Cv Ck

Front 1

Hypercholesterolemia LDL goals
0-1 risk factor

Back 1

LDL goal < 160
lifestyle changes > 160
consider therapy > 190

Front 2

Hypercholesterolemia LDL goals
2 or more risk factor

Back 2

LDL goal < 130
lifestyle change > 130
consider therapy > 160

Front 3

CAD or CAD risk equivalents

Back 3

LDL goal < 100
lifestyle change > 100
Consider therapy >130

Front 4

CAD risk equivalents

Back 4

symptomatic carotid disease
peripheral artery disease
abdominal aortic aneurysm
diabetes

Front 5

Risk factors for hypercholesterolemia

Back 5

smoking
hypertension
HDL < 40
family hx of premature CAD
men > 45
women > 55
HDL > 60

Front 6

Normal BP

Back 6

systolic < 120
diastolic < 80

Front 7

Prehypertensive

Back 7

systolic 120-139
diastolic 80-99

Front 8

Stage I hypertension

Back 8

systolic 140-159
diastolic 90-99

Front 9

Stage 2 hypertension

Back 9

systolic 160 or greater
diastolic 100 or greater

Front 10

Treatment for prehypertension

Back 10

non necessary

Front 11

Treatment for stage I hypertension

Back 11

thiazide diuretics for most
consider ACEI/ARB for mild renal disease

Front 12

Treatment for stage II hypertension

Back 12

two drug combination
usually thiazide + ACEI

Front 13

Stand/Valsalva

Back 13

decrease venous return

increased murmur w/ hypertrophic cardiomyopathy

decreased murmur w/ aortic stenosis

Front 14

Squat/handgrip

Back 14

increase venous return

Front 15

Inspiration

Back 15

hear right problems louder

Front 16

Expiration

Back 16

hear L problems louder

Front 17

Soft S1

Back 17

mitral/tricuspid regurgitation

Front 18

Loud S1

Back 18

mitral/tricuspid stenosis

Front 19

Soft S2

Back 19

aortic/pulmonic regurgitation

Front 20

Loud S2

Back 20

aortic/pulmonic stenosis

Front 21

Wide S2 splitting

Back 21

delayed pulmonic opening
increased oxygenation
increased right ventricular volume

Front 22

Narrow S2 splitting

Back 22

decreased oxygenation
decreased residual volume

Front 23

S3

Back 23

volume (dilated)

Front 24

S4

Back 24

pressure (hypertrophy)

Front 25

Mid-systolic click

Back 25

hear valve buckling during systole

Mitral valve prolapse

Front 26

Ejection click

Back 26

force valve open during systole
- Aortic stenosis
- Pulmonic stenosis

Front 27

Opening snap

Back 27

force valve open during systole
- Mitral stenosis
- Tricuspid stenosis

Front 28

S2 splitting

Back 28

normal on inspiration

Front 29

Wide S2 splitting

Back 29

delayed pulmonic valve

Front 30

Fixed S2 splitting

Back 30

ASD: L to R shunt

Front 31

Paradoxical splitting

Back 31

aorta valve closes later
- aortic stenosis
L BBB

Front 32

S3

Back 32

Tennessee

Dilated ventricle (estrogen stretches m apart, normal in teenage females)
Volume overload
Decompensated (heart gives out)

Front 33

S4

Back 33

Kentucky

Hypertrophied ventricle
Pressure overload
Compensation

Front 34

Radiation to neck

Back 34

aortic stenosis

Front 35

radiation to axilla

Back 35

mitral regurgitation

Front 36

radiation to back

Back 36

pulmonic stenosis

Front 37

Pre-eclampsia < 20 weeks

Back 37

hydatidiform mole

Front 38

Central venous pressure

Back 38

right atrial pressure (3-5 cm)

high: heart failure, cardiac tamponade
low: hemorrhage

Front 39

PCWP

Back 39

indirect measure of LA pressure (nrml = 12)

