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Internal Medicine Review ABIM part 1
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ABIM ABIM Internal Medicine UWorld
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Terms in this set (589)
What is a positive stress test Flat or Down sloping
St-segment depression >1 mm
occurring 80 msec after j point
When to stop a stress test St segment depression > 2 mm,
ventricular tachycardia,
drop in SBP > 15,
CP,
dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? Myocardial perfusion imaging with adenosine,
NOT exercising!
,When to not use doutamine for stress History of VT,
severe HTN,
Low BP,
poor echo images
When to not use adenosine for stress Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
2nd degree heart block, t
heophylline dependent
Normals for PA catheter pressures RA <8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures tamponade
elevated & equalized or restrictive pericarditis
in all chambers,
low BP
Elevated RA and PA pressures, RV MI
decreased or nl PCWP,
hypotension
Elevated PCWP, RA pressure cardiogenic shock
decreased SBP/cardiac output
high RA, mitral stenosis with RV failure
PA very elevated
high PCWP
nl SBP
Elevated PAP, RAP pulmonary HTN
nl PCWP, SBP
decr in SBP>10mmHg with nl inspiration; pulsus paradoxus:
palpated as weakened pulse with inspiration & Constrictive or restrictive pericarditis,
more heart contractions to pulse beats asthma,
tension pneumothorax
What gives you pulsus bisferiens Aortic regurgitation,
(two systolic peaks per cycle) HOCM
What causes pulsus alternans Severe LV dysfunction
What causes pulsus tardus Aortic stenosis
, How do positional maneuvers affect blood flow and -standing/valsalva:
murmurs decreased cardiac filling,
decreases most murmurs
except MVP and HOCM
-squatting/ lying down:
increase cardiac volume,
increased murmurs
except MVP, HOCM
-sustained handgrip:
increases systemic resistance
decreases murmur in HOCM, AS
What causes a physiologic split S2 Increased blood volume in the RV
prolongs systole and
delays pulmonary valve closure
What causes a fixed split S2 Pulmonary stenosis,
PE,
LV pacer,
RBBB,
MR (early AV closure),
ASD,
RV failue
What causes a paradoxic split S2 LBBB,
RV pacing,
HOCM
What causes an S3? Rapid LV filling:
acute ventricular decompensation,
severe AR or MR
What are the parts of the venous waveform? A wave - atrial contraction
X descent - atria relax, RV fills rapidly
Bottom of x descent is TC valve closure
V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens,
passive emptying into ventricle
What gives elevated a and v waves Pulmonary HTN,
RV infarction
Large r side v waves Septal rupture
Large v waves TR (right),
MR (left)
Internal Medicine Review ABIM part 1
Leave the first rating
Play your way to mastery with fun games
Match Blocks Charms NEW
Students also studied
Flashcard sets Study guides
ABIM ABIM Internal Medicine UWorld
2,000 terms 871 terms 132 terms 246 term
acorkery23 Preview michaelwb277 Preview zeem13 Preview Gin
Terms in this set (589)
What is a positive stress test Flat or Down sloping
St-segment depression >1 mm
occurring 80 msec after j point
When to stop a stress test St segment depression > 2 mm,
ventricular tachycardia,
drop in SBP > 15,
CP,
dyspnea,
lightheadedness
Stress test of choice with a LBBB or ventricular pacing? Myocardial perfusion imaging with adenosine,
NOT exercising!
,When to not use doutamine for stress History of VT,
severe HTN,
Low BP,
poor echo images
When to not use adenosine for stress Bronchospasm,
severe valvular dysfunction,
severe carotid stenosis,
2nd degree heart block, t
heophylline dependent
Normals for PA catheter pressures RA <8
RV 30/8
PCWP 3-12
PAP 12--12
Diastolic pressures tamponade
elevated & equalized or restrictive pericarditis
in all chambers,
low BP
Elevated RA and PA pressures, RV MI
decreased or nl PCWP,
hypotension
Elevated PCWP, RA pressure cardiogenic shock
decreased SBP/cardiac output
high RA, mitral stenosis with RV failure
PA very elevated
high PCWP
nl SBP
Elevated PAP, RAP pulmonary HTN
nl PCWP, SBP
decr in SBP>10mmHg with nl inspiration; pulsus paradoxus:
palpated as weakened pulse with inspiration & Constrictive or restrictive pericarditis,
more heart contractions to pulse beats asthma,
tension pneumothorax
What gives you pulsus bisferiens Aortic regurgitation,
(two systolic peaks per cycle) HOCM
What causes pulsus alternans Severe LV dysfunction
What causes pulsus tardus Aortic stenosis
, How do positional maneuvers affect blood flow and -standing/valsalva:
murmurs decreased cardiac filling,
decreases most murmurs
except MVP and HOCM
-squatting/ lying down:
increase cardiac volume,
increased murmurs
except MVP, HOCM
-sustained handgrip:
increases systemic resistance
decreases murmur in HOCM, AS
What causes a physiologic split S2 Increased blood volume in the RV
prolongs systole and
delays pulmonary valve closure
What causes a fixed split S2 Pulmonary stenosis,
PE,
LV pacer,
RBBB,
MR (early AV closure),
ASD,
RV failue
What causes a paradoxic split S2 LBBB,
RV pacing,
HOCM
What causes an S3? Rapid LV filling:
acute ventricular decompensation,
severe AR or MR
What are the parts of the venous waveform? A wave - atrial contraction
X descent - atria relax, RV fills rapidly
Bottom of x descent is TC valve closure
V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens,
passive emptying into ventricle
What gives elevated a and v waves Pulmonary HTN,
RV infarction
Large r side v waves Septal rupture
Large v waves TR (right),
MR (left)
