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Cardiology – Awesome

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QuestionAnswer
No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath). - which NYHA class? I
Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath). - which NYHA class? II
Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea. - which NYHA class? III
Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases. IV
flank or back pain and persistent hypotension after cardiac catheterization suspicion of a retroperitoneal bleed, which usually results from a proximal puncture of the common femoral artery in the setting of ongoing anticoagulation; dx with CT abd if pt is stable enough for scanner
most common cardiac defect after rheumatic fever mitral stenosis
risk assessment tool that would provide the most accurate prediction of cardiovascular risk in women Reynolds risk score, better because it includes family history and high-sensitivity C-reactive protein, which will bump up some women's risk
S3 gallop, pulmonary crackles - think of what decompensated CHF
cumulative dose of doxorubicin in excess of 550 - likely to have what doxorubicin-induced dilated cardiomyopathy
pulsus paradoxus greater than xx mm Hg means cardiac tamponade greater than 10
Radiation-induced constrictive pericarditis typically manifests with... right-sided findings of heart failure disproportionately greater than that of left, BNP nl to slightly elevated
when to use glycoprotein IIb/IIIa inhibitor eptifibatide when ACS and TIMI 5 to 7
treatment of chronic stable angina (typical CP with exertion, no sx's at rest) β-blocker dose is adjusted to achieve a resting heart rate of approximately 55 to 60 beats/min and approximately 75% of the heart rate that produces angina with exertion
when to use Ranolazine considered in patients who remain symptomatic despite optimal doses of β-blockers, calcium channel blockers, and nitrates.
who should NOT use ranolazine metabolized by cytochrome P-450 system. don't use in hepatic impairment, QT prolongation, or with other drugs that inhibit the cytochrome P-450 system (diltiazem and verapamil)
woman with exertional chest pain and evidence of left ventricular hypertrophy and strain on electrocardiogram (ECG) - what test to do next Stress ECHO - can't just do EKG stress because baseline abnl EKG would prevent accurate interpretation
LBBB on EKG - what stress test to do? left bundle branch block needs pharmacologic stress, rather than exercise stress, is preferred because stress tests that depend on increasing heart rate have an increased incidence of false-positive anteroseptal reversible defects on nuclear imaging
renovascular hypertension secondary to fibromuscular dysplasia - how to dx and tx Dx with Catheter-based kidney angiography, tx with Percutaneous transluminal kidney angioplasty
“string of beads” appearance of the involved renal artery fibromuscular dysplasia causing likely renovascular HTN
All patients with an acute coronary syndrome should receive (5 drugs) nitrates, a β-blocker, aspirin, clopidogrel (unless an increased risk of bleeding exists), and a statin
patients with a high TIMI risk score (5-7) should receive (2 drugs) anticoagulation therapy (unfractionated heparin, low-molecular-weight heparin [LMWH], or bivalirudin) and a glycoprotein IIb/IIIa inhibitor, such as eptifibatide
when should someone with LDL < 130 still get statin? when sCRP > 0.2 -> they should get rosuvastatin
Name a glycoprotein IIb/IIIa inhibitor abciximab (ReoPro) eptifibatide (Integrilin) tirofiban (Aggrastat)
when should you give clopidogrel? All NSTE-ACS should receive a statin and a P2Y12 inhibitor (such as clopidogrel). Clopidogrel should be given as a loading dose (300 mg or 600 mg) at hospital admission and then 75-mg daily at least 1 year regardless of the need for PCI or CABG.
When should you give a glycoprotein IIb/IIIa inhibitor patients at intermediate or high risk (TIMI score ≥3),
What should you do with Plavix if patient needs a CABG If CABG is ultimately required, clopidogrel should be discontinued and CABG should be postponed for 5 to 7 days in order to avoid perioperative bleeding.
Eight high-risk features that would require you to treat a patient with acute pericarditis in the hospital TIPCAT with pericarditis falling FW toward the hospital. Tamponade, Immunocompromised, Pericardial effusion, Cardiac biomarker elevation, Anticoagulation meds, Trauma
Created by: christinapham