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61 Cards in this Set
- Front
- Back
What should always be considered in rapid A-fib with RVR (>200)?
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WPW
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What is Beck's triad and what is indicative of?
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Muffled heart tones, hypotension, increased CVP (JVD)
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What is the DeBakey classification of aortic dissection?
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I.Ascending aorta, aortic arch and descending aorta
II. Ascending aorta III.Descending aorta distal to the left subclavian artery |
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What is the most important risk factor for developing aortic dissection?
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Systemic hypertension
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What are ECG findings in pericarditis?
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Diffuse ST segment elevation and PR depression
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What is the most common cause of malignant pericardial tumors?
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lung cancer, breast cancer, leukemia and non-Hodgkin's lymphoma
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What is the most common cause of chronic aortic regurgitation?
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Rheumatic heart disease
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What is acute aortic regurgitation associated with?
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Fulminant endocarditis, aortic disease or trauma
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How is malignant hypertension diagnosed?
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Hypertension with evidence of acute and progressive end organ damage as a result of the hypotension
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What percentage of superficial thrombophlebitis is associated with DVT on presentation?
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1/5
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What percentage of Marfan's develope aortic dissection.
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44%
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When do AAAs typically occur?
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In 60s-70s
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What are the most common causes of aortic stenosis in patients under age 65?
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rheumatic fever and congenital bicuspid valve
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What is acute mitral regurgitation usually a complication of?
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Acute MI, bacterial endocarditis or trauma
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What is torsades de pointes?
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a polymorphic ventricular tachycardia associated with prolonged QT interval
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What MI patients have a higher in-hospital mortality?
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inferior MI and coexisting right ventricular infarction
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What is electrical alternans specific of?
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pericardial tamponade (sensitivity only 30%)
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What is helpful in diagnosing a pericardial effusion?
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ultrasound
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What is the most common presenting symptom of aortic dissection?
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pain
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What is the most common underlying pathologic condition found in AAA?
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atherosclerosis
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When does acute cardiogenic shock result?
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It results when more than 40% of the myocardium becomes necrosed from ischemia, inflammation, toxins or immune destruction.
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Where does rupture of a AAA usually occur?
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retroperitoneum
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What is the most common dysrhythmia associated with WPW?
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paroxysmal atrial tachycardia
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What are the classic symptoms of aortic stenosis?
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dyspnea on exertion, angina and exertional syncope
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What drugs are most commonly associated with torsades de pointes?
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class IA antiarrhythmics (quindine, procainamide) and Class IC agents
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When is thrombolytic therapy most effective?
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patients with prominent ST-segment elevations on initial 12-lead ECG
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What is the classic triad of a ruptured AAA?
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pain, hypotension and pulsatile abdominal mass
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How often does aortic regurgitation occur with aortic dissection?
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31%, most common with a type A dissection
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What percentage of untreated aortic dissection die?
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75% within 2 weeks of onset of symptoms
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What is the classic triad of PE and what percentage of people have it?
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20% of people have hemoptysis, dyspnea and chest pain
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What are the most common signs of a PE?
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dyspnea and tachypnea
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When do left ventricular aneurysms most commonly occur?
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after extensive anterior MIs
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What % of patients w/ acute MI will have high-degree AV block on admission to ED? What percentage will develop it w/i 24 hrs?
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8% present and 24% will develop it w/i 24 hrs and rest will develop it within 3 days of admission.
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What are the two major types of essential hypertension?
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Those with elevated renin and those without elevated renin
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What is the clinical presentation of actue mitral regurgitation?
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Fulminant CHF in previously healthy patient
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What are teh most common ECG findings in patients with PE?
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Tachycardia, non specific ST-T wave changes,
Classic: SI QIII TIII S wave in lead I, q wave in lead III and inverted T in lead III also t wave in versions in V1-V3 and inf. leads is very specific for PE |
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What is the ventricular rate most commonly controlled with in stable conditions?
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digoxin
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What is the most common cause of v-tach
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monomorphic VTach associated with chronic cornary artery disease
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What is the key early sign of cardiogenic shock in anterior MI
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tachycardia
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What do q waves represent?
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myocardial necrosis
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What is the orgin of tricuspid stenosis?
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rheumatic in orgin, commonly coexists with mitral and aortic disease
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What is the most common cause of mitral stenosis?
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rheumatic heart disease
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What are the signs of significant mitral stenosis?
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dyspnea on exertion, orthopnea and hemoptysis
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What is the most common cause of chronic mitral regurg?
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rheumatic heart disease, often coexhists with mtiral stenosis
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What s the most common cause of aortic stenosis in patients >65?
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calcific degeneration of the valve cusp
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What is acute AR?
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a surgical emergency and requires valve replacement
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What % of natve valve endocarditis is caused by staph? What % of IV drug use?
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10-30% and over 80%
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When is valvular surgery indidcated?
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May be indicated in infective endocarditis, severe CHF from valvular incompetence, paravalvular leak around prosthetic valve, fungal endocarditis, persistent bacteremia despite abx
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What is the stanford classification system for aortic dissection?
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Type A involves ascending aorta, type B does not
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What should chest pain with neurological symptoms make you think of?
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dissection
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What is prinzmetal's angina assocated with?
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transient ST elevation
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What can anterior MIs be associated with?
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acute mitral regurgitation, ventricular septal defect and high grade AV blocks
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What can an inferior wall MI be associated with?
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GI symptoms, hypotension, bradycardia and Mobitz I
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What potentiates adenosine?
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tegretol (carbomazapine) and persantine
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What antagonizes adenosine?
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methylxanthines
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What should a short PR and a delta wave make you think of?
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WPW
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What does persistent and diffuse ST elevations mean?
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ventricular aneurysm
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What is a new systolic murmur after an MI?
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MR, caused by rupture of LV papillary muscle usually seen in inf. infarcts since RCA and Cx supplies this area
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What increases the murmur in hypertrophic cardiomyopathy?
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standing, valsalva and hypovolemia
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What should be avoided in WPW patients w/afib?
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digoxin, verapamil and diltiazem
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WHat are the treatments of choice for WPW with wide complex (antidromic) condition?
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Procainamide, cardioversion/catheter conversion
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