cardio

Question 1

what valves are open during S1

Answer 1

aortic / pulmonic

Question 2

what valves are open during S2

Answer 2

mitral / tricuspid

Question 3

what valves are closed during S2

Answer 3

aortic /pulmnic

Question 4

hat valves are closed during S 1

Answer 4

mitral / tricuspid

Question 5

S3 is associated with what

Answer 5

increased fluid states
ex: heart failure, pregnancy

sounds like “Ken-tuck-y”

Question 6

s4 is associated with what

Answer 6

stiff ventricular wall ex: MI, left ventricular hypertrophy, chronic HTN

sounds like “ten-ne-ssee”

Question 7

pt has a moderately loud murmur what grade is this

Answer 7

III/VI

Question 8

patient has a loud murmur with a thrill what grade is this

Answer 8

IV/VI

Question 9

patient has ver loud. murmor that is heard with one corner of stethoscope off chest wall what grade is this

Answer 9

V/VI

Question 10

mitral valve is located where

Answer 10

5th ICS, Apex

Question 11

aortic vavle is located wehre

Answer 11

2nd/3rd ICS, base

Question 12

mnemonic for murmors

Answer 12

M- mitral
s- stenosis
A- aortic
R-regurgitation
d- diastolic

M- mitral
R. - regurgitation
A- aoritc
S- stensosis
S- systolic

Question 13

pt has murmur located at 5th ICS and during diastolic, what is this

Answer 13

mitral stenosis

Question 14

pt has murmur at base of heart during systolic

Answer 14

aortic stenosis

Question 15

pt has murmur during systolic at apex of heart what is this

Answer 15

mitral regurgitation

Question 16

pt has murmur during diastolic at the 2nd ICS what is this

Answer 16

aortic regurgitation

Question 17

what causes dependent edema in right HF

Answer 17

increased capillary hydrostatic pressure

Question 18

medication mtg for HF

Answer 18

diuretic
ACE/ARB
beta blocker

Question 19

diagnostic test for HF

Answer 19

echo

Question 20

hospital mtg of severe acute pulmonary edema

Answer 20

afterload/preload reduction
nitroprusside
hydrolyze

Question 21

your patient has a low cardiac index despite measures to manage acute pulmonary edema - what do you order

Answer 21

dobutamine , if SBP < 100 dopamine 5-20

Question 22

normal BP

Answer 22

<120 and <80

Question 23

elevated BP

Answer 23

120-129and <80

Question 24

stage 1 HTN

Answer 24

130-139 or 80-89

Question 25

stage 2 HTN

Answer 25

>=140 or >= 90

Question 26

primary HTN typically has onset when

Answer 26

<55 years of age

Question 27

where do you see AV nicking

Answer 27

eye - chronic sign of HTN

Question 28

first line drug for HTN with a pt that has DM

Answer 28

ACE or ARB

Question 29

first line HTN drug for AA

Answer 29

thiazide diuretic then CCB

Question 30

MTG of HTN for non-afriacan american

Answer 30

-thiazide - ACE -ARB -CCB

Question 31

what other benefit does thiazide diuretic offer other than HTN management

Answer 31

ma protect against osteoporosis baby reducing amount of calcium expelled in urine

Question 32

dx of HTN emergency and MTG

Answer 32

>=180/120 OR <180/120 plus organ damage - immediate BP reduction within one hour ICU admin and IV cardene/nipride - reduce no more than 25% during first hour

Question 33

pt of 180/110 with no s/s

Answer 33

HTN urgency oral therapy

Question 34

prinzmetal angina

Answer 34

vasospastic occurs at various times , including rest ST elevation TX CCB

Question 35

EKG changes with angina

Answer 35

down sloping of ST segment/ST depression( ischemia)

Question 36

Lipid Panel

Answer 36

Total < 200 VLDL/Triglcyerides < 150 LDL optimal < 100 HDL low <40; high >60

Question 37

Lipid goals for pt with DM or CAD

Answer 37

LDL < 70 HDL > 40 TG <150

Question 38

ST elevation in lead I and aVL indicates

Answer 38

Lateral MI

Question 39

causes of sudden cardiac death

Answer 39

1. coronary artery disease 2. cardiomyopathies

Question 40

ST elevation in II, III, aVF

Answer 40

inferior MI

Question 41

ST elevation in V3 and V4

Answer 41

anterior MI

Question 42

EKG indicates PR ineraval >.20 , what is this

Answer 42

first degree AV block

Question 43

PR interval gradually gets longer until a QRS complex id dropped

Answer 43

type 1 second degree block (wenckebach/Mobits type I)

Question 44

what is type 2 second degree block

Answer 44

Mobitz type II regular trail rhythm, PR interval is constant but ventricular rhythm is irregular; dropped QRS complex

Question 45

atrial and ventricular rhythm are regular but no relationship between p wave and QRS complex

Answer 45

third degree AV block / complete heart block

Question 46

which troponin elevates with MI damage

Answer 46

trop I

Question 47

indications for pharmacologic revasculariztion

Answer 47

unrelieved chest pain ( >30 minutes and < 6 hours) WITH ST segment elevation

Question 48

contraindication for pharmacologic revascularization

Answer 48

prior ICH ischemic stroke in 2 months active bleeding BP >+185/110

Question 49

most definitive test for PVD

Answer 49

arteriography

Question 50

MTG of PVD

Answer 50

stop smoking exercise to build colleteral circulation Cilostazol

Question 51

MTG of CVI (chronic venous insufficiency)

Answer 51

bed rest with legs elevated to diminish edema use heavy duty elastic support stockings tx of weeping dermatitis (tap water compresses, hydrocolloid dressings)

Question 52

s/s of PVD

Answer 52

c/o calf pain cold/numbness to extremities shiny/hairless skin dependent rubor pallor

Question 53

s/s of CVI

Answer 53

aching of lower extremities edema afer prolonged standing night cramps of LE brownish discoloration stasis leg ulcers dermatitis edema of LE

Question 54

dx of CVI

Answer 54

r/o edema to hf or other causes (eg may-turner syndrome"

Question 55

pt presents with pericardial chest pain that is increased by deep inspiration and relieved by sitting forward what do you suspect and how to treat

Answer 55

pericarditis NSAIDs (indomethacin, ketorolac, ibuprofen) corticosteroids -if NSAIDS fail monitor for tamponade

Question 56

pt presents with fever, night sweats and has painful red nodules in distal phalanges what do you suspect and how to treat

Answer 56

endocarditis antibiotics empire if acute including Vanco till culture restyle are AV

Question 57

what physical finding may you see in pericarditis

Answer 57

friction rub ST elevation in all leads depression of PR segment

Question 58

what patient is most likely to experience tamponade

Answer 58

pericarditis

Question 59

s/s of cardiac tamponade

Answer 59

hypotension JVD muffled/distant heart sounds pulses paradoxus

Question 60

gerontology changes related to cardiovascular

Answer 60

arterial walls thicken and stiffin heart becomes stiffer and may increase in size intrinsic and maximum heart rates decrease; resting heart rate and cardiac output are unaffected baroreceptors are less sennsitive HTN diminished pulses and cool extremities dysrhythmias

Question 61

top killer of adult

Answer 61

heart disease (CAD)

Question 62

second top kill of adult

Answer 62

cancer

Question 63

number one killer of African American adults

Answer 63

heart disease