Cardiology

Front 1

Digitalis
1. Tx for
2. adverse effects
3. toxicity ->
4. what should you do for pt. chronically taking dig?
5. how is it cleared from body
6. causes of toxicity

Back 1

1. afib and HF
2. GI stuff (N&V, diarrhea), vision changes, and arrythmias
3. >ed ectopy and >ed vagal tone -> A. tachy + AV block
4. routine monitoring of dig levels
5. renally
6. viral illness, excessive diuretic use (loops -> hypokal -> dig tox)

Front 2

Diastolic dysfnxn:
1. what's wrong?
2. what is the cause
3. Tx
4. other manifestations
4. aka
5. chronically elevated LV pressure can cause what?

Back 2

1. impaired filling from poor myocardial relaxation or dimished ventricular compliance
2. HTN
3. diuretics, and antiHTNs
4. chronically elevated LV diastolic pressures -> LA dilation -> Afib
4. CHF w/ preserved or >ed Left EF (ie =/> 60%)
5. LA dilation -> Afib

Front 3

B-type natriuretic peptide
1. what does it Dx
2. what is the value that dxes this?

Back 3

1. CHF
2. > 100 pg/mL

Front 4

34 yo angina present w/ active sports and AS
1. what is most likely cause of AS?
2. how does the AS cause the angina?

Back 4

1. bc of age, congen. bicuspid aortic valve
2. severe AS -> large LV mass = requires additional O2 -> angina

Front 5

Prinzemetal's angina:
1. aka
2. cause
3. greatest risk factor
4. classic finding
5. ECG findings
6. Tx
7. meds that you shouldn't give
8. other vasospastic disorders assoc.d w/ varient angina
9. most accurate test

Back 5

1. variant angina
2. coronary vasospasm
3. smoking
4.pain @ night, wakes pt.
5. transient ST elevations
6. stop smoking + CCBs + nitrates (promote vasodil and prevent vasocnstrxn)
7. nonselective Beta blockers, and ASA bc they can -> vasocnstrxn
8. raynaud's phenom, and migraine headaches
9. ergonovine test

Front 6

*HY*
EKG shows ST elevation in II, III, and aVF:
1. what does this mean?

Back 6

1. inferior wall MI <- RCA occlusion

Front 7

what would giving lidocaine in ACS (angina or MI) do?

Back 7

> risk of asystole

Front 8

1.MCC of SBE? (damaged heart)
2. Acute endocarditis (normal heart valves)
3. GU procedures
4. upper Resp procedures
5. coag neg

Back 8

1. Viridans group streptococ, enterococci, staph epi
2. S. Aureus
3. enterococci
4. viridans strep.
5. staph epi

Front 9

Afib
1. EKG
2. MCC. other causes
3.Tx

Back 9

1. irreg irreg R-R w/ absent P waves and narrow QRS complexes
2. HTN. valv. heart dz, MI, HF, hyperthyr, and ROH (PIRATES)
3. Tx:
- unstable = (low BP, altered MS). Immediate cardioversion
- Stable:
< 48 hours: cardioversion
> 48 hours: 3-4 wk rate control and anticoag b4 cardioversion.
(Rate control beta blockers or CCB)

Front 10

SVT
1. EKG presentation
2. hemodynamically stable Tx
3. "" unstable TX

Back 10

1.tachycard + narrow QRS
2. vagal maneuvers followed by adenosine and AV nodal blockers
3. (dangerously low BP) emergent cardioversion

Front 11

clopidogrel uses:

Back 11

1. 2ndary prevention following UA/NSTEMI
2. following PCI - prevents thrombosis

Front 12

meds w/ mortality benefits post MI

Back 12

(SSAAB)
1. ASA
2. beta blockers
3. ACE inhibs
4. statins
5.K sparing diuretics (spiro)

Front 13

heat stroke
= clinical appearance
systemic effects:

Back 13

= >105 F. dehyd, hypOTN, tachycard, tachypnea.

can have systemic effects: seizures, ARDS, DIC, hepatic/renal failure

Front 14

V tach Tx

Back 14

- w/ stable BP: amiodarone or lidocaine
- w/ unstable BP: cardioversion

Front 15

what is the most important factor for the survival of pt. who collapses in street and has no pulse?
Leading cause of wtinessed out of hosp. cardiac arrests is?

