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RR Prep > Cardio > Flashcards

Cardio Flashcards

1
Q

Indications for Diuretics

A

HF

Systolic HTN

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2
Q

CI for diuretics

A

Gout

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3
Q

SE diuretics

A

Hypokalemia
Hyponatremia

Hyperuricemia
Hypercalcemia (thiazides)
Hyperlipidemia

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4
Q

Beta Blockers

Indications

A 
Angina
HF
Previous MI
Tachydysrhythmias
Migraine
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5
Q

Beta blockers

CI

A

Asthma
COPD
Heart Block

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6
Q

Beta blocker

SE

A 
Bronchospasm
Bradycardia
HF
Impaired Peripheral circulation
Insomnia, fatigue
Decreased, exercise tolerance
hypertriglycreidemia
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7
Q

ACE inhibitors indications

A 
HF
LV dysfunction
Previous MI
Diabetic nephropathy
Proteinuria
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8
Q

ACE inhibitors CI

A

Pregnancy
Bilateral renal artery stenosis
Hyperkalemia

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9
Q

ACE inhibitors SE

A 
Cough
Angioedema
Hyperkalemia
Rash 
Loss of taste
Leukopenia
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10
Q

CCB indications

A

systolic hypertension

cyclosporine induced HTN

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11
Q

CCB CI

A

orthostatic hypotension

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12
Q

CCB SE

A 
headache
drowsiness
fatigue
weakness
postural hypotension
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13
Q

Alpha blockers indications

A

Prostatic hypertrophy

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14
Q

Alpha blockers CI

A

orthostatic hypotension

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15
Q

Alpha blockers SE

A 
HA
drowsiness
fatigue
weakness
postural hypotension
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16
Q

ARBs indications

A

ace inhibitor associated cough
diabetic nephropathy
proteinuria
HF

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17
Q

ARBs CI

A

pregnancy
bilateral renal artery stenosis
hyperkalemia

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18
Q

ARBs SE

A

angioedema (rare)

hyperkalemia

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19
Q

Which antihypertensive medications are associated with gingival hyperplasia

A

dihydropyridine and nondihydropyridine CCB

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20
Q

JNC 8 for HTN

Blood pressure goals

A

age < 60: 140/90
diabetic: 140/90
age>60 150/90

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21
Q

JNC 8 for HTN

first line tx

A

lifestyle modification

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22
Q

JNC 8 for HTN

non-African American

A

thiazide
ACE/ARB
CCB
alone or in combo

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23
Q

JNC 8 for HTN

African American

A

thiazide
CCB
alone or in combo

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24
Q

JNC 8 for HTN

CKD (with or w/o DM)

A

all races
ACE/ARB
alone or in combo with other drug classes

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25
Q

which antihypertensive is associate with peripheral edema?

A

amlodipine

26
Q

A 60-year-old man with celiac disease presents with severe macrocytic anemia, jaundice, and glossitis. Laboratory testing reveals borderline levels of vitamin B12 and folate. Which additional laboratory test would most likely suggest a diagnosis of vitamin B12 deficiency anemia rather than folate deficiency anemia?

A

methylmalonic acid

27
Q

What part of the spinal tract is damaged with B12 deficiency

A 
posterior column (vibratory sense)
lateral corticospinal tract (motor function of limbs)
28
Q

The build up of methylmalonic acid impairs spinal cord mylenation and leads to…

A

poor propcioception
poor vibratory sense
N/V/D
spastic paresis

29
Q

Causes of B12 anemia

A

MC pernicious anemia
veganism
fish tapeworm, Crohns, pancreatic insufficiency

30
Q

Does folate or B12 deficiency have neurological sx

A

B12 has neurologic sx

31
Q

Causes folate deficiency

A

alcoholism
pregnancy
cancer
folate antagonizing meds (METHOTREXATE)

32
Q

What do PMNs look like macrocytic anemia

A

hypersegmented

33
Q

Lab test elevated for both B12 and folate deficiency

A

homocysteine

34
Q

Lab test elevated only B12, not folate, deficiency

A

methylmalonic acid

35
Q

B12 clinical sx

A

psychologic: depression, irritability, psychosis
hematologic: megaloblastic anemia
neurologic: sensory & motor deficits (absent reflexes, paresthesias), dementia
GI: N/V/D

36
Q

B12 tx

A

parenteral B12 if symptomatic and has impaired absorption

Oral B12 if dietary deficiency

37
Q

What is ferritin

A

is a protein that binds to stored iron and acts as an indirect marker for it. It is the most useful test used to diagnose iron deficiency anemia

38
Q

What is transferrin

A

Transferrin (D), like ferritin, is a useful biomarker used to investigate and diagnose iron deficiency anemia.

