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66 Cards in this Set

  • Front
  • Back
PTT: Path, drug, reversal, dz's
Intrinsic pathway
Heparin
Reverse with Protamine
Hemophilias A, B,vWF DIC
PT: Path, Drug, Reversal, Dz's
Extrinsic Path
Warfarin
Reverse with FFP and Vit K
Liver dz, DIC, Vit K def.
Bleeding Time: Path, Drug, Reversal, Dz's
Platelets
Aspirin
Reverse with Platelet Transfusion
anti-Factor Xa Assay
LMW Heparin
Hemophilia A
Factor 8 deficiency
Hemophilia B
Factor 9 def
X-linked
PTT elevated
vWF
PTT and Bleeding Time Elevated
Normal Factor 8
Normal PT
AD
DIC
PT, PTT, Bleeding time prolonged
D-dimer
FDproducts
Schistocytes, fragmented on pfsmer
Vitamin K def
Neonate, malabsorption, alcoholism, antibiotics use

Factors 2, 7, 9, 10, C, S
Prolonged Bleeding Time
vWF
Uremia
DIC
Aspirin, Clopedogrel
Loud P2
Cor pulmonale
Also: tachypnea, clubbing, parasternal heave, right-sided S4, pulmonary dz
PVC's
Premature Ventricular Contraction
IF severe, give LIDOCAINE
Sinus brady
ATROPINE, if severe
usually post-MI
Sinus tachy
Correct cause
B-blocker if severe
Vfib
defibrillation
VTach
Amiodarone or
LIDOCAINE
WPW
procainamide or quinidine,

DONT use dig or verapamil (blocks AV node and makes reentry track the primary focus!)
PDA: murmer, location, tx, association
machine murmer
LSB
Tx: indomethacin unless cyanotic heart defect then give prostaglandin to keep open
VSD:murmer, location, tx, association
Holosytolic
Sternum
most resolve, if symptomatic repair surgically
MC heart defect
ASD: murmer, location, tx, association
Fixed, split S2
No fix
Asymptomatic until ADULT=ASD
TOF: description, tx, association
VSD, RVH, Pulmonary Stenosis, Overiding Aorta
tx: Surgery
Tet spells: squating to relieve SOB
Coarctation of Aorta
Systolic murmer
Mid-upper Back
Radiofemoral delay
Upper ext HTN
Rib notching on XR
Turner's Syndrome
Endocarditis prophylaxis
Only ASD secundum type doesn't need it of the heart defects!
Zollinger-Ellison Syn
Atypical non-healing ulcers, if 2nd part of duodenum think ZE
Gastrinoma is cuase, tx with PPI
Dumping syn
weakness, dizziness, sweating, N/V after eating
Achlorhydria
pernicious anemia
AB's to parietal cells
Intrinisic factor is diminished leading to VB12 def.
Dermatitis herpetiformes
Celiac Dz
Anti-TTG AB's
HUS:TTP
Post Diarrhea: Ecoli, Shigella
Schistocytes, helmet cells, fragmented cells on perfsmr
Acute Renal Failure
Alcoholic Hepatitis
AST2x>ALT
Autoimmune Hepatitis
Anti-smooth muscle AB's, ANA
Tx: STeroids
Wilson's Dz
Ceruloplasmin is low
High Cu in Pee
CNS and crazy
Kaiser-Fleisher rings laste in dz.
Penacillamine, zinc and trientine.
Cholestasis
Drugs:
OCP's, Pheonothiazines, androgens
Charcot's Triad
Cholangitis:
Fever
Jaundice
RUQ pain
Primary Biliary Cirhosis
Middle-Age women
Pruritis, Jaundice,
AntiMITOCHONDRIAL aBs.
tx: cholestyramine, liver tnplnt
Primary Sclerosing Cholangitis
Young Adults with IBD, Biliary tree all jacked up on imaging
Diffuse esophageal spasm/nutcrakcer
Irregular, forcefull contractions
Tx: CCB's, nitro, myotomy
CREST
ANCA
Scleroderm
Antitopoisomerase
Grey-Turner Sign
Black/Blue flanks: pancreatiis
Cullen's Sign
Black/Blue umbilicus: pancreatitis
Assymetric Septal Hypertrophy
MCDefect in Gestational DM:
Left Ventricluar septum hypertrophy secondary to gestational diabetes resulting in aortic outflow obstruction resluting in:
weak pulses, decreased cap refil, acidoisis, and hypoxia
Treatment of HOCM
Propranolol or metoprolol
Don't use inotropes!
Right Ventricular Infarct MGT
IV fluids, increase Preload!
DX: R sided heart failure, hypotension, V4 elevation
Drug MGT of ACS
Aspirin, then
Heparin, then
Beta Blocker (Meto or Ateno)
Acute Coronary Syndrome
Unstable Angina
NSTEMI
STEMI

