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CV Flashcards

1
Q

A S3 heart sound is associated with?

A

fluid overload

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2
Q

An S4 heart sound is associated with ?

A

hypertrophy- stiff ventricular wall

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3
Q

S4 sounds like?

A

Ten-nes-see

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4
Q

S3 sounds like?

A

Ken-tuck-y

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5
Q

Characteristics of a grade III murmur

A

moderately loud

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6
Q

Characteristics of a grade IV murmur

A

loud, associated with a thrill

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7
Q

Loud S1 murmur, low pitched, mid-diastolic; apical, “crescendo” rumble. Name the murmur.

A

mitral stenosis

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8
Q

S3 with systolic murmur at 5th ICS MCL; may radiate to base or left axilla; musical, blowing or high-pitched. Name the murmur

A

mitral regurg

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9
Q

Systolic, “blowing”, rough, harsh murmur at 2nd R ICS usu radiating to neck. Name the murmur.

A

aortic stenosis

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10
Q

Diastolic, “blowing” murmur at 2nd L ICS. Name the murmur.

A

aortic regurgitation

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11
Q

What murmurs occurs during systole?

A

aortic stenosis, mitral regurg

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12
Q

What murmurs occur during diastole?

A

mitral stenosis, aortic regurg

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13
Q

A patient with HF demonstrating marked limitations of physical activity but comfortable at rest would be classified as what NYHA class?

A

III

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14
Q

A patient with HF demonstrating inability to carry out any physical activity without discomfort (S&S at rest) would be classified as what NYHA class?

A

IV

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15
Q

A suboccipital pulsating HA occurring in the early am, may be indicative of?

A

severe HTN

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16
Q

According to JNC 7, normal BP should be?

A

<120/80

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17
Q

According to JNC 7, prehypertension is defined as?

A

SBP 120-139 OR DBP 80-89

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18
Q

According to JNC 7, stage 1 HTN is defined as?

A

SBP 140-159 OR 90-99

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19
Q

According to JNC 7, stage 2 HTN is defined as?

A

SBP >/= 160 OR DBP >/= 100

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20
Q

According to JNC 8, BP goal for those <60yr?

A

< 140/90

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21
Q

According to JNC 8, BP goal for those >60yr?

A

<150/90

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22
Q

First drug of choice for treatment of HTN in non-African American?

A

**thiazides ACEi CCB ARB

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23
Q

First drug of choice for treatment of HTN in African American?

A

*thiazide diuretics CCB

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24
Q

First drug of choice in treatment of HTN w/CKD/DM?

A

**ACEi (regardless of race or other medical conditions)

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25
Q

Lab abnormalities a/w thiazide diuretics?

A
  • hypokalemia
  • hypomagnesemia
  • hyponatremia
  • hyperglycemia
  • hypercalcemia
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26
Q

What allergy should you ascertain about if you are starting your patient on a thiazide diuretic?

A

sulfas

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27
Q

SE a/w ACEi’s/ARBs

A

*cough

*angioedema (more so with ACEI’s)

*hyperkalemia

rash renal impairment

taste disturbances

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28
Q

SE of CCB’s

A

HA,

flushing,

bradycardia

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29
Q

SE of BBs

A

dizziness

bradycardia

fatigue

insomnia

nausea

heart block

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30
Q

Prazosin (minipress), terazosin (Hytrin), & Doxazosin (cardura) are of what medication class?

A

alpha 1 antagonists

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31
Q

SE of alpha 1 antagonists

A

orthostatic hypotension

dry mouth

dizziness

HA

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32
Q

Clonidine (catapres) &; Methyldopa (aldomet) are of what medication class?

A

alpha 2 agonists

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33
Q

SE of alpha 1 agonists

A

dry mouth

sedation

depression

HA

bradycardia

34
Q

Minoxidil (Loniten) is of what medication class?

A

vasodilator

35
Q

HTN urgency definition

A

BP >180/110 WO/end organ dysfunction

36
Q

Management of HTN urgency

A

PO anti-hypertensives

37
Q

HTN emergency definition

A

BP >180/120 & impending/progressive end organ damage

38
Q

papilledema

A

swelling of the optic disc w/blurred margins

39
Q

BP goal when treating HTN emergency

A

IV agents (Cardene, Nipride) to decrease BP to SBP 160-180 OR DBP <105 **no more than 25% within minutes to 1-2hr, then gradually lowered over several days

40
Q

Levines sign

A

“clenched fist sign”

41
Q

normal total cholesterol

A

<200

42
Q

normal VLDL (triglycerides)

A

<150

43
Q

normal LDL

A

optimal <100

44
Q

normal HDL

A

low <40mg/dl high >/= 60mg/dl

45
Q

LDL, HDL, & TG goal for patients w/DM or CAD

A

LDL: <70 HDL: >40 TG: <150

46
Q

what is the definitive diagnostic procedure for angina?

