Cardio

Question 1

What cardiac marker increases early in MI

Answer 1

AST

Question 2

ALT>AST =

Answer 2

liver dz

Question 3

GGT

Answer 3

detecs SOL, biliary dyschinesia, ETOH abuse

Question 4

CPK_MB

Answer 4

12-24 hours after MI (can be elevated in PE)

Question 5

LDH elevated in

Answer 5

MI LDH1>LDH2

Also elevated in myocarditis, liver dz, CHF, shock, etc.

Question 6

Ammonia (NH3) elevated in

Answer 6

severe liver dz

Question 7

ApoA vs ApoB vs Lipo

Answer 7

ApoA high = good
ApoB high = bad
Lipo high = bad

Question 8

VAP

Answer 8

measures total cholesterol

Question 9

Max dose of Atorvastatin

Answer 9

80mg qd

Question 10

how often do you measure lipids?

Answer 10

6 weeks after med started or changed

Question 11

What is the problem with slow release niacin

Answer 11

more hepatotoxic

Question 12

Give what with niacin to reduce liver burden?

Answer 12

vitamin c and b complex

Question 13

Adrenergic receptor

Answer 13

Epi/Norepi

Question 14

Alpha vs Beta adrenergic receptors (where are they)

Answer 14

Alpha 1 - GI tract - excitatory (inhibitor in GI)
Alpha 2 - CNS
Beta 1 - heart - excitatory
Beta 2 - kidney

Question 15

beta blockers

Answer 15

block epi and decrease strength of heart muscle contraction

Question 16

first line therapy for HTN

Answer 16

ACE
ARB
thiazide diuretics (HCTZ)
CCB

Question 17

age > 60 bp goal

with DM

Answer 17

< 150/90

<140/90

Question 18

age < 60 bp goal

with DM

Answer 18

<140/90

<140/90

Question 19

Drug therapy of choice for black pt

Answer 19

thiazide or CCB (not ACE/ARB)

Question 20

Drug for heart failure

Answer 20

ACE
ARB
BB
Diuretic
Spironalactone

Question 21

Drugs for Post MI/CAD

Answer 21

ACE
ARB
BB

Question 22

Drugs for CAD

Answer 22

ACE
BB
Diuretic
CCB

Question 23

Drugs for CKD

Answer 23

ACE

ARB

Question 24

Drugs for recurrent stroke prevention

Answer 24

ACE

Diuretci

Question 25

Secondary HTN

Answer 25

renal artery stenosis chronic renal dz hyper-aldosteronism pheochromocytoma

Question 26

thiazide diuretics CI in pt with

Answer 26

sulfa allergy

Question 27

alpha 2 agonist

Answer 27

Clonidine

Question 28

catecholamine agent

Answer 28

reserpine (raulfia) decreases catecholamines | SE: depression/suicide

Question 29

Verapamil Diltiazem Amlodipine

Answer 29

CCB: angina and HTN

Question 30

What is CI within two weeks of reserpine

Answer 30

MAO inhibitors

Question 31

Average dose of Rauwolfia and reserpine

Answer 31

Rauwolfia: 1-3mL qd-bid (5ml unsafe!) Reserpine: 0.1-0.25mg tabs qd-bid

Question 32

right HF

Answer 32

blue peripheral edema ascites JVD

Question 33

left HF

Answer 33

``` red pulm edema pulm htn DOE dry cough fatigue rhonchi rales ```

Question 34

signs of cor pulmonale

Answer 34

``` chronic cough exertional dyspnea weakness cyanosis JVD RVH ```

Question 35

Test for vascular dz

Answer 35

ankle brachial index: divide each ankle by highest brachial | < .95 ratio = PVD

Question 36

75% likelihood of AAA rupture if

Answer 36

7cm or >

Question 37

Aortic dissection s/sx workup

Answer 37

severe chest/neck pain, unequal peripheral pulse | CT and transesophageal echo

Question 38

common arrhythmia of younger people with no HD

Answer 38

atrial tachycarida/supraventricular tachy

Question 39

arrhythmia with sweating, dizziness, palpitaitons, weakness, syncope

Answer 39

atrial flutter

Question 40

irregularly irregular pulse

Answer 40

a-fib

Question 41

most common cause of sick sinus syndrome and s/sx

Answer 41

CAD | none, lightheadedness, fatigue, syncompe, confusion, angina

Question 42

presenting sign of heart block

Answer 42

syncope

Question 43

wide QRS

Answer 43

BBB | LBBB more ominous

Question 44

which type of murmurs almost always mean heart disease

Answer 44

diastolic

Question 45

midsystolic

Answer 45

pulmonic/aortic stenosis

Question 46

Pansystlic/holosystolic

Answer 46

mitral/tricuspid regurge, sd

Question 47

opening snap with diastolic rumble, SOB, DOE, PND,

Answer 47

mitral stenosis

Question 48

decrescendo

Answer 48

aortic regurge

Question 49

blowing, soft, diastolic murmur with SOB, palpitations, angia

Answer 49

aortic insufficiency

Question 50

dyspnea, fatigue, pansystolic murmur

Answer 50

mitral regurge

Question 51

when is thrombolysis needed

Answer 51

arrhythmias prosthetic valves hypercoagulable states (high fibrinogen and dehdration)

Question 52

what drugs are used for arrhythmias

Answer 52

digoxin (CHF, a fib, a-flutter) quinidine (a-flutter, a-fib, PAC and PVC) BB CCB

Question 53

Endocarditis Myocarditis Pericarditis

Answer 53

Endo: IV drug usesers - vegetation on echo Myo: after viral infection, URI Peri: agg by deep breathing, more localisex pain

Question 54

angina rx

Answer 54

nitro l-arginine mg zinc

Question 55

earliest lab value for MI

Answer 55

Troponin, then CK-MB, Myoglobin

Question 56

abnormal EKG with Q waves

Answer 56

MI

Question 57

T wave inversion

Answer 57

ischemia

Question 58

Botanicals for atherosclerosis and ED

Answer 58

allium sativa, ginkgo, yohimbe.

Question 59

Which antibiotic is associated with pseduomembranous colitis, liver injury, thrombocytopenia

Answer 59

Clindamycin

Question 60

Supplements for endocarditis

Answer 60

omega 3 and Mg

Question 61

treat pericarditis with

Answer 61

anti-inflammatories (pericardiocentesis if needed)

Question 62

Pt de-stats in office, what type of 02 mask

Answer 62

simple face mask and refer to ED

Question 63

Signs of T3 toxicosis

Answer 63

normal FT4, elevated FT3!

Question 64

Why should you not combine BB with Convallaria

Answer 64

Can cause heart block.

Question 65

Pulse pressure

Answer 65

systolic minus diastolic and indicates aortic stiffening.