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Primary Care > Chapter 6 > Flashcards

Chapter 6 Flashcards

0
Q

The most common symptoms of the vascular component of a cardiovascular condition is

A

Edema and leg pain

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1
Q

The cardinal symptoms of cardiac disease usually include

A

Chest, neck arm pain or discomfort, dyspnea, palpitation, syncope, cough, diaphoresis and cyanosis

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2
Q

Heart is innervated by

A

C3-T4

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3
Q

Fluttering sensations in the neck are usually

A

Caused by anxiety, random muscle fasciculations or minor muscle strain or overuse

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4
Q

Less than ___ palpitations a minute is considered normal

A

6

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5
Q

Palpitation in any person with a history of unexplained sudden death in the family needs

A

Immediate physician referral

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6
Q

Caffeine sensitivity can cause palpitation like feelings because

A

Causes an overactive thyroid

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7
Q

Why does paroxysmal nocturnal dyspnea wake people up

A

The amount of blood returning to the heart and lungs from the lower extremities when lying down

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8
Q

People with CHF usually have these two things

A

PND and unexplained episodes of shortness of breath

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9
Q

Those with CHF breathe easier when

A

Standing and when later in the day due to gravity

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10
Q

Anyone who cannot climb a single flight of stairs without feeling moderately or severely winded or who awakens at night or has sob lying down needs

A

Physician referral

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11
Q

When is dyspnea more likely to be of pulmonary origin

A

When it is relieved by specific breathing patterns or positional changes like leaning forward

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12
Q

Syncope that occurs with no warning period of symptoms may be a sign of

A

Heart valve or arythmia problems

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13
Q

What is pseudoclaudication

A

Claudication from lumbar stenosis

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14
Q

Statins are used to

A

Decrease LDLs

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15
Q

What is the most common mycotoxin event associated with statins

A

Myalgia

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16
Q

What is myositis

A

Muscle symptoms with increased CK levels

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17
Q

Risk factors for statin side effects

A

Age over 80, small body frame, kidney or liver disease, excessive grapefruit juice consumption, use of other medications and alcohol abuse

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18
Q

Signs and symptoms of statin induced side effects

A

Myalgia, fever, nausea, vomiting, liver impairment symptoms

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19
Q

One of the most important primary signs of CAD in women

A

Unexplained, severe episodic fatigue and weakness associated with decreased ability to carry out normal ADLs

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20
Q

What is Prinzmetal’s angina

A

Coronary artery spasms that squeeze arteries shut and keep the blood from reaching the heart

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21
Q

Prinzmetal’s angina typically occurs

A

At rest and at the same time everyday

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22
Q

Women with signs of CAD may have isolated pain in the

A

Mid thoracic spine or right bicep

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23
Q

Why does cardiac pain refer to the jaw

A

Inter nuncial fibers from the cervical spinal cord posterior horns to the spinal nucleus of the trigeminal nerves

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24
Q

80 to 90% of clients experience angina in this location

A

Retrosternal or slightly left of the sternum

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25
Q

The duration of angina as a direct result of myocardial ischemia is typically

A

1-3 minutes and no longer than 3 to 5 minutes

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26
Q

If angina like pain is not relieved with rest or up to ___ nitro tablets notify the physician and take the client to cardiac care unit

A

3

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27
Q

Signs and symptoms of angina

A

Gripping vise like feeling of pain or pressure behind Breast bone, radiating pain, toothache, burning indigestion, dyspnea, nausea, belching

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28
Q

Most common cause of MI

A

Coronary thrombosis

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29
Q

What is the first symptom of heart attack in half of men

A

Sudden death

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30
Q

MIs typically occur at what time of day

A

Morning (40% higher likelihood)

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31
Q

Why do MIs pose a greater risk in the morning

A

The body’s clotting system is more active at this time, BP surges, increased HR from rest and reduced BF to heart

