CVS- Heidi Midterm Doc

Question 1

Which of the following are triggers for atrial fibrillation
Stimulants 
alcohol 
sleep deprivation 
emotional stress 
physical exertion

Answer 1

All of them

Question 2

HATCH score=

Indicates?

Answer 2

HTN
Age >75
TIA/ prev stroke
COPD
HF

Higher occurance and risk of stroke for pts a-fib

Question 3

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?

Answer 3

CHA2DS2-VASc
HAS-BLED
Sparc tool

Question 4

Screening for a-fib via ecg looks for what finding?

Answer 4

Frequent premature atrial contractions / PACs

Question 5

Home blood pressure monitoring for possible hypertension diagnoses-
How to?
Criteria?

Answer 5

2x in am & pm/ week
X 4 weeks
>135/ >85

Question 6

Impaired myocyte contractility and dilated heart
Reduced SV and EF
What type of HF?

Answer 6

Systolic

Question 7

Inadequate relaxation and filling of the hypertrophied heart
Normal myocyte contractility
Preserved ejection fraction and low SV

Answer 7

Disstolic HF

HFpEF

Question 8

Initial investigations for heart failure

Answer 8

Chest x-ray
ECG
Labs- CBC, electrolytes, renal function, urinalysis, glucose, TSH

Question 9

NYHA class?

Much limitation of physical activity, comfortable at rest, less than ordinary activity causes symptoms

Answer 9

Class III

Question 10

NYHA class?

Slight limitation of physical activity, comfortable at rest, ordinary physical activity causes symptoms

Answer 10

Class II

Question 11

NYHA class?

Severe limitation in discomfort with any physical activity, symptoms present at rest

Answer 11

Class IV

Question 12

NYHA class?

No limitation of physical activity, ordinary physical activity does not cause symptoms

Answer 12

Class I

Question 13

HF is likely with
NT-proBNP-
BNP-

Answer 13

NT-proBNP- >125 pg/ml

BNP- >50 pg/ml

Question 14

HFrEF meds? X3

Answer 14

ACE/ ARB + Beta Blocker + MRA (spironalactone)

Question 15

Medication therapy post MI

Answer 15

Antiplatelet + Statin + ACE/ARB + Beta Blocker

*avoid non-DHP CCB + BB due to increased risk of bradycardia

Question 16

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?

Answer 16

A. DVT
B. great saphenous vein
C. Ant accessory saphenous vein
D. Small saphenous vein

Ultrasound and vein study ie. venous doppler?

Question 17

What Wells score indicates likely DVT/PE

Answer 17

> 2 - 28%

Question 18

DVT/ PE trestment?

Answer 18

Rivaroxaban 15mg BID x 3 weeks

Question 19

Common differential diagnosis for SOB

Answer 19

Deconditioning
Anemia
COPD
Pneumonia
HF

Question 20

7 most common anemias in elderly

Answer 20

1 IDA
2 B12
3 Thyroid
4 AOCD
5 AOCKD
6 hemolytic
7 pancytopenia

Question 21

Elevated BUN and anemia, what to suspect?

Answer 21

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.

Question 22

True/False

Rhythm control for a. fib if often started in primary care

Answer 22

False. refer to cardiology

Question 23

Is warfarin absoprtion impacted by food?

Answer 23

No, it is almost fully bound to albumin in blood.