Exam 2 Study Guide

Question 1

What is peripheral arterial disease or PAD? How is it diagnosed and treated?

Question 2

What is a bruit and how do we use it to diagnose carotid artery occlusions?

Question 3

Know the formula for cardiac output and how to algebraically manipulate it to solve for any of
the elements in it.

Question 4

How is the endothelial lining of arteries damaged? What substances or toxins can damage the
endothelial lining of the arteries? What can happen to the artery if it has damage to the
endothelial lining?

Question 5

Bilateral lower extremity venous doppler

Question 6

Arterial catheterization of lower extremities

Question 7

Ankle-Brachial Index, or ABI.

Question 8

What are the risk factors for hypertension or HTN?

Question 9

What are the risk factors for coronary artery
disease or CAD?

Question 10

Serum homocysteine level

Question 11

highly sensitive C-reactive protein or hs-CRP

Question 12

CT of coronary arteries with calcium score,

Question 13

exercise stress test

Question 14

fasting lipid panel with knowing what LDL and HDL are and which one is the “good” cholesterol, and which is the “bad” cholesterol and why?

Question 15

What is an abdominal aortic aneurysm or AAA? What clinical sign can be found in a large AAA?
Who is most at risk for an AAA? How do we screen for AAA? How do we diagnose AAA when the screen is positive? How is it treated?

Question 16

What is an aortic dissection? How does it present clinically? Why does this get confused for an MI?

Question 17

How do we treat hypertension or HTN? Know hydrochlorothiazide or HCTZ (thiazide diuretic),
lisinopril (ace inhibitors, they always end in -pril), olmesartan (angiotensin receptor blocker or
ARB, they always end in -sartan) and why we need to monitor kidney and electrolyte function
with these medications?

Question 18

How do we treat hyperlipidemia? What is the first step? What is the second step?

Question 19

Raynaud’s phenomenon

Question 20

Buerger’s disease

Question 21

Kawasaki disease

Question 22

polyarthritis nodosa

Question 23

Wegner’s granulomatosis

Question 24

cryoglobulinemia

Question 25

Takayasu’s arteritis and temporal arteritis

Question 26

How does nicotine cause damage to arteries and can cause high blood pressure or hypertension (HTN)?

Question 27

Why does HTN cause left ventricular hypertrophy? How does this happen?

Question 28

What are good fats and what are bad fats in our diets and why? Know examples of good and bad fats.

Question 29

What is orthostatic hypotension? How is it diagnosed and what is the danger of this?

Question 30

Know the difference between systolic and diastolic blood pressure. What is the “silent killer”?

Question 31

How does a typical myocardial infarction or MI or unstable angina present?

Question 32

What is an electrocardiogram or EKG or ECG

Question 33

What is the p wave? What does it represent?

Question 34

What is a q wave? What does it mean if you see a q wave on an EKG?

Question 35

What is the s wave? What does it represent?

Question 36

What is the r wave?
What does it represent?

Question 37

What is the t wave?
What does it represent?

Question 38

Which are of the EKG is depolarization of the atria? Which area of the
EKG is repolarization of the atria?

Question 39

Which area of the EKG is depolarization of the ventricles?
Which area of the EKG is repolarization of the ventricles? Where in the EKG do the valves open and close?

Question 40

What is atrial fibrillation and what does it look like on an EKG?

Question 41

What are premature ventricular contractions or PVCs? What do they look like on an EKG?

Question 42

What is the pathophysiology behind a myocardial infarction or MI? What causes them?

Question 43

What is stable versus unstable angina and how are they treated? How do you tell when stable angina becomes unstable angina or an MI?

Question 44

What causes more oxygen demand in the myocardium? What causes less?

Question 45

What are the risk factors for having an MI?

Question 46

What EKG changes are seen in a typical MI? What about an NSTEMI or non-ST segment elevation MI?

Question 47

myocarditis

Question 48

pericarditis

Question 49

infective endocarditis

Question 50

right heart failure

Question 51

left heart failure

Question 52

Dressler’s syndrome

Question 53

On auscultation what is the S1, S2, S3, and S4 sounds? When do we hear these sounds and which ones are common and rare?