Back 15

Time to defibrillation.
Leading cause of wtinessed out of hosp. cardiac arrests is Vtach, Vfib.

Front 16

how nitrates work in heart

Back 16

-> venodilation (ie dilation of CAPACITANCE vessels) -> blood to pool in systemic venous circ. -> <es preload -> <es ventric vol and stretch -> <es myocard O2 demand

Front 17

1. risk factors for aortic disxn
2. if HTN present what's the 1st thing you do?
3. when HTN is taken care of or not present?

Back 17

1. bicuspid aortic valve, pregnancy, coarctation of aorta, and marfan's syndrome
2. AntiHTN meds b4 dxic studies
3. TEE is initial investigation of choice

Front 18

PEA:
1. what is it?
2. tx
3. important to know
4. potentially treatable causes

Back 18

1. discernible rhythm (that isn't vfib or vtach) on cardiac monitor w/ NO palpable pulse
2. CPR and chest compressions, ABCs, and 100% O2, IV access for epi, atropine, and vasopressin
3. NOT A SHOCKABLE RHYTHM!
4. 6 Hs and 5Ts:
6Hs: hypo/hyperkal, hypoxia, H2 (acidosis), hypoglycemia, hypovolemia, hypothermia
5Ts: tablets (drugs), toxins, tamponade (cardiac), tension pneumothorax, thrombosis (MI, PE)

Front 19

atrial flutter
1. pattern
2. cause of pattern
3. classic symptoms
4. Tx

Back 19

1. saw-tooth pattern at rate of 300/min
2. RE-ENTRANT RYTHM FROM VARIABLE AV NODE CONDUCTION
3. palpitations, chest pain, sob, lightheaded
4. rate control w/ CCB, beta block; if meds don't work then cardiovert, if still doesn't work then ablate ectopic focus

Front 20

young, healthy person who develops CHF.
1. what is probable cause?

Back 20

1. myocarditis from viral infxn, coxsackie B is MCC

Front 21

cardiac tamponade:
1. becks' triad
2. pathophys

Back 21

1. hypOTN, JVD, muffled heart sounds.
2. pericardial space fills w/ fluid -> ventricles can't expand as much -> decreasing amount of preload

Front 22

aortic stenosis
1. typical symptoms
2. phys exam

Back 22

1. exertional dyspnea, syncope, angina
2. systolic ejxn murmur radiating to apex and carotid arteries

Front 23

PVCs:
1. morphology
2. Tx

Back 23

1. wide QRS (>120msec)
2. asymptomatic pt. : observation
symptomatic pt. : beta blockers

Front 24

-what is a bad prognostic factor in pt.s w/ HF?
-what can help control this?

Back 24

- hyponatremia indicates severe HF . also hypo/hyperkal can reflect activity of RAAS.
- <ing H2O intake (not >ing Na intake)

Front 25

Tx of aortic dsxn:

Back 25

1) Type A: ascending aorta : Tx = medical (labetolol) + Qx
2) Type B: descending : Tx = labetolol

Front 26

MS
1. MS -> changes in heart?
2. MS is commonly caused by
3. classic auscultative findings
4. ECG findings

Back 26

1. MS -> LA dilation -> afib -> thrombus embolizes -> stroke
MS -> >ed LA Press -> >ed pulmonary vascular Press -> hemoptysis
2. rheumatic dz
3. loud S1 and mid diastolic rumbling murmur at apex
4. irreg irreg rhythm and loss of P waves w/ afib

Front 27

*HY*
<ed CO + >ed PCWP : indicative of LV failure = ?

