CVS- Heidi Midterm Doc Flashcards
Which of the following are triggers for atrial fibrillation Stimulants alcohol sleep deprivation emotional stress physical exertion
All of them
HATCH score=
Indicates?
HTN Age >75 TIA/ prev stroke COPD HF
Higher occurance and risk of stroke for pts a-fib
A fib risk assessment for stroke is done with what tool?
What tool is used in conjunction - To determine bleeding risk?
What tool helps integrate both of the above into risk assessment?
CHA2DS2-VASc
HAS-BLED
Sparc tool
Screening for a-fib via ecg looks for what finding?
Frequent premature atrial contractions / PACs
Home blood pressure monitoring for possible hypertension diagnoses-
How to?
Criteria?
2x in am & pm/ week
X 4 weeks
>135/ >85
Impaired myocyte contractility and dilated heart
Reduced SV and EF
What type of HF?
Systolic
Inadequate relaxation and filling of the hypertrophied heart
Normal myocyte contractility
Preserved ejection fraction and low SV
Disstolic HF
HFpEF
Initial investigations for heart failure
Chest x-ray
ECG
Labs- CBC, electrolytes, renal function, urinalysis, glucose, TSH
NYHA class?
Much limitation of physical activity, comfortable at rest, less than ordinary activity causes symptoms
Class III
NYHA class?
Slight limitation of physical activity, comfortable at rest, ordinary physical activity causes symptoms
Class II
NYHA class?
Severe limitation in discomfort with any physical activity, symptoms present at rest
Class IV
NYHA class?
No limitation of physical activity, ordinary physical activity does not cause symptoms
Class I
HF is likely with
NT-proBNP-
BNP-
NT-proBNP- >125 pg/ml
BNP- >50 pg/ml
HFrEF meds? X3
ACE/ ARB + Beta Blocker + MRA (spironalactone)
Medication therapy post MI
Antiplatelet + Statin + ACE/ARB + Beta Blocker
*avoid non-DHP CCB + BB due to increased risk of bradycardia
Symptom location of superficial phlebitis- possible etiology A. Ipsilateral swelling B. Medial thigh/leg C. Anterolsterslly from groin D. Post calf-knee-ankle
If any are found- what do you do?
A. DVT
B. great saphenous vein
C. Ant accessory saphenous vein
D. Small saphenous vein
Ultrasound and vein study ie. venous doppler?
What Wells score indicates likely DVT/PE
> 2 - 28%
DVT/ PE trestment?
Rivaroxaban 15mg BID x 3 weeks
Common differential diagnosis for SOB
Deconditioning Anemia COPD Pneumonia HF
7 most common anemias in elderly
1 IDA 2 B12 3 Thyroid 4 AOCD 5 AOCKD 6 hemolytic 7 pancytopenia
Elevated BUN and anemia, what to suspect?
Upper GI bleed. rapid digestion of proteins when broaken down release nitrogen compounds. This transiently increases BUN. If new decreasing Hgb and increased BUN, suspect upper GI bleed.
True/False
Rhythm control for a. fib if often started in primary care
False. refer to cardiology
Is warfarin absoprtion impacted by food?
No, it is almost fully bound to albumin in blood.