My Pance Cardio

Front 1

tx for variant angina (prinzmetals angina)

Back 1

CCBs

Front 2

in inferior MIs, what artery usu involved?

Back 2

Right coronary artery (also supplies SA node and AV node so HR will usu decr)

Front 3

R coronary artery occlusion will cause ____ and ____ MIs

Back 3

inferior and posterior

Front 4

lead changes in II, III, and AVf..
what type of MI and what coronary artery

Back 4

inferior---RCA

Front 5

dresslers syndrome

Back 5

pericarditis approx 2 wks after MI

Front 6

post-MI complications

Back 6

PFARTS
Pericarditis, failure of heart, arrhythmia, rupture, thromboembolism, septal perforation

Front 7

first drug of choice in heart failure

Back 7

ACEi (b/c reduces afterload making it easier for L vent to pump & b/c inc GFR--deliver more blood to kidneys and more blood to kidneys=more fluid out)

Front 8

MCC of acute endocarditis of native heart valve

Back 8

staph aureus (suspect in IV drug abuser---will infect R side ie Tricuspid valve first)

Front 9

endocarditis: ____spots, ____lesions, _____nodes

Back 9

Roth spots (flame shaped hemorrhages on retina), Janeway lesions (painless), Osler nodes (painful)

Front 10

if suspecting angina/CAD, whats first thing you do

Back 10

stress test (but gold standard is angiography)

Front 11

is suspect endocarditis (fever + murmur), what must you get

Back 11

culture and sensitivity

Front 12

chest pain thats better if sit up and lean forward usu due to

Back 12

pericarditis (listen for pericardial friction rub)

Front 13

ST elevations in 2-3 limb leads & many chest leads (concave ST elevations)

Back 13

pericarditis (could be horrible MI too)

Front 14

rheumatic fever occurs after what type of infxn

Back 14

Group A strep (rheum heart disease not cont'd infxn; just immunologic response)

Front 15

Erythema MARGINATUM sign of?

Back 15

rheumatic fever

Front 16

most common manifestation of rheumatic heart disease (which occurs yrs after rheumatic fever)

Back 16

mitral stenosis (then aortic stenosis)

Front 17

dependent rubor but pallor when elevate leg

Back 17

arterial occlusive dz

Front 18

Acute arterial occlussion 5 Ps

Back 18

Pulseless, paresthesia, pallor, pain, paralysis

Front 19

elective surgery when AAA is ____cm

Back 19

5-6

Front 20

ankle brachial index of ____ indicates PAD?

Back 20

<0.9

Front 21

Color change in raynauds?

Back 21

white--> blue--> red

Front 22

tx for raynauds

Back 22

ccb's (the -pines, ie nifedipine)

Front 23

triad of aortic stenosis

Back 23

SAD (syncope c exertion, angina, dyspnea)

Front 24

sudden onset of sever chest paine radiating to back with new diastolic murmur...dx?

Back 24

aortic dissection

Front 25

pt with aortic dissection has BP of 180/102....begin infusion of?

Back 25

nitroprusside

Front 26

HTN stage 1 and stage 2

Back 26

stage 1: 140-160; 90-100
stage 2: >160; >100

Front 27

goal BP in diabetic and renal pts

Back 27

<130/80

Front 28

Major Risk Factors for CHD?

Back 28

1) smoking
2) HTN or on meds
3) low HDL
4) fam hx of CHD (M<55, F<65)
5) age (males >45, female >55)

Front 29

CHD risk equivalents (6)

Back 29

1) T1DM x20yrs
2) T2DM
3) AAA
4) symptomatic CAD
5) PAD
6) clinical CAD

Front 30

ALL lipid therapy (including fish oil) is contraindicated in

Back 30

pregnancy

Front 31

when starting lipid therapy (regardless is statin, niacin, fibrate, etc) when do you check LFTs

Back 31

check LFTs at 3 mo, 6 mo, yearly

Front 32

absolute contraindications to thrombolytic agents in MI (6)

Back 32

1) any hx of ICH
2) structural cerebral vascular lesion (ie avm)
3) malignant intracranial lesion
4) ischemic stroke in past 3 mo
5) suspect aortic dissection
6) closed head or facial trauma in past 3 mo

Front 33

NSTEMI due to cocaine...what's tx

Back 33

benzos (never give Beta blocker)

Front 34

Contraindications to exercise stress test (6)

Back 34

1) acute MI
2) unstable angina
3) uncontrolled HTN
4) severe aortic stenosis
5) decompensated CHF
6) dysrhythmia