Back 27

indicative of LV failure = cardiogenic shock

Front 28

*HY*
SEs of thiazide diuretics

Back 28

hyperGLUC, hypoNaKal

Front 29

MR:
1. type of murmur
2. most common symptoms
3. indication of more severe MR
4. causes

Back 29

1. holosystolic murmur heard best @apex with radiation to axilla
2. fatigue and exertional dyspnea
3. dry cough <- pulmonary congestion and edema <- LV dysfnxn
4. rheumatic dz, infective endocarditis, trauma, ischemic heart dz, or HCOM

Front 30

HCOM
1. murmur
2. cause of syncope
3. what is seen on echo?

Back 30

1. systolic cresc-decresc on L. sternal border w/o radiation (helps differentiate from AS)
2. LV Hypertrophy
3. asymmetric septal hypertrophy

Front 31

dilated cardiomyopathy
1. cause
2. how do you Dx
3. what will you see on #2
4.Tx

Back 31

1. MC coxsackie B (others: parvo B19, HHV 6, adenovirus, enterovirus)
2. echocardio
3. dilated ventricles and diffuse hypokinesia -> systolic dysfnxn = low EF
4. supportive, management of CHF symptoms

Front 32

tx of cocaine-related cardiac ischemia

Back 32

benzos + ASA + nitrates (BAN)

Front 33

cardiac tamponade
1. signs
2. ECG
3. Tx

Back 33

1. hypoTN, tachycard, JVD
2. electrical alternans
3. massive vol resuscitation and emergent pericardiocentesis

Front 34

pt. on bed rest develops a cold leg w/ no distal pulses and mottled in appearance.
what do you do?

Back 34

Arterial occlusion:
-LMWH
-ECHO to dx thrombus

Front 35

HTNsive pt. b/l upper abdom. masses are palpated.
-what is this?
- what is this condition assoc.d w/?
-Dx?

Back 35

PKD.
also assoc.d w/ hematuria, 2ndary erythrocytosis, and RF.
Early Dx w/ abdo US

Front 36

acute mngmt of STEMI

Back 36

BMOAN
-reperfusion (thrombolysis or PCA)
- antiplatelet therapy
-morphine
-nitrates (contraindicated in certain circumstances see below*)
-beta blockers
*AS, recent PDE use, or RV infrxn (30% of inf wall MIs)

Front 37

Presentation and Tx:
1. LV STEMI
2. RV STEMI

Back 37

1. hypoTN and PE
BMOAN
2. hypoTN, JVD, clear lungs
IV fluid resuscitation to ? RV stroke vol. Nitrates are CONTRAINDICATED

Front 38

acute MI w/ muffled S1 and S2 and presence of S3. basilar crackles that extend 1/2 way up lung fields b/l:
1. what is it?
2. Next step?
3. what do you do after #2
4. what do you do after #3

Back 38

1. flash Pulm edema 2ndary to MI
2. furosemide = DOC
3. anticoag w/ hep
4. emergent PTCA or thrombolysis

Front 39

1. in what 3 scenarios do you do CABG?
2.common complication post CABG

Back 39

1. 3 vessels w/ @ least 70% occlusion, Left Main coronary artery occlusion, or 2 vessel dz in pt w/ DM
2.AF.

Front 40

Jervell-Lange-Nielson syndrome
1. what is this
2. tell me about it
3. possible complication
4.Tx.

Back 40

-congenital QT syndrome.
-Auto Recess + congenital deaf + QT prolong
-QT prolong -> torsades de pointes -> syncopal episode and sudden death
4. propanolol

Front 41

most effective nonpharm intervention to < BP?

Back 41

>ed fruit and vegies = DASH diet

Front 42

chest pain at night , chronic cough and hoarseness.

