IM Cardio 2 Flashcards
Jones Criteria (J<3NES) aka MAJOR criteria for rheumatic fever
Polyarthritis (joints)
Carditis (<3)
Nodules subcutaneous
Erythema marginatum
Sydenham chorea
How can the initial diagnoses of acute rheumatic fever be made?
two major criteria
or one major and two minor criteira
What is the minor criteria for rhumatic feve?
Arthralgia (joint pain
Fever
elevated acute phase reactants (ESR / CRP)
reversible Prolonged PR interval –
What oinfection is commnonly associated with Rhuematic fever?
Group A Strep
What valve is most comonly impacted by rhematic fever?
Mitral Valve
What causes Wolff Parkinsons-white syndrome ?
acessory conduction pathway(bundle of kent) formed between the ventricles ad atria of the heart, this allows the electrical impulse to bypass the AV node and, thus, cause preexcitation of the ventricular myocardium
What antidysrhythmic medication classes are preferred when providing medical prophylaxis for reentrant tachycardia in Wolff-Parkinson-White syndrome?
ClaSS ic Antiarrythmics : flecainide and propafenone
Class III antiarrhythmics (e.g., amiodarone and sotalol)
Primary hypertension is defined as
resting systolic BP ≥ 130 or diastolic BP ≥ 80 on at least two readings on at least two separate visits with no identifiable cause.
What BP reading is Classified as normal? and how would you treat ?
< 120/80 mmHg and evaluate yearly and encourage healthy lifestyle changes
What BP reading is classified as elevated HTN? and how would you treat?
120–129 mmHg and < 80 mmHg and
healthy lifestyle changes and reassess in 3-6 months
What BP reading is classified as stage 1 HTN?
130-139 OR 80-89
What BP reading is classified as stage 2 HTN?
≥ 140 mm Hg or ≥ 90 mm H
What BP reading is classified as hypertensive crisis?
Systolic over 180 and/or diastolic over 120,
what is ACC/AHA blood pressure target?
< 130/80
JNC 8 treatment targets:
< 140/90 mm Hg for everyone < 60 including those with a kidney disorder or diabetes
and
Reduce BP to < 150/90 mm Hg for everyone ≥ 60
What are the recommendations on treating stage 1 HTN?
Assess ten-year risk using the ASCVD risk calculator
If risk < 10% start healthy lifestyle management and reassess in 3-6 months
If risk > 10% or CVD, DM, CKD - lifestyle mod + 1 medication - reassess in 1 month If goal met after 1 month - reassess in 3-6 months
If goal not met after 1 month, consider different med or titrate
Continue monthly follow-up until goal achieved
What are the recommendations on treating stage 2 HTN
Health lifestyle + 2 BP-lowering medications
If goal met after 1 month - reassess in 3-6 months
If goal not met after 1 month, consider different med or titrateContinue monthly follow-up until goal achieved
For NON-BLACK patients, including those with diabetes: Initial treatment of HTN should be with eithe
-Ace inhibitor or ARB
- Long-acting calcium channel blockers (most often a dihydropyridine such as amlodipine)
-or a thiazide-like diuretic (chlorthalidone or indapamide)
True or False . for BLACK adults 2 or more medications are recommended to achieve a target of less than 130/80 mm Hg
Thiazide-type diuretics and/or calcium channel blockers are more effective in black adults at lowering BP alone or in multidrug regimens
What hypertensive medication is contraindicated in patients with diabetes and proteinuria
ACEI or ARB
What hypertension medication is contraindicated in pregency?
ACE inhibitors (e.g., lisinopril, enalapril) and ARBs (Angiotensin II Receptor Blockers, e.g., losartan, valsartan)
What hypertensive drung is contraindicated in Asthma?
beta blockers
What neducatuin can cause lupus like syndrome and can cause pericarditis ?
Hydralazine
What is the definiton of hypertensive urgency
Severe hypertension in adults is often defined as systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥120 mmHg
