IM：cardio

12 flashcards · Other · by Wanying Koh

  1. aortic stenosis 疾病早期any s/s tx

    NO obvious s/s. only LV hypertrophy (肥厚) to compensate low c/o during this stage if no s/s - echo F/U if s/s present or LVEF <50% - chose SAVR or TAVR : same efficacy

  2. QT prolong causes electrolytes hormones drugs circumstances

    low K, Mg, Ca HYPOthyroidism drugs antiarrthymics 1a, 1c, III abx macrolides, FQ (-thromycin, -floxacin) antipsychotics haloperidol, risperidone, TCA MI, SAH, hypothermia, HIV infection

  3. pt w right ventricle heave, L 2nd intercostal rib systolic thrill, systolic murmur, wide split second heart sound Dx? ASD PDA AS PS

    right ventricle heave = R heart hypertrophy systolic murmur = AS, PS, MR, TR wide split second heart sound = ASD, PS ASD 無 R heart hypertrophy dx = PS

  4. II, III, aVF ST elevation tx

    - suspect right heart MI (RCA) esp. if L heart normal, no pulm edema (LCX) morphine oxygen if SaO2<90% normal saline 300-600ml over 10-15min (NO nitrate 禁忌!!) - hydrate to increase preload

  5. torsade de pointes tx

    IV MgSO4 IVF isoproterenol - B-adrenergic agonist (inc heaert contractility, dec BP) Overdrive pacing 90-110bpm

  6. continuous murmur

    PDA, sinus of valsalva rupture, AV fistula (not ASD - MSM ; VSD - HSM)

  7. HF tx

    ABD ACEI, ARB B-blockers- CBM Diuretics (furosemide, spironolactone, thiazides) CCB - cannot use in HF (unless HF is due to HTN and all other meds are exhausted)

  8. physiological S2 split wide S2 split paradoxical S2 split

    A2 ----> P2 (normally) negative chest pressure during inspiration cause blood flow return to inc = more blood flow back to right heart A2 -------------> P2. right heart more blood. PS, ASD, RBBB P2 -------------> A2. left heart more blood. AS, LBBB, HOCM

  9. what will cause HOCM murmurs to be louder

    standing , Valsalva maneuver (dec preload) 小聲：squatting (inc preload), handgrip (dec bv resistance, afterload inc) leg lift

  10. CHA2DS2VASc score 評估

    CHD HTN Age2 >75: 2 pts ; 65-74: 1pt DM Stroke/TIA - 2pts Vascular dz: PAOD, MI Sex category F 評估whether pt needs to start on anticoagulant M >1; F >2 就要

  11. TIMI risk score

  12. NSTEMI tx

    drug tx same as that for STEMI antiplatelets anticoagulation B blocker NTG invasive tx - only early PCI (<24h) if TIMI score 5-7 (STEMI invasive tx door-to-balloon 90min - PCI (<12hr ok) door-to-needle 30min - tPA (<3-6hr ok)