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28 Cards in this Set
- Front
- Back
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What is the treatment for right ventricular MI?
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volume expansion is the primary supportive tx.
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How you dx peripartum cardiomyopathy?
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Heart failure with LVEF <45% between 3 to 6 months after delivery without identifiable causes.
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When is biventricular pacemaker defibrillator indicated?
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in HF with EF of <= 35 % QRS > 120ms, and NYHA III or IV HF
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What is the sx/sx of pulmonary valve sternosis?
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prominent a wave in jugular venous pulse contour, a parastermal impulse, ejection click, a systolic thrill and early systolic murmur that increasing with inspiration.
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What is the treatment for HOCM that is refactory to medical tx?
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surgical septal myomectomy. in NYHA class III or IV
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What is the tx of HOCM?
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negative inotropic agents (i.e. BB)
chronotrophic agents diurectic. |
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What are the sx/sx of CAD in pt with cardiac transplantation?
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atypical. new onset HF, decrease exercise tolerance, syncope or cardiac arrest.
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What HF medications are contraindicated in pregnancy?
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ACEi, ARB, are contraindicated.
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What is the next step in tx for NSTEMI in pt experiencing ongoing pain despite standard medical therapy?
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Glycoprotein IIb/IIIa inhibitor should be added. (BB, CCB etc.)
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What is the initial treatment for pt with restrictive cardiomyopathy induced by hemochromatosis?
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Phlebotomy, if they cannot tolerate it, then iron chelation therapy.
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What is the tx for post MI pt with reduced EF <35-40%?
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optimized medical tx 1st. Implantable cardioverter-defibrillatory placement is indicated until 40days after infarction.
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How to evaluate recurrent (infrequent) syncope with structurally normal heart?
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implantable loop recorder shown to have greatest dx yield and cost effectiveness for infrequent syncope.
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What is the initial agent for the tx of viral or idiopathic pericarditis?
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high dose aspirin and NSAIDs
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What is the tx for recurrent episodes of pericarditis?
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Colchicine is the treatment of choice for acute abouts of recurrent pericarditis. Steroids is assciated with increased frequency of relapse.
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What is the treatment for cocaine-induced chest pain?
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Vasodilator and or CCB. b/c cocaine is a potent vasoconstrictor. BB is not used b/c of unopposed alpha agonism.
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What is bicuspid aortic valve associated with? (read my mind question)
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It is associated with >50% in pt with coartation. They should be monitored for aortic stenosis and AV regurgitation.
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what is Eisenmenger syndrome?
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Form of cyanotic congential heart disease characterized by irreversible pulmonary vascular dz d/t presence of long standing cardiac shunt.
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When is AV replacement indicated?
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For any symptomatic pts, regardless of age.
ASH (agina yrs, synope, HFyr) with 5, 2.5, 1 year mortality respective if no intervention. |
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When is AV replacement indicated?
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signs of hemodynamic effects or EF<55%, regardless of age.
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What diagnostic test to evaluate pt with intermediate risk for CAD?
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1st is exercise stress testing. If unable, then pharmacologic testing. (adenosine and dipyridomole are contraindicated in pt with bronchospastic dz.
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What is the alternative tx for HF pt who is intolerant of ACEi? (renal failure or hyperK+)
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Combination of hydralazine and nitrate is a suitable alternative.
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When is ICD placement indicated?
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For pt with ischemic or nonischmic cardiomyopathy and an EF of <= 35%, regarless of symptoms.
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What are the criteria for implantation of biventricular pacemaker?
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LVEF =<35% and
QRS >= 120msec and NYHA class III or IV symptoms on optimal med tx. |
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What is a prominent a wave may represent?
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pulmonary sternosis. likely 2nd to pulmonary valve sternosis
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What is the treatment of choice for pulmonary valve sternosis?
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Intervention is recommended for a gradient >50mm Hg or when right ventricular hypertophy is present. Tx is pulmonary balloon valuloplasty
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How to manage antiplatelet therapy following stent placement?
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Dual antiplatelet therapy with clopidogrel and ASA
1. for BMS: clopidogrel for min of 1 month, ASA indefinately. 2. for DES: clopidogrel for min of 1 year, ASA indefinately. |
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What is the managment of black pt with NYHA III or IV HF?
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addtion of hydralazine and isosorbide dinitrate to standard medical tx for black pts.
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How to manage anticoagulation during pregnancy in patient with mechanical prosthetic valve?
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Warfarin use throughout pregnancy until near term provide the lowest complication and death.
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