Back 42

GERD. Tx wih H2 antagonist or PPI

Front 43

when do you see JVD

Back 43

(4 Cs) CHF, constrictive pericarditis, cardiac tamonade, cor pulmonale

Front 44

HTN is defined as

Back 44

Normal pt: >140/ 90
DM or renal dz: >130/80
severe HTN: 160/100 = begin tx w/ 2 meds

Front 45

kussmaul's sign
=
when do you see it
Most accurate test

Back 45

rise of JVP on inhalation (from >ed venous return to heart on inhalation)
seen w/ constrictive pericarditis
CT or MRI -- look for thickened calcified pericardium

Front 46

pulsus paradoxus

Back 46

drop in syst. bp of >10 mmHG w/ inspiration
see it w/ cardiac tamponade, asthma, and emphysema
best initial therapy is bolus of fluid

Front 47

when do you do an angio?

Back 47

- cardiac stress test is abnormal
- prior to coronary surgery or angioplasty
-in ACS like unstable angina
(stenosis must be >70% to be significant)

Front 48

stable angina
1. ECG
2. stable angina + HTN Tx
- why use this as Tx?

Back 48

1. horizontal ST seg depression in stress test
2. beta blocker - will > threshold for anginal episod, control HTN, and is cardioprotective

Front 49

paroxysmal nocturnal dyspnea + long standing HTN + Pulmonary edema (cardiogenic)
1. what kind of HF?
2. what kind of dysfnxn
3. what drug can relieve dyspnea?
4. how does #3 work?
5. what are other mainstays of therapy for decompensated heart failure ?

Back 49

1. LVHF
2. diastolic
3. nitroglycerin (NTG)
4, rapidly reduces preload
5. loop diuretics (work by <ing total body volume)

Front 50

Neurocardiogenic syncope (ie vasovagal syncope):
1. common symptoms
2. usually preceded by
3. dx

Back 50

1. syncope precede by nausea, diaphoresis, tachycard, and pallor.
2. response to stress (medical needles), pain, or urination
3. tilt table

Front 51

dihydropiridine
1. what are they and examples
2. side effects

Back 51

1. CCB. any drug ending in -dipine. ex. nifedipine and amlodipine
2. peripheral edema and don't give if have kidney problems

Front 52

drug that can cause of peripheral edema:

Back 52

Dihydropyridines (CCB)

Front 53

massive PE
1. PE complicated by ___ &/or _____
2. symptoms
3. how do you know you have Part 2 of #1

Back 53

1. PE complicated by hypOTN &/or acute Right heart strain.
2. regular PE: dyspnea + pleuritic CP. Massive PE: Syncope
3. indic.s of right heart strain: JVD and RBBB

Front 54

what causes LV dysfunction?
what improves it?

Back 54

-tachycardia, neurohumoral activation, absence of atrial "kick" and atrial-ventricular desynchronization
-controlling rate and rhythm

Front 55

Infective endocarditis (IE)
1. major criteria
2. minor criteria
3. how many majors and minors are necessary for DX
4. non-cardiac complications and what causes them?
5. what do you do if kid comes in and probably already experienced prior episode of rheumatic fever?

Back 55

1. new murmur; >/= 2 positive blood Cx for org. (S. viridans, S. aureus); endocard involved on echo.
2. predisposing condition (prosthetic valve, IVDrugs); fever, vascular phenom (septic emboli); immuno phenom (glomerulonephritis); or 1 + blood Cx
3. 2 major; 1 major & 3 minor; or 5 minor
4. immune-complex deposition w/in tissues -> JONES (joint, heart,nodules, erythema, syndenham's )
5. give Abx prophylaxis of penicillin (if kid do it until pt. is 18 yo)

Front 56

Pt. comes in w/ heart attack. Had PMHx of eczema and occasional dyspnea w/ coughing. hospitalized and on day 2 of treatment complains of SOB. PE shows b/l wheezing and prolonged expiration. what caused current resp. symptoms

Back 56

Drug SE of metoprolol. PMHx of eczema and dyspnea shows possible asthma.
beta blockers can exacerbate Asthma and COPD

Front 57

1. what is Dxic for malignant HTN
2. what is responsible for pathologic change in end-organ damage in malig HTN

Back 57

1. BP >/= 200/140 mmHg + presence of papilledema
2. fibrinoid necrosis

Front 58

best drug Tx for endocard w/ Strep viridans?

