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Nurse Practitioner > Diagnosis and Management of Cardiovascular Disorder > Flashcards

Diagnosis and Management of Cardiovascular Disorder Flashcards

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1
Q

What are the semilunar valves?

A

Pulmonic Valve and Aortic Valve

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2
Q

What are the AV valves?

A

Tricuspid Valve and Mitral Valve

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3
Q

Heart sound that exemplifies increased fluid states (i.e. HF, pregnancy)

A

S3

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4
Q

Heart sounds that exemplifies stiff ventricular wall (MI, LVH, Chronic HTN)

A

S4

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5
Q

Rate the murmur: moderately loud, easily heard

A

III/VI

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6
Q

Rate the murmur: Audible but faint

A

II/VI

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7
Q

Rate the murmur:
Loud; associated with a thrill

A

IV/VI

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8
Q

Rate the murmur: very loud; heard with one corner of stethoscope off the chest wall

A

V/VI

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9
Q

Systolic mumur at 5th ICS MCL (apex)

A

Mitral Regurgitation

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10
Q

Systolic, “blowing,” rough, harsh murmur at 2nd right ICS usually radiating to the neck

A

Aortic stenois

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11
Q

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

A

Mitral stenosis

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12
Q

Diastolic, “blowing” murmur at 2nd left ICS

A

Aortic regurgitation

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13
Q

Inability to contract results in decreased cardiac output (HFrEF, HFpEF, and or diastolic systolic failure)

A

HFrEF, systolic failure

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14
Q

Inability to relax and fill results in decreased cardiac output (HFrEF, HFpEF, and or diastolic systolic failure)

A

HFpEF, diastolic failure

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15
Q

left or right HF: S3 gallop, murmur of mitral regurgitation

A

Left Failure

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16
Q

left or right HF: frothy cough, appears generally healthy, except for the acute event

A

Left Failure

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17
Q

left or right HF: JVD, S3 and/or S4, paroxysmal nocturnal dyspnea

A

Right failure

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18
Q

what class of NYHA functional classification of the heart failure is this?
Marked limitation of physical activity but comfortable at rest

A

NYHA Class III

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19
Q

what class of NYHA functional classification of the heart failure is this?
Inability to carry out any physical activity without discomfort (s/s while at rest).

A

NYHA IV

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20
Q

what class of NYHA functional classification of the heart failure is this?
Slight limitations of physical activity but comfortable at rest

A

NYHA II

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21
Q

what class of NYHA functional classification of the heart failure is this?
No limitations of physical activity

A

NYHA I

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22
Q

Lab/Diagnostics for HF?

A

Hypoxemia and hypocapnia, BMP, BNP, UA, chest xray, Echo, ECG, pulmonary function tests for wheezing

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23
Q

Management for Hypertension Non-African American

A
  • Thiazide diuretic
  • ACEI
  • ARB
  • CCB
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24
Q

Management for Hypertension African American

A
  • Thiazide diuretics
  • CCB
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25
Q

Management for Hypertension Diabetic

A

ACEI or ARB

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26
Q

Management for > or equal with CKD

A

ACEI

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27
Q

What HTN drug is recommended as first line?

A

Thiazide-type diuretics

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28
Q

What is angina?

A

Decreased blood flow through the vessel leads to tissue ischemia

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29
Q

What type of angina occurs at various times, including rest

A

Prinzmetal’s (variant/vasospastic)

30
Q

What are the criteria of unstable angina?

A

(1) occur at rest; (2) become more frequent, severe, or prolonged than the usual pattern of angina; (3) change from the usual pattern of angina; or (4) not respond to rest or nitroglycerin

31
Q

Physical exam finding for angina

A

Levine’s sign

32
Q

“clenched fist sign”

A

physical finding for angina

33
Q

EKG representation of myocardial ischemia

A

ST-depression

34
Q

Goal for LDL for patients with DM or CAD

A

<70

35
Q

Goal of HDL

A

> 60

36
Q

Management for angina

A
  1. reduction of risk factors when possible
  2. manage diet (low saturated fats and low unsaturated fats)
  3. Low dose enteric coated ASA
  4. pharmacotherapy
  5. optimize lipid panel
  6. Statin therapy
37
Q

Pharmacotherapy for angina

A

nitrates, BB, CCB

38
Q

Who may benefit from statin therapy?

