but not methimazole) also blocks T4 to T3 conversion. |
