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Geriatrics EOR > CARDIO > Flashcards

CARDIO Flashcards

1
Q

What is our goal BP in an elderly pt with HTN without CKD or DM?

A

<150/90

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2
Q

What is our goal BP in an elderly pt with HTN and/or CKD?

A

<140/90

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3
Q

What does the initial eval involve for HTN?

A

2 or more reading at 2 or more visits

CBC, UA, electrolytes, Cr, HbA1c, total cholesterol, HDL cholesterol, and ECG

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4
Q

What are some aggravating factors for HTN?

A

stress, lack of exercise, nicotine, excessive alcohol or sodium intake, low potassium or calcium intake

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5
Q

Is the goal of <120/80 recommended in the elderly?

A

NO

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6
Q

What are non-pharm treatments for HTN?

A

lots of fruits/veggies, aerobic exercise MOST days of week, Na intake (<2.4g/day; optimal <1.5g), SMOKING CESSATION, and weight reduction

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7
Q

Where do we start for treating HTN with meds?

A

HCTZ - ACE/ARBS - CCB

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8
Q

What are some ACE’s?

A

Lisinopril, Captopril, Enalopril

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9
Q

What are some ARBS?

A

Losartan or Valsartan

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10
Q

If a pt has angina, how do we treat their HTN?

A

BB, CA (Calcium agonists AKA CCB)

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11
Q

If a pt has Afib and HTN how do we treat them?

A

BB & NDCA

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12
Q

What are 2 examples of non-dihydropyradine calcium channel blockers?

A

Diltiazem & Verapamil

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13
Q

If a patient has bronchospasm and HTN what should we avoid?

A

BB

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14
Q

Besides metoprolol, what are 2 other beta-blockers?

A

Atenolol & Propranolol

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15
Q

In diabetics, CKD, and HF how do we treat their HTN?

A

ACEI, ARB’s

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16
Q

How does ischemic heart disease present in a young person vs. the elderly?

A

Young = CP & heaviness

Elderly = vague – dyspnea, abdominal pain, fatigue, confusion or malaise

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17
Q

How do we tell the difference between a STEMI & NSTEMI?

A

BOTH have elevated cardiac markers

NSTEMI has NONELEVATED ST segments

18
Q

In the presence of a STEMI how do we treat?

A

door to balloon in 90 minutes

Give NTG, morphine, and BB

19
Q

: In the presence of NSTEMI how do we treat?

A

ASA, BB, and full anti-coag

If everything is normal after 24 hours do stress testing

20
Q

If you heard a crescendo-decrescendo systolic murmur that radiates to the carotids and is heard best over the right 2nd intercostal space – dx?

A

Aortic stenosis

21
Q

If a pt with Afib is unstable – how do we treat?

A

Cardioversion

22
Q

What is rate control for Afib?

A

CCB (non-dihydros)

23
Q

What is rhythm control for Afib?

A

Cardioversion – if longer than 48 hours must anticoagulated x3-4 weeks or get TEE to show no atrial thrombi

24
Q

What is the one murmur that gets louder with standing from a squat or Valsalva?

A

mitral valve prolapse

25
Q

What are our 2 diastolic murmurs?

A

Mitral stenosis & Aortic regurg

26
Q

Which 3 murmurs cause holosystolic murmurs?

A

Mitral regurg, tricuspid regurg, and VSD

27
Q

What murmur is associated with rheumatic fever or HF?

A

Mitral regurg

28
Q

What murmur has an opening snap followed by a low diastolic rumble heard best in the left lateral decubitis position?

A

Mitral stenosis

29
Q

What murmur is blowing holosystolic heard radiating from the apex to the axilla?

A

Mitral regurg

30
Q

What murmur is blowing holosystolic heard best at the left sternal border and on inspiration?

A

Tricuspid regurg

31
Q

What murmur has a diastolic blowing decrescendo heard best over the left sternal border while sitting, leaning forward and exhaling & holding breath?

A

Aortic regurg

32
Q

What diagnosis causes lower extremity exertional pain/fatigue (aka claudication)?

A

Peripheral vascular disease

33
Q

What are the 5 aspects of controlling vascular disease?

A 
Quit smoking
BP control              
DM control              
Lipid lowering agents              
ASA
34
Q

What are some common sxs of HF in the elderly?

A

confusion, irritability, sleep disturbance, anorexia, N/d

Cough, orthopnea, dependent edema

35
Q

How do we diagnose HF?

A
  • BNP! Most useful test, but specificity declines with age
  • XR for increase heart size
  • Echo & EKG (Q waves or LVH)
36
Q

What are the two main components of HF we treat?

A

Reduce preload & afterload

37
Q

How do we reduce preload?

A

Diuretics

38
Q

What must we always check before/after prescribing diuretics?

A

K levels!

39
Q

How do we reduce afterload?

A

ACE inhibitors

40
Q

What must we watch before/after prescribing Lisinopril?

A

Cough & K levels

41
Q

If a pt experiences a cough with Lisinopril, what can we change to?

A

ARB (losartan)

Geriatrics EOR (11 decks)

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