Dit - Cardio 1 & 2

Front 1

Fick principal--

CO=

Back 1

CO= HR X SV = rate of O2 use /(arterial O2 - venous O2)

Front 2

Mean Arterial Pressure eq

Back 2

MAP = CO X TPR =2/3 diastolic + 1/3 systolic

Front 3

What cardiac valve d/o has a widened pule pressure?

Back 3

Aortic regurg

Front 4

Left Anterior Descending
what does it supply
what EKG leads

Back 4

Anterior wall of left ventricle
V2, V3, V4

Front 5

Septal branch
what does it supply
what EKG leads

Back 5

anterior 2/3rds of Intraventricular septum
V1, V2, V3

Front 6

Circumflex branch
what does it supply
what EKG leads

Back 6

Left atrium, posterior and lateral wall of left ventricle
AvL, V5, V6

Front 7

Posterior Descending
what does it supply
what EKG leads

Back 7

Inferior wall of ventricle
II, III, AvF

Front 8

What are the recommendations for LDL levels in patients based on their CAD risk factors

Back 8

0 risk factors: LDL<160
1-2 risk factors: LDL<130
2+ risk factors, or CAD, DM, or PVD: LDL<100

Front 9

what are the risk factors for CAD?

Back 9

tobacco use
HTN
HDL<40
Family Hx of CAD in male <55 or female <65
Age male >45, female >55

(+) risk factor HDL>60

Front 10

HYQ: what is the MCC of death in pts with an acute MI?

Back 10

Arrhythmia, specifically V.fib

Front 11

what medications should be given for all post-MI pts?

Back 11

Aspirin
ACE-I
ARB:Spironolactone or Eplerenone
Beta-blocker : Metoprolol or Carbetalol
Clopidogril
Statin

Front 12

what medications should you give for an acute MI?

Back 12

MONA + BB + K +Mg
Morphine, O2, Nitro, Aspirin
Beta-blocker
K+ > 4
Mg >2

Front 13

QH: coronary arteries fill durring _______.

Back 13

diastole

Front 14

OCP, Diuretics and Testosterone have what effect on LDL and HDL?

Back 14

Increase LDL, decrease HDL

Front 15

How does Nitroglycerine decrease angina?

Back 15

It vasodilates, thereby decreasing preload and thus decreasing cardiac output

Front 16

A pt has chest pain that is relieved by nitroglycerine, is this angina?

Back 16

No, nitro will relieve cp d/t GERD and esophageal spasm

Front 17

A pt has chest pain d/t true angina, what is the next step?

Back 17

Cath, to assess the need for PTCA

Front 18

Whats the diff btw myalgias and myositis? which one is a possible s/e of statin use?

Back 18

Myalgias: muscle pain
Myositis: is assoc w/ statins: muscle inflammation with incr CPK

Front 19

What do you expect to see on an EKG in a pt with worsening angia that occurs at rest? What are the TX options?

Back 19

Unstable angina --> ST depression

TX options: ASA, clopidogril, GP2a3b, Heparin, O2, Nitro, B-blkers

Front 20

A post menopausal female comes in c/o an elephant on her chest, what do you expect to see on EKG?

Back 20

ST elevation and New Left BBB = MI

Front 21

What does every acute MI pt get?

Back 21

MONA + BB

Morphine, O2, Nitro, Asa, Beta-blker

Front 22

What should every post- MI pt be on?

Back 22

ASA, Beta-blker, ACE or ARB
clopidogril if stented
statin to stabilize plaque

Front 23

EKG shows PR interval greater than 1 big block

Back 23

1st degree heart block

Front 24

EKG shows PR interval gets longer, longer and drops a beat

Back 24

Wenckeback, 2nd degree type 1

"one-ckebach"

Front 25

Story Mnemonic for heart blocks

Back 25

1: pedro comes home late every night
2.1: pedro comes home later and later each night and some nights he doesnt come home at all
2.2: pedro comes home on time every night, but misses a night every once in a while
3: pedro is divorced

Front 26

Consistant PR interval with random dropped beats

Back 26

2nd degree type 2

Front 27

What is the diff btw PVCs and Vtach?

Back 27

>3 PVCs in a row is Vtach

Front 28

NS: in a pt with atrial fib, what needs to be done before cardioversion?

Back 28

a TEE to r/o mural thrombus formation

Front 29

S4 heart sounds are seen with _____ while S3 heart sounds are seen in _______

Back 29

S4: Stiffened ventricles, aortic stenosis, LVH

S3: dilated ventricles, CHF, Mitral regurg, MI

Front 30

The Valsalva maneuver increases ______ murmur and decreases _______ murmur

Back 30

Aortic Stenosis is decreased with valsalva b/c it increases afterload

Hypertrophic obstructive cardiomyopathy murmur is increased with valsalva

Front 31

which two drugs have been proven to decrease mortality in CHF?

Back 31

ACE-I
Spironolactone

Front 32

Holosytolic murmur radiating from the apex to axilla with S3 and mid-systolic click

Back 32

Mitral Regurg d/t Mitral valve prolapse

Front 33

Loud S1, opening snap after S2, and early diastolic rumble

Back 33

Mitral stenosis

Front 34

Bounding pulses, diastolic decresendo with late diastolic rumble (austin flint)

Back 34

Aortic Regurg

Front 35

Cresendo-decresendo that is decreased with valsalva

Back 35

Aortic Stenosis

Front 36

S4 heart sound and boot shaped heart on CXR, symptoms worse with exertion.

Back 36

Hypertrophic Obstructive Cardiomyopathy

TX: Beta-blockers

Front 37

S3 heart sound, Balloon shaped heart on CXR

Back 37

Dilated cardiomyopathy

TX: ACE-I

Front 38

HYQ: What is the difference btw a wandering pacemaker and Multifocal Atrial Tachycadia

Back 38

each have >3 diff P wave morphologies

MFAT has a rate >100
Wandering Pacemaker has a rate < 100

Front 39

HYQ: Which antiarrhythmic should be avoided in pts with preexisting lung disease?

Back 39

Amioderone - need to check PFTs, TFTs, and LFTs

Front 40

HYQ: What is the drug of choice for acute onset atrial fibrilation with Rapid Ventricular Rate (A.fib w/ RVR) in a pt with Wolf-Parkinson-White?

Back 40

Cardioversion or Procainimide

Front 41

HYQ: What is the classic appearance of a heart on CXR of a pt with pericardial effusion?

Back 41

Water-bottle

Front 42

HYQ: what would you see on PE of a patient with pericardial effusion?

Back 42

diminished heart sounds, difficult to palpate apical pulse

Front 43

HYQ: signs of heart failure + Diabetes mellitus + elevated LFTs?

Back 43

Bronze Diabetes: Hemachromatosis

Front 44

HYQ: diastolic murmurs are never pathologic, but what is the next step in the work up of a systolic murmur?

Back 44

Echocardiogram

Front 45

What is the acute treatment for exacerbations of congestive heart failure?

Back 45

LMNOP
Loop (lasix)
Morphine
Nitrates
Oxygen
Pressor - dobutamine