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Cardiology > Adam Olsen Review > Flashcards

Adam Olsen Review Flashcards

1
Q

Walking briskly for 30 mins every days of the week can lower systolic bp by how much?

A

4-9

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2
Q

Weight loss of 10kg can decrease systolic bp by how much

A

5-20

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3
Q

Most common type of htn

A

essential or idiopathic

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4
Q

MCC of secondary htn

A

Renal disease

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5
Q

What demographic has more signifigant htn at a younger age

A

AA males

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6
Q

Dash diet alone can decrease the the bp by how much

A

8-14

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7
Q

Sodium restiction can decrease systolic bp by how much

A

2-8

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8
Q

A new onset HTN what is the tx

A

lifestye modifications

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9
Q

Lifestyle modifications for how long

A

6-12 months

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10
Q

What do you need to be careful of with a young female and ACE

A

Pregnancy - highly teratogenic

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11
Q

Pt with HTN and proteinuria

A

ACE

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12
Q

Raynauds and HTN?

A

CCB

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13
Q

Name some CCB’s

A

Amlodipine, Nifedipine, Diltiazem (non-d), verapamil (non-d)

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14
Q

Which CCB can slow AV conduction

A

Non- Dihydro

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15
Q

You are asked to give a med for anti-anginal

A

Nifedipine

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16
Q

Side effects of CCB

A

Constipation, peripheral edema

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17
Q

Name some loop diuretics

A

Furosimide, bumix

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18
Q

Name some thiazide diuretics

A

HCTZ

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19
Q

S/E of loops

A

hypokalemia, hypercalcemia, hypomagnesemia, ototoxicity

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20
Q

A patient has an elevated Ca with normal PTH?

1) Thizide induced
2) Hyperparathyroid
3) Dehydration

A

Thiazide diuretic

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21
Q

A pt has nephrotic syndrome – med>

A

Loop

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22
Q

I am an AA with LV dysfunction give me a med

A

Nitrates and hydralazine

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23
Q

I am a white with LV dysfunction give me a med

A

BB, ACE or ARB and diurtic

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24
Q

Example of ace

A

Lisinopril, enalapril, captopril

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25
Q

ACE s/e

A

angioedema, cough

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26
Q

I have CKD give me a med

A

ACE, ARB

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27
Q

Htn urgency - what is the % of bp you want to decrease in the first 24 hours

A

No more than 25%

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28
Q

Why decrease the bp slow in htn urgency

A

decrease profusion to kidneys, possible heart and

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29
Q

When do you use Nitropressidue

A

HTN emergency (only comes in IV)

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30
Q

Why use labetolol

A

short acting

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31
Q

What are IV anti-hypertensives that you can use for HTN

A

hydralazine (10-20mg IV push), Labetolol, nitropressidue,

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32
Q

You think I have a secondary cause of HTN and I have low K and HTN

A

Primary hyeroaldosteronism

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33
Q

Primary hyperaldosteronism

A

Low potassium and HTN

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34
Q

you think I have a pheo what labs do you order

A

24 hour urine

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35
Q

Ihave elevated Ca and Htn and am not on any meds what secondary cause could we have

A

hyperparathyroid

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36
Q

I take HCTZ and have elevated Ca what could be the cause

A

HCTZ

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37
Q

What medication can you not be on if you are testing for hyperaldosteronism

A

Spiranolactone

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38
Q

Aldosterone is release from the

A

Adrenal gland

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39
Q

Why does the kdney release aldosterone

A

decreased flow to the kidney

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40
Q

Does aldosterone retain water or excrete it

A

retain

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41
Q

You think I may have hyperaldosteronism what labs do you order

A

renin and aldosterone (1:20 or greater)

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42
Q

I have central obesity and striae with Htn

A

cushings

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43
Q

I have htn and decreased femoral pulses

A

Coarctation of aorta

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44
Q

Halmark of pheo

A

elevated catacholamines (metanephrines)

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45
Q

I have tachycardia, nervousness,sweating and htn,

A

pheo

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46
Q

I am obese and have a hard time sleeping at night and I have Htn – what may i develop

A

uncontrolled HTN

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47
Q

I have sleep apnea what am I at risk for

A

arrythmias

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48
Q

What BB do we not give those cocaine peeps

A

Cardioselective (Lopressor, metoprolol)

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49
Q

I am in actue Pulmonary Edema what med should you give me

A

Lasix- then nitro

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50
Q

I had an MI and now I am in severe CHF you do an echo and I have severe MR–why?

A

Ruptured Papilary muscle

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51
Q

What are thesystolic murmurs

A

AS, PS, MR, TR

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52
Q

What is the S1

A

closure of Mitral and tricuspid valve

53
Q

What is the s2

A

closure of aortic and pulmonic

54
Q

S3 and S4 systolic or diastolic

A

diastolic

55
Q

S3 signifies whay

A

LV dysfunction, cardiomyopathy, CHF, volume overlad

56
Q

S3 is heaard best by what side of the stethescope

A

bell

57
Q

when is S3 in diastole

A

early

58
Q

when is S4 in diastole

A

late

59
Q

What is S4 associaed with

A

Stiff ventricle, enlarged LV, Long standing HTN,

60
Q

Can you have an S4 gallop in A fib?

