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LEIK FNP Review > Cardiovascular and peripheral vascular disorders > Flashcards

Cardiovascular and peripheral vascular disorders Flashcards

1
Q

what is stage I hypertension?

list specifics for systolic and diastolic

A

systolic blood pressure greater than 130-139.

diastolic blood pressure 80-89

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2
Q

what is stage II hypertension?

list specifics for systolic and diastolic

A

systolic blood pressure greater than 130-139

diastolic blood pressure 80-89

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3
Q

what is the goal blood pressure for a patient who is less than 60 yrs old?

A

less than 140/90

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4
Q

what is the goal blood pressure for a patient who is older than 65 yrs old?

A

less than 150/90

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5
Q

what is the goal blood pressure for a patient who has chronic kidney disease and DM?

A

less than 140/90

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6
Q

which two antihypertensive agents should be used first line in African American patients?

A

thiazide diuretics and calcium channel blockers

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7
Q

what are the four antihypertensive agents that can be used first line in non-black patients?

A

Thiazide diuretics, calcium channel blocker, Ace inhibitors, and ARBs

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8
Q

which antihypertensive agent has sulfa in it?

A

thiazide diuretics are contraindicated in patients with a sulfa allergy

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9
Q

what labs should be checked for a patient that is on an ace inhibitor or an ARB?
list three labs

A

potassium, BUN, creatinine

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10
Q

what lab should be checked for a patient that is on a thiazide diuretic?

A

potassium

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11
Q

which two statin drugs would you prescribe for a patient that has a history of coronary heart disease or stroke (CVA)? list two statin meds

A

Atorvastatin, Rosuvastatin (think AR 40-80)
you want a 50% reduction in LDL

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12
Q

For patients with a history of DM, aged 40 to 75, with an LDL of 70-189, what intensity of a statin is recommended?

A

moderate intensity statin

atorvastatin 10-20, rosuvastatin 5-10, simvastatin 10-20, pravastatin 20-40

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13
Q

what is the ASCVD goal risk percentage to be Below ?

A

Be below 7.5%
start a statin if higher than 7.5%

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14
Q

when should you initiate a fibrate with a statin medication?

A

only if the triglycerides are over 500.

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15
Q

what is important to acknowledge in patient who use a NSAID such as naproxen in patients with hypertension?

A

It can cause swelling, it changes how kidneys handle sodium.

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16
Q

what antihypertensive class of medication should NOT be used in heart failure patients?

A

calcium channel blockers (example amlodipine)

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17
Q

what heart sound is most common with heart failure?

A

S3

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18
Q

When you hear “a searing or tearing back pain” what should you think of?

A

Abdominal aortic aneurysm

common finding is a “pulsatile mass” in the abdomen in asymptomatic cases

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19
Q

At how many cm is an AAA diagnosed?

A

at 3 cm

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20
Q

what is the screening recommendation for AAA?

A

screen MEN aged 65 to 75 years of age who have Ever smoked ONE time with ultrasonography

**ever smoked is commonly defined as smoking 100 or more cigarettes

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21
Q

stenotic valves have what trouble?

A

don’t open properly

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22
Q

Reguritant valves have what trouble?

A

they don’t close properly

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23
Q

List all the systolic murmurs

(think MR. Peyton Manning AS MVP)

A

Mitral Regurgitation
Physiologic Murmur
Aortic Stenosis
Mitral Valve Prolapse

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24
Q

List all the diastolic murmurs

(think has big “ARMS”)

