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Cardiovasc 3 Angina
Angina
| Question | Answer |
|---|---|
| Chvostek and Trousseau signs are assoc'd with what metabolic abnormality? | Hypocalcemia |
| Cold water is flushed into a pt's ear and the fast phase of the nystagmus is toward the opposite side. Where is the lesion? | No lesion! This is a normal finding. |
| A lesion to which area of the brain is responsible for the following clinical scenarios?: contralateral hemiballismus | subthalamic nucleus |
| A lesion to which area of the brain is responsible for the following clinical scenarios?: hemispatial neglect syndrome | non-dominant parietal lobe (R) |
| A lesion to which area of the brain is responsible for the following clinical scenarios?: coma | reticular activating system |
| A lesion to which area of the brain is responsible for the following clinical scenarios?: poor repetition | arcuate fasciculus |
| A lesion to which area of the brain is responsible for the following clinical scenarios?: poor comprehension | wernicke's |
| A lesion to which area of the brain is responsible for the following clinical scenarios?: poor vocal expression | broca's |
| What meds are used to tx Prinzmetal's angina? | Nitrates, CCBs (most important) |
| Where do the non-dihydropiridine CCBs work? Name 2 drugs in this class. | Work on heart. Verapamil and diltiazem. |
| Where do the dihydropiridine CCBs work? Name 2 drugs in this class. | Work peripherally to decrease preload. Nifedipine and amlodipine. |
| What is the most likely cause of chest pain in the following scenarios?: ST segment elevation only during brief episodes of chest pain | prinzmetal's |
| What is the most likely cause of chest pain in the following scenarios?: pt is able to point to localize chest pain using one finger | musculoskeletal |
| What is the most likely cause of chest pain in the following scenarios?: chest wall tenderness on palpation | musculoskeletal |
| What is the most likely cause of chest pain in the following scenarios?: rapid onset sharp chest pain that radiates to scapula | aortic dissection |
| What is the most likely cause of chest pain in the following scenarios?: rapid onset sharp pain in a 20yo and assoc'd with dyspnea | spontaneous pneumo |
| What is the most likely cause of chest pain in the following scenarios?: occurs after heavy meals and improved by antacids | GERD (or esophageal spasm) |
| What is the most likely cause of chest pain in the following scenarios?: sharp pain lasting hours-days and is somewhat relieved by sitting forward | pericarditis |
| What is the most likely cause of chest pain in the following scenarios?: pain made worse by deep breathing and/or motion | musculoskeletal or pleuritic pain |
| What is the most likely cause of chest pain in the following scenarios?: chest pain in a dermatomal distribution | zoster |
| What is the most likely cause of chest pain in the following scenarios?: MCC of non-cardiac chest pain | GERD, muscoloskeletal |
| What is the most likely cause of chest pain in the following scenarios?: acute onset dyspnea, tachycardia, and confusion in a hospitalized pt | PE |
| What is the most likely cause of chest pain in the following scenarios?: pain began the day following an intensive new exercise program | muscoloskeletal |
| What is the most likely cause of chest pain in the following scenarios?: widened mediastinum on CXR | aortic dissection |
| Which pts are more likely to have atypical angina (or no angina) during an episode of MI? | DM and women |
| How does nitroglycerin work acutely in a cardiac ischemic episode? | Nitro causes venodilation (peripherally) which decreases preload and O2 demand of the heart |
| Why should relief of chest pain with nitroglycerin administration not be used as a dx test for whether or not the chest pain is cardiac in nature? | B/c it can also diminish pain from esophageal vasospasms or GERD. |
| What is the mechanism of action?: streptokinase | converts plasminogen to plasmin which degrades fibrin |
| What is the mechanism of action?: aspirin | COX-1 and COX-2 inhibitor; inihibits platelet aggregation |
| What is the mechanism of action?: clopidogrel | ADP receptor inhibitor; prevents platelet aggregation |
| What is the mechanism of action?: abciximab | GPIIb/IIIa inhibitor; prevents platelet aggregation |
| What is the mechanism of action?: tirofiban | GPIIb/IIIa inhibitor; prevents platelet aggregation |
| What is the mechanism of action?: ticlodipine | ADP receptor inhibitor; prevents platelet aggregation |
| What is the mechanism of action?: enoxaparin | catalyzes stimulation of antithrobin (like heparin) |
| What is the mechanism of action?: eptifibatide | GPIIb/IIIa inhibitor; prevents platelet aggregation |
| What ist he MCC of chest pain in a pt with a sudden tearing chest pain radiating to the back? | Aortic dissection (look for false lumen on imaging) |
Created by:
sarah3148
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