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EOR Exams > Family Medicine EOR Exam > Flashcards

Family Medicine EOR Exam Flashcards

1
Q

Stable Angina

A

Relieved by rest and/or NTG

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2
Q

Unstable Angina

A

Stable angina that increasingly occurs at rest and is more frequent

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3
Q

Prinzmetal angina

A

Coronary artery vasospasm causing transient ST-elevations
No clot

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4
Q

Narrow QRS complex with absent or inverted P wave

A

PJC - Premature Junctional Contraction

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5
Q

Narrow complex tachycardia with no discernable P waves

A

Paroxysmal supraventricular tachycardia

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6
Q

Sawtooth pattern with narrow QRS

A

Atrial flutter

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7
Q

Arrhythmia in which bradycardia alternates with tachycardia

A

Brady-tachy sick sinus syndrome

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8
Q

Sinus arrest

A

Absence of sinus activity for 3+ seconds

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9
Q

NSTEMI

A

St segment depression , t wave inversion, or both
Cardiac markers elevated!

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10
Q

STEMI

A

Elevated Cardiac biomarkers WITH ST segment elevation

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11
Q

Chest pain releived by sitting and leaning forward

A

Pericarditis

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12
Q

Severe tearing, ripping, knife like pain radiating to the back

A

Aortic dissection

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13
Q

Presentation of pulmonary embolism

A

Dyspnea is the MC symptom
Pleuritic chest pain

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14
Q

Best initial test for a PE

A

Spiral CT scan of the chest

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15
Q

Presentation of pulmonary hypertension

A

Dyspnea on exertion, fatigue, chest pain, edema and syncope

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16
Q

Murmur of pulmonary hypertension

A

Loud P2, systolic ejection click and parasternal lift

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17
Q

Dx for pulmonary hypertension

A

Right heart cath with mean pulmonary artery pressure above 25 mmHg

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18
Q

Criteria for rheumatic fever dx

A

2 major criteria or 1 major plus 2 minor

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19
Q

Titers of rheumatic fever

A

Elevated antistreptolysin titers (ASO)

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20
Q

Presentation of costochondritis

A

Pain with palpation or arm movement

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21
Q

Classic presentation of CHF

A

Exertional dyspnea progressing to at rest
Chronic nonproductive cough, worse when recumbent
Fatigue
Orthopnea
Nocturnal dyspnea
Nocturia

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22
Q

S4 in heart failure

A

DIastolic/ HFpEF

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23
Q

S3 in heart failure

A

COmpliant ventricle
Systolic/HFrEF

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24
Q

Physical exam signs of CHF

A

Cheyenne stokes breathing
Edema
Rales
S3 and S4
JVD over 8 cm
CYanosis/Coolness of extremities
Ascites

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25
Q

BNP for heart failure

A

Lower in obese patients
Differentiates SOB of HF from other SOB

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26
Q

CXR of heart failure

A

Kerley B Lines

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27
Q

Best test for CHF

A

ECHO!!!

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28
Q

NYHA Class I

A

No limitation of physical activity

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29
Q

NYHA class II

A

Slight limitation with physical activity but comfortable at rest

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30
Q

NYHA class III

A

Marked limitation of physical activity still comfortable at rest

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31
Q

NYHA class IV

A

Unable to carry on physical activity without discomfort AND have symptoms of angina at rest

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32
Q

Management for Systolic heart failure

A

ACEI, BB, Loop diuretic
NO CCB

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33
Q

Management for diastolic HF

A

ACEI with BB or Non-DHP-CCB
NO DIURETIC

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34
Q

Effect of morphine on HF

A

Reduces preload

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35
Q

Major CAD risk factors`

A

DM
Smoking
Hypertension
HLD
Family Hx
Over 45 for men and 55 for women

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36
Q

Potenital PE findings for ACS

A

Mitral regurg/S4
CHF symptoms (edema, crackles)
Signs of vascular disease (bruits, diminished pulses)