Swanz Ganz Catheter

High: volume problem
- pulmonary edema
- CHF

Low: resistance problem
- hypoxia
- fibrosis
- Phen-Fen
- ARDS

Front 40

Hypertension w/ BPH

Back 40

alpha blocker

Front 41

HTN w/ pregnancy

Back 41

hydralazine
alpha-methyl dopa
labetalol

Front 42

HTN w/ Angina

Back 42

Nitroglycerin

Front 43

HTN w/ MI

Back 43

Esmolol

Front 44

HTN w/ CHF

Back 44

ACE + Spironolactone

Front 45

HTN w/ peripheral vascular disease

Back 45

calcium channel blocker (decrease stroke volume and increase peripheral vascular resistance)

Front 46

HTN w/ atherosclerosis

Back 46

Ca channel blockers (decrease TPR) or thiazides

Front 47

HTN w/ osteoporosis

Back 47

hydrochlorothiazide (increase calcium)

Front 48

HTN w/ cocaine

Back 48

phentolamine

Front 49

HTN w/ opioid withdrawal

Back 49

clonidine

Front 50

HTN w/ renal failure

Back 50

ACE_I

Front 51

HTN w/ diabetes

Back 51

ACE-I

Front 52

Htn w/ gout

Back 52

losartan

Front 53

HTN w/ gout

Back 53

Losartan (pees out uric acid)

Front 54

HTN w/ pheochromocytoma

Back 54

Phentolamine

Front 55

HTN w/ lupus

Back 55

no Hydralazine

Front 56

HTN w/ scleroderma

Back 56

ACE-I

Front 57

Mitral regurgitation

Back 57

holosystolic murmur

Front 58

Holosystolic murmurs

Back 58

tricuspid regurgitation - IV drug abusers

Mitral regurgitation: mitral valve prolapse, endocarditis

VSD: increase on expiration (LV contracts harder)

Front 59

Pulmonary ejection murmur

Back 59

congenital, carcinoid, radiates to back

Front 60

Aortic stenosis

Back 60

aging calcification or bicuspid valve

- syncope, angina, exertional dyspnea
louder on expiration, leaning forward, making fist, BP cuf
hear less w/ valsalva, squat
radiates to neck, delayed carotid upstroke

