Exam 2 Study Guide Flashcards
What is peripheral arterial disease or PAD? How is it diagnosed and treated?
What is a bruit and how do we use it to diagnose carotid artery occlusions?
Know the formula for cardiac output and how to algebraically manipulate it to solve for any of
the elements in it.
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?
Bilateral lower extremity venous doppler
Arterial catheterization of lower extremities
Ankle-Brachial Index, or ABI.
What are the risk factors for hypertension or HTN?
What are the risk factors for coronary artery
disease or CAD?
Serum homocysteine level
highly sensitive C-reactive protein or hs-CRP
CT of coronary arteries with calcium score,
exercise stress test
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?
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?
What is an aortic dissection? How does it present clinically? Why does this get confused for an MI?
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?
How do we treat hyperlipidemia? What is the first step? What is the second step?
Raynaud’s phenomenon
Buerger’s disease
Kawasaki disease
polyarthritis nodosa
Wegner’s granulomatosis
cryoglobulinemia
Takayasu’s arteritis and temporal arteritis
How does nicotine cause damage to arteries and can cause high blood pressure or hypertension (HTN)?
Why does HTN cause left ventricular hypertrophy? How does this happen?
What are good fats and what are bad fats in our diets and why? Know examples of good and bad fats.
What is orthostatic hypotension? How is it diagnosed and what is the danger of this?
Know the difference between systolic and diastolic blood pressure. What is the “silent killer”?
How does a typical myocardial infarction or MI or unstable angina present?
What is an electrocardiogram or EKG or ECG
What is the p wave? What does it represent?
What is a q wave? What does it mean if you see a q wave on an EKG?
What is the s wave? What does it represent?
What is the r wave?
What does it represent?
What is the t wave?
What does it represent?
Which are of the EKG is depolarization of the atria? Which area of the
EKG is repolarization of the atria?
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?
What is atrial fibrillation and what does it look like on an EKG?
What are premature ventricular contractions or PVCs? What do they look like on an EKG?
What is the pathophysiology behind a myocardial infarction or MI? What causes them?
What is stable versus unstable angina and how are they treated? How do you tell when stable angina becomes unstable angina or an MI?
What causes more oxygen demand in the myocardium? What causes less?
What are the risk factors for having an MI?
What EKG changes are seen in a typical MI? What about an NSTEMI or non-ST segment elevation MI?
myocarditis
pericarditis
infective endocarditis
right heart failure
left heart failure
Dressler’s syndrome
On auscultation what is the S1, S2, S3, and S4 sounds? When do we hear these sounds and which ones are common and rare?
What are the tests used to diagnose an MI?
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.
Why do MI patients have to be on statins like lovastatin or simvastatin and a beta blocker like carvedilol or metoprolol?
What are the clinical manifestations of infective endocarditis?
Know embolic versus thrombotic clots.
Know asystole, ventricular fibrillation, fine ventricular fibrillation, and heart blocks. When is electrical defibrillation helpful?
Know the difference between bradycardia and tachycardia.
nitric oxide
endothelin
tumor necrosis factor-alpha
digitalis
beta blocker
ACE-inhibitor
calcium channel blocker
diuretic
cardiac contractility
cardiac afterload
cardiac preload
cardiac output
normal cardiac output for a healthy patient
systolic dysfunction
diastolic dysfunction
Left Sided Heart Failure
- Primary Cause:
- Clinical Signs/Symptoms:
- Treatment:
Right Sided Heart Failure
- Primary Cause:
- Clinical Signs/Symptoms:
- Treatment:
Know the stages of heart failure from the tables particularly the American College of Cardiology / American Heart Association and the NYHA classification.
What is oncotic pressure?
Chronic versus acute CHF.
What can cause right sided heart failure without left sided heart failure?
What is high output heart failure?
What is normal central venous pressure or CVP?
What do angiotensin-converting enzyme or ACE-inhibitors do that help left sided heart failure?
