CV 1

Question 1

why stop naproxen before contrast dye

Answer 1

NSAIDs like naproxen are withheld d/u impact on renal prostaglandin production

Question 2

metformin and contrast dye

Answer 2

this combo can cause lactic acidosis and impair kidney function - stop 48 hours before getting contrast dye

Question 3

why stop furosemide before contrast dye

Answer 3

can contribute to volume depletion

Question 4

thiazide diuretics have a secondary effect of increasing what

Answer 4

serum calcium by decreasing fluid which makes more calcium available for absorption and can be helpful as an adjunct for patients who also are being treated for osteoporosis

Question 5

impede movement of calcium into cells

Answer 5

CCB

Question 6

MVP with no symptoms of arrhythmias or ectopy at rest f/u

Answer 6

no further f/u - check annually

Question 7

med indicated to alleviate atrial or ventricular arrhythmias associated with MVP

Answer 7

BBs like metoprolol

Question 8

serum total and HDL levels in fasting and non fasting pts

Answer 8

there are very small and clinically insignificant differences in values whether fasting or not; the primary effect of eating on a patient’s lipid values is elevation of triglyceride levels

Question 9

max elevated of trig levels occurs when

Answer 9

3-4 hours after eating but may be several peaks during 12 hour period - need a 12 hour fast

Question 10

screening for hyperlipidemia - fast for how long

Answer 10

12-14 hours

Question 11

when and what to monitor after starting ACE I

Answer 11

in 1 week check K, BUN, and Cr

Question 12

most cost effective way to screen for AAA

Answer 12

abd US - although it can be seen on plain film, CT, and MRI

Question 13

which lipid particle has the greatest atherogenic effect

Answer 13

LDL and is the primary target when patients are treated pharmacologically

Question 14

the most common arrhythmia associated with MR is

Answer 14

a fib

Question 15

a fib occurs because the

Answer 15

fibers in the atrium are stretched as the atrium dilates and this stretch results in conduction defects, notable, a fib

Question 16

MR has caused a fib - next intervention

Answer 16

anticoagulation

Question 17

evidence does or does not support routine EKG or cardiac testing in patients who are asymptomatic prior to starting new exercise programs?

Answer 17

does not support this testing - inform pt to watch for s/sx and stop if they develop CP or SOB

Question 18

systolic HF occurs where

Answer 18

in the heart’s left ventricle

Question 19

which class of medication is frequently used to improve long-term outcomes in patients with systolic dysfunction

Answer 19

ACE I as they reduce morbidity and mortality

Question 20

med class that can potentially worsen HF, so monitor carefully although they can decrease morbidity and mortality

Answer 20

BBs

Question 21

do CCBs warrant monitoring of K levels

Answer 21

no

Question 22

hydrochlorothiazide - K level

Answer 22

can cause hypokalemia, monitor

Question 23

isolated systolic HTN is best treated with what

Answer 23

long-acting CCB, particularly those that end in -pine e.g. amlodipine (dihydropyridine CCB)

Question 24

ACE-Is should be d/c immediately in who

Answer 24

pregnant individuals due to teratogenic effects on the renal system of the developing fetus

Question 25

is gout exacerbated by ACEs

Answer 25

no

Question 26

most common indicated for end-organ damage in adolescents with HTN is

Answer 26

left ventricular hypertrophy

Question 27

screening for AAA should take place in who

Answer 27

men 65-75 who have smoked

Question 28

gout is characterized by ____

Answer 28

hyperuricemia

Question 29

uric acid levels are increased when a patient consumes any medication that results in less what

Answer 29

circulating fluid volume - diuretics should be avoided when possible in patients who have a history of gout

Question 30

why are thiazide diuretics contraindicated in sulfa allergy

Answer 30

they have a sulfonamide ring in its chemical structure