Jack Shared "Year 3 Medicine" - 31 Picmonics
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Year 3 Medicine
Deep Vein Thrombosis (DVT) Characteristics
- Mechanism
- Virchow's Triad
- Venous Stasis
- Endothelial Damage
- Hypercoagulability
- Symptoms
- Tenderness
- Homan's Sign
- Warmth
- Redness
- Swelling
- Asymptomatic
1 min
Deep Vein Thrombosis (DVT) Management
- Diagnosis
- Compression Ultrasound (CUS) with Doppler
- D-Dimer
- Contrast Venography
- Treatment
- IVC Filter
- Heparin for Acute Management
- Warfarin for Long-term Management
- Thrombectomy/Thrombolysis
- Stockings
- Walking
4 mins
Leg Veins
- Inferior Vena Cava
- Common Iliac (Ilium)
- External Iliac (Ilium)
- Great Saphenous
- Femoral
- Popliteal
- Small Saphenous
- Anterior Tibial
- Posterior Tibial
1 min
Pulmonary Embolism Causes
- Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Risk Factors
- Hypercoagulable
- Central Venous Lines
- Immobilized
1 min
Pulmonary Embolism Presentation and Diagnosis
- Presentation
- Sudden onset Shortness of Breath (S.O.B.)
- Tachypnea
- Pleuritic Chest Pain
- Hemoptysis
- Hypoxemia
- Sudden Death
- Diagnosis
- Gold Standard: CT Pulmonary Angiography
- X-Ray
- D-Dimer
- V/Q Scan
1 min
Wells' Criteria for Pulmonary Embolism
- Scoring
- Clinical Symptoms of DVT (+3)
- Pulmonary Embolism Most Likely Diagnosis (+3)
- Tachycardia (+1.5)
- Immobilization > 3 Days (+1.5)
- Previous DVT or PE (+1.5)
- Hemoptysis (+1)
- Malignancy (+1)
- Probability
- > 6 = High
- 2-6 = Moderate
- < 2 = Low
3 mins
Types of Heart Failure
- Left Sided
- Pulmonary Congestion
- Right Sided
- Peripheral Edema
- High Output
- Unable to Meet Metabolic Needs
1 min
Right Heart Failure Assessment
- Jugular Venous Distention (JVD)
- Peripheral Edema
- Hepatosplenomegaly
- Nocturia
- Weight Gain
- Ascites
- Fatigue
1 min
Left Heart Failure Assessment
- Pulmonary Assessment
- Pulmonary Congestion
- Pink Frothy Sputum
- Wheezing or Crackles
- Dyspnea with Exertion
- Cough
- Systemic Assessment
- Fatigue
- Tachycardia
- Weak Peripheral Pulse
- S3, S4 Heart Sounds
1 min
Heart Failure Interventions
- Diagnostic Tests
- Echocardiogram
- Invasive Hemodynamic Monitoring
- Improve Gas Exchange
- High Fowler's Position
- Oxygen
- Advanced Airway
- Drugs and Devices
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
2 mins
Stable Angina
- Assessment
- Chest Pain with Exertion
- Relieved within 15 Minutes
- ST Depression
- Interventions
- Nitroglycerin
- Up to 3 Doses q 5 Minutes
- Rest
- Antiplatelet Medication
- CABG
- Angioplasty
2 mins
Unstable Angina
- Assessment
- Chest Pain with Rest or Exertion
- Limits ADLs
- > 15 Minutes
- Less Likely Relieved by Nitroglycerin
- ST Depression
- Fatigue
- Considerations
- Acute Coronary Syndrome (ACS) Treatment
- Emergency Treatment
2 mins
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Cardiac Enzyme Evaluation: Creatine Kinase CK-MB
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 4-8 Hours
- Peak: 12-24 Hours
- Return to Normal: 2-3 Days
1 min
Cardiac Enzyme Evaluation: Myoglobin
- Measures
- Skeletal or Cardiac Muscle Injury
- Time Ranges
- Onset: 1 - 4 Hours
- Peak: 12 Hours
- Return to Normal: 24 Hours
- Considerations
- Elevation After 24 Hours: Reinfarction
2 mins
TIMI Score (Thrombolysis In Myocardial Infarction)
- Use
- Mortality Predictor
- Unstable Angina or NSTEMI
- 2 Week Risk of Death and Ischemic Events
- AMERICA (Each is +1)
- Age Greater or Equal to 65
- Markers Elevated
- EKG ST Changes (Greater or Equal to 0.5mm)
- Risk Factors for CAD (Coronary Artery Disease)
- Ischemia (2 Anginal Events in 24 Hours)
- Coronary Artery Disease (CAD)
- Aspirin Use in the Last 7 Days
3 mins
Evolution of Myocardial Infarction and Complications
- Hours to Days
- Arrhythmia
- Before 7 Days
- Fibrinous Pericarditis
- Papillary Muscle Rupture
- Interventricular Septum Rupture
- Before 14 Days
- Ventricular Pseudoaneurysm
- Ventricular Free Wall Rupture
- After 14 Days
- True Ventricular Aneurysm
- Dressler Syndrome
- Other
- Left Ventricular Failure
2 mins
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