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32
Q

Hormone effect on having an MI in the morning

A

Stress hormone which can induce vasoconstriction increase in the morning

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33
Q

Warning signs of MI - classic ones

A

Chest pain that is unrelieved by rest of nitro tablets and lasts over 30 minutes, pain radiates for hours, pallor, sweating, nausea, vomiting

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34
Q

When working with _____ it can increase the pain associated with MI

A

Arms overhead

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35
Q

Most common symptom of MI in men

A

Feeling of pressure or discomfort in the sternal region or across the chest

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36
Q

Chest pain is less common in ____ during MI

A

Women

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37
Q

In women _____ may relieve the symptoms of MI

A

Antacids

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38
Q

Most common symptom in women one month before heart attack

A

Unusual fatigue

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39
Q

What is pericarditis

A

Inflammation of the pericardium

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40
Q

Chest pain from pericarditis mimics

A

Chest pain of an MI

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41
Q

How can you differentiate MI from pericarditis with position changes

A

MI pain will be unaffected by position,, breathing or movement whereas pericarditis may be relieved by kneeling on all fours , leaning forward or sitting upright

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42
Q

Pericardital chest pain is often worse with

A

Breathing, swallowing, belching or neck or trunk movements especially side bending and rotation

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43
Q

The chest pain in pericarditis may be described as

A

Sharp or cutting and possibly in bursts with a change in body position

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44
Q

What may reduce pericarditis pain?

A

Holding the breath

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45
Q

What is ventricular interdependence

A

The ventricles both need to be functioning, if one fails it almost always leads to failure of the other

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46
Q

Right sided ventricular failure leads to

A

Congestion of peripheral tissues and viscera, liver enlargement, ankle swelling and ascites (fluid buildup in abdomen)

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47
Q

What are the most common signs and symptoms of CHF

A

Breathlessness, exhaustion and LE edema

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48
Q

Why is cough a common symptom of left ventricular failure

A

A large amount of fluid is trap,led in the pulmonary tree, irritating lung mucosa

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49
Q

Why is fatigue and muscle weakness a symptom of left ventricular failure

A

Inadequate CO leads to hypoxic tissue and slowed removal of metabolic waste products causing them to tire easily

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50
Q

Nocturia is possible in both and r and l sided heart failure but more common in

A

Left

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51
Q

What is one of the early signs of right ventricular failure

A

Dependent edema - symmetric edema in the dependent parts of the body where venous pressure is highest

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52
Q

Clinical signs and symptoms of right sided heart failure q

A

Increased fatigue, dependent edema, pitting edema, edema in sacral area or back of thighs, right upper quadrant pain and cyanosis of nail beds

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53
Q

What is a dissecting aortic aneurysm

A

Splits and penetrates the arterial wall creating a false vessel

54
Q

Thoracic aneurysms occur most frequently in

A

Men with hypertension ages 40-70

55
Q

What is the most common site of peripheral arterial aneurysms

A

Popliteal space

56
Q

Abdominal aortic aneurysms occur _ times as often than thoracic aneurysms

A

4

57
Q

The most common site for abdominal aortic aneurysms is

A

Just below the kidney with referred Omani to the thoracic lumbar junction

58
Q

Most AAAs are asymptomatic or symptomatic?

A

Asymptomatic - find out with exams

59
Q

The most common symptom of an AAA is

A

A pulsating mass in the abdomen with or without pain, followed by abdominal pain and back pain

60
Q

Palpating the width of the abdominal aorta should

A

Have a uniform pulse from midline out

61
Q

The abdominal aorta passes posterior to diaphragm at what level

A

T12

62
Q

The abdominal aorta bifurcates at this level

A

L4

63
Q

The BP and HR values that may indicate shock

A

Systolic under 100 and HR over 100

64
Q

What is stenosis

A

A narrowing or constriction that prevents the valve from opening fully and may be caused by growths, scars, or abnormal deposits on leaflets

