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NP course > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Isolated Systolic HTN

A

Elevated systolic with normal diastolic. Good predictor of CV events in the elderly. Vascular compromise.

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2
Q

Stage 1 HTN range

A

140-159 OR 90-99 mm Hg

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3
Q

HTN treatment goals for DM, kidney disease, and increased risk for stroke.

A

130/80 mm Hg

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4
Q

Lab tests for hypertension

A

urinalysis, blood glucose, hematocrit and lipid panel, serum potassium, creatinine, and calcium

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5
Q

Risk factors for cardiovascular disease

A 
Hypertension
• Obesity 
(body mass index >30 kg/m2)
• Dyslipidemia 
• Diabetes mellitus
• Cigarette smoking
• Physical inactivity
• Microalbuminuria, estimated
glomerular filtration rate 55 for men, >65 for women)
• Family history of premature CVD
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6
Q

Identifiable causes of HTN

A 
Sleep apnea
• Drug induced/related
• Chronic kidney disease
• Primary aldosteronism
• Renovascular disease 
• Cushing’s syndrome or steroid
therapy
• Pheochromocytoma
• Coarctation of aorta
• Thyroid/parathyroid disease
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7
Q

Stage 1 Hypertension - treatment without compelling indications

A

Thiazide-type diuretics for most. May consider ACEI, ARB, BB, CCB, or combination

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8
Q

Stage 2 Hypertension - treatment without compelling indications

A

2-drug combination for most (usually thiazidetype diuretic and ACEI, or ARB, or BB, or CCB).

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9
Q

Compelling indication - Heart failure

A

THIAZ, BB, ACEI, ARB, ALDO ANT

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10
Q

Compelling indication - Post myocardial infarction

A

BB, ACEI, ALDO ANT

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11
Q

Compelling indication - High CVD risk

A

THIAZ, BB, ACEI, CCB

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12
Q

Compelling indication - Diabetes

A

THIAZ, BB, ACEI, ARB, CCB

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13
Q

Compelling indication - Chronic kidney disease

A

ACEI, ARB

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14
Q

Compelling indication - Recurrent stroke prevention

A

THIAZ, ACEI

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15
Q

Lifestyle modification for HTN

A

Components of lifestyle modifications include weight reduction, DASH eating plan, dietary sodium reduction, aerobic physical activity, and moderation of alcohol consumption.

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16
Q

Weight reduction drop in SBP

A

5-20

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17
Q

DASH diet drop in SBP

A

8-14

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18
Q

Sodium reduction drop in SBP

A

2-8

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19
Q

Exercise drop in SBP

A

4-9

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20
Q

Alcohol consumption limits (<2 drinks per day) drop in SBP

A

2-4

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21
Q

thiazide diuretics

A

suffix “ide” first line unless compelling indication not to use.

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22
Q

ACE inhibitor

A

suffix “pril” Use in high renin states and DM

23
Q

ARB

A

suffix “sartan” Use in high renin states, DM, alternative to an ACE

24
Q

Beta blockers

A

suffix “lol” Not for use in uncomplicated HTN but a god add on medication

25
Q

Calcium channel blockers

A

suffix “dipine” Use for isolated systolic HTN

26
Q

How long do you trial lifestyle modifications

A

3 months

27
Q

Common side effect of HCTZ

A

erectile dysfunction

28
Q

What medication should not be used with a calcium channel blocker?

A

HCTZ - no synergism

29
Q

What medication should not be used in pregnancy?

A

ACE/ARB

30
Q

General population - total cholesterol goal

A

<200

31
Q

General population - LDL goal

A

<130

32
Q

General population - HDL goal

A

40-60

33
Q

General population/DM -triglycerides

A

< 150

34
Q

DM patients - total cholesterol goal

A

no recommendation

35
Q

DM patients - LDL goal

A

<100

36
Q

DM patients - HDL goal

A

> 40 males, >females

37
Q

Medication with the best effect on LDL

A

statins, slight decrease with niacin

38
Q

Medication with the best effect on total cholesterol

A

statins, slight decrease with niacin

39
Q

Medication with the best effect on HDL

A

niacin, slight increase with statins and tricor

40
Q

Medication with the best effect on triglycerides

A

fibrates, omega 3s, slight decrease with statins and niacin

41
Q

Clinical signs and symptoms of heart failure

A

tachypenea, crackles, tackycardia, possibly HTN, S3 and S4, peripheral edema possible

42
Q

What medication should you never use with heart failure?

A

calcium channel blockers

43
Q

stenotic valves

A

do not OPEN properly

44
Q

regurgitant valves

A

do not CLOSE properly

45
Q

Associated findings aortic stenosis

A

angina, syncope, HF

46
Q

Aortic stenosis complications (ASC)

A

A - angina
S - syncope
C - congestive heart failure

47
Q

Aortic regurgitation - assoc findings

A

angina, HF, dizziness, chest pain

48
Q

mitral stenosis - assoc findings

A

dyspnea, afib

49
Q

mitral regurgitation - assoc findings

A

SOB, fatigue, HF

50
Q

mitral regurgitation - etiology

A

congenital conditions, rheumatic heart disease, acute endocarditis, MVP, calcufied annulus

51
Q

mitral regurgitation - physical exam

A

PMI displaced laterally and is diffuse, murmur is holosystolic and apical, transmission to the axilla and sternum, usually grade II or more

52
Q

mitral valve prolapse

A

most common in adults, common click, can have palpitations and chest pain

53
Q

most common murmur in adults

A

mitral valve prolapse

54
Q

What class of drugs is verapamil?

A

Calcium channel blocker

NP course (12 decks)

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