Back 58

if it is sensitive for pen:
IV pen G or IV ceftriaxone (NEVER TX ENDOCARD W/ ORAL ABX!)

Front 59

Acute Mitral regurg:
1. cause
2. Tx of #1
3. common sequela of MR
4. wht would PCWP show?

Back 59

1. papillary muscle dysfnxn in acute MI
2. emergent Qx
3. PE (orthopnea and bibasilar crackles)
4. >ed P in LA

Front 60

Causes of peripheral edema assoc.d w/
>ed cap hydrostatic P

Back 60

1. HF (LV or cor pulmonale), primary renal Na retention (renal dz, drugs, pregs), venous obstrxn (cirrhosis, acute PE and venous insuff.)

Front 61

Cause of peripheral edema from hypoalbuminemia (<ed oncotic P)

Back 61

protein loss (nephrotic synd and GI tract losses)
<ed albumin synth (cirrhosis and manlnutrition)

Front 62

causes of peripheral edema assoc.d w/ >ed capillary permeability

Back 62

- burns, trauma, and sepsis
- allergic rxns
- ARDS
- Malignant ascites

Front 63

Causes of peripheral edema assoc.d w/ lymphatic obstrxn/ <ed oncotic P

Back 63

malignant ascites, hypothyroidism

Front 64

How to tell btwn MI and gerd from presenting symptoms

Back 64

MI will have diaphoresis and SOB, GERD won't
also S4 is a classic finding of MI

Front 65

HTN + ^Ca (stones, bones, psych overtones)

Back 65

hyperparathyroidism is an uncommon cause of 2ndary HTN

Front 66

How does COPD -> pitting edema?

Back 66

COPD (chronic hypoxemia) -> cnstrx of pulmonary arteries -> pulm HTN, RVH, and RVF (cor pulmonale)

Front 67

Right heart failure:
1. ECG
2. how to confirm?
3. signs that point to RV failure
4. how does RV fail affect preload?
5. Tx
6. drugs to avoid

Back 67

1. ST elevations in inf. leads = inf infarct = RV. and ST depression in leads I and AVL (left most leads) = STEMI affecting R side of heart
2. do a right sided ECG
3. JVD + Kussmaul's sign (>ed JVD w/ insp) + clear lung fields
4. <ed preload -> <ed CO and HYPOTN
5. IV fluids to maintain preload and BP
6. nitrates and diuretics

Front 68

pt w/ hyperthyroid-related afib, what's DOC?

Back 68

beta blocker

Front 69

3 mechanical complications of MI. when they happen. what you see with each

Back 69

1. Papillary muscle rupture : 5 days. -> MR (will hear holosytolic murmur loudest @ apex w/ rad to axilla)
2. LV free wall rupture : day 3-7. Majority are w/ Ant wall MI, Tamponade -> PEA is common of LV free wall rupture
3. interventricular septum rupture : 5 days. -> VSD (new onset holosystolic murmur. no PEA)

Front 70

AAA:
-rad of choice for Dx
- " " "" follow up

Back 70

Abdo US for both

Front 71

MVA pt. driving car w/o seatbelt in (ie blunt chest trauma) w/ JVD, tachycard, and hypoTN despite fluid resusc.
1. DX
2. CXR findings

Back 71

1. cardia tamponade
2. normal cardiac silhouette w/o tension pneumothorax

Front 72

End stage renal dz Hemodialysis :
1. absolute indications
2. contraindications

Back 72

1. (1) fluid overload not responsive to medical Tx (2) hyperkal not responsive to medical mngt (3) uremic pericarditis (4) refractory metab acidosis
2. severe irreversible dementia

