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Cardio & Pulmonary PT I > Eval and Treatment of Cardiac Patient > Flashcards

Eval and Treatment of Cardiac Patient Flashcards

1
Q

when are males peak incidence of CV disease?

A

50s

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2
Q

females peak incidence of CV disease?

A

60s

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3
Q

how many ingredients are known to cause cancer?

A

50

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4
Q

whats in a cigarette?

A

ammonia, acetone, arsenic, cadmium, carbon monoxide, formaldehyde, methanol, nicotine, tar, tolulene

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5
Q

by what % does second hand smoke increase your chances of cancer, heart disease or sudden infant death syndrome?

A

20-30%

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6
Q

Inflammation as a result of CO damage to epithelium is thought to cause _______.

A

atherosclerosis

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7
Q

smoking and CO can also cause what?

A

vasoconstriction - HTN
increased clotting & risk for stroke - increased fibrinogen, increased platelet aggregation, increased total cholesterol

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8
Q

recommendation for waist for women?

A

35 inches

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9
Q

recommendation for waist for men?

A

40 inches

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10
Q

what are the 5 steps to evaluation?

A 
interpretation 
integration 
diagnosis 
prognosis 
plan of care
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11
Q

smoking can increase the risk for:

A

CAD, PAD,CVA, SCD, MI

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12
Q

what did the cocaine study show?

A

30-35% aortic stiffening
8mm higher in systolic BP
18% greater thickness of heart’s left ventricular wall

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13
Q

marijuana has 4x more tar than cigarettes. T/F

A

T

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14
Q

adverse health effects of marijuana

A 
epithelial cell damage 
increases HR, BP 
frequent lung infections, sputum production 
slowed reaction time 
reduces fertility
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15
Q

_____ is strongly linked with HTN and diabetes.

A

obesity

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16
Q

2-4x increase in risk in CAD

A

diabetes

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17
Q

what is not perceived well if you have diabetes?

A

angina

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18
Q

Risk factors of hypertension

A

inactivity, obesity (BMI>30), Age, gender, heavy alcohol use, stress, race, genetics, high salt diet >2300mg/day

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19
Q

primary HTN means…

A

no identifiable cause

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20
Q

secondary HTN means…

A

HTN from another cause such as kidney disease

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21
Q

what should you do if a pt has greater than 10 mmHg SBP difference side to side?

A

related to CAD and therefore should be referred to MD for follow up

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22
Q

what are general lifestyle changes that all patients with high blood pressure should do?

A

DASH diet
weight loss
<2.4g/day of sodium
30 minutes of aerobic activity

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23
Q

nitric oxide causes…

A

vasodilation

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24
Q

Endothelin causes…

A

vasoconstriction

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25
Q

stiffness in the left ventricle during HTN can cause an elevation in what?

A

diastolic pressures

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26
Q

what is accounted for when recommending drugs for HTN?

A

end stage renal disease

diabetes

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27
Q

generally, how do diuretics work?

A

optimizes preload, reduces afterload

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28
Q

Major mechanisms of actions for diuretics

A

increases Na and H2o excretion

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29
Q

adverse reactions of thiazide diuretics

A

hypokalemia, hypomagnesemia, hypercalcemia, hyperglycemia, hyperurecemia

30
Q

adverse reactions of loop diuretics

A

hypokalemia, hypomagnesemia, hypocalcemia, hyperuricemia

31
Q

major difference between thiazide vs loop diuretics

A

increased urination vs. increased electrolyte depletion

32
Q

hypokalemia value

A

<3.5 meQ/L

33
Q

hypomagnesemia value

A

<1.2 meQ/L

34
Q

hypocalcemia value

A

<8.6 meQ/L

35
Q

hyperurecemia value

A

> 6mg/dL in women

>7mg/dL in men

36
Q

hypokalemia electrolyte abnormalities causes:

A

weakness, fatigue, muscle cramps, constipation, dysrhythmia

37
Q

hypomagnesemia electrolyte abnormalities causes:

A

weakness, confusion, diminished reflexes, muscle twitching, dysrhtyhmia

38
Q

hypercalcemia electrolyte abnormalities causes:

A

weakness, increased thirst, frequent urination, constipation

39
Q

adverse reaction of potassium sparing diuretic

A

hyperkalemia (5.1 meQ/L)
kidney stones
increased urination

40
Q

adverse reaction of aldosterone antagonists

A

hyperkalemia
gynecomastia
impotence

41
Q

beta 1 receptor stimulation

A

cardiac stimulation
increase contraction and HR
cardioselective beta blockers act on Beta 1

42
Q

beta 2 receptor stimulation

A 
lung stimulation (bronchodilation) 
peripheral vasculature (vasodilation) 
nonselective beta blockers act on beta 1 and beta 2
43
Q

nonselective beta blockers cause what 3 negative results?

A

blocks symptoms of hypoglycemia, increased risk of hypoglycemia, bronchospasm

44
Q

what is known to have the lowest incidence of side effects?

A

angiotensin receptor blockers (ARBs)

45
Q

what reduces myocardial oxygen and decreases cardiac output

A

non-dihydropridines

46
Q

non-dihydropyridines are most indicated for what?

A

angina

47
Q

what is the first line agent for treating high cholesterol?

A

statin

48
Q

define rhambdomyolysis.

A

damaged skeletal muscle, breakdown of muscle cells (myoglobin) that are released into bloodstream -> kidney failure

49
Q

myglobin released in bloodstream leads to…

A

kidney failure

50
Q

Higher risk if female 1st degree relative had their first coronary event

A

65, 55

51
Q

what layer is destructed during atherosclerosis?

A

elastic layer of media

52
Q

4 ways CHD is presented

A

sudden cardiac death
chronic stable angina
acute coronary syndrome
cardiac muscle dysfunction

53
Q

what are stable angina symptoms relieved by?

A

REST
reduction in work intensity
nitroglycerin

54
Q

what is difference between stable and unstable angina

A

unstable angina - ischemia at a lower workload of the heart or at rest

55
Q

what should you do if someone has unstable angina

A

ER referral

56
Q

what is prinzmetal/variant angina related to?

A

vasospasm

57
Q

intermediate probability of MI on ECG

A

ST segment depression

T wave inversion

58
Q

what wave is diagnostic for infarction?

A

Q wave

59
Q

Q wave is 0.04 seconds or more or 25% or more of the amplitude of __ wave.

A

R

60
Q

what is the most specific and sensitive marker for an MI?

A

Troponin I

61
Q

when do troponin I serum levels peak?

A

24-48 hours

62
Q

normal CK-MB levels:

A

men: 53-336 U/L
women: 38-176 U/L

63
Q

what can an elevated BUN level indicate?

A

kidney disease, CHF

64
Q

what is a cardiac cath most commonly used for?

A

coronary artery disease

65
Q

what is a stent used in conjunction with?

A

PTCA

66
Q

what does angina indicate?

A

ischemia

67
Q

symptoms of angina (equivalents)

A

diaphoresis, fatigue, lightheadedness, dyspnea, pallor, indigestion

68
Q

chest discomfort for >20 minutes indicates what?

A

acute coronary syndrome: unstable angina, acute MI

69
Q

define symptoms variant/prinzmetal angina. what is this associated with?

A

symptoms at rest, usually early AM

vasospasm

70
Q

what is the most common use of a cardiac cath?

A

CAD extent

Cardio & Pulmonary PT I (5 decks)

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