A

cardiac angiography

47
Q

high intensity statins should lower LDL by how much?

A

>/= 50%

48
Q

Name and dose of high intensity statins

A

Atorvastatin (Lipitor) 40-80mg Rosuvastatin (Crestor) 20-40mg

49
Q

When do cardiac enzymes rise after MI?

A

4-6hrs, remain high for several days

50
Q

NL INR:

A

0.8-1.2sec

51
Q

NL ACT time

A

70-120sec

52
Q

NL ACT time post PTCA/stent

A

>300

53
Q

NL aPTT

A

28-38sec

54
Q

NL PT

A

11-16sec

55
Q

NL PTT

A

60-90sec

56
Q

Indications for tPA revascularization with MI:

A

unrelieved CP (>30min & <6hr) + ST elevation >0.1mV in 2 or more contiguous leads

57
Q

Contraindications for tPA

A
  • prior ICH
  • ischemic CVA wi/ 3 mon
  • intracranial or intraspinal sx wi/3 mon
  • significant closed head trauma or facial trauma wi/3mon
  • severe uncontrolled HTN >185/110
  • suspected aortic dissection
  • active bleeding, or risk thereof, including ABN coags
  • structural cerebral vascular lesion or malignant intracranial neoplasm
58
Q

Treatment for DVT

A

lovenox 1mg/kg q12hr OR Heparin x 7-10d *Coumadin therapy x 12 wk

59
Q

Most common cause of PVD

A

atherosclerosis

60
Q

Peak incidence of PVD

A

40-70yr

61
Q

S&S of PVD

A

1st: c/o calf pain (claudication)
- cold/numbness to extremities
- progresses to pain at rest

62
Q

Physical findings of PVD

A

shiny/hairless skin

  • dependent rubor (redness in dependent position)
  • *reduced pulses
  • pallor
  • cyanosis
  • ulcerations
63
Q

Diagnostic tests to diagnose PVD

A

Dopppler US

**ABI

-anteriography

64
Q

most definitive test to diagnose PVD

A

anteriography

65
Q

Management of PVD

A

**stop smoking

-walk 1 hr/d–> stop when painful, resume when pain subsides–> develops collateral circulation

66
Q

Pentoxifylline (Trental) and Cilostazol (Pletal) are medications used to treat what disease?

A

PVD

67
Q

Chronic venous insufficiency (CVI) is more common in which gender?

A

women

68
Q

S&S of CVI

A
  • aching LE improved w/elevation
  • edema after prolonged swelling
  • night cramps of LE
69
Q

Physical findings of CVI

A
  • trophic changes w/discoloration
  • *stasis leg ulcers
  • edema of LE
  • dermatitis may be common
  • cool to touch
70
Q

Management of CVI

A

**elevate legs to diminish edema

  • *pneumatic compression stockings for acute weeping dermatitis:
  • wet compresses -0.5% hydrocortisone cream after compress -systemic abx only if bacterial infection
71
Q

most common cause of pericarditis

A

viruses

72
Q

Characteristics of pericarditis

A

localized retrosternal, pleuritic CP pain increased by deep inspiration, coughing, *recumbent

73
Q

S&S of endocarditis

A

fever & malaise

night sweats

weight loss

general “sick” feeling

74
Q

Key physical findings with endocarditis (8)

A
  1. *murmur (may be absent in up to 30%)
  2. fever
  3. osler nodes
  4. petechiae, purpura, pallor
  5. splinter hemorrhages
  6. janeway lesions
  7. roth spots
  8. splenomegaly
75
Q

painful, red nodules in the distal phalanges

A

osler nodes

76
Q

small & NOT painful macules on the palms and soles

A

janeway lesions *rarely observed

77
Q

Diagnosis of Pericarditis

A

ST elevation in all leads *depression of PR segment highly indicative of pericarditis

**inc ESR

78
Q

Management of Pericarditis

A

**NSAIDS -Ibuprofen 400-600mg q6-8hr

  • Indomethacin 25-50mg q8hr x 2 wk
  • corticosteroids -*only when complete failure of NSAIDs
  • Codeine 15-60mg PO QID for pain

**monitor for tamponade

79
Q

Diagnostic workup of Endocarditis

A

**bandemia

  • ECHO to assess valves
  • BCx x3 (3 separate sites in 1 hr)
80
Q

Management of Endocarditis

A

PCN G 2million units IV q4hr + Gent OR Naficillin 2g IV q4hr

*Vanco used for PCN-resistant strep or MRSA

81
Q

treatment for venous stasis ulcer/ stasis dermatitis

A

compression stockings

leg elevation

CV (1 decks)

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