Question 54

What are the tests used to diagnose an MI?

Question 55

MI Tx , coronary catheterization, stenting of coronary arteries,
bare metal versus drug-eluting stents, coronary artery bypass grafting or CABG, and treatment
for MI like MONA or morphine, oxygen, nitroglycerin, and aspirin.

Question 56

Why do MI patients have to be on statins like lovastatin or simvastatin and a beta blocker like carvedilol or metoprolol?

Question 57

What are the clinical manifestations of infective endocarditis?

Question 58

Know embolic versus thrombotic clots.

Question 59

Know asystole, ventricular fibrillation, fine ventricular fibrillation, and heart blocks. When is electrical defibrillation helpful?

Question 60

Know the difference between bradycardia and tachycardia.

Question 61

nitric oxide

Question 62

endothelin

Question 63

tumor necrosis factor-alpha

Question 64

digitalis

Question 65

beta blocker

Question 66

ACE-inhibitor

Question 67

calcium channel blocker

Question 68

diuretic

Question 69

cardiac contractility

Question 70

cardiac afterload

Question 71

cardiac preload

Question 72

cardiac output

Question 73

normal cardiac output for a healthy patient

Question 74

systolic dysfunction

Question 75

diastolic dysfunction

Question 76

Left Sided Heart Failure

Answer 76

• Primary Cause:
• Clinical Signs/Symptoms:
• Treatment:

Question 77

Right Sided Heart Failure

Answer 77

• Primary Cause:
• Clinical Signs/Symptoms:
• Treatment:

Question 78

Know the stages of heart failure from the tables particularly the American College of Cardiology / American Heart Association and the NYHA classification.

Question 79

What is oncotic pressure?

Question 80

Chronic versus acute CHF.

Question 81

What can cause right sided heart failure without left sided heart failure?

Question 82

What is high output heart failure?

Question 83

What is normal central venous pressure or CVP?

Question 84

What do angiotensin-converting enzyme or ACE-inhibitors do that help left sided heart failure?

Question 85

What does the renin-angiotensin-aldosterone system or RAAS do?

Question 86

Know how to measure JVD in a patient using a ruler, there is a table that shows you this in the
textbook.

Question 87

Know tuberculosis or TB and how we test for it

Answer 87

• Definition:
• Signs/Symptoms:
• Testing for it:
• Treatments:

Question 88

What do the lungs sound like both auscultated and percussed in a normal patient? A patient with pleural effusions? A patient with pneumonia?

Question 89

Why do we make mucus in the airways? What purpose does the mucociliary apparatus play?

Question 90

Know the typical pneumonia is like streptococcal pneumonia or viral pneumonia and know the
atypical pneumonias like mycoplasma, legionella, etc. What pneumonia do patients with AIDS get? Remember the name has been changed to pneumocystis jiroveci

Question 91

What are the pulmonary function testing
findings of each and examples? What are the two main types of obstructive lung disease?

Question 92

Know restrictive versus obstructive lung disease

Question 93

Know the pulmonary function test, mainly forced vital capacity or FVC and FEV1 which is how much air a patient can expel in one second. What is the FEV1/FVC ratio?

Question 94

Know the basic normal values of FEV1 and FVC and when it is obstructive or restrictive based on these.

Question 95

What is coal miner’s pneumoconiosis?

Question 96

What is hypoventilation syndrome also known as obstructive sleep apnea or OSA and how is it tested for and treated?

Question 97

What are the signs, symptoms and causes of a pulmonary embolus or PE? Know d-dimer and CT angiogram or CTPE study.

Question 98

What are the signs of cor pulmonale?

Question 99

How do we evaluate and treat pleural effusions?

Question 100

What is the treatment for pneumothorax? When is just air removed by needle? When do we
place a chest tube and when do we need a chest tube to suction?

Question 101

Know idiopathic pulmonary fibrosis and it how it has a “honeycomb” pattern in the lungs.

