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Cardio > STUDY QUESTIONS > Flashcards

STUDY QUESTIONS Flashcards

1
Q

List the parameters for normal blood pressure, elevated blood pressure, stage 1 HTN, and
Stage 2 HTN?

A

●Normal blood pressure – Systolic <120 mmHg and diastolic <80 mmHg

●Elevated blood pressure – Systolic 120 to 129 mmHg and diastolic <80 mmHg

●Hypertension:
*Stage 1 – Systolic 130 to 139 mmHg or diastolic 80 to 89 mmHg

*Stage 2 – Systolic at least 140 mmHg or diastolic at least 90 mmHg

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2
Q

Describe what risk factors are for development of HTN?

A

Age, Obesity, Family history, Race, reduced nephron number, high sodium diet, excessive alcohol intake, and Physical inactivity

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3
Q

A 24 year old Active Duty Navy CS3 presents to you in clinic for his annual PHA. He has no past
medical history, no significant family history, exercises 1 hour per week only, does not smoke, and
drinks 2-3 12 ounce beers per week. Vitals BP: 132/89, HR 68, RR: 14, Temp: 98.0, Pulse Ox: 99%,
Weight 240, HT: 66 inches. What would be some non-
pharmacological recommendations for treatment of elevated blood pressure?

A

Diets rich in fruits and vegetables and low in saturated fats (DASH), weight reduction, and
increase exercise

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4
Q

Name some common diagnosis that can cause secondary hypertension?

A

Oral contraceptives,
NSAIDS,
anti-depressants, corticosteroids,
Decongestants (such as
phenylephrine and pseudoephedrine),
ADHD medications (methylphenidate, amphetamines), illicit drugs such as methamphetamine and cocaine, and caffeine

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5
Q

What are complications of long term Hypertension without good control of blood pressure?

A

Left ventricular hypertrophy, Congestive heart failure,
Ischemic stroke,
AMI,
ischemic heart
disease, Renal failure

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6
Q

What is the biggest and most important distinguishing feature between Hypertensive
Urgency and Hypertensive Emergency?

A

Signs of End Organ Damage will define Hypertensive Emergency

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7
Q

What are some complications of Hypertensive Emergency?

A

Hypertensive encephalopathy (mental status changes, confusion, headache)

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8
Q

What is treatment for Hypertensive Urgency?

A

ORAL medications with the goal of reducing DBP < 110 over 24 hours

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9
Q

What is the treatment for Hypertensive Emergency?

A

reduce blood pressure by 15-25% within 1 hour with IV medications, then < 160/110 in 24
hours.

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10
Q

Name the 5 primary sites of atherosclerotic plaque build up.

A

Coronary, Cerebral, Carotid, Aorta, and Arteries of the lower extremities (iliac, femoral, popliteal,
and tibial) arteries

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11
Q

List the 6 risk factors for Atherosclerotic disease.

A

Hypercholesterolemia,
HTN,
Diabetes,
Male gender,
Smoking, and
family history of atherosclerotic disease.

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12
Q

List some signs and symptoms of Coronary Artery Disease.

A

Substernal Chest pain,
radiation of pain to left shoulder or neck,
diaphoresis,
nausea/vomiting,
indigestion,
new heart murmur,
S3, S4,
or sudden cardiac death

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13
Q

List some non-pharmacological treatments for Coronary artery disease.

A

Stop Smoking,
Increase exercise and activity, moderate use of alcohol,
low fat diet,
control of HTN,
DM,
and hypercholesterolemia

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14
Q

What are the 2 first line pharmacological treatments for Coronary artery disease?

A

HMG CoA reductase inhibitors and Aspirin

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15
Q

What is the most common symptoms a patient will complain about when they have Peripheral arterial disease?

A

Intermittent claudication

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16
Q

What are other typical symptoms of Peripheral arterial disease?

A

diminished lower extremity pulses, tissue ulceration or gangrene, erectile dysfunction,
loss of hair on lower extremities, thinning and cool skin,
atrophy of muscles, and ABI < 0.9

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17
Q

List the 4 important non-pharmacological treatments for PAD.

A

Smoking cessation,
risk factor reduction,
weight loss
regular moderate exercise

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18
Q

What is the etiology of Acute Arterial Occlusion of a limb?

A

Acute occlusion due to emboli or thrombus with the most common cause being secondary to atrial
fibrillation

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19
Q

List the 6 P’s associated with Acute occlusion of a limb.

