AAFP Cardiology Flashcards

0
Q

Diabetes drug classes that should not be given to patients with heart failure?

A

Thiazolidiodiones

Metformin

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1
Q

Most common cause of hypertension in children under six (work up)?

In older children and adults?

A

Renal parenchymal disease (UA, urine culture, renal ultrasound)

Essential hypertension

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2
Q

Metformin contraindicated with?

A

Renal insufficiency or heart failure

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3
Q

Optimal HF candidate for cardiac resynchronization therapy (pacemaker)?

A
#LVEF under 35%
#QRS over 120
#Sinus rhythm
#Maximal medical therapy (carvedilol 25 BID., furosemide 40 BID, ACE inhibitor 40 BID)
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4
Q

Food shown to decrease risk of sudden cardiac death in patients with cardiovascular disease? (Mech)

A

Omega-3 fatty acids – (anti-inflammatory, antiplatelet, vasodilator, antiarrhythmics)

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6
Q

Management of descending aortic dissection?

A
#Lower rate below 60 with beta blockers (propanolol or labetalol)
#Lower systolic blood pressure to 100-120 (nitroprusside)

*B-blocker must be given before nitroprusside to prevent reflex tachycardia

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7
Q

Who should be screened for abdominal aortic aneurysms?

A

Male smokers age 65-75

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8
Q

Patient presents with supraventricular tachycardia – treatment? If fails? If fails? If fails?

A
  1. Adenosine
  2. Verapamil or beta blocker
  3. Flecainide or propafenone
  4. DC cardioversion
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9
Q

Monotherapy for hypertension and African-Americans should include these drugs? (instead of these drugs)

A

Calcium channel blockers and diuretics (beta blockers or ACE inhibitors)

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10
Q

Renal failure will affect the dosing of what anticoagulant?

A

Lovenox

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11
Q

Significance of new onset left bundle branch block in pt with MI?

Indicated treatment?

A

Occlusion of LAD

Thrombolytics

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12
Q

Isolated systolic hypertension in the elderly – responds best to what drug class?

A

Thiazides

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13
Q

Pt with depression – do not use these antihypertensives?

A

Beta blocker, clonidine

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14
Q

Best initial test for peripheral vascular occlusive disease?

A

ABI

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15
Q

Symptoms of congestive heart failure in infants are usually observed when?

A

Feeding

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16
Q

Surgeries with the highest incidence of DVTs?

A
#neurosurgical procedures
#Orthopedic procedures
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17
Q

Patient with aortic stenosis – do not perform this test?

Perferred treatment?

Effect of balloon valvotomy on survival?

Use of medical management?

A

Exercise stress test

Valve replacement

Does not prolong survival

Not effective

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18
Q

Contraindications for beta blockers?

A
#Hemodynamic instability
#Severe asthma
#Heart block
#Bradycardia
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19
Q

Leading cause of death among women?

A

Cardiovascular disease

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20
Q

Who should get a resting EKG for surgery?

A
#Males over 45, females over 55
#Diabetes
#Chest pain
#Previous history of cardiac disease
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21
Q

Perioperative drug to use in patients with prior MI?

A

Beta-blocker

22
Q

Before treating hyperlipidemia, need to rule out?

A
# diabetes
#Hypothyroidism
#Liver or renal disease
23
Q

Why should NSAIDs be avoided in patients with heart failure?

A
#Cause sodium and water retention
#Increases systemic vascular resistance (can cause cardiac decompensation)
24
Q

First-line treatment for a geriatric patient with a systolic blood pressure of at least 160?

A

Thiazides

25
Q

Treatment for pregnant patients with severe hypertension?

A
#Hydralazine
#Labetalol
#Oral nifedipine
26
Q

Drug associated with lower mortality in CHF patients?

A

ACE inhibitor

27
Q

Major risk factors for perioperative cardiovascular risk in the elderly?

A
#Unstable coronary syndrome
#CHF
#arrhythmias (AV block, ventricular arrhythmia, uncontrolled ventricular rate)
#Severe valvular disease
28
Q

Intermediate risk factors for perioperative cardiovascular events in elderly?

A
#Mild angina
#Previous MRI
#Compensated CHF
#Diabetes
#Efficiency
29
Q

Two signs of peripheral vascular disease after exercise?

A
#Decrease in ABI
#20 mm or Greater decrease in ankle systolic blood pressure
30
Q

Criteria for severe preeclampsia?

A
# blood pressure of 160/110
#Proteinuria over 5 g per day
#Thrombocytopenia under 100,00
#LFT abnormalities
#Epigastric/right upper quadrant pain
#altered Mental status
31
Q

Renal failure will affect the dosing of what anticoagulant?

A

Lovenox

32
Q

Significance of new onset left bundle branch block in pt with MI?

Indicated treatment?

A

Occlusion of LAD

Thrombolytics

33
Q

Isolated systolic hypertension in the elderly – responds best to what drug class?

A

Thiazides

34
Q

Pt with depression – do not use these antihypertensives?

A

Beta blocker, clonidine

35
Q

Best initial test for peripheral vascular occlusive disease?

A

ABI

36
Q

Symptoms of congestive heart failure in infants are usually observed when?

A

Feeding

37
Q

Surgeries with the highest incidence of DVTs?

A
#neurosurgical procedures
#Orthopedic procedures
38
Q

Patient with aortic stenosis – do not perform this test?

Perferred treatment?

Effect of balloon valvotomy on survival?

Use of medical management?

A

Exercise stress test

Valve replacement

Does not prolong survival

Not effective

39
Q

Contraindications for beta blockers?

A
#Hemodynamic instability
#Severe asthma
#Heart block
#Bradycardia
40
Q

Leading cause of death among women?

A

Cardiovascular disease

41
Q

Who should get a resting EKG for surgery?

A
#Males over 45, females over 55
#Diabetes
#Chest pain
#Previous history of cardiac disease
42
Q

Perioperative drug to use in patients with prior MI?

A

Beta-blocker

43
Q

Before treating hyperlipidemia, need to rule out?

A
# diabetes
#Hypothyroidism
#Liver or renal disease
44
Q

Why should NSAIDs be avoided in patients with heart failure?

A
#Cause sodium and water retention
#Increases systemic vascular resistance (can cause cardiac decompensation)
45
Q

First-line treatment for a geriatric patient with a systolic blood pressure of at least 160?

A

Thiazides

46
Q

Treatment for pregnant patients with severe hypertension?

A
#Hydralazine
#Labetalol
#Oral nifedipine
47
Q

Drug associated with lower mortality in CHF patients?

A

ACE inhibitor

48
Q

Major risk factors for perioperative cardiovascular risk in the elderly?

A
#Unstable coronary syndrome
#CHF
#arrhythmias (AV block, ventricular arrhythmia, uncontrolled ventricular rate)
#Severe valvular disease
49
Q

Intermediate risk factors for perioperative cardiovascular events in elderly?

A
#Mild angina
#Previous MRI
#Compensated CHF
#Diabetes
#Efficiency
50
Q

Two signs of peripheral vascular disease after exercise?

A
#Decrease in ABI
#20 mm or Greater decrease in ankle systolic blood pressure
51
Q

Criteria for severe preeclampsia?

A
# blood pressure of 160/110
#Proteinuria over 5 g per day
#Thrombocytopenia under 100,00
#LFT abnormalities
#Epigastric/right upper quadrant pain
#altered Mental status