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Unit 4 JG > POM > Flashcards

POM Flashcards

1
Q

murmurs: auscultation of the apex of the heart (mitral/tricuspid/2nd pulmonic/pulmonic/aortic)

A

mitral

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2
Q

murmurs: auscultation of the lower left sternal border of the heart (mitral/tricuspid/2nd pulmonic/pulmonic/aortic)

A

tricuspid

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3
Q

murmurs: auscultation of the 3rd left intercostal space at the sternal border (mitral/tricuspid/2nd pulmonic/pulmonic/aortic)

A

second pulmonic

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4
Q

murmurs: auscultation of the 2rd left intercostal space at the sternal border (mitral/tricuspid/2nd pulmonic/pulmonic/aortic)

A

pulmonic

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5
Q

murmurs: auscultation of the 2rd right intercostal space at the right sternal border (mitral/tricuspid/2nd pulmonic/pulmonic/aortic)

A

aortic

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6
Q

murmurs: intensity on a scale of 1 to _

A

6 can be heard with a stethoscope off the chest!

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7
Q

murmurs: intensity level _ is a palpable thrill

A

4

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8
Q

murmurs: S3 is (an atrial/a ventricular) gallop

A

ventricular

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9
Q

murmurs: S4 is (an atrial/a ventricular) gallop

A

atrial

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10
Q

murmurs: S3 and S4 are (high/low) pitched, so they are heard better with the bell

A

low pitched

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11
Q

murmurs: (systolic/diastolic) include aortic stenosis and mitral regurg

A

systolic

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12
Q

murmurs: (systolic/diastolic) include aortic regurg and mitral stenosis

A

diastolic

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13
Q

OSA: second most common sleep related breathing disorder after ____

A

primary snoring

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14
Q

syncope: Tilt-table is useful in diagnosing (cardiac/neurogenic/orthostatic hypotension) syncope

A

neurogenic

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15
Q

syncope: holter monitoring is useful in diagnosing (cardiac/neurogenic/orthostatic hypotension) syncope

A

cardiac. also echo, implantable loop recorders

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16
Q

syncope: (cardiac/neurogenic/orthostatic hypotension) most effectively treated

A

cardiac

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17
Q

syncope: (2) (cardiac/neurogenic/orthostatic hypotension) tx by avoiding trigger, tight stockings, medications review, lifestyle changes

A

neuro and orthostatic hypotension

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18
Q

OSA: second most common sleep related breathing disorder after ____

A

primary snoring

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19
Q

OSA: incomplete upper airway obstruction (hyopapnea/apnea)

A

hypoapnea

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20
Q

OSA: who has a greater risk, men or women?

A

men have 3x greater than premenopausal women

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21
Q

OSA: three subgroups of women with increased risk

A

post menopausal, pregnant, PCOS

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22
Q

OSA: (caucasian/non caucasian) higher risk

A

non caucasian

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23
Q

OSA: three main pathogenic factors: obesity, decreased upper airway size, and ____

A

sedentary behavior

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24
Q

OSA: upper airway size is smaller, particularly the (vertical/lateral) dimensions

A

lateral. evaluate with Mallampati score (MMS)

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25
Q

OSA: sedentary behavior causes increased ___ at night

A

fluid shifts from the lower extremities to the upper torso

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26
Q

OSA: two most reliable indicators of OSA

A

nocturnal choking and gasping

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27
Q

OSA: Epoworth ____ Scale assesses the main daytime symptom

A

sleepiness!

28
Q

OSA: MMS of __-__ and an increased neck circumference of more than __ inches in men

A

III-IV and 17 inches in men, 16 inches in women

29
Q

OSA: most commonly used screening method (mnemonic)

A

STOP-Bang

30
Q

OSA: Portable monitors used for ambulatory sleep testing can (over/under) estimate the severity of OSA as they do not differentiate sleep from awake and severity index could be art factually lower.

