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50 Cards in this Set

  • Front
  • Back
What conditions can cause RBBB
– COPD
– valvular disease
– surgical repair of VSD
– think PE if combined w/ JVD
1st degree vs. 2nd degree AV block
– CCBs, B-blockers, vagal tone
– CCBs, B-blockers, dig, vagal tone
MAT
– from COPD and hypoxemia
– more than 3 p waves
– treat w/ verapamil or B-blockers
AVNRT
– A and V depolarize at the same time
– P is in QRS
– treat w/ carotid massage, valsava, adenosine
– cardioversion if needed
AVRT
– reciprocating tachy
– WPW can lead to this and its bad
– goes down AV node back to atrium via bypass
– may see retrograde p after normal QRS
– treat w/ carotid massage, valsava, adenosine
– cardioversion if needed
Paroxsymal atrial tachy dx
– adenosine turns off ventricular response to look at underlying atrial activity
PE EKG
– S1Q3T3 (v1 and III)
LVH and RVH criteria
– avL + V3 > 24 or 20 – V1 > 7
What 2 drugs do you give for Stage B CHF?
– ACEIs and B-blockers
RIL of ACEI side effects
– Rash
– indomethacin inhibition
– liver tox
At what EF should you start warfarin?
– 25%
Statin effect and SE’s
– decrease LDL and TGs
– potentiate warfarin
Fibrates mechanism, effect and SE’s
– Increases LL which increases VLDL and TG metabolism
– decrease TGs and increase HDL
– GI upset, gallstones, myositis, LFTs
Zetia (ezetimibe) mechanism, effect and SE’s
– inhibits cholesterol absorption
– decrease LDL
– angioedema
Niacin mechanism, effect and SE’s
– decreased fatty acid release
– decrease LDL and increase HDL
– paresthesias, pruritis, GI upset, LFTs
Blie Acid resins effect and SE’s
– decrease LDL
– Constipation, GI upset, LFTs, decrease absorption from other drugs
Unstable angina Tx
– g-2b3a inhibitors
– also heparin, angiography, and revascularization
Sequence of MI EKG changes
– peaked T
– STE
– Q waves
– T inversion
– ST normal
– T normal
Osmotic Diuretic SE
– Pulmonary edema
– cant give w/ anuria or CHF
Carbonic anhydrase inhibitor SE
– Hyperchloriemic acidosis
– neuropathy
– Ammonia Tx
– sulfa allergy
Thaiazide SE’s
– alkalosis
– hyponatremia
Dihydropyridines SE’s
– HA and flushing
– peripheral edema
HTN tx for people w/ isolated systolic HTN
– Diuretcs and long acting Dihydropyridines
– this is common in elderly men from decreased complicance
– HCTZ is the answer for this
PR interval in pericarditis
– PR depression in precordial leads
Beck’s Triad
– hypotension
– distant heart sounds
– distended neck veins
– this is w/ cardiac tamponade where you would also see electrical alterans
Conn syndrome acid base
– metabolic alkalosis (loose K so loose H too)
Renal artery Stensis tx
– angiography and stenting or surgery
– only give ACEI’s if unilateral disease b/c the preferentially dilate the efferent arteriole
AR murmurs
– high pitched blowing diastolic at 3rd L intercostals
– Austin Flint is low pitched mid diastolic
– midsystolic at the base
AR exam and Tx
– Wide pulse pressure and lateral PMI w/ R and L heart failure
– valve replacement and afterload reducers
Mitral stenosis treatment
– B blockers and diuretics
– tx any Afib
Mitral regurg treatment
– ACE’s, vasodilators, diuretics, dig and anticoagulation
Where are foot ulcerations w/ PVD?
– dorsal
PVD treatment
– Exercise, ASA, cilostazol, thromboxaine inhibitors
– if acute emboic, do an embolectomy and an Echo
Tx for newly diagnosed mitral stenosis in adolescents
– monthly IM penicillin
Why does HOCM lead to MR?
– the systolic anterior motion of the mitral leaflet
Aortic stenosis exam
– PMI is displaced and lateral
– can look like an MI
What do you give for V-tach w/ normal BP?
– Amiodarone (lidocaine is 2nd choice)
Variant angina treatment
– CCB’s or nitrates
– B-blockers and ASA can lead to vasospasm
– also avoid B-blockers in PVD and do CCB’s
How do you treat a CHF exacerbation due to Afib?
– Digoxin
Dig tox (and non-tox!) on EKG
– Atrial tachycardia w/ AV block
– Therapeutic levels can show ST depression, T wave inversion, and 1o AV block
Brady arrhythmia vs. tachyarrhythmia on EKG
– BBB and long QT, respectively
Cocaine MI tx
– benzos, nitrates, ASA
– dilt or pure alpha blocker ok too
Lone A-fib treatment
– just ASA is OK
Nitroglycerin mechanism
– dilated veins (capacitance vessels) to decrease preload
When do you do a dobutamine stress test?
– LBBB, WPW, idioventricular rhythm, STD > 1 mm
Leriche syndrome
– aortoiliac occlusion
– it leads to impotence
What normally causes Toursades?
– quinidine
Symptoms of Dig use
– N and V
– diarrhea
– vision change
– arrhythmia
How do you treat cardiogenic pulmonary edema?
– nitroglycerin to control symptoms
Endocarditis prophylaxis
– Amox or Clinda for dental and resp
– Amp (or Vanc!) and Gent for GI, GU