A

No- you need atrial contraction to have an S4

61
Q

I have a crescendo- decrescendo radiating to my neck

A

AS

62
Q

I have a diastolic blowing murmur

A

AR

63
Q

Waterhammer pulse is associated with

A

AR

64
Q

Corrigans sign is associated with

A

AR

65
Q

Quinkes pulse is associated with

A

AR

66
Q

Traubes sign is associates with

A

AR

67
Q

Holosystolic in apex radiating to axilla

A

MR

68
Q

opening snap with diastolic rumble

A

MS

69
Q

I had rheumatic heart disease what valvular problem do I have

A

MS

70
Q

Rheumatic heart disease and what criteria

A

Jones

71
Q

Mid systolic click

A

MVP

72
Q

I have a loud crescendo decrescendo murmur that increasess with valsalva

A

HCM

73
Q

Valsalval ___________ preload

A

Decreases (you are underfilling the heart)

74
Q

Hand grip ___________________ preload

A

increases

75
Q

Cardiomyopathy definition?

A

Disease process of the heart

76
Q

Most common cause of restrictive cardiomyopathy

A

Amylodosis

77
Q

Dilated cardiomyopathy causes

A

alcohol, uncontrolled htn, valvular disease, CAD, MI, Cocaine, pregnancy, hyperthyroidism, iatrogenic, viral (most common- cowasaki)

78
Q

Hypertrophic cardiomyopathy examples

A

genetic (most common), athletes, long standing

79
Q

Restricted cardiomyopathy causes

A

Sarcoid, amyloid, hemachromatosis

80
Q

secondary outcome of HCM

A

Ventricular arrhythmias

81
Q

MCC of sudden cardiac death

A

v fib

82
Q

What medication should you treat someone with HCM

A

BB

83
Q

I have high levels of monoclonal light chains in my blood- differentials please

A

Multiple myloma or amyloidosis

84
Q

What is the MC type of cardiomyopathy

A

Dialated

85
Q

What is the least common type of cardiomyopathy

A

restrictive

86
Q

If you see Right axis deviation what type of disease states should you think of

A

Pulmonary

87
Q

Left heart failure symptoms

A

pulmonary edema, orthopnea and PND

88
Q

Right heart failure

A

Peripheral edema, anasarca, ascites, JVD, hepatomegaly

89
Q

can you have right and left sided yeart failure

A

yes—bad question

90
Q

class 1 NYHA

A

No limitations to physical activity, no symptoms

91
Q

Class 2 NYHA

A

slight symptoms with activity

92
Q

Class 3 NYHA

A

Symptomatic with limtited activities

93
Q

Class 4 NYHA

A

Symptomatic at rest

94
Q

Systolic dysfunction is classified as

A

EF< 40%

95
Q

What is the EF

A

Amount of blood left at the end of diastole following systole— or rather the % of blood pumped out of the left ventricle

96
Q

MCC of CHF

A

Ischemic heart disease of MI

97
Q

Diastolic dysfunction

A

increase in ventricular stiffness - normal EF

98
Q

Fluid with protein < 0.6 what is the type of fluid

A

transudatice

99
Q

Causes of transudative

A

CHF (MC), Chiirrosis, low albumin, low nutitional status

100
Q

cause of exudative fluid

A

Infection (MC), cancer

101
Q

You give an elderly patient levothyroxine and they are having SOB….why could that be

A

Highoutput CHF caused by too much T4

102
Q

I have CHF with normal LV function and i am not fluid overload what is the best bedication for me to start now?

A

Metoprolol- always a BB

103
Q

A patient has angina that lasts 15 mins and is resolved he has negative tests (trop and ekg) what next

A

Serial Trops

104
Q

What do you do after serial troponins is a patient if they are all neagative and the patient is still asymptomatic

A

stress test

105
Q

Stress test shows mild area of ischemia what do you do

A

Medical therapy

106
Q

Stress test shows a large area of ischemia what do you do

A

cath them

107
Q

Pharmaolical stress testing is done with what 3 agents

A

dypridamole(persantine), adenosine, dobutimine

108
Q

contraindications for adenosine and persantine?

A

bronchospasm, phulmonary disease, heart block (use dobutimine)

109
Q

ACS includes

A

unstable angina
Non ST elevation MI
STEMI

110
Q

Is demand ischemia classified as an ACS

A

NO- it is a type 2 MI.

111
Q

When does trop I begin to rise

A

4-8 hours and lasts 10-14 days

112
Q

What test is good to test for re-infarct?

A

CK and CK MB

113
Q

You want to use the earliest test to ssee if there is an MI what do you use

A

CKMB- rises within 4-6 hours so a little quicker

114
Q

Immediate tx for ACS

A

MONA (morphine, oxygen, nitro, asprin)

115
Q

I have an inferior wall infact what should you not give

A

Nitro

116
Q

Should you chew or swollow asprin? Why?

A

Chew, faster absorbed

117
Q

What is the drug that decreases mortality in patients at the time of infarct

A

Asprin- always give asprin first!!!!!!!

118
Q

What else should you give patients with ACS besides MONA initially

A

BB, Heparin, Clopidogrel (plavix)

119
Q

When should you give TPA

A

STEMI with no access to cath lab

STEMI with contraindication to surgery or cath for some reason

120
Q

I have cp after a recent MI- my EKG shows PR depressions what do I probably have

A

Dresslers syndrome (remember PR depressions are as important as ST elevations)

121
Q

Pericarditis treatment

A

NSAIDS
steroids
Colchecine (sorry for bad spelling)

122
Q

What is nicotinic acid

A

Niacin

123
Q

What do you use to lower tiglicerides

A

fibric acid derivitives (genofibrozil, fenofibrate)

124
Q

What is the perferred therapy for someone with low HDL high LDL and High Tigs?

A

HMG-CoAreductase inhibitor

125
Q

I have a bad reaction to a statin what do you give me next

A

bile acid sequestrant

126
Q

What is the only cholesterol lowering medication to decrease morbidity and mortality

A

STATIN

127
Q

What are 2 s/e of statins

A

HYPERGLYCEMIAS, and rhabdomyolisis

128
Q

Most common congenital defect

A

VSD

Cardiology (8 decks)

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