CVS

Question 1

Osler nodes

Answer 1

Painful violet colored nodes on fingers or feet

Question 2

janeway lesions.
What may you also seen on fundoscopic exam?

Answer 2

non-tender red macules on palms and soles seen in endocarditis. May also see roth spots on fundoscopic exam

Question 3

S3

Answer 3

Ventricular gallop. Heard in pregnancy, some athletes and in children. Occurs during early diastole.

Question 4

S4

Answer 4

Occurs during late diastole. Atrial gallop. D/t stiff ventricles. Always pathologic.

Question 5

Split S2
Appears during ____ and disappears with ____

Answer 5

Benign. best heard over pulmonic area.
Appears during inspiration and disappears with expiration

Question 6

T/F?
S3 is a sign of CHF and S4 is a sign of LVH

Answer 6

True

Question 7

at what grade can a thrill be palpated

Answer 7

Grade IV

Question 8

“holiday heart” or increased ETOH intake is associated w/ what dysrhythmia?

Answer 8

a. fib

Question 9

Paroxysmal a. fib

Answer 9

Episodes < 7 days and asymptomatic (usually)

Question 10

CHADS2 VASc

Answer 10

CHF
HTN
Age > 75
DM
Sex (Female higher risk)
Stroke
Vascular disease
Age 65-74

Question 11

Pancystolic/holocystolic murmur that radiates to auxilla

Answer 11

Mitral regurgitation

Question 12

Murmur that radiates to neck; midsystolic ejection murmur

Answer 12

Aortic stenosis

Question 13

Low pitched diastolic rumbling murmur at apex of heart with opening snap

Answer 13

Mitral stenosis

Question 14

High pitched diastolic murmur, best heard at left sternal border

Answer 14

Aortic regurgitation

Question 15

What grade of heart murmur is thrill palpable?

Answer 15

IV Grade

Question 16

INR < 5

Answer 16

skip next dose and reduce maintenance dose

Question 17

INR 5-9

Answer 17

Hold 1-2 doses, monitor INR every 2-3 days, reduce maintenance dose

Question 18

Causes of pulsus paradoxus - apical pulse can be heard even through the radial pulse is no longer palpable

Answer 18

Pulmonary cause - asthma, emphysema
Cardiac cause - tamponade, pericarditis, effusion

Question 19

Stage I HTN

Answer 19

> 140/90

Question 20

Alpha 1 blocker examples

Answer 20

Tamsulosin “osin”

Question 21

Side effects of thiazide diuretics
“Hyper” x 3
“Hypo” x 3

Answer 21

Hyperglycemia
Hypercholesterolemia
Hypertrigliceridemia
Hyperuricemia

Hypokalemia
Hyponatrema
Hypomagnesemia

Question 22

Preferred meds for isolated systolic HTN in elderly

Answer 22

Thiazide or CCB

Question 23

Normal JVP

Answer 23

4 cm or less

Question 24

NYHA II S&S

Answer 24

ordinary physical activity results in fatigue, exertional dyspnea

Question 25

What ABI score is diagnostic for PAD

Answer 25

0.9 or less

Question 26

Endocarditis prophylaxis

Answer 26

Amoxicillin 2 gm PO in adults

Question 27

S2 click with systolic murmur in tall thin adult that c/o of fatigue, palpitations, lightheadednss taht is exacerbated by exertion

Answer 27

MVP

Question 28

Lipid screening

Answer 28

> /= 20 - Q 5 years
/= 40 - Q 2-3 years
If RF screen more often

Question 29

if elevated LDL and trigs, which to treat first?

Answer 29

Trigs for target < 150
LDL < 100 or < 130 if < 2 RF

Question 30

Secondary prevention w/ ASCVD
< 75 years
> 75 years

Answer 30

< 75 - high dose statin
> 75 years - moderate intensity

Question 31

Secondary prevention w/ out ASCVD
LDL >/= 190 -
DM (40-75 YRS) w/ LDL < 190 -
w/ out DM or ASCVD (40-75) w/ 10 year ASCVD risk >/= 7.5% -

Answer 31

LDL >/= 190 - high intensity statin
DM (40-75 YRS) w/ LDL < 190 - moderate intensity statin
w/ out DM or ASCVD (40-75) w/ 10 year ASCVD risk >/= 7.5% - moderate to high intensity statin

Question 32

List 2 high intensity statins
** what foods to avoid **

Answer 32

Atorvastatin
Rosuvastatin

AVOIDgrapefruitjuice

Question 33

Criteria for metabolic syndrome

Answer 33

waist circumference > 40 inch in males and > 35 in females
HTN
FBG > 100
increased trig > 150
Decreased HDL < 40

Question 34

Normal BMI

Answer 34

18.5-24.9