Front 35

long QT interval vs short QT interval

Back 35

Long QT interval: HYPOcalcemia
Short QT internal: HYPERcalcemia

Front 36

saw tooth on ekg

Back 36

atrial flutter

Front 37

most common dysrhythmia in COPD

Back 37

multifocal atrial tachycardia

Front 38

suspect thoracic aortic dissection...what med to give first

Back 38

beta blocker

Front 39

1st intervention in cardiac tamponade

Back 39

IV fluids

Front 40

Becks triad: the 3 signs of cardiac tamponade

Back 40

JVD
Muffled heart sounds
Hypotension

Front 41

4 characteristics of tetralogy of fallot

Back 41

1. Pulm stenosis
2. vsd
3. overriding aorta
4. R vent hypertrophy

Front 42

most common cause of cyanosis in childhood/infancy

Back 42

tetralogy of fallot

Front 43

boot shaped heart on CXR

Back 43

tetralogy of fallot

Front 44

2 diastolic murmurs

Back 44

aortic insuff.
mitral stenosis

Front 45

mitral stenosis is primarily a result of

Back 45

rheumatic fever

Front 46

tx of kawasaki's dz

Back 46

gamma globulin/asa

Front 47

rib notching on cxr sign of

Back 47

coarctation of aorta

Front 48

aortic murmurs always louder when?

Back 48

sit and lean forward

Front 49

mitral stenosis murmur louder when in what position

Back 49

left lateral decubitus

Front 50

tx of afib if also has heart failure or hypotension

Back 50

digoxin

Front 51

in coarctation of aorta, where is BP higher....upper or lower extrem

Back 51

higher in upper extrem

Front 52

after one yr of age, what exam finding is most consistent with coarctation of aorta

Back 52

diminished or absent femoral pulses

Front 53

pregnant pt comes in with SOB and some palpitations. you hear mid-diastolic low pitched murmur with opening snap...whats likely dx

Back 53

mitral stenosis

Front 54

how to determine if left atrial abnormality present

Back 54

look at P wave of lead II: wide, M shaped, or diphasic

Front 55

wide QRS on EKG indicates

Back 55

LBBB

Front 56

target INR when anticoagulating for mechanical valve

Back 56

2.5-3.5 (usu 2-3 for other reasons such as afib)

Front 57

which antithrombolytic agent should be avoided in pts who have previously rec'd it?

Back 57

streptokinase

Front 58

blowing holosystolic murmur heard along left sternal border that is louder during valsalva. Afib on EKG. what valve problem?

Back 58

tricupsid regurg

Front 59

ST elevation in leads I, aVL, and V2-V6...where is MI

Back 59

anterior infarction

Front 60

prominent U waves on EKG...dx

Back 60

hypokalemia

Front 61

pt has Right bundle branch block and left hemiblock on EKG...dx

Back 61

myocarditis

Front 62

most common cause of myocarditis

Back 62

coxsackie virus

Front 63

how is heart sounds in Atrial septal defect

Back 63

fixed split of S2

Front 64

pt has orthostatic hypotension when drop in systolic BP of at least ___ OR drop of diastolic BP of at least ___ within 3 minutes of standing from sitting position

Back 64

20 drop in systolic OR
10 drop in diastolic

Front 65

common causes of cardiac tamponade

Back 65

malignant effusion, uremia, idiopathic pericarditis

Front 66

pt with CHF who is on digoxin develops afib, and you need to add amiodarone.. how should you adjust dosing of her meds

Back 66

dec dog by half when adding amiodarone (bc amiodarone inc serum levels of dig)

Front 67

what med should be used to control ventricular rate during rapid afib

Back 67

beta blockers

Front 68

recommended Na intake for pt with severe congestive heart failure

Back 68

maintain 1 g Na diet

Front 69

tx for paroxysmal supraventricular tachycardia

Back 69

vagal maneuvers, valsalva, carotid massage, THEN adenosine

Front 70

digoxin, verapamil, and propranolo can all cause what EKG abnormality

Back 70

mobitz I av block (bc they all slow signal at AV node)

Front 71

5 y/o with systolic ejection murmur at L upper sternal border with systolic click. EKG shows RVH. dx?

Back 71

pulmonic stenosis

Front 72

the murmur of what dx starts softly then gets louder after a few months

Back 72

VSD

Front 73

most common physical sign in pt with acute MI

Back 73

S4 gallop (infarcted myocardium becomes stiff)

Front 74

adverse rxn of thiazide diuretics...
___glycemia
___kalemia
___calcemia

Back 74

hyperglycemia
hypokalemia
hypercalcemia

Front 75

what coronary artery involved in lateral wall MIs (ST elevations in I, aVL, V5, V6)

Back 75

circumflex artery

Front 76

vtach...give shocks and if that doesnt help, give what med

Back 76

lidocaine

Front 77

in addition to diffuse ST segment elevation, what EKG abnormality is found in acute peridcarditis

Back 77

PR segment depression

Front 78

most common cause of pulseless electrical activity (PEA)

Back 78

hypovolemia

Front 79

echo shows pt has severe left ventricular dysfunction...what will decr risk of sudden cardiac death

Back 79

implant cardioverter-defibrillator device