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Advanced Clinical Reasoning > Quiz #3 > Flashcards

Quiz #3 Flashcards

1
Q

CHA2DS2-VASc

A 
CHF (1)
HTN (1)
Age > 75 (2)
DM (1)
Stroke/TIA (2)
Vascular dz (1)
Age 65-74 (1)
Sex female (1)
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2
Q

Tx for Atrial Fibrillation w/o LV dysfunction or HF

A

Beta blocker
Amiodarone
Diltiazem
Verapamil

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3
Q

Tx for Atrial Fibrillation w/ LV dysfunction or HF

A

Beta blocker, Digoxin, Amiodarone

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4
Q

Anticoagulation Options for Positive CHA2DS2-VASc Score

A

Warfarin
Dabigatran
Rivaroxaban
Apixaban

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5
Q

Treatment for Stage B HF Patients

A

ACE/ARB

Beta Blockers

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6
Q

Treatment for Stage C HF Patientst

A

ACE/ARB
Beta Blockers
Diuretics
Aldosterone antagonist (Spironolactone)

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7
Q

Examples of diuretics

A 
HCTZ
Chlorothiazide
Furosemide
Torsemide
Bumetanide
Spironolactone
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8
Q

Preferred Beta Blocker for HF Treatment

A

Metoprolol

Carvediolol

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9
Q

Preferred ACE Inhibitor for HF Treatment

A

Enalapril

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10
Q

Preferred diuretic for HF treatment

A

Furosemide (Lasix)

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11
Q

Symptoms of Heart Failure

A 
Fatigue
Shortness of Breath
Orthopnea
PND
Chronic cough
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12
Q

Physical Exam Signs of Heart Failure

A 
Pedal Edema
Jugular Venous Distention
Ascites
S3 Gallop/S4 Gallop
Crackles in lungs
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13
Q

Secondary Causes of Hypertension

A 
Renovascular Dz
Hyperaldosteronism 
Pheochromocytoma
Cushing's Dz
Sleep Apnea
Coarctation of the Aorta
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14
Q

Fundoscopy findings from long term HTN

A

Cotton Wool Spots
Hard Exudates
AV Nicking
Copper Wiring

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15
Q

Steps for Statin Use Algorithm

A
  1. 21 y/o and candidate for statin use?
  2. Clinical ASCVD?
  3. LDL >/= 190?
  4. Diabetic?
  5. ASCVD Risk > 7.5% and 40-75 y/o?
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16
Q

10 Year ASCVD Risk Calculator Components

A 
Age 40-75
Diabetes
Sex, Race
Smoker
Total Cholesterol, HDL
Systolic Blood Pressure
Treated for HTN?
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17
Q

High Intensity Statins

A

Atorvastatin 80 mg

Rosuvastatin 20 mg

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18
Q

Moderate Intensity Statins

A 
Atorvastatin 10 mg
Rosuvastatin 10 mg
Simvastatin 20-40 mg
Pravastatin 40 mg
Lovastatin 40 mg
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19
Q

Low Intensity Statins

A

Pravastatin 10-20 mg

Lovastatin 20 mg

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20
Q

Symptoms of spontaneous pneumothorax

A

Dyspnea
Chest pain
Diminished breath sounds

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21
Q

Symptoms of tension pneumothorax

A

Rapid labored breathing
Tachycardia
Cyanosis

22
Q

Acute infection of lung parenchyma which must have occurred before or at most 48 hours after hospitalization

A

Community Acquired

23
Q

Most common etiology of community acquired pneumonia

A

Streptococcus pneumoniae

24
Q

Defined as pneumonia developing 48 hours after hospitalization

A

Healthcare associated pneumonia

25
Q

Common etiologies of HAP

A

Pseudomonas
E. coli
MRSA

26
Q

Symptoms of CAP/HAP

A

Productive Cough
Fever
Pleuritic Chest Pain

27
Q

Physical Exam Signs of CAP/HAP

A

Increased fremitus
Dullness to percussion
Egophony
Crackles

28
Q

Diagnosis of CAP/HAP

A

CXR (infiltrates)

Sputum culture

29
Q

CAP/HAP associated with rust colored sputum

A

Pneumococcus

30
Q

CAP/HAP associated with currant jelly sputum and alcoholic (aspiration)

A

Klebsiella

31
Q

CAP/HAP associated with bullous myringitis, cold agglutinin hemolysis

A

Mycoplasma

32
Q

CAP/HAP associated with GI sx and confusion. Contaminated water sources.

A

Legionella

33
Q

CAP/HAP associated with influenza

A

Staph aureus

34
Q

CAP/HAP associated with COPD

A

Haemohphilus influenza

35
Q

CAP/HAP associated with AIDs (strep still most common)

A

Pneumocystis

36
Q

Tx for CAP in healthy individuals who have not received ABX in last 3 mo

A

Macrolide (Azithromycin, Clarithromycin, Doxycycline)

37
Q

Tx for CAP in pts with comorbidities or recent ABX use

A 
Respiratory fluoroquinolones (levofloxacin, moxifloxacin)
Amoxicillin or Augmentin or Ceftriaxone PLUS macrolide or doxycycline
38
Q

CURB-65

A 
Confusion
Uremia (BUN > 19)
Respirations (> 30)
Blood pressure (hypotension)
Over 65
0-1: outpatient
2: outpatient w/ close obs or inpatient
3-5: inpatient
39
Q

Tx for inpatient CAP/HAP

A 
Respiratory fluoroquinolone (Levofloxacin/Moxifloxacin)
Ceftriaxone plus macrolide
40
Q

Samter’s Triad

A

Aspirin allergy, nasal polyps, asthma

41
Q

Management of asthma exacerbations

A

O2
SABA
Systemic corticosteroids
Consider IV MgSO4

42
Q

Stepwise approach to asthma

A
  1. SABA prn
  2. Low dose ICS
  3. Low dose ICS + LABA
  4. Med dose ICS + LABA
  5. High dose ICS + LABA
  6. High dose ICS + LABA + oral corticosteroid
43
Q

Examples of SABA

A

Albuterol, levalbuterol, pirbuterol

44
Q

Examples of ICS

A

Beclomethasone, Budesonide, Fluticasone, Mometasone

45
Q

Examples of LABA

A

Salmeterol, Formoterol

46
Q

Sx of COPD

A

DOE and productive cough

47
Q

Dx for COPD

A

CXR (hyperinflation - increased AP ratio and flattened diaphragm)
CBC (increased hematocrit due to chronic hypoxemia)
CMP - respiratory acidosis and metabolic alkalosis
PFTs: FEV1 < 80%, FEV1/FVC ratio < .70
EKG: multifocal atrial tachycardia associated with COPD

48
Q

Stepwise treatment of COPD

A
  1. SABA or ipratropium
  2. LABA or tiotropium
  3. ICS
49
Q

Mild COPD

A

FEV1/FVC < 0.70

FEV1 > 80% predicted

50
Q

Moderate COPD

A

FEV1/FVC < 0.70

FEV1 < 80% > 50%

51
Q

Severe COPD

A

FEV1/FVC < 0.70

FEV1 < 50% > 30%

52
Q

Very Severe COPD

A

FEV1/FVC < 0.70

FEV1 < 30%

Advanced Clinical Reasoning (8 decks)

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