Busy. Please wait.
Log in with Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password

Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Didn't know it?
click below
Knew it?
click below
Don't Know
Remaining cards (0)
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Cardiology Unit I

Clinical medicine I Final Review

Vector same direction as the axis + deflection
Vector and Axis perpendicular to each other Straight line or equal deflections up and down
Vector and axis is opposite direction - deflection
Length of the PR interval, QRS width, .12-.20s, <.12
SA, AV, Ventricle node conduction rates SA: 60-100, AV: 40-60, Ventricles: 20-40
Time from the SA node to the AV node PR interval
How do we determine the axis? look at lead I and lead aVF,
Determination BPM on EKG sheet 300 150 100 75 60 52 45
Rhythm that is no NSR but is irregular Sinus arrhythmia
Another name for Paroxysmal atrial tachycardia (PAT) Supraventricular tachycardia (SVT)
Atrial rate in atrial flutter 250-350bpm sawtooth pattern
MC cause of Atrial flutter Underlying Heart dz, 30% find no cause, seen w/ dig tox, and PE
MC cause of Afib Rheumatic ht dz, HTN, Ischemic ht dz, thyrotoxicosis ->predisposes for thrombus in atria
If SVT stimulus is near SA node, how can we tell the diff b/w SVT and sinus tach? Rate, Sinus tach
Tx of SVT vagal maneuvers, Adenosine, verapamil, break conduction through re-entry circuit
Three or more ectopic beats in a row w/ wide QRS V-tach –usually underlying ht dz
Tx Vtach Immediate electrical defibrillation, CPR, amiodarone, lidocaine
PR interval >,20 sec, in nl hearts, no tx 1st degree heart block
Preogressive prolongation of PR interval until blocked non-conducted P wave 2nd degree ht block type I (wenckebach)
Do distance b/w P waves change with type I 2nd degree ht block? No, PR gets longer to no QRS complex
Causes of 2nd degree block type II Acute anteroseptal MI, Cardiomyopathy
Nl PR interval with sudden dropped QRS complexs 2nd degree AV block: mobitz II, (non-wenkebach)
Atrial and ventricular depolarizations are independent of each other 3rd degree AV block
Causes of 3rd degree AV block Acute MI, drugs (dig, BB)
Are premature atrial contractions problematic no happen in all ages all ppl, frequent
MC cause of PVC’s hypoxia (uncommon in absence of ht dz): stress, alcohol, caffeine
3 or more PVC’s in a row considered Vtach , problematic w/ >10/min
Dz orientated, ability of a test to correctly identifiy those w/ the dz (true +) sensitivity True +/True + + false -
Healthy orientated, refers to true negatives specificity
Main components of CBC Hgb, Hct, WBC, MCV, platelets (also get MCH, MCHC, RBC)
Nl value of Hgb and Hct 12-18gm/dl, 21-48%
Causes of elevated hgb dehydration, ^altitude, smokers, Congential ht dz, polycythemia vera
Cuases of low hgb ^ destruction RBC, dec production of RBC, blood loss, preggo, Vit def.
Nl value of WBC 4,000-10,000 x 10^9/L
WBC w/ diff components Neutrophils, lymphocytes, eosinophils, basophils, macrophages
MC WBC and found when Neutrophils 50-70%, bacterial infx, inflammatory condistion
When do we see lymphocytes and eosinohpils lymphocytes: viral (25-40%) E: 1-3%, allergic or fungal infx
When do we see basophils and monocytes B: inflammatory states/parasitic infx, M: phagocytosis bacterial infx
Reasons for low WBC Viral, overwhelming bact. Infx, hypersplenism, meds that suppress bone marrow,
Left shift ^ ration of band cells (immature neutrophils): healthy immune response to infx
Increase and decreased of MCV I: Vit b12, folic acid def. D: iron def. nl: 90-100femoliters
Nl platelet count 150,000-400,000
What is found in with a urinalysis dipstick? Specific gravity, pH, protein, glucose, ketone, leukocyte esterase, bilirubin, blood, urobilinogen, nitrates
Bence Jones Proteins is associated with Multiple myeloma
What do RB casts and WB casts signify R: glomerulonephritis, W: pyelonephritis
