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ACNP REVIEW > cardiology > Flashcards

cardiology Flashcards

1
Q

Systolic murmurs

A

Mitral Regurg Aortic Stenosis Systolic murmurs Mitral Valve Prolapse

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2
Q

Diastolic murmurs

A

Mitral Stenosis Aortic Regurg Diastolic murmurs

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3
Q

Medication class best in patients with CAD and MI

A

Beta Blockers

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4
Q

Medication class best in patients with Diabetes and renal failure

A

ACE-I and ARBs

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5
Q

PE EKG changes

A

S1: deep S wave in lead I Q3: Q wave in lead III T3: ST elevation and T wave inversion in Lead III

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6
Q

Global ST elevation and treatment

A

Pericarditis and treatment with NSAIDs (Toradol)

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7
Q

NASPE pacing codes

A

chambers paced chambers sensed response to sensing programmability and rate modulation

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8
Q

Stage 1 HTN

A

Systolic BP 140-159 or Diastolic BP 90-99

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9
Q

Stage 2 HTN

A

Systolic BP > 160 or Diastolic BP > 100

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10
Q

Prehypertension

A

Systolic BP 120-139 or Diastolic BP 80-89

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11
Q

S3 heart sound

A

ventricular gallop resistance to ventricular filling due to fluid overload, CHF, and cardiomyopathy Sounds like “Ken-tuc’-ky”

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12
Q

S4 heart sound

A

atrial or presystolic gallop caused by increased ventricular diastole due to MI, HTN, and ventricular hypertrophy

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13
Q

Grade 1 murmur

A

barely audible

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14
Q

Grade 2 murmur

A

clearly audible but faint

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15
Q

Grade 3 murmur

A

moderately loud, easily heard

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16
Q

Grade 4 murmur

A

loud, associated with thrill on palpation

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17
Q

Grade 5 murmur

A

very loud; heard with one corner of stethoscope off chest wall

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18
Q

Grade 6 murmur

A

loudest; no stethoscope needed

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19
Q

Hypercalcemia can cause what rhythm abnormalities

A

AV blocks and bundle branch blocks due to increased contractility of heart and shortening of depolarization

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20
Q

What electrolyte imbalances cause U waves

A

hypomagnesemia and hypokalemia

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21
Q

To be diagnosed with HTN the pt. must have

A

3 elevated pressures on 2 separate occasions

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22
Q

Target BP for pts. with CKD, DM, or < 60 years old

A

< 140/90

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23
Q

Hypertensive urgency treatment

A

ORAL treatment with any short-acting agent Not Nifedipine

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24
Q

S/S of hypertensive urgency

A

upper level stage II HTN disc edema microalbuminuria LVH hair loss severe perioperative HTN

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25
Q

Hypertensive emergency treatment

A

Hospitalized, A line, IV therapy Goal is to reduce MAP by no more than 25% within 2 hours, then toward 160/100 within 2-6 hours Drug of choice: Nipride

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26
Q

S/S of Hypertensive emergency

A

HA, confusion, irritability (hypertensive encephalopathy) hematuria, proteinuria (hypertensive nephropathy) unstable angina, MI, aortic disection, PE, preeclampsia

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27
Q

leading cause of mortality and morbidity in US

A

CAD 4:1 men:women Age >70 1:1

28
Q

Lead II, III, aVf represents

A

inferior wall; 90% RCA, 10% Circumflex

29
Q

Lead I, aVL, V5, V6 represent

A

Lateral wall

30
Q

Lead V1-V6 represent

A

Anterior wall

31
Q

Indications for thrombolytics

A

ST segment elevation >0.1 in 2 or more leads CP and ST elevation not relieved by SL NTG <80 pt. is A/O and knows medical hx

32
Q

Absolute contraindications for thrombolytics

A

Hx of CVA, cranial or spinal trauma, severe uncontrolled HTN, known bleeding tendencies, trauma or surgery within 10 days, known or suspected pregnancy

33
Q

Relative contraindications for thrombolytics

A

puncture or non compressible vessel < 10 days ago Poorly controlled HTN Hemorrhagic opthalmic condition PT >15 secs