Front 73

1. MCC of 2ndary HTN?
murmur assoc.d w/ it?

Back 73

1. Renal artery stenosis,
2. periumbilical

Front 74

1. asymmetrically elevated BP in left arm suggestive of
2. Asymmetrically elevated BP in Right arm or arms>legs

Back 74

1.subclavian Artery stenosis
2. coarctation of aorta

Front 75

Dxing PAD in high risk or syptomatic pt.s

Back 75

ABI using Doppler

Front 76

kussmaul's (K) vs pulsus paradoxus (PP)
1. event
2. mechanism
3. Dz assoc.d w/

Back 76

1. K = JVD w/ inspiration; PP = >ed SBP by > than 10 mmHg on inspiration
2. K = <ed capacitance of RV; PP = <ed capacitance of LV
3. K : constrictive pericard >> cardiac tamp
PP : cardiac tamp >> const pericard

Front 77

Outpatient treatment for CHF

Back 77

SAAB DL
spironolactone, ACEi, ASA, Beta block, Digox (maybe), loop (furos)

Front 78

Acute Tx of exacerbations of CHF

Back 78

LMNOPP
Loop, morphine, nitrate, O2, Pressors (dobutamine) and positioning of legs (legs down and pt sitting up)

Front 79

1. LBBB causes
2. EKG dx of LBBB
3. RBBB causes
4. EKG of RBBB

Back 79

1. Acute MI, dilated cardi, AS
2. WiLLiam (of william marrow)
V1 W and V6 M (or rabbit ears)
3. relatively benign when compared to LBBB
4. MaRRoW
V1 M and V6 W

Front 80

PCI (angioplasty) vs thrombolytics

Back 80

door to balloon time = 90 minutes
if > than 90 then use thrombolytics unless contraindication to them

Front 81

absolute contraindications to thrombolytics

Back 81

-Nonhemorrhagic stroke w/in the last 6 mo.s
- severe HTN >180/110
- Recent Qx w/in last 2 wks
- Major bleeding ex. CNS or GI

Front 82

complications of acute MI:
1- assoc.d with bradyarrhythmia
2- assoc.d w/ tachy

Back 82

1- sinus brady or 3rd heart block (cannon a waves)
2. (1) RV infarction (- new inferior wall MI: I, II, AVF and clear lungs; - flip the leads, - Tx: fluid replacement
(2) Tamponade/ free wall rupture
(3) VTach/ Vfib
(4) valve or septal rupture - new onset murmur and pulmonary congestion

Front 83

systolic dysfnx (CHF)

Back 83

dilated heart
<ed EF (< 60%)

Front 84

massive pulmonary embolism:
-what will you see?
- what are changes in heart chamber pressures?
- complication

Back 84

PE complicated by hypOTN &/or acute right heart strain.
- Syncope+JVD+RBBB
- RA Pressure > 10 (norm = 5), Pulmonary Artery pressure > 40 (norm = 25)
- shock (hypoTN & tachycardia)

Front 85

What is most likely cause of 2ndary HTN?: Pt presents w/ agitation, headaches , gained 14 lbs in 3 mo.s, K level of 3.2, glucose of 205.

Back 85

Adrenal cortical dz being Cushings in this scenario.

Front 86

Dude w/ anterior wall MI one month ago comes in complaining of exertional dyspnea and fatigue. Exam shows pansystolic murmur. EKG shows Q waves and persistent ST segment elevation in anterior leads. Whats the cause?
What symptoms come with this?
How do you confirm Dx?

Back 86

Ventricular aneurysm:
- symptoms of Vent an: CHF, vent. arrhythmias, mitral regurg and/or thrombus formation. Also persistent ST elevations are also often seen.
confirm Dx w/ echo: shows dyskinetic wall motion

Front 87

what drugs do you want to avoid in STEMI?