A

Pain,
Pallor,
Poikilothermia,
Pulselessness,
Paresthesia,
Paralysis

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20
Q

What is the immediate treatment for Acute occlusion of a limb?

A

Heparin Sulfate IV or Lovenox

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21
Q

What are the two diagnosis associated with Occlusive cerebrovascular disease and how do
they differ?

A

Ischemic stroke and Transient ischemic attack (TIA). The only difference is
that a TIA will resolve spontaneously in 24 hours, whereas with a stroke, the symptoms will not.

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22
Q

What are important differential diagnoses that can mimic acute occlusive cerebrovascular
accident?

A

Hypoglycemia,
Seizure,
intracranial hemorrhage,
adverse reaction to a medication, drug use,
or toxic metabolic effects like hypo or hypernatremia.

23
Q

What is the difference between good and bad cholesterol?

A

HDL is considered “good cholesterol” because it transports cholesterol to your liver to be expelled from your body.

LDL is considered “bad cholesterol” as elevated levels have been shown to accelerate plaque formation.

24
Q

Discuss what lifestyle modifications are for the treatment of dyslipidemia.

A

Eating a low-fat diet, high fiber diet, stop smoking,
aerobic exercise at least 40 minutes 3-4 times per week,
weight loss of overweight or obese, and reduce alcohol intake to 1-2 standard drinks per day

25
Q

What are side effects of HMG CoA reductase inhibitors?

A

Rhabdomyolysis, hepatotoxicity, acute renal failure, myopathy, pancreatitis

26
Q

List where the leads go when performing a 12 lead EKG.

A
27
Q

Describe what waveforms are seen on an EKG.

A
28
Q

Describe what ST elevation and ST depression looks like on an EKG and discuss what each mean.

A

ST Elevation represents full-thickness myocardial muscle infarction

ST Depression represents myocardial ischemia and partial thickness myocardial infarction.

29
Q

Describe what T wave inversion looks like on an EKG.

A
30
Q

List the regions of the heart that each of the leads represent.

A
31
Q

List the criteria to make the diagnosis of a left bundle branch block on EKG.

A
32
Q
A

2nd degree heart block,

33
Q
A

1st degree heart
block

34
Q
A

Sinus Bradycardia

35
Q
A

Ventricular
Fibrillation

36
Q
A

Ventricular
Tachycardia

37
Q
A

2nd degree heart block,
type 2

38
Q
A

Tachycardia

39
Q
A

Paroxysmal Ventricular tachycardia

40
Q

What valvular disorders will cause a systolic murmur?

A

Mitral Regurgitation, Aortic stenosis, VSD, Hypertrophic obstructive cardiomyopathy
(HOCM)

41
Q

What valvular disorders will cause a diastolic murmur?

A

Mitral Stenosis, Aortic Regurgitation

42
Q

What valvular disorder will cause a mid-systolic click?

A

Mitral valve prolapse

43
Q

What 2 valvular heart disorders have murmurs that radiate, and describe where they radiate to?

A
  1. Mitral Regurgitation is best heard at the apex and radiates to the left axilla
  2. Aortic Stenosis is best heard at the right sternal boarder and radiates to the right carotid
44
Q

What valvular disorder will cause a wide pulse pressure?

A

Aortic Regurgitation will cause a wide pulse pressure.

45
Q

What is the definition of a wide pulse pressure?

A

wide pulse pressure is defined as the difference between the systolic blood pressure and the
diastolic blood pressure is greater than 60

46
Q

What is the most common cause of acute pericarditis?

A

Mostly caused by viral infections to include from influenza, upper respiratory infections,
mono

47
Q

What is the most common sign of acute pericarditis?

A

Pericardial friction rub which sounds like Velcro or crunching snow

48
Q

What will be the EKG findings in acute pericarditis?

A

Diffuse ST-segment elevation

49
Q

What is the definition of myocarditis?

A

Myocarditis is defined as inflammation of the myocardium

50
Q

What is the only way to tell myocarditis with a pericardial rub from pericarditis?

A

The presence of positive Cardiac Enzymes (elevated troponin and/or CK-MB)

51
Q

What is the most important and telling physical findings due to acute myocarditis?

A

Sinus Tachycardia out of proportion to the Temperature

52
Q

What is the name of the triad associated with pericardial tamponade and what are the three findings?

A

Becks Triad which is muffled heart sounds, Jugular venous distension, and hypotension
unresponsive to a fluid challenge

53
Q

What is the treatment for life threatening cardiac tamponade?

A

Pericardiocentesis

Cardio (24 decks)

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