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Step III

Step III - Cardio 3

QuestionAnswer
apical crescendo/decrescendo systolic murmur that is characterized by mid-systolic clicks MVP
tx of aortic regurgx Positive inotrope (incr force of ventricular contraction) eg dopamine + vasodilator eg nitroprusside (improve systolic fxn and decr afterload)
what rx are CI in aortic regurg Β(-)
what agents decrease mortality in hypertensive patients status-post myocardial infarction cardio selective Β(-) and ACE-I
based on EF of hypertensive patients status-post myocardial infarction what Rx do you give nL EF use B(-); low EF use ACEI
Rx that decreases mortality in HTN w/o comorbid dz diuretics
Rx decr mortality in HTN w/ low EF ACEI
What rx decr renal and vasc dz in DM pts ACEI
Aortic dissections occur at what points At arch, 2.2cm above root, distal to subcalvian
Aortic dissection is classified into Types I-III. Define each I: asc + desc II: asc only III: desc only (IIIa: desc aorta @ distal L subclavian aa down to diaphragm IIIb: desc below diaphragm)
surgical vs medical tx of aortic dissections split into type A and B. Define each A: needs surgery, involves Type I and II B: medically usually, involves Type III
which aortic dissection type classically a/w elderly pt w/ h/o atherosclerosis and HTN Type III (desc only)
most often seen in patients < 65 years of age and is the most lethal form of aortic dissection Type I (asc + desc)
what does a delta wave represent on EKG Early ventricular excitation
delta waves are a/w what kinds of cardiac conditions Alcoholic cardiomyopathy (dilated), WPW
hypovolemic shock causes decr preload and affects CO, PCWP, and PVR how Low: CO, PCWP; high: PVR
cardiogenic shock affects CO, PCWP, and PVR how Low: CO; high: PCWP, PVR
Septic shock affects CO, PCWP, and PVR how Low: PCWP, PVR; High: CO
a syndrome of ischemic pain that typically occurs at REST rather than with exertion and is associated with transient ST-segment elevation due to focal coronary artery spasm Prinzmetal angina
mainstays of treatment for Prinzmetal angina Nitrates and calcium channel blockers
Best Rx for WPW in hemo stable pt procainamide
Best rx for WPW pt not hemo stable w/ irr tachy HR cardioversion
How long should pt be treated w/ warfarin before and AFTER cardioversion 3-4wks before and minimum 4 wks after
When can you cardiovert AF w/ prior tx w/ warfarin <48hrs onset
AE of HCTZ hyponatremia, hyperglycemia, hypercalcemia, HYPO K+, aggravates gout
episodic headache, sweating, and tachycardia, paroxysmal HTN, psychiatric disorders pheo
workup for pheo 24 Urine fractionated catecholamines and metanephrines; plasma free metanephrines, MR/CT adrenals +/- MIBG scan
most accurate test for pheo MRI/CT of adrenals (if negative get MIBG to look for mets of pheo)
CHF pt c/o palpitations, visual disturbances, and mental status changes, EKG shows prolonged PR, and depressed ST. dx Digitalis toxicity
prolonged PR intervals, depressed (scooped) ST segments, and alterations in T wave morphology = dig toxicity
major electrolyte abnL in dig toxicity that predicts mortality HYPER K+
Created by: DrINFJ