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Sachin Shared "P1" - 394 Picmonics

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P1

Ischemia and Vulnerable Tissues
Brain
MCA-ACA and MCA-PCA Interface
Heart
Subendocardium of Left Ventricle
Kidney
Proximal Tubule
Thick Ascending Limbs of the Loop of Henle
Liver
Central Vein
Colon
Splenic Flexure
Rectosigmoid Junction
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2 mins
Cardinal Signs of Inflammation
Redness (Rubor)
Warmth (Calor)
Swelling (Tumor)
Pain (Dolor)
Loss of Function (Functio laesa)
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1 min
Cancer Warning Signs (CAUTION)
CAUTION
Change in Bowel or Bladder Habits
A Sore That Does Not Heal
Unusual Bleeding or Discharge
Thickening or Lump in the Breast or Elsewhere
Dyspepsia (Indigestion)
Obvious Change to Warts or Moles
Nagging Cough
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1 min
Right to Left Heart Shunts
The 5 Ts
Truncus Arteriosus
Transposition of the Great Vessels
Tricuspid Atresia
Tetralogy of Fallot
Total Anomalous Pulmonary Venous Return (TAPVR)
Associations
Cyanosis at Birth
May Require PDA
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1 min
Left-to-Right Heart Shunts
The 3 Ds
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
PDA
Associations
Later Cyanosis
Clubbing
Eisenmenger's Syndrome
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2 mins
Atrial Septal Defect (ASD)
Pathophysiology
Hole in Septum between the Atria
Symptoms
Often Asymptomatic
Wide and Fixed Split S2
Cyanosis and Dyspnea
Easily Fatigued
Diagnosis
Chest X-ray shows Increased Pulmonary Vascular Markings
Echocardiogram
Treatment
Surgery if CHF as Child
Antibiotic Prophylaxis
Most Close Spontaneously
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2 mins
Ventricular Septal Defect (VSD)
Pathophysiology
Opening at Intraventricular Septum
Most Common Congenital Heart lesion
Symptoms
High-pitched Holosystolic Murmer (over left sternal border)
Dyspnea and Respiratory Distress
Loud Pulmonic S2
Diagnosis
Echocardiogram
Treatment
Small VSDs Close Spontaneously
Large VSDs Require Surgery
Complications
Endocarditis
Eisenmenger's Syndrome
CHF
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2 mins
Patent Ductus Arteriosus
Continuous
Machine like murmur
Often Due to Congenital Rubella
Prematurity
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1 min
Persistent Truncus Arteriosus
Common Arterial Trunk
Single Trunk Emerges from Both Ventricles
Symptoms
Cyanosis
Pulmonary Congestion
Heart Failure
Single S2 Sound
Diagnosis
Echocardiogram
Chest X-ray
Treatment
Early Surgical Correction
Avoids Pulmonary Hypertension
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2 mins
Tetralogy of Fallot (TOF)
Features
Blue Baby Syndrome
Mechanism
PROVe Acronym
Pulmonary Infundibular Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular Septal Defect (VSD)
Diagnosis and Treatment
Boot-Shaped Heart
Squatting for Tet Spells
Surgery
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2 mins
Total Anomalous Pulmonary Venous Return (TAPVR)
Pathophysiology
Pulmonary Veins Do Not Connect to Left Atrium
Oxygenated Blood Return to Right Atrium
Incompatible with Life without a Shunt
With Obstruction
Vessel Enters at an Acute Angle
Severe Cyanosis
Pulmonary Edema
Without Obstruction
Delayed Manifestation (1 or 2 years)
Right Heart Failure
Chest X-ray Shows "Snowman"
Diagnosis
Echocardiogram
Treatment
Surgical Correction
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3 mins
Transposition of Great Vessels
Pathophysiology
Pulmonary and Systemic Circulation are in Parallel
Incompatible with Life Without a Shunt
Symptoms
Severe Cyanosis at Birth
Single S2 sound
Diagnosis
Echocardiogram
Chest X-ray shows "Egg-shaped Silhouette"
Treatment
Prostaglandin
Avoid NSAIDs
Surgical Correction
Balloon Atrial Septostomy
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2 mins
Coarctation of The Aorta
Pathophysiology
Constriction of a Portion of Aorta
Turner Syndrome
Symptoms
Asymptomatic Hypertension
BP Higher in Upper Extremities, Right Arm
CHF
Diagnosis
Echocardiogram
Cardiac Catheterization
3 Sign on Chest X-Ray
Rib Notching
Treatment
Surgical Correction
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2 mins
Ebstein's Anomaly
Pathophysiology
Displacement of Tricuspid Valve Leaflets
Etiology
"Atrialization" of the Right Ventricle
Lithium Exposure In Utero
Signs and Symptoms
Tricuspid Regurgitation
Right-Sided Heart Failure
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1 min
Primary Hypertension Risk Factors
Excessive Alcohol Consumption
High Sodium Diet
Dyslipidemia
Obesity
People of African Descent
Advanced Age
Vitamin D Deficiency
Reduced Nephron Number
Diabetes
Lack of Physical Activity
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2 mins
Hypertension Assessment
Mechanism
Essential Hypertension
Secondary Hypertension
Assessment
Headache
Vision Changes
Nosebleed (Epistaxis)
Chest Pain
Syncope (Fainting)
Diagnosis
Average 2 Sets, 2 Minutes Apart
After 2 or More Visits (within 1-4 weeks)
Nursing Considerations
Take BP Both Arms
Common in African Americans
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2 mins
Blood Pressure Classification (JNC 7)
Classifications
Normal
Systolic (<120)
Diastolic (< 80)
Prehypertension
Systolic +20 (120-139)
Diastolic +10 (80-89)
Stage 1 Hypertension
Systolic +20 (140-159)
Diastolic +10 (90-99)
Stage 2 Hypertension
Systolic + > 20 (160)
Diastolic + > 10 (100)
Hypertensive Crisis
Systolic > 180
Diastolic > 110
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4 mins
Blood Pressure Classification (ACC/AHA 2017)
Classifications
Normal
Systolic Less than 120
Diastolic Less than 80
Elevated
Systolic +10 (120-129)
Diastolic Less than 80
Stage 1 Hypertension
Systolic +10 (130-139)
Diastolic +10 (80-89)
Stage 2 Hypertension
Systolic +40 (140-179)
Diastolic +30 (90-119)
Hypertensive Crisis
Systolic greater than or equal to 180
Diastolic greater than or equal to 120
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5 mins
Hypertension Management (JNC-8)
Goal of Treatment
Age Over 60 years (and Healthy)
150/90
Age Under 60 years (and Healthy)
Any Age with Diabetes or CKD
140/90
Treatment
ARB/ACE-I/Thiazide/CCB (Primary or Combo)
CKD (w/wo Diabetes)
ARB or ACE-I Primary
African American
Thiazide or CCB Primary
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3 mins
Hypercholesterolemia Disease
Risk Factors
Diabetes
Smoking
Family History
Hypertension
HDL < 40
Men Older than 45 Years of Age
Women Older than 55 Years of Age
Signs and Symptoms
Atheromas
Plaques in Blood Vessel Walls
Tissue Ischemia
Xanthomas
Lipemia Retinalis
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2 mins

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