Back 87

dihydropyridine (CCB: nifedipine and amlodipine).
Bc. -> peripheral vasodil and reflex tachycard -> cardiac ischemia

Front 88

32 yo woman, S3, enlarged cardiac silhouette (cardiomeg), b/l pleural effusions (pulm edema), enlarged liver. recent URI.
1. what is the Dx?
2. most likely cause of her symptoms
3. additional cause of Dx
4. complication

Back 88

1. myocarditis
2. viral infxn (coxsackie)
3. Drug tox (doxorubicin)
4. CHF

Front 89

how can you clinically determine if edema is cardiac in cause?

Back 89

Positive Hepato-jugular reflex indicates that venous pressure is elevated and suggests that heart disease-related edema is present. If reflex is negative if the liver is the cause.

Front 90

High-output (= high CO) cardiac failure:
1. causes

Back 90

1. Arterio-venous fistula (AVF -> AV shunting -> >ed preload and CO and <ed SVR), thyrotoxicosis, Paget dz, anemia, and thiamine deficiency

Front 91

situations that predispose to torsades do pointes

Back 91

1. malnourished (ex ROHic)
2. Drugs: moxiflox, fluconazole, TCA, amiodarone
3. familial long QT: jervell -Lange-Nelisen = deaf; Romano ward = not deaf
Tx mag sulfate
(+ beta blocker for familial long QTs)

Front 92

In tetralogy of fallot why does knee to chest position help?

Back 92

When pt. is having a "tet spell" this position increases systemic vascular resistance -> >ed blood flow from the right ventricle to the pulmonary circulation. (morphine and IV fluid bolus can also be given to > pulmonary blood flow)

Front 93

Endocarditis Tx:
1. 1st
2. Viridans or HACEK
3. Staph A (sensitive)
4. Fungal
5. S. Epi or S. Aureus (resistant)
6. Enterococci

Back 93

1. 1st draw blood then empiric Tx of : Vanc + Gent
2. Ceftriaxone
3. Oxacillin, Nafcillin, or Cefazolin
4. Ampho + valve replacement
5. Vanco + Gent
6. Amp + Gent

Front 94

Pericardial effusions:
1. Causes
2. appearance on CXR
3. when does this become tamponade?

Back 94

1. MCC = idiopathic, viral, CA, post MI, uremia, autoimmune, hypothyroid
2. "water bottle" shape
3. when pericardial space can no longer stretch to accommodate the effusion

Front 95

Post MI complication of interventricular wall rupture vs. ventricular free wall rupture:
1. when do they happen
2. what differentiates them

Back 95

1. both approx. 5 days post MI
2. interventricular wall -> VSD (new onset holosys murmur)
ventri free wall rupture -> pericard tamponade (development of Pulseless Electrical Activity)

Front 96

Post MI complication of recurrent ischemia
1. what will you see bc. of it

Back 96

1. ventricular arrythmia (vtach or vfib; not PEA)

Front 97

Post MI complic of papillary muscle rupture
1. when does it happen
2. what does it cause?

Back 97

1. approx 5 days post MI
2. Mitral regurg (new onset holosys) -> hypOTN

Front 98

Post MI ventricular aneurysm:
1. when
2. what does it present w/

Back 98

1. days to months
2. akinesis of involved LV wall, vent arrhythmias, and systemic embolization

Front 99

peripheral edema causes:
1. non-pitting
2. pitting

Back 99

1. lymphatic obstrxn (lymphedema), or >ed interstitial accumulation of albumin and other proteins (ex myxedema assoc.d w/ hypOthyroid)
2. caused by >ed movement of fluid from vascular to interstitial space:
- >ed hydrostatic pressure (CHF, portal hyperTN)
- <ed plasma oncotic P (low albumin from malnutrition, nephrotic syndrom, cirrhosis)
- >ed capillary leak (burns, trauma, or infxn)

Front 100

what can reverse heart failure in alcoholic cardiomyopathy

Back 100

abstinence from ROH