palpable thrill in suprasternal notch

Front 61

Aortic regurgitation

Back 61

diastolic blowing decrescendo murmur

wide pulse pressure

Front 62

Tricuspid stenosis

Back 62

rheumatic fever, carcinoid syndrome

Front 63

Mitral stenosis

Back 63

rheumatic fever --> emboli, hemoptysis, loud S1

Front 64

Friction rub while breathign only

Back 64

pleuritis

Front 65

friction rub while holding breath

Back 65

pericarditis

knife-like pain relieved by leaning forward

Front 66

Transposition of Great arteries

Back 66

Aoritcopulmonary septum did not spiral

X ray: egg-shaped heart
Tx: alprostadil

Front 67

Tetrology of fallot

Back 67

turn blue when crying
squat after running
Tet spells determine
fatal w/o surgery

Front 68

Total anomalous venous return

Back 68

all pulmonary veins to right atrium

snowman x-ray

Front 69

Truncus arteriosus

Back 69

spiral membrane not developed
one A/P trunk, mix blood

Front 70

Ebstein anomaly

Back 70

Tricuspid sitting lower than normal
Mom's lithium increases risk

Front 71

Aortic atresia

Back 71

blood can't get out of heart

Front 72

Pulmonary atresia

Back 72

no blood to lungs

Front 73

Tricuspid atresia

Back 73

RA contractsharder
has FO/VSD

Front 74

Hypoplastic left heart

Back 74

Small LV
low BP
weak pulse
increased HR
aortic stenois
mitral stenosis

Front 75

Drugs that cause pulmonary fibrosis

Back 75

BBAT

Busulfan
Bleomycin
Amiodarone
Tocainide

Front 76

First degree AV block

Back 76

no problem at AV node

associated w/ increased vagal tone and beta blocker or CCB use

PR > 200 msec

Front 77

First degree AV block Tx

Back 77

None necessary

Front 78

Second degree AV Block I

Back 78

Progressive PR lengthening until a dropped beat occurs; PR then resets

Early ischemia at AV node

Front 79

Second degree AV Block I Tx

Back 79

None necessary

Front 80

Second degree AV block II

Back 80

unexpected dropped beats w/o change in PR interval

late ischemia at AV node

Front 81

Second degree AV block II tx

Back 81

Pacemaker placement

Front 82

Third degree AV block

Back 82

complete electrical dissociation

NO relationship btw P waves and QRS complexes

Tx: pacemaker placement

Front 83

Sick sinus syndrome

Back 83

abnormalities is supraventricular impulse generation and conduction

Front 84

Sick sinus syndrome tx

Back 84

pacemaker placement

Front 85

Atrial fibrillation

Back 85

no discernable p waves; irregular QRS response

Front 86

Atrial fibrillation tx

Back 86

1. anticoagulate > 48 hrs (time it takes for clot to form

2. Rate control w/ calcium channel blockers, beta blockers, digoxin, or beta blocker

3. cardioversion if new onset or after 3-6 weeks of warfarin tx

Front 87

Atrial flutter

Back 87

sawtooth pattern

Front 88

Atrial flutter tx

Back 88

anticoagulation and rate control w/ calcium channel blocker

Front 89

Multifocal atrial tachycardia

Back 89

three or more unique p waves

Front 90

Multifocal atrial tachycardia tx

Back 90

1. treat underlying disorder
3. verapamil or beta blockers for rate control

Front 91

Atrioventricular nodal reentry tachycardia

Back 91

atrium and ventricle depolarize nearly simultaneously

p wave often buried in QRS or shortly after

Front 92

Atrioventricular nodal reentry tachycardia tx

Back 92

1. try carotid massage or valsalva
2. adenosine
3. if unstable, cardioconvert

Front 93

Atrioventricular reciprocating tachycardia

Back 93

retrograde p wave seen after a normal qrs

Front 94

Atrioventricular reciprocating tachycardia

Back 94

1. try carotid massage or valsalva
2. adenosine
3. if unstable, cardioconvert

Front 95

Paroxysmal atrial tachycardia

Back 95

p wave w/ unusual axis before each normal qrs

Front 96

Paroxysmal atrial tachycardia tx

Back 96

adenosine to unmask underlying atrial activity

Front 97

Premature ventricular contraction

Back 97

early, wide QRS not preceded by a p wave, usually followed by compensatory cause

Front 98

Premature ventricular contraction tx

Back 98

treat underlying cause

if symptomatic, give beta blockers or other anti-arrhythmics

Front 99

Ventricular tachycardia

Back 99

three or more consecutive PVS's

Front 100

Ventricular tachycardia tx

Back 100

1. synchronized cardioversion
2. antiarrhythmics (e.g., amiodarone, lidocaine, procainamide)

Front 101

Ventricular fibrillation

Back 101

Total erratic wide-complex tracings

Front 102

Ventricular fibrillation tx

Back 102

Immediate electrical cardioversion

Front 103

Torsades de pointes

Back 103

Polymorphous QRS,

Front 104

Torsades de pointes

Back 104

1. Correct hypokalemia
2. Withdraw offending drugs
3. Magnesium
4. Cardiovert if unstable

Front 105

Acute congestive heart failure management

Back 105

Lasix
Morphine
Nitrates
Oxygen
Upright Positioning

Diurese w/ loop and thiazide diuretics

Front 106

Chronic congestive heart failure - drugs that reduce mortality

Back 106

beta blockers
ACEI
Aspirin