Cardiology Flashcards
Prehypertension
Starts at –
120 systolic
80 diastolic
Stage 1 HTN
Starts at –
140 systolic
90 diastolic
Stage 2 HTN
> 160 systolic
> 100 diastolic
Is the systolic or diastolic number more important in determining risk in someone OVER 50?
Systolic.
And the wider the pulse pressure the greater the cardiovascular risk.
Treatment for pre-hypertension?
Lifestyle modification - weight loss, DASH eating plan, sodium restriction, aerobic activity, moderation of alcohol consumption.
Treatment for stage 1 hypertension?
Lifestyle modification and medication.
Thiazide diuretic is usually first line.
May add ACE, ARB, BB, CCB.
Treatment for stage 2 hypertension?
Lifestyle modification and 2+ medications.
Combination of 2 or more drugs, usually a thiazide plus additional medication.
BP goal for general population?
140/90
BP goal for those with DM or renal impairment?
130/80
What kidney-related cardiovascular risk factors were identified by JNC-7?
Microalbuminuria and and GFR of less than 60 mL/min.
Treatment for African Americans with hypertension?
ACE or ARB for renal protection.
CCB or thiazide to increase effectiveness of treatment.
A mid-systolic murmur which gets louder when the patient stands may represent…?
Hypertrophic cardiomyopathy
A grade III systolic murmur is usually about as loud as what heart sound?
S1
S3 and S4 are best heard with what part of the stethoscope?
The bell
S3 is heard when in the cardiac cycle?
Early diastole
What heart sound is associated with ventricular overload?
S3
What heart sound is associated with poorly controlled hypertention?
S4
What physical finding is associated with MITRAL VALVE PROLAPSE?
Pectus excavatum
When in the cardiac cycle would you expect the murmur of MITRAL VALVE PROLAPSE?
Mid to late systolic
What is an additional characteristic sound associated with MITRAL VALVE PROLAPSE?
A mid-systolic click
When assessing MITRAL STENOSIS what murmur is anticipated?
Localized diastolic with little radiation
Crescendo-descrescendo with radiation to the neck?
Aortic stenosis
Is a physiological murmur likely to become louder or softer when the patient stands?
Softer
What antibiotic should be used for endocarditis prophylaxis in patients who are allergic to PCN?
Azithromycin
S1 and S2 are best heard with what part of the stethoscope?
The diaphragm
A PHYSIOLOGIC split of S2 is affected by inspiration in what way?
INcreases with INspiration
Benign, generally seen in the less than age 30 population if at all.
A PATHOLOGICAL split of S2 is affected by inspiration in what way?
Fixed split - no change
Paradoxical split - narrows with inspiration
A PATHOLOGICAL S2 split may be found in conditions that delay ______ closure, such as ________.
Delay AORTIC closure such as BUNDLE BRANCH BLOCK.
When in the cardiac cycle is S3 heard?
Early diastole
What is the significance of S3?
Indicative of ventricular overload
Can also be systolic dysfunction or both
When in the cardiac cycle is S4 heard?
Late diastole
somtimes called a “presystolic” sound
What is the significance of S4?
Often found in poorly controlled hypertension or post MI
