Brainscape's Knowledge GenomeTM

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


See full index

NP School > Cardiac > Flashcards

Cardiac Flashcards

1
Q

What is the mechanism of action and classification of Heparin?

A

Class: anticoagulant
MOA: inhibits factor Xa

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

What are potential causes for pericarditis?

A
  • viruses (most common cause)
  • MI
  • cardiac surgery
  • rheumatic fever
  • neoplasia
  • radiation therapy
  • uremia
  • tuberculosis (TB)
  • idiopathic
  • trauma
  • drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What viruses are the most common cause(s) of pericarditis?

A
  • coxsackie virus
  • echoviruses
  • Epstein-Barr
  • influenza
  • hepatitis
  • varicella
  • mumps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the s/s of pericarditis?

A
  • precordial/retrosternal, localized, pleuritic chest pain
  • Chest Pain worse with cough, swallowing, inspiration
  • Chest Pain relieved by sitting forward
  • dyspnea
  • pericardial friction rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A pericardial friction rub heard when auscultating heart sounds is indicative of what?

A

pericarditis

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

What ECG changes are associated with pericarditis?

A
  • depressed PR interval (diagnostic)
  • ST concave (smile) elevation in multiple leads
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What lab findings are associated with pericarditis?

A
  • leukocytosis = high WBC
  • elevated erythrocyte sedimentation rate (ESR) = inflammation
    1) < 50 y/o
    • Male > 15 mm/hr
    • Female > 20 mm/hr
      2) > 50 y/o
    • Male > 20 mm/hr
    • female > 30 mm/hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is the diagnosis of pericarditis confirmed?

A
  • depressed PR interval on ECG
  • elevated ST concave shaped interval (smile)
  • echocardiogram to confirm pericardial fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the treatment/management for pericarditis?

A
  • colchicine (anti-inflammatory)
  • NSAIDs
  • proton pump inhibitor d/t risk of Gi toxicity
  • corticosteroids only if NSAID use is contraindicated or has failed
  • antibiotics (bacterial infections)
  • monitor for cardiac tamponade
  • Vicodin (PRN for pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Vicodin is a combination of what drugs?

A

hydrocodone and acetaminophen

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

what is the name of the medication that has hydrocodone and acetaminophen?

A

Vicodin

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

Why is colchicine used in the treatment of patients with atherosclerotic disease or with multiple risk factors for cardiovascular disease?

A
  • reduces risk of the below by:
    • reducing high-sensitivity C-reactive protein
    • prevents the activation, degranulation and migration of neutrophils which causes an anti-inflammatory effect
  • MI
  • stroke
  • cardiovascular death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the most common causes of endocarditis?

A
  • bacteria are most common cause
  • staphylococcus aureus (gram pos)
  • streptococcus pyogenes (gram pos)
  • pneumococcus (gram pos)
  • neisseria orgasms (gram neg)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common predisposing risk factor for endocarditis?

A

invasive procedures
- dental surgery
- GU surgery
- catheter placement
- HD
- burn treatment

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

What are the s/s of endocarditis?

A
  • signs of infection
  • splenomegaly
  • pallor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What lab findings are associated with endocarditis?

A
  • normochromic, normocytic anema
  • leukocytosis with a left shift
  • WBC bands present
  • elevated erythrocyte sedimentation rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is normochromic, normocytic anemia?

A

type of anemia where the RBCs are the normal in size, shape and color

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

What tests should be done in a patient that presents with s/s of endocarditis?

A
  • blood cultures (3 from different sites)
  • echocardiogram to assess valvular involvement (presence of vegetation)
  • BMP
  • erythrocyte sedimentation rate
  • CBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment/management for endocarditis?

A
  • infectious disease consult
  • empiric AB therapy that covers gram positive bacteria while waiting for cultures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the normal ejection fraction range?

A

50-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are causes of HFrEF?

