Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NPTE Study > 4.1 - CVP - PPT CVP DDx (Cardiovascular Section) > Flashcards

4.1 - CVP - PPT CVP DDx (Cardiovascular Section) Flashcards

Week 4, Monday

1
Q

Describe the pH scale (neutral vs acidic vs alkaline)

A

Neutral = 7
Acidic <7
Alkaline >7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the abnormal responses to exercise

A

Angina
Dyspnea
Pallor
Cyanosis
Dizziness, light-headedness
Ataxia
Intermittent claudication

Blunted BP response
Hypertensive BP response >200/110 mmHg
Drop in SBP >10-15 mmHg
Significant change in EKG rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is angina?

A

Substernal (chest) symptoms - heaviness, pressure, tightness, burning, squeezing, choking

Includes radiation to (L) neck, arms, back, or epigastrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the 3 types of angina - stable, unstable, Prinzmetal

A

Unstable - new, recent onset (within 6 wks); occurs at rest w/o precipitating factors; or abrupt change in patient’s pattern of symptoms

Stable - experienced at predictable myocardial workloads / demands / effort; “stable pattern”

Prinzmetal - coronary artery vasospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the clinical implications of unstable vs stable angina

A

Stable - want to stay under the anginal threshold while exercising; may use ntg prn if angina is present or prophylactic medications (long-acting nitrates, beta-blockers, calcium channel blockers) to decrease likelihood of experiencing angina

Unstable - usually signifies worsening of the underlying CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is nitroglycerin used for?

Describe how ntg should be used/

A

Taken prn during angina

Sublingual dose
Have patient lay down as expecting BP to drop

Releases NO, which is a potent vasodilator -> increased BF to heart, decreased TPR

Should act to relieve pain w/in 1-2 min

If no relief after 2 or 3 doses or within 20 min -> call 911

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the appropriate management for unstable vs stable angina

A

Stable - stay below anginal threshold during exercise

Unstable - immediate medical evaluation; i.e., call 911; goal is to prevent MI!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the clinical presentation of Prinzmetal angina

A

NOT preceded by increased myocardial demands

More common in women <50 yrs

S/sx:
- Pain often occurs early in AM, awakening patients from sleep
- Occurs at rest
- Sx difficult to induce w/ exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the medical management of Prinzmetal angina

A

Nitrates (ntg)
CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a myocardial infarction?

A

Cell death of the myocardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What physiologically causes an MI?

A

Lack of blood supply to myocardium –> tissue injury & infarction

Often results from plaque rupture with thrombus formation in a coronary vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What life-threatening condition can an MI lead to?

A

Cardiogenic shock
- Insufficient BP to heart & vital organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What cardiac enzymes are present and indicative of an MI? Describe these

A

Creatine-kinase-myocardial band (CK-MB)
Lactic dehydrogenase (LDH)
Troponin
Myoglobin

Cell death -> elevation in enzymes (does not occur w/ just ischemia)

Diagnosis of MI:
- Serial measurement troponin, AND
- Clinical changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the clinical presentation of an MI

A

Chest pressure
Radiating pain to L arm, jaw, and thorax
Dizziness, light-headedness
Diaphoresis
Fatigue, weakness

Women:
Mental status changes
Dyspnea
Weakness / lethargy
GERD pain
Anxiety / depression
Sensation of inhaling “cold air”
Achiness, heaviness, weakness of BIL UEs
Symptoms relieved by antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is it okay to initiate PT following an MI?

A

When cardiac troponin starts falling (before this, the cells are still dying)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the “traditional” sternal precautions

A

No pushing, pulling, or lifting >5-10 lbs
No twisting of trunk
No raising elbows above shoulder level
(No horizontal abduction)

Advised to follow for 6-8 wks

17
Q

Statins

Indications
Mechanism of action
Side effects

A

Indications: hyperlipidemia
- Decrease LDLs -> decrease risk of MI, CVA

MOA: Inhibit liver’s production of cholesterol

Potential side effects:
- Myalgia / myopathy (due to skeletal muscle breakdown)
- Rhabdomyolysis
- Liver impairment - asterixis, ascites
- Fever
- Nausea/vomiting

Teratogenic - must be avoided in pregnancy

18
Q

What is pericarditis?

What can cause it?

