Term
|
Definition
crescendo
mid-late systolic click
systolic |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
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
|
|
Term
| coarction of the aorta pts may have __ __ |
|
Definition
|
|
Term
| Aortic stenosis symptoms: |
|
Definition
- dyspnea
- decreased exercise tolerance
- fatigue
- angina
- syncope
- sudden death |
|
|
Term
|
Definition
- VSD
- overriding of aorta over VSD
- pumonic stenosis
- RVH |
|
|
Term
| results of not treating tetrology of fallot: |
|
Definition
| pulmonary HTN> polycythemia arrhythmias> stroke |
|
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Term
|
Definition
| transposition of great arteries |
|
|
Term
| With a junctional rhythm, the __ node is the pacemaker. |
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Definition
|
|
Term
| accelerated junctional rhythm is greater than __ bpm. |
|
Definition
|
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Term
|
Definition
- Beta blockers
- long term stroke prevention (Warfarin) |
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|
Term
|
Definition
|
|
Term
| Second degree heart block is block at the __ __. |
|
Definition
|
|
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
|
|
Term
|
Definition
- antiarrhythmics: vasopressin, amiodarone, procainamide, lidocaine
- implant defib (ICD) |
|
|
Term
| PVCs with R on T phenomenon can result in __ __. |
|
Definition
|
|
Term
|
Definition
- defib
- lidocaine
- amiodarone
- procainamide
- beta blockers |
|
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Term
|
Definition
|
|
Term
| results after early PVC with a pause: |
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Definition
|
|
Term
| Erythromycin and Seldane may cause: |
|
Definition
|
|
Term
|
Definition
| magnesium and cardioversion |
|
|
Term
|
Definition
- amiodarone
- lidocaine
- procainamide
- beta blockers |
|
|
Term
| Sodium channel blockers __ __. |
|
Definition
|
|
Term
| Beta blockers and calcium channel blockers __ __ __. |
|
Definition
|
|
Term
| Potassium channel blockers prolong __ __. |
|
Definition
|
|
Term
| a fib tmt focus is on __. use __ __ and __ . |
|
Definition
- rate
- beta blockers
- non-dihydropyridine calcium channel blockers |
|
|
Term
| Supraventricular tachycardia tmt: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Long QT syndrome can lead to : |
|
Definition
|
|
Term
| disease of the ions channel leading to prolonged action potentials, these pts also have increased sympathetic activity in the heart: |
|
Definition
|
|
Term
| metabolic causes of LQTS: |
|
Definition
- hypokalemia
- hypomagnesia
- hypocalcemia
- hypothyroidism
- anorexia |
|
|
Term
|
Definition
- antiarryhtmics- sotalol, amiodarone
- macrolides
- fluroquinolones
- Psychotropic: Haldol, TCAs, Thloridazine
- SSRIs: Risperidone Methadone, Droperidol, protease inhibitors |
|
|
Term
|
Definition
- Beta blockers
- Defibrillator |
|
|
Term
| Genetic disease with EKG changes but structurally normal hearts: |
|
Definition
|
|
Term
| Brugada syndrome is more common at __ |
|
Definition
|
|
Term
|
Definition
- RBBB
- persistent ST elevation of cove-like morphology
- T wave inversion in V1, V2, V3 |
|
|
Term
|
Definition
| coved ST elevation of greater than 2 mm with negative T wave |
|
|
Term
|
Definition
| saddleback ST elevated of greater than or equal to 2 mm with ST troughs greater than or eequal to 1 mm |
|
|
Term
|
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
|
|
Term
| Most lethal of the cardiac channelopathies: |
|
Definition
| Catecholamine Polymorphic Ventricular Tachycardia (CPVT) |
|
|
Term
| exertional palpitations and syncope: |
|
Definition
|
|
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
|
|
Term
| Brugada pts have a structurally normal heart, but an abnormal EKG. CPVT have normal EKGs. |
|
Definition
|
|
Term
|
Definition
| - exercise stress test> bidirectional VT with a beta to beat 180 degree rotation of QRS |
|
|
Term
|
Definition
|
|
Term
| Aschoff body with biopsy indicates: |
|
Definition
|
|
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
|
Definition
|
|
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
|
|
Term
