Cardiovascular

Question 1

what is isolated systolic hypertension?

Answer 1

systolic pressure >160 with a diastolic pressure <90

Question 2

what initial labs should be drawn with a hypertensive patient

Answer 2

serum creatinine
postassium
glucose
fasting lipid profile
UA
electrocardiogram

Question 3

A ratio of aldosterone to plasma reinin activity (PRA) greater than what is suggestive of primary aldosteronism.

Answer 3

20

Question 4

if a patient presents w/ HTN, hypokalemia and difficult to control BP what should they be evaluated for?

Answer 4

primary aldosteronism

Question 5

how are aldosterone levels attempted to be suppressed?

Answer 5

high sodium diet

Question 6

If a patient has difficult to control BP, spells of palpitations, HA and marked elevated BP what should be suspected?

Answer 6

pheochromocytoma

Question 7

What test is highly sensitive for pheochromocytomas?

Answer 7

plasma metanephrines

Question 8

What are diastolic pressures <65 associated with?

Answer 8

increased stroke risk

Question 9

IV meds for hypertensive emergencies

Answer 9

labetalol (alpha/ beta blocker)
nicardipine (CCB)
fenoldopam (dopamine-1 agonist)

Question 10

when should antihypertensive meds be started in patients who don’t attain BP goals w/ lifestyle changes?

Answer 10

after 6-12 months of nonpharm therapy

Question 11

ADR of diuretics

Answer 11

urinary frequency

muscle cramps

Question 12

ADRs of ACE inhibitors

Answer 12

cough

angioedema

Question 13

ADR of beta blockers?

Answer 13

bradycardia sexual dysfunction

Question 14

what is an alpha-2 agonist used for BP?

Answer 14

clonidine

Question 15

what are alpha-1 antagonists?

Answer 15

doxazosin, terazosin

Question 16

what is used to treat primary aldosteronism?

Answer 16

aldosterone antagonist (sprionolactone)

Question 17

most commonly affected valvues for valvular heart disease

Answer 17

aortic and mitral

Question 18

aortic valvue disease is more common in what sex?

Answer 18

male

Question 19

most common cause of valvular heart disease?

Answer 19

rheumatic fever

Question 20

do stenotic valvular lesions lead to pressure overload or volume overload?

Answer 20

pressure

Question 21

symptoms seen with aortic stenosis

Answer 21

exertional angina
effort-related syncope
dysnpea (from LV systolic/ diastolic dysfunction)

Question 22

symptoms seen w/ aortic regurgitation

Answer 22

foreceful heartbeat/ palpitations (increased LV stroke volume)
angina
exertional dyspnea

Question 23

what valvular condition can present w/ exertional dyspnea, palpitations, hemoptysis

Answer 23

mitral stenosis

Question 24

what valvular disease present with a systolic, crescendo-decresendo at upper sternal border?

Answer 24

aortic stenosis

Question 25

what valvular problems presents with a diastolic rumbe at LV apex?

Answer 25

mitral stenosis

Question 26

what valvular condition presents w/ holosytolic murmur at LV apex that radiates to axilla?

Answer 26

mitral regurgitation

Question 27

what type of valvular problems presents with a decrescendo diastolic “blow” parasteneral

Answer 27

aortic regurgitation

Question 28

what are some peripheral manifestations of increased pulse pressure (associated w/ aortic regurgitation)

Answer 28

pulsatile flow in nail beds
head bobbing
rapidly rising falling carotid pulse
bobbing uvula

Question 29

Diagnostic studies for valvular heart diseases

Answer 29

EKG
chest x-ray
echo

Question 30

treatment for mitral stenosis

Answer 30

heart rate control (beta blockers or CCB)

Question 31

treatment for acutely symptomatic mitral regurg

Answer 31

afterload reduction- nitroprusside or hydralazine

diuretics

Question 32

treatment for aortic regurgitation

Answer 32

afterload reduceion w/ ACEI or CCB

Question 33

what signals the development of tight mitral stenosis

Answer 33

short S2 to OS interval, prolonged diastolic murmur, left arterial enlargement

Question 34

what toxicity should be considered in patients presenting w/ a-fib w/ regular ventricular response?

Answer 34

digoxin

Question 35

bradyarrythmias w/ progressively increasing PR intervals before a dropped QRS complex

Answer 35

Type-1 second degree block (Wenckebach)