Shared Flashcard Set

Details

Cardiac Murmurs Final
Cardiac Murmurs Final
149
Anatomy
Graduate
11/09/2011

Additional Anatomy Flashcards

 


 

Cards

Term
Mitral Valve Prolapse:
Definition
crescendo
mid-late systolic click
systolic
Term
Tricuspid regurg is :
Definition
holosystolic
Term
widely split fixed S2:
Definition
Atrial Septal Defect
Term
can hear when ascultating on back:
Definition
- coarction of the aorta
- pulmonic stenosis
- aortic dissection
Term
high blood pressure in UE, low blood pressure in LE:
Definition
coarction of the aorta
Term
coarction of the aorta pts may have __ __
Definition
rebount HTN
Term
Aortic stenosis symptoms:
Definition
- dyspnea
- decreased exercise tolerance
- fatigue
- angina
- syncope
- sudden death
Term
Tetrology of fallot:
Definition
- VSD
- overriding of aorta over VSD
- pumonic stenosis
- RVH
Term
results of not treating tetrology of fallot:
Definition
pulmonary HTN> polycythemia arrhythmias> stroke
Term
cyanotic baby at birth:
Definition
transposition of great arteries
Term
With a junctional rhythm, the __ node is the pacemaker.
Definition
AV node
Term
accelerated junctional rhythm is greater than __ bpm.
Definition
60
Term
A. Fib tmt:
Definition
- Beta blockers
- long term stroke prevention (Warfarin)
Term
saw tooth p waves:
Definition
atrial flutter
Term
Second degree heart block is block at the __ __.
Definition
AV node
Term
often don't treat PVCs. But if chronic PVCs can treat with ___. In an acute setting you can treat PVCs with _ and __.
Definition
- Beta blockers
- lidocaine and procanamide
Term
tmt of complete heart block:
Definition
pacemaker
Term
V tachy tmt:
Definition
- antiarrhythmics: vasopressin, amiodarone, procainamide, lidocaine
- implant defib (ICD)
Term
PVCs with R on T phenomenon can result in __ __.
Definition
Ventricular fibrillation
Term
V. fib tmt:
Definition
- defib
- lidocaine
- amiodarone
- procainamide
- beta blockers
Term
polymorphic VT:
Definition
Torsades
Term
results after early PVC with a pause:
Definition
Torsades
Term
Erythromycin and Seldane may cause:
Definition
Torsades
Term
Tmt of Torsades:
Definition
magnesium and cardioversion
Term
Tmt of V fib:
Definition
- amiodarone
- lidocaine
- procainamide
- beta blockers
Term
Sodium channel blockers __ __.
Definition
affect repolarization
Term
Beta blockers and calcium channel blockers __ __ __.
Definition
slow AV conduction
Term
Potassium channel blockers prolong __ __.
Definition
prolong action potential
Term
a fib tmt focus is on __. use __ __ and __ .
Definition
- rate
- beta blockers
- non-dihydropyridine calcium channel blockers
Term
Supraventricular tachycardia tmt:
Definition
beta blockers
CCBs
Term
PVC tmt:
Definition
beta blockers
Term
Long QT syndrome can lead to :
Definition
Torsades
Term
disease of the ions channel leading to prolonged action potentials, these pts also have increased sympathetic activity in the heart:
Definition
Long QT syndrome
Term
metabolic causes of LQTS:
Definition
- hypokalemia
- hypomagnesia
- hypocalcemia
- hypothyroidism
- anorexia
Term
Meds that cause LQTS:
Definition
- antiarryhtmics- sotalol, amiodarone
- macrolides
- fluroquinolones
- Psychotropic: Haldol, TCAs, Thloridazine
- SSRIs: Risperidone Methadone, Droperidol, protease inhibitors
Term
LQTS syndrome tmt:
Definition
- Beta blockers
- Defibrillator
Term
Genetic disease with EKG changes but structurally normal hearts:
Definition
Brugada Syndrome
Term
Brugada syndrome is more common at __
Definition
night while sleeping
Term
EKG findings of Brugada:
Definition
- RBBB
- persistent ST elevation of cove-like morphology
- T wave inversion in V1, V2, V3
Term
Type I Brugrade:
Definition
coved ST elevation of greater than 2 mm with negative T wave
Term
Type II Brugada:
Definition
saddleback ST elevated of greater than or equal to 2 mm with ST troughs greater than or eequal to 1 mm
Term
Type 3 Brugada:
Definition
coved/saddle ST elveation greater than or equal to 2 mm, with ST trough less than 1 mm
Term
mutation of Brugada syndrome:
Definition
SCN5A sodium channel mutation- dominant
Term
LQTS is more common in men/women?
Definition
women
Term
Most lethal of the cardiac channelopathies:
Definition
Catecholamine Polymorphic Ventricular Tachycardia (CPVT)
Term
exertional palpitations and syncope:
Definition
CPVT
Term
Genetic mutations with CPVT:
Definition
- Ryanodine (RYR2)- most common
- Calsequestrin (CASQ2)- recessive
Term
these pts have a NORMAL EKG, but are at great risk for sudden cardiac death:
Definition
CPVT
Term
Brugada pts have a structurally normal heart, but an abnormal EKG. CPVT have normal EKGs.
Definition
Term
CPVT dx:
Definition
- exercise stress test> bidirectional VT with a beta to beat 180 degree rotation of QRS
Term
CPVT tmt:
Definition
- beta blockers
- ICDs
Term
Aschoff body with biopsy indicates:
Definition
myocarditis
Term
Rheumatic fever is an __ __ disorder of __ __, __, __, and __ __.
Definition
- inflammatory autoimmune
- connective tissue
- heart
- joints
- blood vessels
Term
Dx of Rheumatic fever requires:
Definition
- 1 major Jone's criteria
- 2 minor Jone's criteria
- evidence of recent strep infection
Term
Jones major criteria for Rheumatic Fever:
Definition
Come Meet Corinne Soon Erika.
- Carditis
- Migratory polyarthritis
- Chorea
- Subcutaneous nodules- painless
- Erythema marginatum
Term
Jones minor criteria for rheumatic fever:
Definition
Can't Find A Lab And Purse.
- Clinical
- Fever
- Athralgia
- Labs
- Acute phase reactants increased (ESR, CRP)
- Prolonged PR interval
Term
Evidence of recent GAS infection:
Definition
- positive throat culture
- rapid antigen detection
- increased strep antibody test
Term
Dx of Aortic Aneurysm:
Definition
CT scan
Term
signs of ascending aortic aneurysm:
Definition
- distend neck veins (vena cava obstruction)
- aortic regurg (displacement of aortic valve)
- hoarseness (left recurrent laryngeal nerve)