A
  • ischemic heart disease (ex. CAD), myocardium can’t get enough O2
  • MI, heart is damaged
  • cardiomyopathy, thickened or scarred myocardium = less contractility
  • aortic stenosis, decreased CO
  • mitral regurgitation, decreased CO
  • arrhythmias, ineffective pumping
  • myocarditis, inflammation = low CO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are risk factors/causes of HFrEF?

A
  • age, vessels are less elastic
  • obesity
  • HTN
  • DM type II
  • CAD
  • CKD
  • COPD
  • sleep apnea
  • anemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the NYHA functional classifications?

A
  • class I: no symptoms/limitations
  • class II: symptoms with moderate exertion
  • class III: symptoms with any activity
  • class IV: symptoms at rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are AHA stages of heart failure?

A
  • Stage A: high risk, no structural disease
  • Stage B: structural disease, no symptoms
  • Stage C: structural disease w/ s/s
  • Stage D: refractory HF, s/s at rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the mortality rate r/t a diagnosis of heart failure?

A

50% mortality rate within 5 years of diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most common cause of chronic heart failure?

A

LV dysfunction r/t coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most common cause of acute heart failure?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the 4 compensatory mechanisms r/t heart failure?

A
  • ventricular hypertrophy d/t increased strain and workload
  • dilation d/t increase volumes caused by reduce stroke volume
  • SNS activation, increased HR
  • Renin-Angiotensin-Aldosterone System
27
Q

What are the s/s of left sided heart failure?

A
  • LV contractility is impaired resulting in increased filling of the LV and backup of blood in the left atrium, pulmonary veins and lungs = pulmonary edema
  • dyspnea, SOB
  • cough
  • rales, wheezes, crackles
  • blood tinged sputum
  • bilateral infiltrates on CXR
  • increased PCWP (> 12mmHg)
  • tachypnea
  • tachycardia
  • cyanosis
  • pulsus alternans
  • A-Fib d/t atrial enlargement
28
Q

What is the term for when every other pulse beat is diminished and what is it r/t?

A

pulsus alternans
- r/t left sided heart failure

29
Q

What are the s/s of right sided heart failure?

A
  • RV contractility is impaired causing reduced emptying and backup in to the systemic venous circulation
  • cor pulmonale
  • jugular vein distention
  • increased CVP (>12 mmHg)
  • peripheral edema
  • splenomegaly
  • hepatomegaly
  • ascites
  • weight gain
30
Q

What is the term for right ventricular enlargement cause by a pulmonary condition/disease process?

A

cor pulmonale

31
Q

What is cor pulmonale?

A

right ventricular enlargement cause by a pulmonary condition/disease process

32
Q

What are the general symptoms of heart failure?

A
  • fatigue
  • orthopnea
  • cough
  • tachycardia
  • peripheral edema
  • nocturia, fluid shifts from tissues back to vessels when patient lies down, increasing renal perfusion
  • diaphoretic, cool, dusky skin
33
Q

What tests should be done in patient suspected of heart failure?

A
  • ABG
  • BNP
  • BNP
  • magnesium
  • BUN/Creatine
  • GFR
  • glucose
  • lipid profile
  • liver function tests (AST,ALT)
  • CXR
  • ECG
  • echocardiogram
  • nuclear stress test
  • NT-proBNP if HF diagnosis is uncertain
34
Q

Which BP medication is recommended for all patients with HFrEF (<40%) and DO NOT have renal insufficiency?

A

ACE inhibitors

35
Q

What is Carvedilol also known as?

A

Coreg
- non-selective 3rd generation beta blocker
- block B1, B2, and A1 adrenergic receptors

36
Q

What does ARNI stand for?

A

angiotensin receptor/neprilysin inhibitor

37
Q

What is Entresto’s MOA?

A

angiotensin II receptor blocker and neprilysin inhibitorW

38
Q

What two medications are are combined to make Entresto?

