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Line 146: − − =Missed Concepts= − *'''Verapamil inhibits renal tubular secretion of digoxin, leading to toxicity''' − *6-minute walk test and cardiopulmonary exercise testing are useful tests for risk assessment prior to '''cardiac or pulmonary surgery.'''
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=Missed Concepts=
*'''Verapamil inhibits renal tubular secretion of digoxin, leading to toxicity'''
*6-minute walk test and cardiopulmonary exercise testing are useful tests for risk assessment prior to '''cardiac or pulmonary surgery.'''
*Give '''Lorazepam''' for cocaine induced hypertensive crisis. Metoprolol is contraindicated because it can '''cause unopposed alpha and may make it worse'''.
=Electrocardiogram=
=Electrocardiogram=
* sinus or not sinus? (look at P waves in II and V1)
* sinus or not sinus? (look at P waves in II and V1)
=Vascular Diseases=
=Vascular Diseases=
* [[Aortic Aneurism]]: Most are abdominal, most are below the renal arteries. Different types of repair (open vs endovascular), when to intervene (> 5.5 cm, rapidly enlarging, or causing organ damage), one time screening abdominal US recommended in ever smokers ages 65-75.
* [[Aortic Aneurism]]: Most are abdominal, most are below the renal arteries. Different types of repair (open vs endovascular), when to intervene (> 5.5 cm, rapidly enlarging, or causing organ damage), one time screening abdominal US recommended in ever smokers ages 65-75.
* [[Aortic Dissection]]: Stanford classification: type B (post left subclavian and descending aorta) is medically managed; type A (ascending aorta to the left subclavian or beyond) is a surgical emergency.
* [[Aortic Dissection]]: Stanford classification: type B (post left subclavian and descending aorta) is medically managed; type A (ascending aorta to the left subclavian or beyond) is a surgical emergency. Cocaine Related Chest Pain is a risk factor.
* [[Deep Venous Thrombosis]]: Virchow's triad, mostly occur in the legs, DVTs leading to PEs are usually in the femoral veins. Hofman's sign is neither sensitive or specific. Risk stratify based on Well's score, then get D-dimer (sensitive, not specific) if pre-test probability is low to rule out DVT. Can give therapeutic dose heparin if pre-test probability is high. '''Factor V Leiden increases risk of venous but not arterial thrombosis'''.
* [[Deep Venous Thrombosis]]: Virchow's triad, mostly occur in the legs, DVTs leading to PEs are usually in the femoral veins. Hofman's sign is neither sensitive or specific. Risk stratify based on Well's score, then get D-dimer (sensitive, not specific) if pre-test probability is low to rule out DVT. Can give therapeutic dose heparin if pre-test probability is high. '''Factor V Leiden increases risk of venous but not arterial thrombosis'''.
* Peripheral Arterial Disease: ABI
* Peripheral Arterial Disease: ABI
** [[Carotid Artery Stenosis]]
** [[Carotid Artery Stenosis]]
* [[Lymphedema]]
* [[Lymphedema]]
** In developed countries, is usually secondary to lymph node resection (e.g. radical mastectomy)
** In developed countries, is usually secondary to lymph node resection (e.g. radical mastectomy)
=Syncope=
=Syncope=
* Ddx includes cardiac arrhythmias ('''VT after MI or iso cardiomyopathy occurs without warning symptoms'''), vasovagal, seizures, orthostatic hypotension, SAH, vertigo, symptomatic anemia
* Ddx includes cardiac arrhythmias ('''VT after MI or iso cardiomyopathy occurs without warning symptoms'''), vasovagal, seizures, orthostatic hypotension, SAH, vertigo, symptomatic anemia