DAH
Term
S/S of descending thoracic aortic aneurysm:
Definition
- wheezing, stridor, cough (tracheal compression)
- dysphagia (esophageal compression)
Term
S/S of acute arterial occlusion:
Definition
- pain
- pallor
- pulselessness
- polar sensation (cold)
- paresthesia
Term
Dx of acute arterial occlusion:
Definition
angiography
Term
Chronic Arterial Occlusion is aka __ __ __.
Definition
Peripheral Arterial Disease
Term
risk factors for PAD;
Definition
- smoking
- HTN
- dyslipidemia
- diabetes
- fhx atherosclerosis
Term
Dx of PAD:
Definition
ABI ratio (ankle:arm systolic bp ratio)

less than 0.9 i s abnormal
Term
s/s of PAD:
Definition
- intermittent claudication
- thinning skin/hair on extermities
- uclers on toes/heals may occur
- pallor
- cyanosis
Term
PAD tmt:
Definition
- exercise
- antiplatelets: ASA, clopidogrel
- Cilostazol (not for CHF)
- Pentoxifyllin
Term
Tmt of giant cell arteritis:
Definition
- corticosteroids: prednisone 40-60 mg
Term
Dx criteria for Temporal Arteritis, must have 3 of the following 5:
Definition
So Next Time Please Stay
- Symptoms in pt older than 50 yrs
- New onset HA/localized pain
- Temporal artery tenderness to palpation
- decreased Pulsations
- Sed rate great than 50
Term
pt has dull achy legs that feel heavy, worse in evening and after exercise, ankle sweeling, skin is ithciny and thin:
Definition
varicose veins
Term
varicose veins tmt:
Definition
- compression stockings
- sclerotherapy
- surgical vein ligation and removal
Term
To dx Infectious Endocarditis must have:
Definition
- 2 major dx criteria OR
- 1 major + 3 minor criteria OR
- 5 minor criteria
Term
Duke Major Dx criteria for Infectious Endocarditis:
Definition
1. 2 separate positive blood cultures
2. Positive echo findings
3. New Valvular Regurgitation
Term
Duke Minor Criteria for Infectious Endocarditis:
Definition
1) Predisposition (hx of IV drugs/CHD)
2) Fever with temp greater than 38 C
3) Vascular phenomenon
4) Immunologic phenomenon
5) Positive blood culture w/o meeting above criteria or serologic evidence of active infxn
Term
Infective Endocarditis tmt;
Definition
Penicillin G for 4 weeks

