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What is the MOA of diltiazem?
Class IV antiarrhythmic Ca2+ blocker used for rate control
What type of heart block involves the His-Purkinje system?
2nd Degree Mobitz II, and 3rd degree
S3 gallop implies ______ hypertrophy
eccentric
Ms. Howard has CHF due to excessive alcohol use. She is given furosemide, thiamine, digoxin, and spironolactone. Which have mortality benefit?
spironolactone
BNP is the ventricular response to increased pressure and volume of the ventricles. What effect does it have at the kidney?
Decrease Na+/H20 resorption. However it is overpowered by RAAS
Where is the chapman point for the heart?
R anterior 2nd intercostal space along the sternal border
What is the difference between creatine kinase and creatinine?
Creatinine = renal function; CK = muscle damage
What does colchicine do?
Colchicine can be used in pericarditis/myocarditis to reduce neutrophil migration to inflammed sites
What is Buerger's test and what is it used for?
Lift lower leg 15-30° --> pale, lower the leg --> rubor. Used to test for leg ischemia
What is the ankle-brachial index and what is it used for?
Indicates the compressibility of vessels. If ABI <0.90 --> peripheral artery Dz. May underestimate severity, and DM/CKD Pts may have false ↑ of ABI
What does asymmetric dimethyl arginine (AMDA) do? Hint: Peripheral artery Dz
competitively inhibits nitric oxide synthase -/-> vasodilation
Why might we find bilateral palpable dorsalis pedis pulses during acute DVT in the femoral vein?
DVT in vein, dorsalis pedis pulses are in arteries
Likely cause of syncope in young male with cresendo-decrescendo systolic murmur along left sternal border w/o carotid radiation?
Hypertrophic obstructive cardiomyopathy
What is the primary mitral valve abronmality in HOCM?
Systolic anterior motion of mitral valve, leaflet elongation
ID the most likely etiologic agent in 62 y/o F with pneumonia, T=104°F, pleuritic chest pain, rust colored sputum. Cultures show α-hemolysis.
Streptococcus pneumoniae
ID the most likely etiologic agent in 49 y/o F with fever and pleuritic chest pain. Exam reveals apical systolic murmur, splinter hemorrhages in fingernails. Hx of IV drug abuse. Culture reveals ß-hemolysis gram pos coccus
Staphalococcus areus