Nl values of AST and ALT AST: 10-40IU/L: elevated w/ liver, muscle, cardiac injury ALT: 5-35IU/L ^w/ liver injury (more sensitive)
Marker of liver fxn albumin
Coagulation studies Prothrobin time PT, Partial thromboplastin time aPTT
Pancrease studies Amylase 12-60 U/L, elevates first. Lipase: 20-200U/L remains elevated longer
Na+ elevation causes V/D endocrine K+ dec w/ V/D
Nl blood fasting glucose, A1C 60-126, <5%
Nl BUN, creatinine 6-20 mg/dL C: .6-1.3 (elevated: impaired renal fxn)
Increases w/ congestive heart failure BNP brain natriuretic peptide: produces by ventricles
Grades of Heart murmurs 1-6, 1 hard to hear w/ stethoscope, 4-6loud with palpable thrills
Where are most murmurs located? 95% L sided 50%mitral 45% aortic
Sxs frequently seen w/ murmurs Decreased exercise tolerance, fatigue, syncope, CP, dyspnea, BP^ delayed upstroke or bounding
Crescendo-decrescendo murmurs Systolic, Aortic& Pulmonic stenosis, hypertrophic cardiomyopathy
Holosystolic murmurs Systolic: Mitral & tricuspid regurg, VSD
Decrescendo, pistol shot sound murmur Aortic regurgitation (diastolic)
Mid-diastolic murmur Pulmonic regurg, (diastolic)
Low pitched ruble, opening snap murmur Mitral stenosis (diastolic)
Low pitched ruble w/ RV heave Tricuspid stenosis (diastolic)
MC of all valvular ht dz Aortic stenosis: d/t athreloclerosis, bicuspid valve in the young, Rheumatic ht dz
Aortic Stenosis Complications Angina, Syncope, CHF
Palpable S4 heard with heave aortic stenosis, ECG makes dx
Mitral stenosis is a complication of? Sxs? Rheumatic fever, sxs: exercise intolerance, CHF, Horseness, Afib
Crisp systolic click and late systolic murmur MVP
Causes of MVP Congenital, Autosomal dominant, Connective tissue disorders
What increases/decreases the length of a MVP murmur Standing: valsalva, brings the click closer to S1, squatting: relax, click closer to s2
Primary and secondary causes of Mitral regurg 1: MVP, leaflet defects, 2: LV dilation, Endocardial cushions d/t ischemic ht dz
When are prophylactic Abx recommended? With prosthetic ht valve, hx endocarditis, Cong HD,
Types of prosthetic heart valves and uses Bioprosthetic: mitral, reoperation common, Mecahnical: bleeding common: aortic valve Tissue: recommended w/ life expectancy <15 yrs
RF of PVD age, smoking, obesity, sedentary, hyperlipidemia, HTN, DM
PVD Chart Refer to it :D
Significant about sxs of PAD reproducible pain w/ cramping and tightness
Gold std for Temporal arteritis temporal artery bx: shows giant cells infiltrating the tissue
Ankle brachial test assessing for PAD, take the systolic pressure in legs/ SP in arms Nl: .9-1.2 if > than that: hardening of arteries, .8-.9mild, .5-.8 mod <.5 severe
Diff b/w raynauds dz and phenomenon D: young, no other factors, both hands, -Allen’s P: secondary to HTN, unilateral, + Allen’s
Inflammatory changes in sm/med sized arteries and veins in extremities Buerger’s Dz (Thromoangitis Obliterans)
Sxs Buerger’s dz Male, 20-40 smokers, severe pain w/o physical findings, Clinically dx, w/ angiogram for integrity of arteries
Tx Buerger’s dz Avoid vasoconstriction, proper fitting shoes, elevate foot of bed
Etiology of thrombus formation Virchow’s Triad: Stasis, Intimal Injury, Hypercoagulability
Prolonged venous thrombosis Chronic Venous Insufficiency or Venous Stasis
Diagnostic test for DVT, Homan’s test, Wells Score
Wells score results >3 75% DVT, 1-2, 17%, <1 3%
Tx for Superficial venous thrombosis, DVT SVT: warm compression, NSAIDs for pain and inflammation, DVT, anticoag, compression socks, may need surgery
Leading cause of death for men and women of all races and ethnicities Coronary Heart Disease
Types of cholesterol LDL: bad HDL: good, removes excejss cholesterol from tissues, Chylomicrons and VLDL: transport exogenous lipids, TG’s Main storage for fat