| Chronic Arterial Occlusion is aka __ __ __. |
|
Definition
| Peripheral Arterial Disease |
|
|
Term
|
Definition
- smoking
- HTN
- dyslipidemia
- diabetes
- fhx atherosclerosis |
|
|
Term
|
Definition
ABI ratio (ankle:arm systolic bp ratio)
less than 0.9 i s abnormal |
|
|
Term
|
Definition
- intermittent claudication
- thinning skin/hair on extermities
- uclers on toes/heals may occur
- pallor
- cyanosis |
|
|
Term
|
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
|
|
Term
|
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
|
Definition
|
|
Term
|
Definition
| neoplastic disease of the heart |
|
|
Term
|
Definition
hypotension
muffled heart sounds
JVD |
|
|
Term
| Becks triad and pulsus paradoxus are seen with __ __. |
|
Definition
|
|
Term
| pulsus paradoxus defined: |
|
Definition
| fall of bp greater than or equal to 10 mmHg with inspiration |
|
|
Term
| EKG findings of cardiac tamponade: |
|
Definition
|
|
Term
| drugs that may cause pericardial effusion: |
|
Definition
- minoxidil
- hydralazine
- phenytoin |
|
|
Term
|
Definition
| increased JVP during inspiration |
|
|
Term
| Pericardial effusion tmt: |
|
Definition
- NSAIDs
- colchicine
- steroids (may cause relapse)
acute: pericardiocentesis
chronic: pericardial window |
|
|
Term
|
Definition
|
|
Term
|
Definition
diffuse st elevation
t wave inversions |
|
|
Term
| diffuse ST elevations, pain is worse when laying down, better sitting up: |
|
Definition
|
|
Term
| Pericarditis usually has a __ cause. |
|
Definition
|
|
Term
| PRECORDIAL/SUBSTERNAL CHEST SHARP STABBING CHEST PAIN THAT RADIATES TO THE BACK, NECK, LEFT SHOULD, ARM. INSPIRATION AGGRAVATES THE PAIN: |
|
Definition
|
|
Term
|
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
|
|
Term
| aortic stenosis causes a __ S2. |
|
Definition
|
|
Term
| Aortic stensois has a __ pulse pressure. |
|
Definition
|
|
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
|
|
Term
| Mitral stenosis causes enlargement of the __ __, while mitral regurgitation causes enlargment of the __ __. |
|
Definition
- left atrium
- left ventricle |
|
|
Term
|
Definition
- hydralazine
- nifedipine
- nitroprusside |
|
|
Term
| Tricuspid stenosis has a prominent __ wave on jugular venous inspection. |
|
Definition
|
|
Term
| Tricuspid regurgitation has a prominent __ wave on jugular venous inspection. |
|
Definition
|
|
Term
| tmt of tricuspid regurgitation: |
|
Definition
| - diuretics to prevent pulmonary HTN |
|
|
Term
| 2nd most common congenital heart disease: |
|
Definition
|
|
Term
| Pulmonary HTN results in __ __ called a __ ___ __. |
|
Definition
- pulmonic regurg
- Graham steele murmur |
|
|
Term
| Tmt of pulmonic regurg and tricuspid regurg: |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
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
|
Definition
MAP= diastolic pressure + (1/3)(pulse pressure)
MAP= 1/3 (systolic) + (2/3) (diastolic) |
|
|
Term
|
Definition
| systolic pressure- diastolic pressure = pulse pressure |
|
|
Term
|
Definition
|
|
Term
| Ejection fraction formula: |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| highest ankle systolic bp/ highest brachial systolic bp |
|
|
Term
|
Definition
|
|
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
|
Definition
| - normal kidneys, low fluid |
|
|
Term
| FNa greater than one means; |
|
Definition
|
|
Term
|
Definition
|
|
Term
| formula for Systemic Vascular Resistance: |
|
Definition
|
|
Term
|
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
|
|
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
|
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
|
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
|
|
Term
| 2+ CHD risk factors, LDL goal: |
|
Definition
|
|
Term
| CHD and CHD risk equivalents LDL goal : |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
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
|
|
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
|
|
Term
| With pts who have 0-1 CHD risk factor initiate drug therapy if their LDL gets to __ or higher. |
|
Definition
|
|
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
|
|
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 |
|
|