A
  • clinical evidence of ASCVD
  • LDL >190
  • DM 40 - 75 years of age with LDL between 70-189 without clinical evidence of ASCVD
  • Without DM or hyperlipidemia, but with an estimated 10-year ASCVD risk of 7.5% or highter
39
Q

What agents could be used other than HMG-CoA reductase inhibitors?

A
  • bile acid sequestrants (low LDL, may increase triglycerides)
  • fibrates (low triglycerides, slightly low LDL and possibly increase HDL)
  • Cholesterol absorption inhibitor (used in combo with statin to lower LDL)
  • Niacin (lower LDL and triglycerides and increase HDL)
40
Q

Example of cholesterol absorption inhibitor

A

Ezetimibe (Zetia)

41
Q

what is the disease of “clot on plaque”

A

MI/ACS

42
Q

Which leads are the lateral leads

A

I and aVL

43
Q

which leads are anterior

A

V3 and V4

44
Q

which leads are inferior

A

III, II, AVF

45
Q

What are ECG changes that may be noted

A

Peaked T waves, ST elevations, Q wave development

46
Q

What enzymes are elevated during an MI or ACS?

A

troponin T, toponin I (cardiac selective), and CK-MB (cardio selective)

47
Q

Indications for pharmacologic revascularization

A
  1. unrelieved chest pain (>30 minutes and <6 hours) WITH
  2. ST segment elevation in two or more contiguous leads
48
Q

ABSOLUTE CONTRAINDICATIONS TO REVASCULARIZATION

A

active bleeding or risk thereof, including abnormal coagulation values

49
Q

What is the most common cause of pericarditis

A

virus

50
Q

s/s” Very localized retrosternal/precordial chest pain

A

pericarditis

51
Q

s/s: pleuritic pain

A

pericarditis

52
Q

s/s: SOB secondary to pain with inspiration, pain increased by deep inspiration, coughing, swallowing, or recumbent

A

pericarditis

53
Q

s/s: pain relieved by sitting forward

A

pericarditis

54
Q

Pericardial friction rub

A

pericarditis

55
Q

ST segment elevation in all leads, return of ST segment to normal in few days/ depression of PR segment

A

pericarditis

56
Q

Management of pericarditis

A

NSAIDS, corticosteroids (only when there is a total failure of high dose NSAIDs over several weeks and with relapsing pericarditis bx it can increase viral replication), abx (if bacterial infection)

57
Q

hypotension, JVD, muffled/distant heart sounds, pulsus paradoxus

A

tamponade

58
Q

dependent rubor, ulcerations, pallor

A

PVD

59
Q

statis leg ulcers, trophic changes with brownish discoloration

A

Chronic venous insufficiciency

60
Q

when would we use ankle-branchial index (ABI)?

A

diagnostic test for PVD

61
Q

what is the most definitive test for PVD

A

anteriography

62
Q

aching of the lower extremities relieved by elevation

A

chronic venous insufficiency

63
Q

night cramps of the lower extremities. edema after prolonged standing

A

chronic venous insufficiency

64
Q

c/o calf pain (claudication)

A

PVD

65
Q

cold/numbness to extremities, progresses to pain at night

A

PVD

66
Q

risk factors for PVD

A
  1. HLD
  2. Smoking
  3. DM
67
Q

Management for PVD

A
  1. stop all tobacco use
  2. exercise (stop during pain and resume when pain subsides)
  3. cilostazol in combo with aspirin/clopidogrel
  4. weight reduction
  5. manage DM and HLD
  6. angioplasty
  7. bypass surgery
  8. amputation
68
Q

Manageemet for CVI

A
  1. bed rest with legs elevated
  2. support stockings
  3. weight reduction in the obese
  4. treat dermatitis or ulcers
  5. acute weeping dermatitis - tap water compresses, hydrocolloid dressings, hydrocortisone cream
69
Q

in the elderly, what physiologic changes could cause syncope?

A

baroreceptors that monitor blood pressure become less sensitive

70
Q

geriatric: what are possible findings?

A

hypertension (increased risk for CVA, MI, and renal failure and/or dysrhythmias

Nurse Practitioner (1 decks)

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