A

underestimate

31
Q

OSA: if a home sleep study is negative, what is indicated?

A

an in lab sleep study

32
Q

OSA: most efficacious treatment

A

CPAP

33
Q

OSA: (BIPAP/CPAP) used if hypoventilation due to associated pulmonary pathology is present

A

BIPAP

34
Q

OSA: ____ is an option for patients with mild to moderate OSA who don’t want to use CPAP

A

oral applicance

35
Q

PAD: 6 risk factors

A

smoking, age, cholesterol, HTN, diabetes, renal insuff

36
Q

PAD: listen with a ___ device if pulses are not palpable in the lower extremities

A

doppler

37
Q

PAD: skin is (warm/cool) to the touch

A

cool

38
Q

PAD: a test that allows assessment of blood flow in the lower extremity

A

ABI

39
Q

PAD: an ABI of 1-1.1 is (normal/claudication/ischemic rest pain/tissue necrosis)

A

normal

40
Q

PAD: an ABI of less than .2 is (normal/claudication/ischemic rest pain/tissue necrosis)

A

tissue necrosis

41
Q

PAD: an ABI of .2-.4 is (normal/claudication/ischemic rest pain/tissue necrosis)

A

ischemic rest pain

42
Q

PAD: an ABI of .4-.9 is (normal/claudication/ischemic rest pain/tissue necrosis)

A

claudication

43
Q

PAD: first step to treatment

A

address modifiable risk factors

44
Q

PAD: what is the goal HbA1C level?

A

less than 7%

45
Q

CHF: (NYHA/ACC-AHA) clinical classification based on symptoms

A

NYHA

46
Q

CHF: (NYHA/ACC-AHA) clinical classification based on disease progression

A

ACC-AHA

47
Q

CHF: (systolic/diastolic) thick and stiff ventricle, HTN is MCC

A

diastolic. due to impaired filling

48
Q

CHF: (systolic/diastolic) dilated spherical ventricle, ischemic CMP is MCC

A

systolic. due to pump failure

49
Q

CHF: (increases/decreases) RAAS

A

increases

50
Q

CHF: displaced PMI, S3, CXR with pulm congestion rule (in/out) CHF

A

rule in

51
Q

CHF: negative BNP/Framingham criteria rules (in/out) CHF

A

rules out

52
Q

CHF: essential first line tx for chronic CHF (three drug classes)

A

diuretics, ACEis, Beta blockers

53
Q

PNA: _____ associated PNA is associated with IV therapy, wound care, IV chemo, residence in a nursing home

A

healthcare

54
Q

PNA: (healthcare associated/hospital acquired) PNA is nosocomial

A

hospital acquired

55
Q

PNA: who gets it more? men or women? black or white?

A

men more than women, black more than white

56
Q

PNA: cultures who are admitted to the hospital need cultures and ___

A

urine antigen test

57
Q

PNA: pro calcitonin is (up/down) regulated by viral infections

A

down regulated

58
Q

PNA: pro calcitonin gets (lower/higher) in bacterial infections when the treatment is working

A

gets lower when treatment is working

59
Q

PNA: most useful and reliable index to predict mortality and how you will treat your patient

A

PSI (five classes associated with risk of death within 30 days)

60
Q

PNA: (major/minor) criteria of the severe community acquired PNA score: arterial pH and systolic BP

A

major

61
Q

PNA: need to ask your patient if they’ve received antibiotic tx in the last six months when considering?

A

drug resistance in treatment of PNA

62
Q

PNA: non responding PNA usually due to (host mechanisms/inappropriate antibiotic therapy)

A

host mechanisms

63
Q

PNA: the clinical diagnosis of PNA has (good/poor) sensitivity

A

poor

64
Q

PNA: treatment depends on severity score and ?

A

risk factors

65
Q

PNA: if a patient isn’t responding to treatment, how to proceed?

A

more invasive diagnostic evaluation

Unit 4 JG (5 decks)

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