A

Inflammation of the pericardium (fuild-filled sac)

Trauma, autoimmune, idiopathic

19
Q

Describe the clinical presentation of pericarditis

A

Chest pain
Dyspnea
Pain RELIEVED by HOLDING BREATH or LEARNING FORWARD, SITTING UPRIGHT, KNEELING ON ALL FOURS
Pain AGGRAVATED by TRUNK MOVEMENT (creates friction of the pericardium)
Fever, chills, cough
LE edema

20
Q

Mitral valve prolapse

What is it?
Describe the clinical presentation
Treatment

A

Mitral valve w/ lax supporting structure leads to abnormally excessive movement of mitral valve leaflets
- –> regurgitation of blood back into the L ventricle

60% of patients have no symptoms

IF symptomatic, common triad:
a) Profound fatigue
b) Palpitations (strong, fast, or galloping)
c) Dyspnea

Treatment: surgery

21
Q

What is the end result of congestive heart failure?

A

Low cardiac output

22
Q

Describe the clinical presentation of left vs right-sided heart failure

A

General symptoms of heart failure:
- Fatigue
- Edema (pulmonary or peripheral)
- Fluid weight gain (“congestion”)
- Dyspnea

Left-Sided:
- PULMONARY EDEMA
- Progressive dyspnea
- Productive cough
- Paroxysmal nocturnal dyspnea (sudden recurrent attack at night due to lying position)
- Orthopnea
- Fatigue, exercise intolerance

R-Sided:
- Jugular venous distension
- PERIPHERAL EDEMA (ascites, abdominal pain / discomfort, pleural effusion)
- Cyanosis

23
Q

Define orthopnea

A

SOB (dyspnea) that occurs while lying supine

24
Q

Describe systolic HF vs diastolic HF

A

Both result in decreased CO, but for different reasons!

Systolic HF
- Reduced ejection fracture
- Heart is “too weak to pump”
- Decreased contractility

Diastolic HF
- Preserved ejection fraction
- Heart is “too stiff to fill”
- Decreased chamber compliance -> decreased EDV -> decreased SV -> decreased C

25
Q

What heart sounds may be indicative of chronic heart failure? Systolic HF? Diastolic HF?

A

Chronic heart failure = often S3

Systolic HF = S3 (due to increased atrial pressure leading to increased flow rates)

Diastolic HF = S4 (forceful atrial contraction into a stiff ventricle)

26
Q

What is cor pulmonale?

Describe the physiology

A

Cor pulmonale - condition that causes the R-side of the heart to fail due to excessive pulmonary arteries hypertension

Pulmonary hypertension –> R ventricular hypertrophy & alveolar damage / capillary wall damage –> R-sided heart failure

27
Q

How is jugular venous distension measured?
What is normal jugular venous distension?
What is it indicative of?

A

Measured w/ patient’s HOB elevated 45 deg (semi-fowler position)

Normal: <3-5 cm

R-sided heart failure

28
Q

What is a DVT?

A

A blood clot that forms in the veins

29
Q

Describe the clinical presentation of a DVT

A

Often asymptomatic

Pain in the region
Unilateral swelling, tenderness, & pain
Warmth
Discoloration / redness
Homan’s sign

30
Q

What is Homan’s sign?

A

Special test for DVT

Reproduction of patient’s symptoms by squeezing calf

NOT specific nor sensitive

31
Q

Review Wells Criteria for DVT

What score on Wells criteria indicates that a DVT is likely?

A

2 or more points

32
Q

What is a pulmonary embolism?

A

Pulmonary vascular obstruction caused by a displaced thrombus

“blood clot in the pulmonary arteries”

33
Q

Describe the clinical presentation of a PE

A

Dyspnea
Sharp, localized chest pain
Diffuse chest discomfort
Persistent cough
Hemoptysis (cough up blood)
Tachypnea
Tachycardia
Anxiety, restlessness

34
Q

Abdominal aortic aneurysm

What is it?
Clinical presentation

A

Aneurysm (abnormal bulge) of the abdominal aorta

Clinical Presentation:
-Pulsating mass in the abdominal area
- Bruit heard over swollen area
- Abdominal / back / flank pain
- Claudication (poor circulation)
- Poor distal pulses (turbulent flow due to aneurysm)

35
Q

Describe the medical management for an abdominal aortic aneurysm

A

If suspecting one –> refer to provider

If suspecting it has ruptured –> call 911

NPTE Study (49 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions