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77 Cards in this Set
- Front
- Back
What condition does this suggest?
Sharp stabbing chest pain left of the sternum that is worse when a patient takes a deep breath. |
Pericarditis
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How is chest pain from pericarditis relieved?
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sitting up and leaning forward
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Where does chest pain from angina occur?
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retrosternal, radiating to jaw, arm & shoulder
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Chest pain described as squeezing, tightness, pressure, or heaviness along with Levine's sign indicates what condition?
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Angina
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How is chest pain from angina relieved?
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rest & nitro
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Tearing chest pain with sudden onset is characteristic of what disorder?
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Aortic Dissection
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Systolic murmur over the left sternal border & interscapular area indicates ____________
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coarctation of aorta
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What are the components of the Tetralogy of Fallot?
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1)Right Ventricular Outflow Obstruction
2)Membranous VSD 3)Overriding Aorta Over VSD 4)RVH |
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A wide fixed split S2, SOB, and fatigue are symptoms found in __________
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Atrial Septal Defect
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Pansystolic murmur, hyperdynamic precordium & thrill on exam is characteristic of ____________
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Ventricular Septal Defect
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What type of congenital cardiac defect is seen in Down's Syndrome patient?
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Atrioventricular Canal VSD
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A loud continuous machinery sounding murmur is characteristic of ____________
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Patent Ductus Arteriosus (PDA)
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What type of murmur is heard with Pulmonic Valve Stenosis?
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Systolic murmur at left upper sternal border that increases with inspiration
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Cyanosis, boot shaped heart on x-ray and clubbing is characteristic of ________
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Tetralogy of Fallot
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Upper extremity HTN and weak lower extremity pulse is indicative of ____________
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Coarctation of Aorta
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What is the most common congenital cardiac defect?
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Ventricular Septal Defect
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Pulmonic Valve Stenosis obstructs _________________
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right ventricular outflow
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Harsh systolic murmur radiating to the carotids and a soft or absent A2 is indicative of __________
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Aortic Stenosis (AS)
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Diastolic, blowing, decrescendo murmur best heard with patient leaning forward after expiration is characteristic of _____
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Aortic Regurgitation (AR)
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Austin Flint murmur - low pitched diastolic murmur is characteristic of ___________
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Aortic Regurgitation (AR)
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Diastolic low pitched murmur best heard in left lateral decubitus position with bell is characteristic of ____________
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Mitral Stenosis (MS)
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Holosystolic murmur radiating to axilla is characteristic of _______
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Mitral Regurgitation (MR)
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Midsystolic click followed by a late systolic murmur is characteristic of ___________
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MVP
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Diastolic murmur along the left sternal border indicates _________
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Tricuspid Stenosis
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Systolic murmur along the left sternal border that increases with inspiration is characteristic of _____
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Tricuspid Regurgitation
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Name 3 Class IA anti-arrhythmics
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procainamide
disopyramide quinidine |
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Name 3 Class IB anti-arrhythmics
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Lidocaine
Tocainide Phenytoin |
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Flecainide & Propafenone are in class ______
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IC
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B-blockers are in class _____
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II
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Amiodarone, Ibutilide, Sotalol, Bretylium & Dofetilide are class _____
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III
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Calcium channel blockers - Verapamil & Diltiazem are class ______
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IV
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Adenosine & Digoxin are class __
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V
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What is JVP an indicator of? What is considered abnormal?
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1) right atrial pressure
2) >3-4cm above sternal angle |
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Increased JVP indicates _______
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increased central venous pressure
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An increased a-wave indicates _____________
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Increased resistance to emptying right atrium
Ex: TS, RVH, HTN, anything that makes the heart work harder |
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ST elevation in leads II, III, and aVf indicates ___________
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inferior MI
Right Coronary Artery |
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Patients with ______ (5) are not candidates for a stress test
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unstable angina
AMI severe AS CHF exacerbation uncontrolled HTN |
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Stress test is not useful in patients with ______, _______, or abnormal baseline EKG
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LBBB
LVH |
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What are the cardinal symptoms of Aortic Stenosis?
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Syncope
Angina SOB (CHF) |
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Which valve is most often effected by rheumatic fever?
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Mitral Valve
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What are the major Jone's Criteria?
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C--Carditis
A--Arthritis...polyarthritis S--Sydenham's chorea E--Erythema marginatum S--Subcutaneous nodules |
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What are the minor Jone's Criteria?
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P = Prolonged PR interval-EKG
E = Elevated ESR A = Arthralgias C = C-Reactive Protein raised H = History rheumatic fever or strep |
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What is the treatment for stable angina?