37
Q

Why might we want a CXR in ACS

A

To rule out aortic dissection

38
Q

Meds for use in ACS

A

MONA
May use ACEI

39
Q

Drugs to improve mortality post MI - 4 and 1 NOT TO USE

A

Antiplatelet (Aspirin or Plavix)
Beta blocker
ACE or ARB
Statin

NO CCB’s

40
Q

Presentation of endocarditis

A

Fever with a new onset heart murmur

41
Q

MCC pathogen in Acute, Subacuite, IVDU, and prosthetic valve endocarditis

A

Acute and IVDU - Staph aureus
Subacute S. viridans
Prostetic valve - S epidermitis

42
Q

Major Dukes criteria for endocarditis - 3

A

2 positive blood cultures 12 hours apart (staph for drug users strep for non drug users)
Vegetations are seen on Echo (tricuspid-IV drug users, mitral-non drug users
New regurg murmur

43
Q

Minor Dukes criteria for endocarditis 2 + 4 skin signs

A

Risk factor
Fever 100.5
Splinter hemorrhages,
Janeway lesions
Osler node
Roth spots

44
Q

Janeway lesions

A

Painless lesions, palms and soles. Assoc with endocarditis
Flat macules

45
Q

Osler Node

A

Raised painful tender immunologic lesion assoc with endocarditis
Ouchy nodes!

46
Q

Roth spots

A

Exudative lesions on the retina assoc with endocarditis. Immunologic

47
Q

Diagnostic Duke criteria for endocarditis

A

2 major criteria, or
1 major and 3 minor criteria, or
5 minor criteria

48
Q

Tx for infective endocarditis

A

IV vancomycin or ampicillin/sulbactam PLUS aminoglycoside

49
Q

Drug to add to endocarditis for those with prosthetic valves

A

Rifampin

50
Q

Prophylaxis for endocarditis in dental surgeries

A

Amoxicillin - 2 g 30-60 minutes before the procedure

51
Q

USPSTF HLD screening guideline

A

Start at 35 for ALL adults

52
Q

4 statin benefit groups

A

Patients with any form of clinical atherosclerotic cardiovascular disease (ASCVD)

Patients with primary LDL-C levels of 190 mg per dL or greater

Patients WITH diabetes mellitus, 40 to 75 years of age, with LDL-C levels of 70 to 189 mg per dL

Patients WITHOUT diabetes, 40 to 75 years of age, with an estimated 10-year ASCVD risk ≥ 7.5%

53
Q

Statin for benefit group 1 - Patients with ASCVD

A

High intensity statin if under 75
Evaluate risk/benefit if over 75

54
Q

Statin for benefit group 2 - LDL-C of 190+ or triglycerides over 500

A

High intensity statin, try to reduce LDL by 50%

55
Q

Statin for benefit group 3 - WITH diabetes mellitus, 40 to 75 years of age, with LDL-C levels of 70 to 189

A

Moderate intensity if ASCVD risk under 7.5%
High intensity if ASCVD risk 7.5%+
RIsk benefit for out of age range

56
Q

Statin for benefit group 4 - WITHOUT diabetes, 40 to 75 years of age, with an estimated 10-year ASCVD risk ≥ 7.5%

A

Moderate to high intensity
Moderate if risk is 5-7.5%

57
Q

Lipid goals for LDL, HDL, and Total cholesterol

A

LDL under 100
Total under 200
HDL over 60

58
Q

2 high intensity statins

A

Atorvastatin 40-80mg
Rosuvastatin 20-40mg

59
Q

5 Low intensity statins

A

Simvastatin 10
Pravastatin 10-20
Lovastatin 20
Fluvastatin 20-40
Pitavistatin 1 mg (you read that right)

60
Q

Elevated blood pressure

A

120-129 with DBP under 80

61
Q

Stage 1 hypertension

A

130-139 with DBP 80-89

62
Q

Stage 2 HTN

A

140+/90+

63
Q

Elevated peds BP

A

SBP and/or DBP ≥90th percentile but <95th percentile, or 120/80 mmHg to <95th percentile (whichever is lower)