65
Q

What is insufficiency

A

Regurgitation, occurs when The valve does not close properly and causes blood flow to back into the heart chamber

66
Q

Prolapse…

A

Involves only the mitral valve, and occurs when enlarged valve leaflets bulge backward into the left atrium

67
Q

Signs and symptoms of valvular disease

A

Easy fatigue, dyspnea, palpitation, chest pain, pitting edema, Orthopnea and paroxysmal dyspnea, dizziness and syncope

68
Q

What is rheumatic fever caused by

A

Stretoloccocal bacteria

69
Q

Why is it called rheumatic fever

A

The two more common symptoms are fever and joint pain

70
Q

Most typical presentation of rheumatic fever in children and young adults

A

Cold or sore throat followed two to three weeks later by painful joints and fever, with palpitations and fatigue

71
Q

What is endocarditis

A

Inflammation of the cardiac endothelium and damages either the tricuspid, mitral or aortic valves

72
Q

Endocarditis is caused by

A

Bacteria, abnormal growths on the closure lines of previously damaged valves or artificial valves

73
Q

Two groups most at risk for endocarditis

A

Injection drug users and post cardiac surgical patients

74
Q

Up to 45% of individuals with endocarditis Inititally have

A

Musculoskeletal symptoms including arthralgia, arthritis, low back pain and myalgia

75
Q

The most common musculoskeletal symptom of endocarditis is

A

Arthralgia, generally in proximal joints

76
Q

Most common site of arthralgia in endocarditis

A

Shoulder

77
Q

If a patient is suspected of RA due to symmetric arthralgia in knees and ankles, how could you differentiate

A

If they have morning stiffness, it would be RA, this is not present in those with endocarditis

78
Q

Endocarditis may produce destructive changes in the

A

Sacroiliac joint

79
Q

Endocarditis induced low back pain mimics symptoms of someone with

A

Herniated lumbar disk

80
Q

How do you differentiate endocarditis low back pain and herniated disk

A

Neurological deficits aren’t present in endocarditis

81
Q

Systemic lupus erythematosus releases

A

Broad spectrum of autoantibodies into the circulation

82
Q

The most common cardiac lesion associated with SLE

A

Pericarditis

83
Q

Usually symptoms of mitral valve prolapse are due to

A

Dysautonomia

84
Q

There is a high incidence of mitral valve prolapse in those with

A

Fibromyalgia

85
Q

The triad of symptoms for mitral valve prolapse

A

Fatigue, dyspnea and palpitations

86
Q

The therapist should monitor pulse carefully before, during and after exercise in anyone who has had a

A

Stroke

87
Q

Explain a fib and possible complication

A

Disorganization of atrial activity without effective atrial contraction, the chambers quiver rather than contract causing pooling of blood and clots to form increasing risk for a stroke

88
Q

Which bacteria is of concern may cause A fib

A

H. Pylori in the stomach, confirm with high concentration of c reactive protein

89
Q

Sinus tachycardia is defined as

A

More than 100 bpm

90
Q

Bradycardia is less than

A

60bpm

91
Q

What is pulse pressure

A

Systolic minus diastolic

92
Q

A widened pulse pressure usually results from

A

Stiffening of the aorta secondary to atherosclerosis

93
Q

If the pulse pressure widens this will increase

A

Stroke volume

94
Q

Primary hypertension is also called ______ and makes up ____ of all hypertensive clients

A

Idiopathic, 95%

95
Q

Secondary hypertension results from

A

Diseases that cause it

96
Q

What is labile or borderline hypertension

A

When there is intermittent elevation of BP interspersed with normal readings

97
Q

What is isolated systolic hypertension and what does it increase the risk for

A

Systolic rises but diastolic is normal and it increases the risk for stroke and death

