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Abdominal US: advantages
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Cardio Dx Med
Cardiology
| Question | Answer |
|---|---|
| Initial dx test to screen for & follow known AAA = | Abdominal US |
| Abdominal US: advantages | 100% sensitivity, no contrast, low cost |
| AAA: CT scan | pre-op or if US indeterminate; better defines shape & location/ extent of AAA |
| AAA: Catheter aortography may: | underestimate diameter |
| TAA Evaluation | CXR; Echo (TTE vs TEE); CT/ MRI |
| TAA: CXR for dx: | CXR NOT dx alone (need CT or MRI to r/out if CXR neg) |
| Aortic Dissection Eval: CXR = | wide aortic silhouette & mediastinum, poss L sided pleural effusion |
| Aortic Dissection Eval: Echo = | 98% sensitive, 99% specific, +/- pericardial effusion, done bedside |
| Aortic Dissection Eval: CT helpful in: | acute presentation |
| Aortic Dissection Eval: MRA/MRI useful for: | serial follow up |
| Aortic Dissection Eval: EKG = | LVH, nonspecific or inferior abnormalities (dissections preferentially extend into Right coronary ostium) |
| DVT Evaluation | D-dimer; LE Doppler/ US; if PE suspected, VQ scan versus spiral CT; hypercoaguable w/u if no identifiable predisposing event |
| a break down product of a thrombus | d-dimer |
| characteristic of d-dimer | sensitive, but not specific |
| d-dimer is best for _______ DVT, or PE | ruling out |
| gold standard for suspected DVT, however it is rarely done | contrast venography |
| most common and practical means of detecting DVT | ultrasound |
| most common test for PE | spiral CT |
| gold standard for PE but rarely done | pulmonary arteriogram |
| CHF on CXR | Fluffy bilateral edema, Kerley B Lines, pleural effusions |
| cardiac biomarkers for stable/unstable angina | always negative |
| CHF: Cardiac Cath consists of: | Left ventriculogram; Arch shot; Coronary angiography to assess for blockages |
| Cardiac Cath: Indicated in: | MI, USA |
| Kerley B lines = | sharp, linear densities of interlobular interstitial edema |
| CHF: Echo provides: | structural, anatomic & physiologic info about the heart |
| BNP: relationship to CHF: | BNP secreted from ventricles under stress in CHF |
| BNP may be falsely elevated in: | renal failure |
| HTN eval labs | UA; serum Cr, glu, K+, Na+ ; Lipids (TC, trigs, HDL, LDL); 12-Lead EKG (LVH) |
| Venous Thromboembolism: Screen with: | duplex Doppler venous ultrasound |
| Echo: TTE vs TEE | TTE only good to visualize aortic root (good for Marfan); TEE to visualize entire aorta, but is semi invasive (CT/ MRI better) |
| Hx angina but no acute sx; EKG no acute changes; next step: | Do exercise stress test |
| Diagnostic features of systolic CHF | Echo reduced EF; CXR Cardiomegaly; CXR Pulm edema |
| Diagnostic features of diastolic CHF | Echo LVH; EKG LVH; CXR Pulm edema |
| Echo features present in systolic HF & absent in diastolic HF | Reduced EF; LV dilation |
| In a pt with HTN, CAD, A-fib, and multiple TIA episodes in last 2 weeks (currently asymptomatic), what test is next step in mgmt? | TEE |
| Patient with hx of HTN and CAD presenting with substernal CP is given SL NTG and then has syncope. What is next diagnostic step in mgmt? | TTE |
Created by:
Abarnard
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