64
Q

Stage 1 HTN for peds

A

SBP and/or DBP ≥95th percentile to <95th percentile + 12 mmHg, or 130/80 to 139/89 mmHg

65
Q

Stage 2 HTN for peds

A

SBP and/or DBP ≥95th percentile + 12 mmHg, or ≥ 140/90 mmHg (whichever is lower)

66
Q

ACC/AHA BP target

A

130/80

67
Q

Tx guidelines for normal BP

A

Evaluate yearly, encourage healthy lifestyle

68
Q

Tx guidelines for elevated BP

A

Lifestyle changes with 3-6 month reassessment

69
Q

Management for Stage 1 hypertension with ASCVD risk <10%

A

Lifestyle management with 3-6 month follow up

70
Q

Management for Stage 1 hypertension with ASCVD risk >10% or w/ CVD, DM, CKD

A

1 medication with 1 month follow up
Monthly follow up with adjustment until goal BP is met; 3-6 month follow up after that

71
Q

Management for stage 2 HTN

A

2 BP medications with 1 month followed with monthly f/u until goal met then 3-6 month f/u

72
Q

Initial agents for HTN treatment

A

ACE or ARB
Thiazide diuretic (chlorthalidone)
Long acting CCB (amlodipine)

73
Q

Initial agents for HTN in African Americans

A

CCB and/or Thiazide diuretics

74
Q

Contraindication for CCBs

A

Angina pectoris
Can cause leg edema

75
Q

ACE/ARB contraindications

A

Diabetes with proteinuria

76
Q

ACE specific contraindication

A

Cough and hyperkalemia
COntraindicated in pregnancy

77
Q

Contrindication for spironolactone

A

Hyperkalemia

78
Q

Contraindications for beta blockers

A

Asthma, may cause impotence

79
Q

Hypertensive urgency

A

180/120+ BP without hypertensive urgency
Patients whould start a 2 drug regimen with frequent follow up

80
Q

End organ damage signs that make it a hypertensive emergency - 7

A

(BP 180/120+)
retinal hemorrhages/ papilledema encephalopathy,
acute and subacute kidney injury,
intracranial hemorrhage,
aortic dissection,
pulmonary edema,
unstable angina or MI

81
Q

Management for hypertensive emergency

A

In the first hour reduce by 10-20 percent
Reduce by 5-15 percent over then next 23 hours
First hour goal is generally under 180/120
24 hour goal is usually under 160/110

82
Q

Management for hypertensive emergency with retinopathy or encephalopathy

A

Rapidly lower the mean arterial pressure by approximately 10 to 15 percent in the first hour and by no more than 25 percent compared with baseline by the end of the first day of treatment

Gradually reduce to under 130/80 over 2-3 months

83
Q

Drug of choice for hypertensive urgency

A

Clonidine

84
Q

Drug of choice for hypertensive emergency

A

Sodium nitroprusside

85
Q

Drugs of choice for hypertenve emergency with retinopathy/encephalopathy

A

Sodium nitroprusside or clevidipine

86
Q

Upper limits of normal, moderate, moderate to severe, and severe hypertriglyceridemia

A

Under 150
150-499
500-999
1000+

87
Q

NCEP triglyceride screen recommendation

A

Beginning at 20 every 5 years. Fasting is best but may be non-fasting in healthy asymptomatic individuals
Yearly for CHD equivalent with fasting
Fasting should be 12-16 hours to confirm reading

88
Q

Management option for hypertriglyceridemia

A

Lower below 500 to prevent pancreatitis
Fibrates and Niacin is isolated
Lipitor and FIsh oil may also help
Aspirin may help with HDL

89
Q

Side effect of niacin administraction

A

May cause hyperglycemia

EOR Exams (4 decks)

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