CV 1

Question 1

what is predictive of ACS in women

Answer 1

shoulder and arm pain

Question 2

ACS/acute MI s/sx
5

Answer 2

shoulder and arm pain - women
radiation of pain into jaw, neck, or arms
NV
diaphoresis
SOB

Question 3

ACS/acute MI - elderly, DM, and females may not present with classic CP, what can they present with?
4

Answer 3

1. abd pain
2. fatigue
3. nausea
4. lightheadedness

Question 4

what type of pain is less likely to ACS/acute MI (but does not rule it out)

Answer 4

pain lasting only seconds, positional, pleuritic, or highly localized

Question 5

CP - assess lungs for
4

Answer 5

1. decreased breath sounds
2. crackles/rales
3. wheezes
4. rhonchi

Question 6

CP - assess CV for
5

Answer 6

1. rate and rhythm
2. presence of murmurs
3. extra heart sounds
4. adequate peripheral perfusion
5. BP asymmetry in extremities

Question 7

CP - assess chest wall for
3

Answer 7

1. tenderness/reproducibility
2. rash
3. signs of trauma

Question 8

CP - assess neck for
1

Answer 8

presence/absence of JVD

Question 9

CP - assess abd for
1

Answer 9

tenderness

Question 10

CP - assess extremities for
2

Answer 10

1. distal pulses in all extremities
2. dependent edema/asymmetrical leg swelling

Question 11

CP - img/testing
2

Answer 11

1. ekg
2. cxr

Question 12

acute MI tx
3

Answer 12

1. call EMS
2. administer 81 mg chewable ASA x 2 unless allergic or already given
3. prepare ACLS - place pads

Question 13

musculoskeletal CP/costochondritis tx

Answer 13

NSAIDs

Question 13

CHF

Answer 13

pathologic state in which the heart is unable to circulate enough blood to meet metabolic needs

Question 14

CHF - gather hx on
4

Answer 14

1. prior CHF or cardiac dx
2. most recent EF
3. med hx and adherence
4. associated symptoms - CP, SOB, nocturnal dyspnea, leg swelling, weight gain, fevers, recent illness

Question 15

CHF - clinical features left side failure
3

Answer 15

1. dyspnea
2. orthopnea
3. signs of pulmonary vascular congestion

Question 16

CHF - clinical features of right side failure
3

Answer 16

1. peripheral edema
2. hepatomegaly
3. JVD

Question 17

CHF - common triggers
6

Answer 17

1. sodium/fluid overload - dietary, medication non adherence, missed dialysis
2. cardiac ischemia/arrhythmia
3. infection
4. excessive excretion
5. PE
6. acute HTN

Question 18

CHF - PE neck findings - JVD present in what percent

Answer 18

50% cases

Question 19

CHF - respiratory PE findings
4

Answer 19

1. tachypnea
2. hypoxia
3. crackles/rales
4. wheezing

Question 20

CHF - CV PE findings
2

Answer 20

1. presence of murmurs
2. S/S4 heard

Question 21

CHF - abd and extremities PE findings
3

Answer 21

1. tender abd
2. distal pulses decreased
3. pedal edema

Question 22

CHF - img/testing
2

Answer 22

ekg
cxr

Question 23

CHF - sx attributed to dietary or med non compliance and stable w/o respiratory sx may be - tx

Answer 23

suitable for d/c w/ close cardio f/u

Question 24

CHF - when to refer to ER
3

Answer 24

1. hypoxia
2. respiratory distress
3. new onset CHF

Question 25

HTN

Answer 25

persistent elevation of SBP 140 or more and/or DBP 90 or more

Question 26

HTN - consider fundoscopic exam to assess for

Answer 26

papilledema

Question 27

HTN - img/testing, always assess for

Answer 27

end organ damage

Question 28

HTN - img/testing
4

Answer 28

1. ekg
2. urine for protein
3. cxr
4. pregnancy test

Question 29

HTN - DD

Answer 29

1. white coat
2. physiologic response to pain
3. preeclampsia

Question 30

HTN - overall tx
3

Answer 30

1. reinforce med compliance
2. lifestyle modifications
3. refer to PCP for consideration of meds

Question 31

HTN - rapid reduction of elevated asymptomatic BP

Answer 31

not recommended in urgent care setting

Question 32

HTN - return precautions include
4

Answer 32

1. CP
2. numbness/weakness/tingling
3. vision changes
4. SOB