Question 102

What causes pulmonary hypertension?

Question 103

What is respiratory distress syndrome and why is it so deadly?

Question 104

Know the basics of an arterial blood gas: pH, PCO2, PO2, and a calculated bicarbonate. What is a respiratory acidosis and a respiratory alkalosis?

Question 105

What are the types of asthma and know how to tell one from another?

Question 106

What is Pickwickian syndrome and what condition is usually associated with it?

Question 107

Know that Marfan syndrome patients can get spontaneous pneumothorax as well as long standing emphysematous patients

Question 108

normal daily potassium for a human

Question 109

What are the signs and symptoms of dehydration?

Question 110

What causes potassium, calcium, phosphorous and magnesium to be too high or low? Know clinical signs and symptoms for too high and low electrolytes. Chvostek’s sign and Trousseau’s sign. How do we correct these electrolyte imbalances?

Question 111

What does ADH and aldosterone do?

Question 112

What does hypokalemia look like on an EKG?

Question 113

Know the renin-angiotensin-aldosterone system and use the diagram in the textbook to help
you.

Question 114

Natriuresis versus diuresis.

Question 115

How is albumin related to oncotic pressure and fluid retention or third spacing?

Question 116

What can cause a lack of albumin in a person?

Question 117

Why is it dangerous to give digitalis to a patient with hypokalemia?

Question 118

Know SIADH

Question 119

What is the relationship between calcium and phosphorous in the human body?

Question 120

How is vitamin D related to calcium?

Question 121

hypervolemic hyponatremia versus hypovolemic hyponatremia

Question 122

Active versus passive transport

Question 123

Acute versus chronic renal failure. Know prerenal, interstitial, or renal and post renal failures and give examples of each

Question 124

Know normal urinary output and what is low or high. What percentage of the body’s cardiac output is received by the kidneys?

Question 125

diabetic nephropathy, the mnemonic to remember about nephrOpathy is protein or albumin Out

Question 126

Know blood urea nitrogen or BUN and creatinine. Know lab normal for both. Which is better at predicting kidney function or GFR?

Question 127

Know your kidney stones as there are a lot of questions about them. Calcium is the most common type and seen easily on X-rays. Uric acid is the second most common type. Which type is seen with patients who are bed bound and immobile with chronic Foley catheters?

Question 128

UA Inerpretation

Answer 128

• pH:
• Color:
• SG:
• Glucose:
• Protein(Albumin):
• Nitrites:
• Leukocyte esterase:

Question 129

What age range is at the peak of GFR?

Question 130

What is nephrolithiasis? Ureterolithiasis? Cystolithiasis? Which one is most painful?

Question 131

What are the clinical signs that a patient has ureterolithiasis?

Question 132

what causes high BUN or creatinine
without kidney problems?

Question 133

If a type 1 diabetic is in diabetic ketoacidosis, what would their urinalysis have positive?

Question 134

Know that IV contrast can damage kidneys, so anyone with chronic or acute renal failure cannot have it. Which diagnostic tests use IV contrast dye and which ones do not?

Question 135

Stress versus urge urinary incontinence and how to distinguish between the two. What is a urodynamic study?

Question 136

Know interstitial cystitis, know the most common causes of urinary tract infections or UTIs and which bacteria are involved, do women or men get UTIs more often? What ages get UTIs more often?

Question 137

What is the most common cause of obstructive renal (post renal failure) in men older than 65?

Question 138

Know clinical signs and symptoms of UTI versus pyelonephritis.

Question 139

Know the causes and which is the more common urinary stones: Calcium stones, uric acid stones, struvite stone, cysteine stones. How do they form?

Question 140

Which bacteria is more common in the urine with indwelling Foley catheter for UTI?

Question 141

What can happen if a bacterial UTI goes untreated?

Question 142

Define polyuria, anuria, oliguria, dysuria, hematuria, proteinuria

Question 143

What is bladder cancer and what causes it and the most common type? What is prostate cancer and what causes it?

Question 144

How do we evaluate microscopic hematuria and what is the concern here?