A

Aortic Regurgitation
Mitral Stenosis

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25
where is aortic stenosis best heard? (remember we tend to hear murmurs best where they originate)
2nd right intercostal space
26
which systolic murmur has a mid-systolic click?
Mitral valve prolapse
27
which systolic murmur has a holosystolic murmur?
Mitral regurgitation
28
Ankle brachial index value less than ____ and greater than ____ suggests peripheral artery disease.
Ankle brachial index valve less than 0.9 and greater than 1.3 suggests peripheral artery disease
29
The "lub" sound is what heart sound?
S1
30
S1 or the "lub" sound is the closure of what two valves? (think Motivated Apples)
closure of the mitral, tricuspid, and AV valves
31
The "dub" sound is what heart sound?
S2
32
S2 or the "dub" sound is the closure of what two valves? (think motivated apples)
closure of the aortic, pulmonic, and semilunar valves
33
which heart sound is associated with systole?
S1
34
which heart sound is associated with diastole?
S2
35
S3 heart sound is associated with what?
heart failure, often heard as a gallop
36
S3 heart sound can be a normal finding in children, pregnant women and some athletes younger than 35 yrs, true or false?
TRUE
37
which heart sound occurs in LATE diastole?
S4 sounds like tennesse
38
which heart sound occurs in LATE diastole?
S4 sounds like Tennessee
39
how is S4 best heard?
with the bell of the stethoscope
40
which heart sound occurs in early diastole?
S3
41
To hear low tones of the stethoscope, which side of the stethoscope would you use?
use the bell of the stethoscope
42
To hear mid to high-pitched tones such as lung sounds, which side of the stethoscope would you use?
diaphragm
43
what murmur is this: A very soft murmur heard only under optimal conditions
Grade I
44
what murmur is this: Murmur is so loud that it can be heard even with the stethoscope off the chest. The thrill is easily palpated.
Grade VI
45
what murmur is this : Very loud murmur heard with edge of stethoscope off the chest. Thrill is more obvious.
Grade V
46
what murmur is this: A louder murmur. First time that a thrill is present. A thrill is like a “palpable murmur.”
Grade IV
47
what murmur is this: A mild to moderately loud murmur
Grade II
48
what murmur is this: Loud murmur that is easily heard once the stethoscope is placed on the chest.
Grade III
49
what grade of murmur is first palpated?
Grade IV (4)
50
which heart sound is a sign of LVH?
s4
51
what is the recommended INR range for a patient who has A-fib?
2.0 to 3.0
52
what is the recommended INR range for a patient who has had synthetic or prosthetic heart valve?
2.5 to 3.5
53
what is pulsus paradoxus?
defined as a fall in systolic BP of more than 10 mmhg during the inspiratory phase
54
pulsus paradoxus is associated with what cardiac condition?
cardiac tamponade
55
IF INR is between 4.01 and 4.99, what is the action the provider should do?
Hold one dose, do not give vitamin K
56
what is a normal PR interval?
0.12 to 0.20 (3-5 small boxes)
57
S3 heart sound is common in what trimester of pregnancy?
third trimester
58
what drugs are used to control or manage blood pressure in pregnancy? list 3
methyldopa, nifedipine, and labetalol (metoprolol)
59
Hypertensive retinopathy has what characteristic?
silver and/or copper wire arterioles flame-shaped hemorrhages, papilledema
60
what are some causes of secondary hypertension?
renal artery stenosis, polycystic kidney disease, CKD, hyperthyroidism, hyperaldosteronism, pheochromocytoma, OSA, cortication of the aorta
61
renal artery stenosis is more common in what population?
younger adults
62
what is orthostatic hypotension?
Decrease in systolic blood pressure by 20 mmhg or decrease in diastolic blood pressure by 10mmhg.
63
when should you reassess blood pressure in patients that you initiate a med on for the first time?
in one month
64
what are side effects of thiazide diuretics ?
hyperglycemia hyperuricemia hypertriglyceridemia hypercholesteremia hypokalemia hyponatremia hypomagnesemia
65
what are side effects of calcium channel blockers?
headaches (due to vasodilation), ANKLE EDEMA, heart block or bradycardia, reflex tachycardia
66
calcium channel blockers are contraindicated in what conditions?
bradycardia second-third degree heart block CHF
67
what are two biggest side effects of alpha 1 blockers/antagonists?
dizziness and hypotension
68
what medications can be used for BPH and hypertension?
Terazosin and Doxazosin
69
Flomax or tamulosin is just used for BPH only.
true
70
Aliskiren should not be given with what two antihypertensive classes?
ACE inhibitors or ARBs
71
what is a side effect of spironolactone ?
gynecomastia
72
what is the concern when combining an ACE inhibitor and a potassium sparing diuretic?
hyperkalemia is at an increased risk
73
what antihypertensive class should not be used in patients with renal artery stenosis?
ACE inhibitors and ARBs will precipitate acute renal failure
74
women with hypertension and osteopenia/osteoporosis should receive what class of antihypertensive meds?
thiazide diuretics because thiazides help bone loss by slowing down calcium loss (from the bone) and stimulating osteoclasts
75
what is homan's sign?
lower leg pain on dorsiflexion of the foot (low sensitivity test)
76
what is homan's sign associated with?
DVT
77
what is the gold standard for diagnosis DVT?
Ultrasonography
78
what is the first line medication for a stable heart failure patient?
ACE inhibitor or ARB
79
NY association functional capacity rating: "No limitations on physical activity"
class I
80
NY association function capacity rating: "symptoms are present at rest, with or without physical activity"
class IV
81
NY association function capacity rating: "Ordinary physical activity results in fatigue, exertional dyspnea"
Class II
82
NY association function capacity rating: "Marked limitation in physical activity"
Class III
83
in patients with peripheral arterial disease, how do legs look?
Red in dependent position, white/pallor in elevated position. Shiny skin, hyperpigmented ankles, hairless, and cool to the touch.
84
what are some medications used to treat Raynaud's phenomenon?
nifedipine or amlodipine
85
Subungual hemorrhages is associated with what heart condition?
Bacterial endocarditis
86
a mid-systolic click by a a late systolic murmur is most likely which heart murmur?
mitral valve prolapse
87
what is the triad of rhabdomyolysis?
triad of muscle pain (myalgia), weakness, and red to brown urine.
88
An adult (21 to 75 yrs) with any type of ASCVD (CAD, PAD, Stroke, TIA) is given what type of statin strength?
high intensity statin
89
Patients on a statin should avoid what?
grapefruit juice

LEIK FNP Review (19 decks)

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