Patho of Atherogenisis ^LDL->oxidized, Macrophages ingest ox. LDL—Foam cells, collegen over it:fibroud plaque: ruptures:platelet aggregation:thrombus
Unmodifiable RF for atherosclerosis Fhx, Dm, Age, also maybe CRP, impaired fasting glucose
Modifiable RF for atherosclerosis Smoking, HTN, low HDL, lifestyle: obesity, physical inactivity, atherogenic diet
What cause secondary hyperlipidemia DM, Hypothroidism, obstructive liver dz, chronic renal failure, drugs ^LDL and dec. HDL
Metabolic Syndrome sxs >3 of following TG’s >150, HDL <40, BP: >130/85, Fasting BGC>110, Waiste obesity
When do we check for lipoprotein disorders parts of cholesterol are way high for the pt’s habitus, age, wt, etc
Routine lipid screening recommendations 20yo every 5 years, FLP
CHD Risk equivalents DM, PAD, AAA, symptomatic carotid A. dz, Multple RF’s confer a 10-yr risk of CHD >20%
Major CHD RF’s Current cigarette smoking, HTN or on antiHTN med, Low HDL <40, FMhx CHD death/MI M<55 F<65, pt age M>45, F>55, Subtrat one RF for HDL >60
CHD risk or equivalents LDL goal <100, Drug therapy of >100 or considered <100
Moderate high risk, 10-yr 10-20%(>2RF’s) LDL <130, consider drugs 100-130
Miderate Risk , 10 yr <10% LDL: <130, Drugs >160
0-1RF Lower risk LDL < 160, Consider Drug >190
TLC’s Healthy diet, wt reduction, increased Physical activity
Complications of untreated hyperlipidemia cardiovascular, cerebrovascular, peripheral vascular dz
Comorbitities to HTN CAD, L ventricular hypertrophy, Ischemic stroke, chronic kidney dz, DM, PAD
Phase of cardiac cycle in which venctricles contract systole
Phase of cardiac cycle in which ventricles relax diastole
Understand wiggers diagram wiggers diagram
Maximuc atrial pressure during ventricle contraction systolic pressure
Point of lowest arterial pressure, pressure which L ventricle must overcome to open aortic valve Diastolic pressure
Cardiac output HR x SV
Nl BP systolic < 120, Diastolic < 80
Prehypertension systolic 120-139, Diastolic, 80-89
HTN stage 1 and 2 1: S: 140-159 D: 90-99 2: S: >160 D: >100
Measurement needed to classify HTN two or more readings at 2 or more visits after initial screen
Uncomplicated and Comorbities HTN goal U: 140/90,C: 130/80
Some secondary causes of HTN Pheochromcytoma, Cushing’s, 1 aldosteronism, congenital adrenal hyperplasia, Hyperparathyroidism, Hyper,Hypothyroidism
Causes of 2 HTN: Renal, Mechanical, Medication-induced, “white-coat”
Malignant HTN classifications SBP ≥ 180, DBP ≥ 120
Longstanding HTN can lead to what? encephalopathy, seizures/ and or coma if not treated
Modifiable RF’s for HTN smoking, ETOH intake, physical inactivity, Renal Dz, Obesity, Dyslidemia, DM
Unmodifiable RF’s for HTN age, genetics, race
Metabolic syndrome THBFW, TG’s ≥150, HDL < 40 B: BP ≥ 130/85 F: Fasting BG: >110 Waist: >40M >35F
Sxs of HTN usually asymptomatic, but Neuro: occipital HA early morning, Dizzi, palpitations, fatigue, impotence, Vascular: Epistaxis, hematuria, metorrhagia, blurred vision, CP
Labs for HTN workup find underlying causes, CBC, K+ BUN/Creatinint, Ca+, phosphate, FBG, Lipid profile, TSH, UA, CXR, EKG
What are end organ damage evidence of HTN Brain: stroke, TIA, Eye: Retinopathy
Papilledema, A/V nicking, Heemorrhage, Exudates, Cotton Wool spots Signs of retinopathy of HTN
When can S4, cardiomegaly on CXR, and EKG changes all be seen together longstanding HTN
Lifestyle modifications for HTN Lower BP, Wt reduction, Diet, Exercise, Reduce ETOH to 1-2/day
Causes of orthostatic BP drop MS, Parkinson’s, peripheral neuropath (DM), Gullain-barre’ syndrome, raynaud’s, Reflux sympathetic dystrophy, Drugs, Physical deconditioning, Dec. BV,
Dx of Orthostatic testing Measure BP and HR from supine to standing; Sustained drop of SBP >20mg or DBP >10, HR ^ of 15 BPM: neurogenic Upright Tilt table testing
Created by: becker15
Popular Clinical Skills sets




Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
restart all cards