OR

Ceftriaxone + Gentamycin for 2 weeks
Term
Rheumatic fever tmt:
Definition
penicillin
erythromycin
Term
regional Q waves:
Definition
neoplastic disease of the heart
Term
Becks' triad:
Definition
hypotension
muffled heart sounds
JVD
Term
Becks triad and pulsus paradoxus are seen with __ __.
Definition
cardiac tamponade
Term
pulsus paradoxus defined:
Definition
fall of bp greater than or equal to 10 mmHg with inspiration
Term
EKG findings of cardiac tamponade:
Definition
low voltage QRS
Term
drugs that may cause pericardial effusion:
Definition
- minoxidil
- hydralazine
- phenytoin
Term
Kussmaul's sign:
Definition
increased JVP during inspiration
Term
Pericardial effusion tmt:
Definition
- NSAIDs
- colchicine
- steroids (may cause relapse)

acute: pericardiocentesis
chronic: pericardial window
Term
diffuse ST elevations :
Definition
pericardial effusion
Term
Pericarditis:
Definition
diffuse st elevation
t wave inversions
Term
diffuse ST elevations, pain is worse when laying down, better sitting up:
Definition
Pericarditis
Term
Pericarditis usually has a __ cause.
Definition
viral
Term
PRECORDIAL/SUBSTERNAL CHEST SHARP STABBING CHEST PAIN THAT RADIATES TO THE BACK, NECK, LEFT SHOULD, ARM. INSPIRATION AGGRAVATES THE PAIN:
Definition
Pericarditis
Term
Tmt:
Definition
- treat cause and hemodynamics changes
- inflammation: NSAIDs, corticosteroids, Abx
Term
constrictive pericarditis:
Definition
fibrous changes of pericaridum : caused by radiation, infections, surgery
Term
constrictive pericarditis has a __ onset.
Definition
slow
Term
aortic stenosis causes a __ S2.
Definition
soft
Term
Aortic stensois has a __ pulse pressure.
Definition
narrow
Term
Aortic regurgitation has Quinckes pulses which alternate __ and __ with __ and __ __.
Definition
- blanching and flushing with diastole
Term
Tmt of aortic regurgitation:
Definition
no tmt if not bad
hydralazine
nifedipine
ACE-I

(decrease resistance to decrease aortic regurg)
Term
Mitral stenosis symptoms:
Definition
- exertional dyspnea
- paroxysmal nocturnal dyspnea
- orthopnea
- LOUD S1 OPENING SNAP
- LEFT ATRIAL ENLARGEMENT
Term
Mitral stenosis is more common in :
Definition
females
Term
Mitral stenosis causes enlargement of the __ __, while mitral regurgitation causes enlargment of the __ __.
Definition
- left atrium
- left ventricle
Term
MR tmt:
Definition
- hydralazine
- nifedipine
- nitroprusside
Term
Tricuspid stenosis has a prominent __ wave on jugular venous inspection.
Definition
a wave
Term
Tricuspid regurgitation has a prominent __ wave on jugular venous inspection.
Definition
v wave
Term
tmt of tricuspid regurgitation:
Definition
- diuretics to prevent pulmonary HTN
Term
2nd most common congenital heart disease:
Definition
Pulmonary stenosis
Term
Pulmonary HTN results in __ __ called a __ ___ __.
Definition
- pulmonic regurg
- Graham steele murmur
Term
Tmt of pulmonic regurg and tricuspid regurg:
Definition
diuretics
Term
HOCM is autosomal __.
Definition
dominant
Term
HOCM tmt:
Definition
- beta blockers
- CCB
- anti-arrythmics
- avoid dehydration
- septal ablation
Term
with aortic/mitral regurgitaion treatment focus is on decreasing __ __ _ via __, __, and/or __.
Definition
- systemic vascular resistance
- hydralazine
- dihyrdro CCBs (nifedipine_
- ACE-I
Term
MAP formula:
Definition
MAP= diastolic pressure + (1/3)(pulse pressure)

MAP= 1/3 (systolic) + (2/3) (diastolic)
Term
Pulse Pressure:
Definition
systolic pressure- diastolic pressure = pulse pressure
Term
CO formula:
Definition
CO= SV x HR
Term
Ejection fraction formula:
Definition
EF= (SV/EDV) x100
Term
Stroke volume formula:
Definition
SV= EDV-ESV
Term
preload is equal to:
Definition
END DIASTOLIC VOLUME
Term
Blood pressure formula:
Definition
BP= CO x TPR
Term
Ankle brachial index:
Definition
highest ankle systolic bp/ highest brachial systolic bp
Term
total body water:
Definition
TBW= weight in kg x 0.6
Term
formula for sodium needed:
Definition
mEq sodium needed = (140-serum sodium)x TBW
Term
Fractional excretion of sodium formula:
Definition
FNa= (Urine sodium x Serum Cr)/(Serum sodium x Urine Cr)

less than 1= low fluid, normal kidneys
greater than 1= impaired kidney function
Term
FNa less than one means:
Definition
- normal kidneys, low fluid
Term
FNa greater than one means;
Definition
impaired kidney function
Term
pulse pressure=
Definition
PP= SP- DP
Term
formula for Systemic Vascular Resistance:
Definition
SVR= (MAP-CVP) x (80/CO)
Term
Kawasaki tmt:
Definition
IV gamma globulin 1-2 g/kg dose given over 12 hours