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aspirin
nitro long acting nitrates B-blockers Ca+ channel blockers |
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What is the treatment for unstable angina?
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aspirin
heparin/lovenox GP IIB/IIIA Revascularization if meds don't help (CABG, PTCA, Stents) |
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What is the treatment for Prinzmetal's angina?
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Ca+ channel blockers
aspirin nitrates |
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What are the LDL goals?
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LDL < 100 for CAD/CAD equiv
LDL < 130 w/o CAD & >2 cardiac risk factors LDL < 160 w/o CAD & <2 cardiac risk factors |
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What are the absolute contraindications for thrombolytic therapy?
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aortic dissection
acute pericarditis active bleeding intracranial neoplasm previous cerebral hemorrhage cerebral aneurysm AV malformations |
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What are the relative contraindications for thrombolytic therapy?
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bleeding diaphysis/coagulopathy
major surgery/trauma/puncture nonhemorrhagic stroke w/in 6mo GI bleed w/in 6mo Severe HTN >180/95 prolonged CRP pregnancy proliferative retinopathy |
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Which cardiac enzyme peaks first and lasts the shortest length of time?
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myoglobin
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Which cardiac enzyme rises within 3-4 hours and lasts the longest?
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Troponin
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A systolic ejection murmur at the left sternal angle that increases with the Valsalva Maneuver is characteristic of __________
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Hypertrophic Cardiomyopathy
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____________causes thickening of the LV which results in ________
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Hypertrophic Cardiomyopathy
decrease in LV outflow |
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SOB, tachycardia, fatigue, distended jugular veins and pulsus paradoxus are symptoms/signs found in ___________
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Cardiac Tamponade
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Beck's Triad is associated with Cadiac _______
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Tamponade
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What is Beck's Triad?
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Muffled heart sounds
Distended JVD Hypotension |
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What are the symptoms of Acute Arterial Embolism?
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Pain
Pallor Paresthesias Paralysis Poikilothermia Pulselessness A-Fib 60-70% of pts |
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What is the recommended therapeutic anti-coagulation prior to cardioversion for A-Fib?
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>48 hrs or unknown time since AF
anticoagulate 3 weeks prior & 4 weeks following |
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Positive QRS concordance, presence of AV dissociation, capture beats or fusion beats is diagnostic of _____
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VT
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Atypical RBBB; monophasic R, QR, RS; triphasic QRS in V1; R to S ratio < 1 is suggestive of ____
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VT
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Atypical LBBB; R > 30ms or R to S; nadir or notch is suggestive of ___
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VT
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Shift of axis from baseline, history CAD (prior MI, ischemia, or CHF) is suggestive of ____tachycardia
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Ventricular
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QRS during tachycardia identical to QRS during sinus rhythm is suggestive of _____tachycardia
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Supraventricular (SVT)
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Termination with Adenosine is suggestive of _____tachycardia
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Supraventricular
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What are the abnormal values associated with ABI
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ABI < 0.9 is abnormal
ABI 0.5-0.8 is claudication ABI < 0.5 pain at rest |
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Abnormalities of ABI can be diagnostic of ________.
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Coarctation of Aorta
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What does ABI show?
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Difference in upper/lower extremity pressures
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What is Virchow's Triad?
What does it help to diagnose? |
endothelial damage
venous stasis hypercoagulation -DVT |
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What are the lab values associated with primary aldosteronism?
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*aldosterone/plasma renin >20ng/dL
*Serum aldosterone >15ng/dL *decreased K+ *decreased renin |
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What are the side effects associated with thiazide diuretics?
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hypokalemia
hyperuricemia hyperglycemia |
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What are the side effects associated with ACE-i
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angioedema
cough hyperkalemia rash |
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What are the side effects associated with b-blockers?
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bradycardia
bronchospasm depression fatigue sexual dysfunction |
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What are the side effects associated with Ca+ channel blockers?
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lower extremity edema
bradycardia constipation - verapamil |
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What is the JNS7 guideline for pre-HTN
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systolic 120-139
diastolic 80-89 |
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What is the JNS7 guideline for stage I HTN
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systolic 140-159
diastolic 90-99 |
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What is the JNS7 guideline for stage II HTN?
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systolic >160
diastolic >100 |
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What are the contraindications for a pacemaker?
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-asymptomatic sinus bradycardia or sinus node dysfunction
-bradycardia during sleep -1st degree AV block -asymptomatic Mobitz I second degree AV block -transient asymptomatic pause during A-fib -recurrent syncope of unknown origin |
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When is urgent surgery indicated for aortic dissection?
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-Type A aneurysms
-Type B aneurysms if dissection is continuing or aortic branch is compromised |