Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RRCCPA Clin Med Exam 4 > Hall cardiomyopathies > Flashcards

Hall cardiomyopathies Flashcards

1
Q

What are the three types of cardiomyopathy?

A
  1. Dialated
  2. Hypertrophic
  3. Restrictive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is dilated cardiomyopathy?

A

A condition in which the heart becomes weakened and enlarged and fails to pump the blood efficiently.

There is either left or right systolic dysfunction leading to the progressive cardiac enlargement and hypertrophy. This is know as remodeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common form of non-ischemic cardiomyopathy?

A. Hypertrophic cardiomyopathy

B. Dilated cardiomyopathy

C. Restrictive cardiomyopathy

A

B. Dilated cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

S/Sxs of dilated cardiomyopathy?

A
  1. Fatigue
  2. SOB/DOE
  3. Paroxsymal nocturnal dyspnea
  4. LE edema, clubbing, weight gain, JVD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for dilated cardiomyopathy?

A
  1. CAD, HTN, Pregnancy, Thyroid disfunction, Cancer (breast)
  2. Alcohol
  3. Drug use (bad drugs) or Good depending on how you get down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dilated cardiomyopathy would present as congestive heart failure with volume overload. True or False

A

This is true because the heart is falling to pump adequetly so blood is backing up increasing the volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A obese smoker who drinks comes in complaining of SOB, Edema in the legs, DOE, anf fatigue what would be the next BEST step?

A. CXR and EKG

B. Labs

C. Echo

D. All of the above should be performed

A

D. all of the above is a workup for dilated cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the labs you should draw for dilated cardiomyopathy?

A
  1. CBC
  2. BNP
  3. CMP
  4. TSh
  5. Cardiac markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a key finding on a CMP you should look for when you suspect dilated cardiomyopathy

A

Low Na+ and elevated Creat. This pt would have a poor prognosis and needs immeiated Tx

It was stressed during halls lecture so know this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a widened mediastienum on an Xray considered until proven other wise?

A

Aortic Disection

Also stressed during the lecture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which of the following would be considered a normal size for a cardiac silhouette

A. 1/3

B. 1/4

C. 1/2

D. 5/8

A

C. 1/2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would be a normal size for the mediumstinum

A. 1/3

B. Less than 1/2 the cardiac silhouette

C. 2/3 that of Card silhouette

D. None of the above

A

B. less than 1/2 cardiac silhouette

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the main thing you want to do for a Pt with dilated cardiac myopathy? Think pts with this have volume overload.

A

Your first line of action would be to decrease the volume. This will lead to a reduction in preload and after load

Treat with CPAP and diuretics and good airway support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long does a 12 lead ekg record for before printing off?

A

10 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Medications you can use to treat dilate cardio myopathy?

A
  1. ACE/ARBs
  2. diruetics
  3. Beta blockers
  4. Alodsterone antagonists
  5. Inotropic agents
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Non-medication Tx for dilated cardiomyopathy? AKA surgery?

A
  1. Left ventricular assist devices
  2. Cardiac resynchronization therapy Biventricular pacing
  3. Ventricular restoration surgery
  4. Heart transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which of the following is the most common cause of sudden cardiac death?

A. cocaine use (ay yo for the ya yo)

B. Hyperthrophic Cardiomyopathy

C. Dilated Cardiomyopathy

D. V-fib

A

B. Hypertrophic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A 16 year old male is playing basketball and suddenly passes out on the court. He wakes up and feels fine and tells the couch to put him back in saying he passed out cause he was just dehydrated. Why do you not want him to go back into the game?

A

Because teens should not pass out (syncope) you should be thinking Hypertrophic Cardiomyopathy (HOCM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Who is more at risk of HOCM men or women?

A

Men and usually presents in third decade of life.

-it is the leading cause of sudden cardiac death in young adults and they are likely to have more severe form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following symptoms are most likely seen in people with hypertrophic cardiomyopathy?

A. Dyspnea, syncope, CHF angina

B. HA, Tinnitus, Vertigo

C. Nausea/Vomiting, CP, abdominal pain

D. None of the above

A

A. Dyspnea, syncope, CHF angina

-and he stressed Syncope and CHF so make sure to remember those two

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which of the following is the only arrythmia that can hit a HR 290?

A. SVT

B. AVRNT

C. Sinus Tachy

D. WPW

A

D. WPW can get up to a HR of 290

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What medication do you use to Tx WPW with?

A
  1. Procainamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which of the follow is true?