39
Q

MC anemia in hospitalized pts with chronic ds

A

anemia of chronic ds

40
Q

What B vitamin is folate

A

B9

41
Q

Irregularly irregular rhythm

A

atrial fibrillation (quivering)

42
Q

MC disorders associated with Afib

A 
HTN
CAD
DM
OSA
COPD
Hyperthyroidism
rheumatic heart ds
43
Q

what can provoke afib

A

anxiety
alcohol consumption
exercise

44
Q

PE of afib

A

irregularly irregular HR

tachycardia (often)

45
Q

Dx confirmation

A

ECG
irregularly irregular
no P waves
varying ventricular rate

46
Q

What sx someone with afib have

A 
palpitations
dizziness
syncope
HA
fatigue
dyspnea
chest pain
47
Q

What are the complications of afib

A

HF
peripheral embolism
stroke
secondary thrombus formation in the atrium

48
Q

tx afib techniques

A

cardio version
cardiac ablation
pacemaker

49
Q

What two things try to control with afib

A

rate and rhythm

50
Q

Acute Afib that is hemodynamically unstable… what do you do?

A

electrical cardioversion

51
Q

Acute Afib and hemodynamically STABLE… what do you do?

A

ventricular rate control with beta blockers or calcium channel blocker and cardioversion to sinus rhythm after rate control is achieved

52
Q

What if pt presents with AFib >48 hours or unknown period of time…

A

3 weeks of anticoagulation, then cardiovert, then 4 more weeks of anticoagulation

53
Q

AFib: how do you evaluate the left atrium for thrombus prior to cardioversion?

A

TEE - transesophageal echocardiogram

54
Q

What meds used to control rate in chronic AFib

A

BB (metoprolol) and CCBs (diltiazem)

55
Q

What is the CHA2DS2 VASc score

A

is a tool used to calculate the risk of a patient with atrial fibrillation developing a stroke or thromboembolism over one year and is used to guide the decision to start long term anticoagulation.

56
Q

Does AFib have P waves

A

no

57
Q

Describe Atrial Flutter

A

is an atrial tachycardia characterized by regular atrial contractions originating outside of the sinoatrial node. Atrial flutter is most common in individuals with underlying pulmonary disease or heart conditions such as valvular disorders, recent or remote heart surgery, and pericardial disease. Symptoms are similar to atrial fibrillation including dizziness, headache, fatigue, chest pain, and shortness of breath. Physical exam may show tachycardia with or without an irregular heart rate noted. Diagnosis is made with electrocardiogram revealing classic flutter waves described as a “sawtooth” pattern. The most common ventricular rate in a patient presenting with atrial flutter is 150 beats per minute. Similar to atrial fibrillation, treatment should address heart rate versus rhythm control as well as anticoagulation.

58
Q

Describe Sinus tachycardia

A

Sinus tachycardia (C) is a normal physiologic response to increased oxygen demands in the body such as with exercise, fever, or infection. Patients are typically asymptomatic but may complain of palpitations. Physical exam reveals a regular, rapid heart rate. Diagnosis is confirmed with an electrocardiogram showing a narrow-complex tachycardia with normal p-waves prior to each QRS. Treatment is generally aimed at addressing the underlying condition.

59
Q

Describe Ventricular Fibrillation

A

Ventricular fibrillation (D) is a ventricular arrhythmia that results in rapid, unorganized ventricular contractions with no substantial cardiac output. Left untreated, this condition is fatal within minutes. Ventricular fibrillation most commonly occurs in patients with underlying heart disease. Patients have sudden collapse into an unresponsive state with no pulse or respirations. Telemetry or electrocardiogram reveals the presence of irregular fibrillatory waves of varying amplitude and morphology with no p-waves or QRS complexes. Treatment requires emergent cardiopulmonary resuscitation and defibrillation.

60
Q

Question: What is an early, wide QRS complex with no associated p-wave followed by a brief pause and return to normal sinus rhythm known as?

A

premature ventricular contraction

61
Q

Afib RR

A

Rate will be irregular
Rhythm will be irregular
Notable feature: No defined P waves
Treatment
Unstable: cardioversion
Stable: rate control is mainstay
Comments:
> 48 hours - anticoagulate for 21 days prior to cardioversion
Determine the need for anticoagulation by using CHA2DS2-vasc score
Most common sustained dysrhythmia in adults

RR Prep (8 decks)

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