Cardiac

Question 1

We initiate stain therapy when the ASCVD risk is > ____

Answer 1

ACVD greater than 7.5%

Question 2

What is a normal triglyceride level?

Answer 2

<150

Question 3

What is a normal LDL

Answer 3

<100

Question 4

How often do we do a lipid profile on a patient?

Answer 4

Every 5 years

Question 5

What s/s do we need to be aware of when a patient starts a statin?

Answer 5

Arcus Senilis (gray halo around eye)
Xanthelasma

Question 6

What are 2 high intensity statins?

Answer 6

Atorvastatin
Rosuvastatin

Question 7

What are symptoms we need to monitor when a patient starts a statin?

Answer 7

muscle pain
jaundice

Question 8

If someone is experience rhabdo from their statin….how how will their CK level be?

Answer 8

5x normal limit

Question 9

if someone on a statin is becoming jaundice…what are they experiencing?
What lab do you want to draw

Answer 9

acute drug induced hepatitis

LFTs

Question 10

A normal triglyceride level is <150….what if it’s greater than 500? What might happen to the patient?

Answer 10

pancreatitis

Question 11

What are 2 possible clinical signs of necrotizing pancreatitis? Describe them

Answer 11

Cullen’s sign - hemorrhagic discoloration of the umbilical area due to intraperitoneal hemorrhage
Turner’s sign - discoloration of the left flank associated with acute hemorrhagic pancreatitis

Question 12

According to JNC 8 guidelines, we wat to initiate BP management in people >60 years if their BP is greater than _____

Answer 12

150/90

Question 13

According to JNC 8, for people <60 years with CKD or DM…when do you initiate BP management?

Answer 13

140/90

Question 14

What do you want to monitor on an ACE inhibitor?

Answer 14

Renal function
Potassium (risk hyperkalemia)

Question 15

Who should not get a thiazide?

Answer 15

People who would not benefit from
-increased triglycerides
-increased uric acid
-increased glucose

Question 16

Who are thiazides great for?

Answer 16

People with osteoporosis because it stimulates osteoblasts to make bone and the body to retain more calcium

Question 17

Who should not take CCB?

Answer 17

GERD (vasodilation lowers esophageal sphincter)

Question 18

What BP medication do we prefer on African Americans?

Answer 18

Thiazide diuretics or CCB

Question 19

What are the 3 preferred meds in pregnant women preferred for BP control?

Answer 19

Labetalol
nifedipine
Methyldopa

Question 20

What are category X BP meds in pregnant women?

Answer 20

ACE-I & ARBs

Question 21

According to AHA/ACC we can initiate BP meds in HTN if their ASCVD risk is greater than

Answer 21

10%

Question 22

If a patient has isolated systolic htn, what is the preferred BP med?

Answer 22

CCB

Question 23

What is going on with our patient if they’re having variances in their heart rate between inspiration and expiration?

What patient is this seen in?

Answer 23

Respiratory sinus arrhythmia

young and healthy athlete

Question 24

What is pulsus paradoxus?

What does it indicate?

Answer 24

10mmHg drop in SBP upon inspiration

Cardiac tamponade
Status asthmaticus

Question 25

A HF patient gains X amount of weight in X amount of time, when should they report it?

Answer 25

2kg in 24 hours

Question 26

What extra heart sound do you hear in fluid overload

Answer 26

S3

Question 27

What extra heart sound might you hear in pregnancy?

Answer 27

S3 d/t extra fluid

Question 28

What diabetes medication should be avoided in HF patients?

Answer 28

TZDs

Question 29

What OTC meds should HF patients avoid? Why?

Answer 29

NSAIDs Increased Na+ & fluid retention

Question 30

When do we hear the S1 heart sound?

Answer 30

Closure of the AV valves: Mitral & tricuspid

Question 31

When do we hear the S2 sound?

Answer 31

closure of semilunar valves: aortic and pulmonic

Question 32

When do we hear S3 sound?

Answer 32

Extra fluid -pregnancy -heart failure

Question 33

When do we hear the S4 sound?

Answer 33

-uncontrolled htn -LVH

Question 34

What do we do when we hear a split between S2 in inspiration and expiration?

Answer 34

refer

Question 35

When is a split S2 normal?

Answer 35

only when it occurs during inspiration only

Question 36

What murmurs need to be referred?

Answer 36

diastolic

Question 37

What type of murmur radiates?

Answer 37

systolic

Question 38

What are the diastolic murmurs?

Answer 38

ARMS Mitral stenosis Aortic regurgitation

Question 39

What are the systolic murmurs?

Answer 39

MR PASS MVP Mitral Regurgitation Physiological Aortic stenosis Mitral valve prolapse

Question 40

What murmur radiates to the neck?

Answer 40

Aortic Stenosis Systolic

Question 41

What murmur radiates to the armpit?

Answer 41

Mitral regurgitation systolic

Question 42

What systolic murmur do you hear a click?

Answer 42

Mitral valve prolapse

Question 43

When is mitral valve prolapse with a click commonly seen?

Answer 43

Marfan syndrome usually pediatrics

Question 44

what grade murmur are we going to hear a palpable thrill?

Answer 44

Grade 4 or higher

Question 45

What is pain with activity and relieved with rest?

Answer 45

intermittent claudication

Question 46

How is Raynaud's treated?

Answer 46

CCB