98
Q

This important mineral deficiency is known to contribute to hypertension

A

Potassium

99
Q

Clinical signs and symptoms of hypertension

A

Occipital headache, vertigo, flushed face, spontaneous epistaxis, vision changes and nocturnal urinary frequency

100
Q

How long do transient ischemic attacks last

A

5 to 20 minutes usually but can last up to 24 hours

101
Q

An untreated TIA is likely to result in stroke in 10-20% of patients within

A

3 months

102
Q

Signs and symptoms of TIAs

A

Slurred speech, difficulty with speech, or difficulty understanding others, sudden confusion, loss of memory, even loss of consciousness, temporary blindness or other dramatic visual changes, dizziness, severe headache, paralysis or weakness usually one sided, symptoms typically lasting a few minutes

103
Q

Orthostatic hypotension is

A

SBP drops 20 mmHg or a drop of 10 mmHg or more of both systolic and diastolic BP upon an erect position with a 10-20% decrease in HR

104
Q

DM is an insect or direct risk factor for heart disease

A

Indirect, it’s the combination of what it effects that increases the risk

105
Q

The first sign of vascular occlusive disease may be

A

The loss of hair on the toes

106
Q

The most common lesion of vascular occlusive disease is the

A

Superficial femoral artery causing pain in the calf and lower thigh

107
Q

What is Raynaud’s phenomenon

A

Intermittent episodes during which small arteries or arterioles in extremities contrict, causing temporary pallor and cyanosis of the digits and changes in skin temperature

108
Q

Unilateral Raynaud’s may be a sign of

A

Hidden neoplasm

109
Q

Secondary Raynaud’s is known To be caused by these things

A

Connective tissue or collagen vascular disease like sclerderma, polymyositis/dermatomyositis, systemic lupus erthmatosus or RA

110
Q

Raynaud’s disease is

A

A primary vaso spastic or vaso motor disorder caused by hypersensitivity to cold, release of serotonin and congenital predisposition to vaso spasm

111
Q

80% of those with Raynaud’s disease are

A

Women between 20-49

112
Q

Acute venous disorders are due to

A

Formation of thrombi which obstruct venous flow

113
Q

DVT is more common in men or women and children or adults?

A

Women and adults

114
Q

The most significant risk factors for a DVT are

A

Age over 70 and previous thromboembolism

115
Q

Thrombus formation is attributed to what three things

A

Venous stasis, hypercoagulability, injury to the venous wall

116
Q

What is venous stasis caused by

A

Prolonged immobilization or absence of the calf muscle pump

117
Q

Women on progestogen only pills are at little or no increased risk of

A

Blood clots

118
Q

Lymphadema is

A

An excessive accumulation of fluid in the tissue spaces.

119
Q

Potassium levels should be monitored for those taking

A

Dieretics

120
Q

Med in particular that lowers potassium

A

Digitalis

121
Q

What are the cardiac effects of too much potassium

A

Ventricular arythmias and a systole or flat line

122
Q

Magnesium deficits often accompany these deficits

A

Potassium and calcium

123
Q

NSAIDs have the ability to decrease the effectivness of

A

ACE inhibitors

124
Q

___ and ___ is combo with NSAIDs will

A

Exacerbate the effects of NSAIDs

125
Q

Diuretics work by

A

Lowering BP by eliminating sodium and water and thus reducing blood volume

126
Q

Beta blockers work by

A

Relaxing the blood vessels and the heart muscle by blocking the beta receptors on the SA node and myocardial cells producing a decline in the force of contraction and a reduction in heart rate

127
Q

Alpha 1 blockers…

A

Lower BP by dilating blood vessels

128
Q

Alpha 1 blocker medications all end with

A

“Zocin”

129
Q

Ace inhibitors also

A

Vaso dilate

130
Q

Calcium does what to blood vessels

A

Constricts

131
Q

Calcium channel blocking Meds end with

A

Pine

132
Q

Angina does ___ occur immediately after physical activity

A

Not

Primary Care (8 decks)

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