What does the renin-angiotensin-aldosterone system or RAAS do?
Know how to measure JVD in a patient using a ruler, there is a table that shows you this in the
textbook.
Know tuberculosis or TB and how we test for it
- Definition:
- Signs/Symptoms:
- Testing for it:
- Treatments:
What do the lungs sound like both auscultated and percussed in a normal patient? A patient with pleural effusions? A patient with pneumonia?
Why do we make mucus in the airways? What purpose does the mucociliary apparatus play?
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
What are the pulmonary function testing
findings of each and examples? What are the two main types of obstructive lung disease?
Know restrictive versus obstructive lung disease
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?
Know the basic normal values of FEV1 and FVC and when it is obstructive or restrictive based on these.
What is coal miner’s pneumoconiosis?
What is hypoventilation syndrome also known as obstructive sleep apnea or OSA and how is it tested for and treated?
What are the signs, symptoms and causes of a pulmonary embolus or PE? Know d-dimer and CT angiogram or CTPE study.
What are the signs of cor pulmonale?
How do we evaluate and treat pleural effusions?
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?
Know idiopathic pulmonary fibrosis and it how it has a “honeycomb” pattern in the lungs.
What causes pulmonary hypertension?
What is respiratory distress syndrome and why is it so deadly?
Know the basics of an arterial blood gas: pH, PCO2, PO2, and a calculated bicarbonate. What is a respiratory acidosis and a respiratory alkalosis?
What are the types of asthma and know how to tell one from another?
What is Pickwickian syndrome and what condition is usually associated with it?
Know that Marfan syndrome patients can get spontaneous pneumothorax as well as long standing emphysematous patients
normal daily potassium for a human
What are the signs and symptoms of dehydration?
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?
What does ADH and aldosterone do?
What does hypokalemia look like on an EKG?
Know the renin-angiotensin-aldosterone system and use the diagram in the textbook to help
you.
Natriuresis versus diuresis.
How is albumin related to oncotic pressure and fluid retention or third spacing?
What can cause a lack of albumin in a person?
Why is it dangerous to give digitalis to a patient with hypokalemia?
Know SIADH
What is the relationship between calcium and phosphorous in the human body?
How is vitamin D related to calcium?
hypervolemic hyponatremia versus hypovolemic hyponatremia
Active versus passive transport
Acute versus chronic renal failure. Know prerenal, interstitial, or renal and post renal failures and give examples of each
Know normal urinary output and what is low or high. What percentage of the body’s cardiac output is received by the kidneys?
diabetic nephropathy, the mnemonic to remember about nephrOpathy is protein or albumin Out
Know blood urea nitrogen or BUN and creatinine. Know lab normal for both. Which is better at predicting kidney function or GFR?
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?
UA Inerpretation
- pH:
- Color:
- SG:
- Glucose:
- Protein(Albumin):
- Nitrites:
- Leukocyte esterase:
What age range is at the peak of GFR?
What is nephrolithiasis? Ureterolithiasis? Cystolithiasis? Which one is most painful?
What are the clinical signs that a patient has ureterolithiasis?
what causes high BUN or creatinine
without kidney problems?
If a type 1 diabetic is in diabetic ketoacidosis, what would their urinalysis have positive?
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?
Stress versus urge urinary incontinence and how to distinguish between the two. What is a urodynamic study?
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?
What is the most common cause of obstructive renal (post renal failure) in men older than 65?
Know clinical signs and symptoms of UTI versus pyelonephritis.
Know the causes and which is the more common urinary stones: Calcium stones, uric acid stones, struvite stone, cysteine stones. How do they form?
Which bacteria is more common in the urine with indwelling Foley catheter for UTI?
What can happen if a bacterial UTI goes untreated?
Define polyuria, anuria, oliguria, dysuria, hematuria, proteinuria
What is bladder cancer and what causes it and the most common type? What is prostate cancer and what causes it?
How do we evaluate microscopic hematuria and what is the concern here?