NO LIVE VIRUS VACCINES FOR NEXT 11 MONTHS

80-100mg/kg/day of Aspirin divided into 4-6 doses until fever subsides

Reduce ASA to 2-10mg/kg/day after fever subsides

May need coumadin if pt has large coronary artery aneurysms
Term
If you use coumadin in pts with Kawasakis, what is there target INR?
Definition
2-2.5
Term
symptoms of lymphatic filarisis:
Definition
episoditc attacks of lymphangitis/adenitis, fever, epididymitis, elephantitis, and lymphedema
Term
asymptomatic pts with lymphatic filarisis still have hidden damage to the __ __ and __.
Definition
- lymphatic system and kidneys
Term
Acute lymphatic filarisis symptoms:
Definition
- filarial fever: pain/inflammation of lymph nodes/duct, accompanied by fever, nausea, vomiting
Term
Chronic filarisis:
Definition
elephantitis and possibly hydrocele in males and enlarged breasts in females
Term
dx of lymphatic filarisis:
Definition
- hard to isolate microfilae b/c they're nocturna
- CARD TEST- FINGER STICK TEST THAT DETECTS PARASITE ANTIGEN, does not require lab equipement
Term
Tmt of lymphatic filarisis:
Definition
- Diethylcarbamazine (DEC): reduces microfillae concenetrations, kills adult worms
- Albendazole- kills adult worms
- Ivermectin-kills microfillae made my adult worms
- Doxycycline
Term
CHD risk equivalents:
Definition
- Diabetes
- AAA
- PAD
- symptomatic carotid artery disease
- multiple risk factors leading to a 10 year CHD risk of greater than 20%
Term
0-1 CHD risk factor LDL goal;
Definition
<160
Term
2+ CHD risk factors, LDL goal:
Definition
<130
Term
CHD and CHD risk equivalents LDL goal :
Definition
<100
Term
low HDL is less than:
Definition
40
Term
high HDL is :
Definition
greater than or equal to 60
Term
Total cholesterol should be less than __, between __ and __ is borderline high, and greater than or equal to __ is high.
Definition
- 200
- 200-239
- 240
Term
causes of secondary dyslipidemia:
Definition
- Diabetes
- Hypothyroidism
- Obstructive liver disease
- Chronic renal failure
- Drugs that raise LDL and lower HDL (progestins, anabolic steroids, corticosteroids)
Term
5 major risk factors when determing LDL goal:
Definition
- Hypertension
- Smoking
- Low HDL
- First degree relative with early CHD (less than 55 in males or less than 65 in females)
- Age (45 and over for males, 55 and over for females)
Term
When to initial LDL lowering drugs in pts with CHD or CHD risk equivalents:
Definition
LDL greater than or equal to 130

(remember their goal is less than 100)
Term
In patients with 2+ CHD risk factors, their goal LDL is less than __. Initiate drug therapy at __ if their 10 year risk factor is 10-20% or at __ if their 10 year risk factor is less than 105.
Definition
- 130
- 130
- 160
Term
With pts who have 0-1 CHD risk factor initiate drug therapy if their LDL gets to __ or higher.
Definition
190
Term
General features of metabolic syndrome:
Definition
- abdominal obesity
- atherogenic dislipidemia
- HTN
- insulin resistance
- prothrombic state
- proinflammatory state
Term
on a TLC diet, saturated fat should be less than __ of your total calories and dietary cholesterol should be less than ___/day.
Definition
- <7%
- <200 mg/day
Term
LDL lowering therapeutic options:
Definition
- Plant stanold/sterols (2g/day)
- Viscous soluble fiber (10-25 g/day)
Term
saturated fat should be less than 7% daily calories, polyunsaturated fat less than 10%, and monounsaturated fat less than 20%
Definition
Term
Metabolic Syndrome synonyms:
Definition
- insulin resistance syndrome
- metabolic syndrome x
- Dysmetabolic syndrome
- Multiple Metabolic syndrome
Supporting users have an ad free experience!