AANP EXAM NOTES 5 Flashcards
Increased risk for insulin resistance, Type 2 diabetes mellitus, renal dz.. hepatic dz., hyperlipidemia, HTN, CV dz are risk factors for PTs who are obese. T/F
TRUE
WHAT IS THE MEANING OF LUB, DUB, KENTUCKY, TENNESSEE
S1, S2, S3, S4
S1 = Systole, LUB. What valves are included in the S1?
(S1 heart sounds: mitral, tricuspid, & atrioventricular valves)
S2 = diastole DUB. Where is this sound best heard?
2nd ICS on left side
If the S2 sound is heard during inspiration, is it normal/abnormal?
normal
S3 = Cardiac apex. Where on the body is the S3 sound best heard?
5th ICS on left MCL.
If the S2 sound is heard during expiration, is it normal/abnormal?
abnormal
What valves are associated with the S2 sound?
(aortic, pulmonic, semilunar valves)
An abnormal S3 sound may be a sign of CHF in PTs older than what age?
40
Hearing the S3 sound is normal in children, athletes, and during pregnancy. T/F?
TRUE. The left lateral recumbent position brings the apex closer to the wall & improves the ability to hear the left ventricular S3.
The S4 sound is best heard where on the body?
5th ICS on left side,
An S3 that sounds like “Kentucky,” is associated with CHF in children, pregnancy, and some athletes. T/F
TRUE
The S4 sound is best heard at apex (bell). It indicates LVH (think oldest). T/F
TRUE
The S4 sound occurs early/late in diastole.
LATE
If the S4 sounds like “Tennessee” it indicates what atrial condition?
atrial gallop/atrial kick
The Bell of stethoscope is used for high/low tones ?
LOW Tones, (mitral stenosis),
The Diaphragm of the stethoscope is best used for Mid to high pitched sounds. T/F
TRUE. ? (MR, AS)
A Physiological S2 Split is normal if heard on expiration. T/F
FALSE. A Physiological S2 Split is normal if heard on INSPIRATION.
WHERE IS A PHYSIOLOGICAL S2 SPLIT BEST HEARD ON THE BODY?
2ND ICS UPPER LEFT SIDE OF STERNUM
What is the most common cause of death for people with DM?
HEART DZ
Heart disease & DM are common in what ethnic groups?
Mexican & African Americans, East Asians
What type of murmur radiates?
Systolic murmurs
Name 2 condx that may be indicated by Diastolic murmors
Aortic regurgitation, Mitral stenosis
If a murmur is found in a child, what is your next step?
Refer to cardiology
What type of holosystolic atrial murmur radiates to the axilla?
MR
A PT with Afib requires what type of TX?
Anticoagulation
Where is Aortic Regurgitation heard the loudest?
2nd ICS to right of sternum
What condx is characterized by a long asymptomatic period followed by exercise intolerance.
Aortic Regurgitation
What is a common early finding in a PT with AR?
Hypertrophied left ventricle
What murmur presents as a high pitched, diastolic that radiates toward the cardiac apex?
AR
Where is Mitral Stenosis murmur best heard?
Loudest Near cardiac apex
What GRADE is a murmur that is easily audible, associated with a thrill?
IV/VI
HTN is defined as BP above what levels?
130/80
A correlation between BP and age > 60 years exists. As age increases DBP decreases
TRUE
Naproxen has a FAVORABLE effect on HTN (Na + & K+). T/F
FALSE. Naproxen may have an UNFAVORABLE effect on HTN (Na + & K+).
Pt on Thiazide should have what levels monitored?
K+ Levels
Pt on Thiazide may experience what symptoms due to hypokalemia?
weakness, fatigue, muscle cramps, ED
A PT treated with candesartan (ARB) should avoid what supplement?
Potassium
What is one side effect of Lisinopril?
dry cough
Lisinopril is what type of enzyme inhibitor?
ACE