Random Cardiac Facts For Usmle Step 2

Front 1

1st line of tx for htn in a pt wiht no other complications

Back 1

thiazide diuretic

Front 2

pathophysiology behind edema in chf

Back 2

na retention
mechanical impedence of fluid removal

Front 3

pathophysiology of vasovagal syncope
sx
how is dx made

Back 3

excessive vagal tone
episodes preceded by sweating, nausea, tachycardia, pallor
tilt-table test

Front 4

sx of aortic regurg

Back 4

pounding hearbeat (assoc with waterhammer pulse)

laying flat and tunring onto left side makes heartbeat appear more forceful than it is, b/c it puts the heart closer to the chest wall

Front 5

things to check when giving amiodarone

Back 5

pft
lft
tft

Front 6

tx for hocm
meds that are contraindicated?

Back 6

bb and ccb

digoxin diuretics, and vasodilators

Front 7

when is a new S4 heard

Back 7

classic findings s/p mi

Front 8

what lab finding indicates rhabdo

Back 8

very elevated cpk

Front 9

dx of peripheral vascular dz

Back 9

abi (nml is >1, as it approaches 0, this is indication of worsening dz)

Front 10

describe process of cardiac remodeling

what inhibits this process

Back 10

s/p mi, ventricular remodeling occurs --> dilation of lv and thinning of ventricular walls --> chf

ace-i inihibit this remodeling

Front 11

complication of ventricular free wall rupture, when does it usually occur and what results

Back 11

pericardial tamponade, usually occurring after anterior wall mi
--> rapid onset pea

Front 12

how does body compensate for rapid onset pea seen in ventricular free wall rupture

tx

Back 12

tachycardia

pericardiocentesis

Front 13

complication resulting from intraventricular rupture

Back 13

vsd

Front 14

complications of papilary muscle rupture

Back 14

mitral regurg --> hypotension

Front 15

dx of cardiac tamponade

Back 15

echo is diagnostic and must be done

Front 16

recent h/o of uri --> sudden onset heart failure in an otherwise healthy person

Back 16

dilated cmp (from acute myocarditis)

Front 17

ekg findings of cardiac tamponade

Back 17

electrical alternans (beats in ekg go in different directions beat to beat)

Front 18

what happens to pressures in cardiac tamponade

Back 18

equalization of pressures intracardially and intrapericardially
ventricular filling is impaired with diastole as a result

Front 19

clinical findings in cardiac tamponade

Back 19

increased jvp
narrowed pulse pressure from decreased sv

Front 20

sx of dig toxicity

Back 20

n/v/anorexia
av block
afib

Front 21

initial tx for chf if sx

Back 21

diuretic + ace-i

Front 22

why should beta blockers be used post-mi

Back 22

they decrease mortality in post-mi chf

Front 23

ekg findings in svt

Back 23

loss of regular p waves, narrow qrs >140 bpm

Front 24

tx of svt

Back 24

if hemodynamically unstable, give cardioversion

if stable, vagal maneuvers, if they don't work, give adenosine

Front 25

pathophysiology of compartment syndrome

Back 25

edema or hemorrhage --> swelling inside a muscle comopartment, rising pressure inside the fascial compartment --> permanent nerve damage and muscle necrosis

Front 26

conditions when it is appropriate to use synchronized cardioversion

Back 26

svt
a fib
a flutter
monomorphic vt

Front 27

conditions when it is ok to use defibrillator

Back 27

vt or vf

Front 28

management for a pt in cardiac arrest with a non-shockable rhythm

Back 28

cpr

Front 29

causes of pea

Back 29

H: hypovolemia, hypoxia, H+ increase, hypothermia, hypoglycemia, hypo/hyperkalemia

T: tamponade, tension ptx, thrombus, trauma, tablets, toxins

Front 30

what electrolyte imbalance --> vt

Back 30

hypokalemia

Front 31

management of unstable pt with afib

Back 31

immediate cardioersion

Front 32

management of stable pt with afib <48 hrs

>48 hrs

Back 32

pharmacologic cardioversion

meds for rate control and anticoagulation

Front 33

what effect does hangrip have on aortic stenosis murmur?

mitral regurg?

Back 33

decreases murmur

increases murmur

Front 34

why do ocps --> htn

Back 34

they cause incresaed synthesis of angiotensinogen in liver

Front 35

management of a fib in a pt who is otherwise healthy and no other medical conditions

Back 35

asa

Front 36

pathophysiology of ruptured esophagus in the setting of trauma

Back 36

sudden explosive increase in intra-abdominal pressure against a closed glottis

Front 37

sx of ruptured esophagus

Back 37

severe cp
pneumomediastinum
subq neck crepitus

Front 38

sx of tracheobronchial rupture

Back 38

dyspnea, hemoptysis, ptx, pneumomediastinum

Front 39

describe the pathophysiology of aortic rupture and their managment

Back 39

if at ascending aorta, just above aortic valve, the prognosis is very very bad; there is heart damage and the pt will not survive

if rupture is in descending aorta distal to L subclavian, survival is slightly better. if pt survives, then a hematoma has formed that is contained within the mediastinum, preventing exsanguination. aortic lumen is compressed by hematoma and leads to pseudocoarctation and compresses recurrent laryngeal nerve

Front 40

ekg changes on ekg during active dissection

Back 40

none

Front 41

tx of the 2 types of aortic dissections

Back 41

type a (ascending): tx with labetolol and surgery

type b (descending): tx with labetolol

Front 42

describe rationale behind b-b in aortic dissection

Back 42

decresaes hr and bp, placing less stress on aortic wall

Front 43

tx for wpw

Back 43

procainabmide or quinidine
avoid digoxin and verapamil

Front 44

what hormones are released from adrenal medulla

Back 44

catecholamines

Front 45

what hormones are released from adrenal cortex

Back 45

mineralocorticoids, glucocorticoids, sex hormones