34
Q

Systolic heart failure

A

results from inability to expel blood normally d/t depressed LV contraction ACE-I and BB is standard of therapy

35
Q

Diastolic heart failure

A

inability of heart to relax Treatment is to prevent tachy, reduce LV filling, reduce BP and improve exercise tolerance and quality of life Treatment: BB, ARBs, ACE-I, Digoxin reserved fro diastolic HF with afib

36
Q

Acute left sided heart failure S/S

A

Manifested in the lungs: dyspnea at rest coarse rales S3 heard

37
Q

Chronic right sided heart failure S/S

A

Manifested in periphery: Dyspnea with exertion JVD Peripheral edema Abdominal discomfort Fine, diffuse rales

38
Q

First line management for CHF

A

ACE-I and BB Then add: diuretic, aldosterone antagonists, MSO4, and O2 Identify underlying cause

39
Q

Osler’s nodes

A

on the tips of fingers and toes Caused by septic emboli from infected heart valve Painful

40
Q

Best way to diagnose AAA

41
Q

This type of angina occurs more in woman that in men

A

Printzmetal- vasospasm not secondary to atherosclerosis Occurs more often in early morning hours

42
Q

Causes of secondary HTN

A

CKD, Coarc of Aorta, Cushing’s, pheochromocytoma, aldosteronism, sleep apnea, thyroid/parathyroid disease Most common cause is Renal Artery Stenosis

43
Q

Drug class for HTN in African Americans

A

Ca Channel Blockers

44
Q

Post MI drugs

A

ASA, Statin, BB, ACE-I (for first 6 weeks post-MI)

45
Q

Goal INR for pts. with afib on coumadin

46
Q

Goal INR for pts. with artificial valve on coumadin

47
Q

Chads-2 score

A

CHF, HTN, Age >75, DM, Hx of stroke

48
Q

Duke criteria for endocarditis

A

Two major or one major and 3 minor or 5 minor: Major: positive cultures consistent with IE organisms,evidence of cardiac involvement (echo, new regurg) Minor criteria: Predisposing heart condition or IV drug use, Fever > 38.0, vascular phenomena: major arterial emboli septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjuncitval hemorrhages, and Janeway lesions Immunologic phenomena: glomerulonephritis, Osler’s nodes, Roth spots and rheumatoid factor Microbiological evidence: positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE Echocardiographic findings: consistent with IE but do not meet major criterion

49
Q

Assess patients prior to administering SL NTG about what medication

A

phosphodiesterases (sildenafil or Viagra class)

50
Q

Hepatojugular reflux

A

Have patient positioned at 45 degrees and press on liver, if JVP rises >3 is a positive test

Indications: Tricuspid regurg, congestive heart failure

51
Q

Jugular Venous Pressure

A

Normal < 8 cm

Measure with patient at 45 degrees and measure highest impulse of jugular vein from angle of Louis on sternum. Then add 5 cm (measurement from RA to sternum)

52
Q

Critical Aortic Stenosis Triad

A

Angina, Heart failure, and exertional syncope

53
Q

V1- V4 represent

A

V1 & V2 septum

V3 & V4 anterior

Left anterior descending

54
Q

Normal RA pressure

55
Q

Normal RV pressure

56
Q

Normal PA pressure

A

20-30/8-12

Mean < 20

57
Q

SvO2 range

A

60-80%

Mixed venous oxygen saturation

58
Q

SVR

A

resistance of blood flow by systemic vasculature

900-1300

59
Q

Cardiac output range

A

4.8-6.4 L per minute

60
Q

Cardiac Index (CI)

A

Cardiac output/ Body surface area

62
Q

Drug class used for DM and HTN should use

A

ACE inhibitor

63
Q

Pts. with CAD and HTN should use what class

A

Beta-blocker

64
Q

Drug class used for HTN in African Americans

A

Calcium Channel Blocker

65
Q

Hydrostatic pressure

A

Pushes water out of the vessel

The PCWP is a measure of hydrostatic pressure

66
Q

Oncotic pressure

A

pulls water into the vessel

ACNP REVIEW (32 decks)

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