Angiography will dicatate further mgt: if few vessel then PCTA w/wo stent. If many vessel CABG (also if DM)
Drug Management of Acute CHF
Furosemide
then inotropes
MGT of Acute Pulmonary Edema
Furosemide, Nitrates, and Morpine.
If this doesn't work give dobutamine to decrease afterload.

If hypotension from this give dopamine for pressor effect
ACS in young male on exertion
Anomalous Coronary Artery path, basically gets compressed by other vessels ie aorta during exercise.
Canon "A" Wave
Increased Wave in JVD
Caused by Complete Heart Block leading to Atrial contraction against closed Tricuspid valve
Idiopathic Hypertrophic Subaortic Stenosis
S&S, TX
Systolic Murmer
LSB
S4
Tx: Beta Blocker to increase size of ventricle (preload)
Treatment of Acute CHF
Lasix/furosemide
Morphine
Nitrates
Oxygen
Pulmonary Ventiliation
Treatment of Post MI Heart Block
Give Atropine, Then
External Pacer if this doesn't work
HOCM
S&S
Systolic Murmer, LSB radiates to carotids
Increased with Valsalva
Decreased with Squating
Brisk carotid upstrokes
SOB, Syncope, Sudden death
MGT of new onset AFIB
If Stable, then dig or beta, rate control
If unstable, cardioversion
MGT of Aortic Insufficiency
Reduce Afterload
ACE inhibitor
R/O MI in which patients with an echo?
Post MI
Pacemaker
LBBB
Digoxin
Dx of Subclavian Steal
Aortic Angiography, will show stenosis of subclavian and dilation, which steals blood from the vertebral artery that comes of of the subclavian distally.
Congenital Cyanotic Heart Dz
Transposition of Great Vessels
Truncus Arteriosis, double outlet, single ventricle, total anomalous pulmonary venous return
When to choose submaximal vs maximal stress test
Submaximal is when 70% of PHR is reached, use for 5-7 d post MI
Maximal is 80%, use 14-21 days postMI
MGT of Mitral Stenosis
Tx for Afib with Digoxin
Also anticoagulate with Warfarin
Last if this doesn't work, ballon valvuloplasty
Finally, replacement.
Diastolic Dysfunction
Start with BetaBlocker, unless they have COPD or Asthma
Then use CCB, verapamil
Aortic Stenosis
Replace valve if symptomatic
Watch if not
Papillary Muscle Rupture
Dx: S&S
TX
Pansystolic Murmer at apex radiates to axilla
12 hours post mi
Hypotension
TX: Surgery
Mitral Stenosis
sounds
Tapping apex beat
Diastolic
Middiastolic Rumble
Jervell-Lange-Nielson Syndrome
Recurant Torsades rhythm
Deafness
Congenital Long QT syndromes
TX:
Jervell-Lange-Nielson= Torsades+deafness
Romano-Ward=Torsades, no deafness
TX: high dose beta-blocker or gangliectomy