A
  • Sacubitril, blocks breakdown of natriuretic peptides
  • Valsartan, angiotensin receptor blocker
39
Q

What is the recommended initial daily dose of Carvedilol (coreg) for a patient with HFrEF?

A

Coreg initial dose = 3.125mg BID

40
Q

Why is carvedilol used in the treatment of patients with HFrEF?

A

Improves LV function and reduces symptoms r/t HF by:
1) Reducing the following:
- HR
- mean pulmonary arterial pressure
- pulmonary capillary wedge pressure
2) Increases the stroke volume = increased ejection fraction

41
Q

What is the recommended initial daily dose of metoprolol for a patient with HFrEF?

A

12.5 - 25 mg QD

42
Q

What is the creatinine goal of therapy when using an aldosterone antagonist or mineralocorticoid receptor antagonist for a patient with HFrEF?

A
  • men < 2.5 mg/dl
  • women < 2.0 mg/dl
43
Q

Which BP/cardiac meds are standards of therapy for a patient with HFrEF?

A

ACE inhibitors used with a beta blocker
- an ARB can be substituted if the patient cannot tolerate an ACEi

44
Q

What are the 3 layers of an artery?

A
  • intima (inner)
  • tunica media (middle)
  • adventitia (outer)
45
Q

What is the inner most layer of an artery called?

A

intima
- monolayer of endothelial cells

46
Q

What is the middle layer of an artery called?

A

tunica media
- consists of smooth muscle cells

47
Q

What is the outer most layer of an artery called?

A

adventitia
- consists of fibroblasts, mast cells and nerve terminals

48
Q

Which e-lyte is responsible for vascular smooth muscle contractions?

A

calcium
- voltage dependent L-type calcium channels open and calcium enters cell

49
Q

What is the normal ejection fraction?

A

50-70%

50
Q

Pulsus paradoxus is a sign of what condition(s)?

A
  • cardiac tamponade
  • massive pulm embolism
  • hemorrhagic shock
  • severe obstructive lung disease
  • tension pneumothorax
51
Q

What does the S1 heart sound represent?

A
  • AV valve closure
  • tricuspid (Right side)
  • mitral (left side)
52
Q

What does the S2 heart sound represent?

A

Semi lunar valve closure
- aortic
- pulmonic

53
Q

What is the most common cause of a mid systolic murmur in an adult?

A

Aortic stenosis

54
Q

What type of murmur is associated with aortic stenosis?
A mid systolic murmur, heard after S1 and ends before S2

A

A mid systolic murmur, heard after S1 and ends before S2

55
Q

The intensity of a heart murmur is graded on a scale of _____?

A

1-6

56
Q

What is Hypertrophic obstructive cardiomyopathy (HOCM)?

A

a heart condition that causes the heart’s muscle tissue to thicken, often blocking blood flow from the left ventricle to the aorta

57
Q

What is the normal flow of depolarization of the heart?

A

SA node, AV node, bundle of his, bundle branches, purkinje fibers

58
Q

What is the junction between the end of the QRS complex and beginning of the ST-segment called?

A

The J point

59
Q

What is the J-point on an EKG?

A

the junction between the end of the QRS complex and beginning of the St-segment

60
Q

Which EKG leads show activity on the frontal plane of the heart?

A

the limb leads
- lead I
- lead II
- lead III
- lead aVR
- lead aVL
- lead aVF

61
Q

The limbs leads show the electrical activity of what part of the heart?

A

the frontal plane

62
Q

Which EKG leads show activity on the horizontal plane of the heart?

A

chest leads
(V1-V6)

63
Q

What is the normal length of the PR interval on an EKG?

A

120-200ms

64
Q

What is the normal length of the QRS interval on an EKG?

A

60-100ms

65
Q

What it is the normal QTc interval for men?

A

< 450ms

66
Q

What it is the normal QTc interval for women?

A

< 460ms

67
Q
A

NP School (19 decks)

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