A. Someone with HOCM will have their murmur decrease with squatting and increase with valsalva

B. Someone with HOCM will have their murmur increase with squatting and decrease with valsalva

C. People with HOCM do not usually have a murmur

D. There is no change with the murmur with either squatting or standing

A

A. Someone with HOCM will have their murmur decrease with squatting and increase with valsalva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

After you find that ever so mythical PMI on your exam of a Pt with HOCM what would you expect to feel?

A. Normal Apical impulse

B. Bounding Apical impulse with laterally displaced PMI

C. Double apical pulse with laterally displaced PMI

D. All of the above

A

C. Double apical pulse with laterlally displaced PMI

-Very common characteristic of Hypertrophic Cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What workup would you do on a Pt with HOCM?

A
  1. EKG
  2. 2-D echocardiography
  3. Cardiac MRI
26
Q

You do your job and order an EKG on the young athelete that suddenly passed out. Which of the following EKG findings do you see?

A. Normal T-waves, P-waves, ST segment, bradycardia

B. T-wave inversion, ST-depression, conduction delay, right axis deviation, right atrial enlargement

C. T-wave inversion, ST-depression, conduction delay, conduction, left axis deviation, left atrial enlargement

D. A and B would both be seen

A

C. T-wave inversion, ST-depression, conduction delay, conduction, left axis deviation, left atrial enlargement

27
Q

Tx for HOCM both medical (medications) and surgical would be?

A
  1. Beta blockers, CCB’s
  2. AICD/Pacemaker
  3. Cardiac transplant
28
Q

You have an 75 year old Pt come into your office complaining of gradullay worsnening SOB and DOE. Upon Physical examination you note ascites, LE edema, hepatomegaly and JVD. Which of the following do you suspect?

A. HOCM

B. Dilated myopathy

C. Restrictive Cardiomyopathy

D. they are just old and obese

A

C. Restrictive Cardiomyopathy

29
Q

What other condition must you absolutely rule out when thinking restrictive cardiomyopathy?

A

Constrictive Pericarditis

30
Q

What labs should you draw on a patient with restrictive cardiomyopathy ?

A
31
Q

Which of the following would be elevated on the cbc i pts with restricitve cardiomyopathy?

A. Esinophils

B. Neutrophils

C. Glucose

D. RBCs

A
32
Q

Which of the following is true?

A. BNP elevated in patients with constrictive cardiomyopathy and normal BNP in patients w/restricitve cardiomyopathy

B. BNP normal in patients with constrictive cardiomyopathy and grossly elevated in patients with restrictive cardiomyopathy?

C. Normal BNP for bothe patients with constricitve and restrictive?

D. None of the above are true

A

B. BNP normal in patients with constricitve cardiomyopathy and grossly elevated in patients with restricitve cardiomyopathy

-Make sure to remember this. There is a table comparing constrive and restrictive on slide 59 be good to review

33
Q

What is the Tx for cardiomyopathy?

A

There is no specific treatment exists. Things you can do to are:

  1. diuretics
  2. vasodilators
  3. ACEI
  4. anticoags

Surgical innervention:

Permanent pacing, LVAD therpay until heart transplant

34
Q

Pt comes into the office looking very sickly, chest pain 5/10 thats dull and achy, IV drug usuer. Echo of heart so vegetation on the valves. What Dx is top on your list?

A

Endocarditis

35
Q

True or false: Endocarditis is inflammation of the endocardium/inner layer of the heart usually involves the valves both native and prosthetic

A

True- it may also include the chordae tendinea, interventricular septum and even surfaces of intracardiac devices

36
Q

With infective endocarditis which is true?

A. The valves of the hear recieve adequate blood supply and are able to have an immune response

B. There usually is no issue with the valves of the heart just the endocardium

C. The valves of the heart do not receive adequate blood supply resulting in a lack of immune response resulting in a blunted immune response

D. with damaged valves the risk of organism attachment is lower

A

C. The valves of the heart do not receive adequate blood supply resulting in a lack of immune response resulting in a blunted immune response

and D is false it is actually the opposit Damaged valves= greater chance of organism attachment

37
Q

Whhich bacteria are the main cause of endocarditis?

A

usually caused by a form of streptococci viridans

Other strains can be

streptococci bovis and equines- more common in pts with GI malignancies

38
Q

Difference btw subacute and acute endocarditis and the bacteria associated with each?

A

Subacute- streptococci and slowly progresses over weeks to months

Acute- Staph aureus and is a fulmiant illness that occurs over days to weeks

39
Q

What are classic symptoms of endocarditis present in about 50% of cases?

