Get your STUDY PANCE on!
Card Set Information
Get your STUDY PANCE on!
In preparation for the PANCE.
Which cardiomyopathy is caused by reduced strength of ventricular contraction?
In which cardiomyopathy is the LV outflow tract narrowed during systole between the bulging septum and an anteriorly displaced anterior mitral valve leaflet?
Hypertrophic obstructive cardiomyopathy
In hypertrophic obstructive cardiomyopathy, will you have elevated diastolic pressures or systolic dysfunction? Why?
You will have elevated diastolic pressures because of a hypertrophic LV. The amount of obstruction is preload and afterload dependent.
Which cardiomyopathy results from fibrosis or infiltration of the ventricular wall?
Which is the most common chronic arrhythmia?
What does A-fib look like on an EKG?
Narrow complex rhythm at any rate, irregularly irregular with no P waves
What medication class commonly used to treate a-fib should be avoided in patients with WPW syndrome?
CCBs- they may lead to a rate acceleration in patients with antidromic conduction
What etiologies should you consider in new-onset a-fib?
PIIRATES! P: pulmonary disease including PE; I: idiopathic disease including idiopathic HTN; I: inflammatory disease including pericarditis and pericardial trauma or surgery; R: rheumatic valvular heart disease; A: atherosclerotic CAD; T: thyrotoxicosis; E: ethanol consumption "holiday heart"; S: sick sinus syndrome
What issues must be addressed in every patient with a-fib?
1. Stability, 2. Rate control, 3. anti-coagulation, 4. anti-arrhythmic drugs, 5. cardioversion
How do you treat a-fib in a patient with hypotension and dyspnea?
Direct electrical cardioversion (synchronized if possible)
What medications are used to control the ventricular rate of a-fib?
CCBs (diltiazem and verapamil), B-adrenergic blockers, digoxin, and amiodarone
What medication can be used to cardiovert patients who are in a-fib?
Which arrhythmia usually occurs in people with COPD, CHF, atrial septal defect, or CAD?
Which arrhythmia shows a "sawtooth" pattern of atrial activity in leads II, III, and aVF?
What is the usual treatment for atrial flutter?
Chemical conversion with ibutilide or electric cardioversion.
What is the treatment for chronic a-flutter?
What is the treatment for a-flutter refractory to usual treatment?
Which conduction disturbance is characterized by refractory conduction of impulses from the atria to the ventricles through the AV node and/or bundle of His?
What symptoms will you see in a patient with AV block?
Fatigue, light-headedness, and syncope
What is the treatment for AV block?
The only effective long-term treatment for AV conduction disorders is cardiac pacing.
What is first-degree AV block?
PR interval > 0.21 seconds with all atrial impulses conducted
What is second-degree AV block?
Intermittent blocked beats. Subclassified into Mobitz type I (Wenckbach) and Mobitz type II.
What is Wenckbach?
AKA Mobitz type I. The PR interval progressively lengthens, with the RR interval shortening, before the blocked beat; this phenomenon is almost always due to abnormal conduction within the AV node.
What is Mobitz type II?
Intermittently non-conducted atrial beats not preceded by lengthening AV conduction. Usually due to block within the His bundle system.
Which conduction disturbance is due to a lesion distal to the His bundle and associated with bilateral bundle branch block? Is the QRS wide or narrow? What is the ventricular rate?
Complete (third-degree) heart block. The QRS is wide and the ventricular rate is usually around 50 bpm.
What is the most common mechanism for paroxysmal supraventricular tachycardia?
Re-entry- which may be initiated or terminated by a fortuitously timed atrial or ventricular premature beat.
How can you treat paroxysmal supraventricular tachycardia?
With vagal maneuvers. Otherwise, IV adenosine IV CCBs. B-blockers.
Which drug, used for paroxysmal supraventricular tachycardia, can also promote bronchospasm?
Adenosine, so don't use it in patients with reactive airways disease.
What is the usual treatment for symptomatic patients with sick sinus syndrome?
What is sick sinus syndrome?
Sinus arrest, sinoatrial exit block, or persistent sinus bradycardia.
What is the definition of ventricular tachycardia?
Three or more consecutive ventricular premature beats.
Which congenital heart anomaly is characterized by a subaortic septal defect, RV outflow obstruction, and overriding aorta, and RV hypertrophy?
Tetralogy of Fallot
What is coarctation of the aorta?
Narrowing in the proximal thoracic aorta
What is an atrial septal defect? Which is the most common type?
An opening between the R and L atria. Of the four types, ostium secondum is the most common
What is a patent ductus arteriosus?
A failure to close or a delay in closure of the channel bypassing the lungs, which allows placental gas exchange during the fetal state.
What test differentiates saphenofemoral valve incompetence from perforator vein incompetence?
The Brodie-Trendelenberg test
What is the most common cause of secondary hypertension?
Renal parenchymal disease
When heard in a patient with cardiac disease, what does S3 indicate?
ventricular dysfunction or atrioventricular (AV) valvular incompetence
What is malignant hypertension?
Elevated blood pressure associated with papilledema and either encephalopathy or nephropathy; if untreated, progressive renal failure occurs
What is the most common complaint of patients with undiagnosed hypertension?
What is the treatment of choice for Giardia sp. infection?
What sound is the hallmark for prolapse of the mitral valve?
What is the most common cause of acute pericarditis?
What is the usual treatment for pericarditis?
Which leukemia is associated with primitive lymphoid cells?
Acute lymphocytic leukemia
Which leukemia is associated with Auer bodies?
Acute myeloblastic leukemia
Which leukemia is associated with absolute lymphocytosis?
Chronic lymphocytic leukemia
Which leukemia is associated with a left-shift myelopoesis?
Chronic myelogenous leukemia
Which leukemia is associated with the Philadelphia chromosome?
Chronic myelogenous leukemia
With what medications can you treat BPH?
A-adrenergic agonists and 5A-reductase inhibitors
You hear crackles/rales on lung exam. What does this mean?
Fluid in the small airways or atelectasis, could indicate pneumonia
Crackles/rales are heard when- on inspiration or expiration?
Ronchi on lung exam- what does this indicate?
secretions in larger airways, pneumonia