A

Osler nodes- very painful nodules found on the distal pads of the digits

Janeway lesions- non-tender, maculae on the palms and soles

Petechia- common but not specific finding

splinter hemorrhages- Dark red linear lesions in the nail beds

40
Q

What are the most common symptoms associated with endocarditis?

A

fever

chills

murmurs

41
Q

To confirm endocarditis according to the duke criteria what does a pt need?

A

one of the following

2 major criteria

1 major criterion and 3 minor

5 minor criteria

42
Q

What would be your workup on a pt with endocarditis?

A

Labs: renal function, serology eval, CBC

Blood cultures: 3 sets over a few hours

echocardiogram

43
Q

Tx for infective enocarditis?

A

broad spectrum antibiotics

Tx of CHF

Surgical eval for possible valve replacement

44
Q

What is acute pericarditis?

A

inflammation of the pericardium lasting less than 6 weeks characterized by a pericardial friction rub and serial ekg changes

most concerning complication of pericarditis is a cardiac tamponade

45
Q

What is the cardinal symptom of pericarditis?

A

Chest pain which refers to the trapezius, neck, left shoulder and left arm.

Most pts will be lening forward on exam

46
Q

What is your workup for acute pericarditis?

A
  1. History and physical exam
  2. CXR
  3. EKG
  4. Lab work (doesnt specify)
  5. 2D-echo if indicated
47
Q

causes of acute pericarditis

A
  1. Infections (viral, bacterial, and Tb)
  2. Inflammatory (RA, SLE, scleroderma, rheumatic fever)
  3. Metabolic (renal failure, hypothyroidism, and hypercholesterolemia)
  4. Cardiovascular (MI, Dressler effect (post by-pass or stent surgery), and aoritc dissection)
48
Q

What Heart issue would produce this kind of EKG

A

Pericarditis

Note the depression in lead II and the diffuse ST-elevation

49
Q

What is the Tx for acute perocarditis?

A
  1. Treat the underlying the cause
  2. Ibuprofen and tordol
50
Q
A
51
Q

What is a cardiac tamponade?

A

It is an acute type of pericardial effusion with either fluid, pus, blood, clots, or gas accumulates in the pericardium resulting in a slow or rapid compression of the heart

52
Q

What are the components of Becks triad for a cardiac tamponade?

A
  1. Hypotension occurs because decreased stroke volume
  2. JVD due to impaired venous return to the heart
  3. Muffuled heart sounds due to fluid buildup inside the pericardium
53
Q

What is the workup for a Cardiac Tamponade?

A
  1. Labs (CBC, chem panel, Troponin)
  2. EKG
  3. CXR (bottle shaped heart)
54
Q

What causes the alternating QRS complexes?

A

Because with a cardiac tamponade the heart is suspended in fluid, with every beat itll swing back and forth causing the change in amplitude of the QRS

55
Q

Tx for cardiac tamponade?

A
  1. Medical emergency patients go straight to ICU
  2. Oxygen
  3. Remove the FLUID!!!!

The main method you want to use to remove the fluid is U/S GUIDED PERICARDIOCENTESIS

56
Q

What are the three ways to remove fluid in someone who has a cardiac tamponade?

A
  1. Emergency subxiphoid percutaneous drainage
  2. U/S guided pericardiocentesis
  3. Percutaneous ballon pericardiotomy
57
Q

What are the types of pericardial effusions?

A
  1. Transudative (chf, myxoedema, nephrotic syndrome)
  2. Exudative (Tb, spread from empyema)
  3. Hemorrhagic
  4. Malignant (fluid accum due to metastasis)
58
Q

What are S/Sx of pericardial effusion?

A
  1. chest pain, pressure, discomfort
  2. light headedness, syncope
  3. palpitations
  4. cough
  5. dyspnea
  6. hoarsness
  7. hiccups
59
Q

What is the workup for a suspected pericardial effusion?

A
  1. Labs (electrolyte levels, CBC, cardiac markers, ESR, CRP, TSH, blood cultures, auto immune workup, RF, ANA…..lots of options
  2. EKG
  3. CXR
  4. 2D-echo
60
Q

What is this ekg suggestive of?

A

Pericardial effusion-note the alternating QRS complexes but no PR depression or ST elevation like in a cardiac tamponade

61
Q

Tx for pericardial effusion?

A

Pharmacotherapy:

  1. Aspirin/NSAIDS
  2. Colchicine
  3. Steroids
  4. Antibiotics

Systemica chemotherapy if due to malignant cause

steroid and NSAIDS are helpful due to autoimmune conditions

RRCCPA Clin Med Exam 4 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions