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AANP EXAM > AANP EXAM NOTES 5 > Flashcards

AANP EXAM NOTES 5 Flashcards

1
Q

Increased risk for insulin resistance, Type 2 diabetes mellitus, renal dz.. hepatic dz., hyperlipidemia, HTN, CV dz are risk factors for PTs who are obese. T/F

A

TRUE

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2
Q

WHAT IS THE MEANING OF LUB, DUB, KENTUCKY, TENNESSEE

A

S1, S2, S3, S4

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3
Q

S1 = Systole, LUB. What valves are included in the S1?

A

(S1 heart sounds: mitral, tricuspid, & atrioventricular valves)

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4
Q

S2 = diastole DUB. Where is this sound best heard?

A

2nd ICS on left side

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5
Q

If the S2 sound is heard during inspiration, is it normal/abnormal?

A

normal

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6
Q

S3 = Cardiac apex. Where on the body is the S3 sound best heard?

A

5th ICS on left MCL.

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7
Q

If the S2 sound is heard during expiration, is it normal/abnormal?

A

abnormal

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8
Q

What valves are associated with the S2 sound?

A

(aortic, pulmonic, semilunar valves)

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9
Q

An abnormal S3 sound may be a sign of CHF in PTs older than what age?

A

40

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10
Q

Hearing the S3 sound is normal in children, athletes, and during pregnancy. T/F?

A

TRUE. The left lateral recumbent position brings the apex closer to the wall & improves the ability to hear the left ventricular S3.

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11
Q

The S4 sound is best heard where on the body?

A

5th ICS on left side,

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12
Q

An S3 that sounds like “Kentucky,” is associated with CHF in children, pregnancy, and some athletes. T/F

A

TRUE

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13
Q

The S4 sound is best heard at apex (bell). It indicates LVH (think oldest). T/F

A

TRUE

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14
Q

The S4 sound occurs early/late in diastole.

A

LATE

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15
Q

If the S4 sounds like “Tennessee” it indicates what atrial condition?

A

atrial gallop/atrial kick

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16
Q

The Bell of stethoscope is used for high/low tones ?

A

LOW Tones, (mitral stenosis),

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17
Q

The Diaphragm of the stethoscope is best used for Mid to high pitched sounds. T/F

A

TRUE. ? (MR, AS)

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18
Q

A Physiological S2 Split is normal if heard on expiration. T/F

A

FALSE. A Physiological S2 Split is normal if heard on INSPIRATION.

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19
Q

WHERE IS A PHYSIOLOGICAL S2 SPLIT BEST HEARD ON THE BODY?

A

2ND ICS UPPER LEFT SIDE OF STERNUM

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20
Q

What is the most common cause of death for people with DM?

A

HEART DZ

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21
Q

Heart disease & DM are common in what ethnic groups?

A

Mexican & African Americans, East Asians

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22
Q

What type of murmur radiates?

A

Systolic murmurs

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23
Q

Name 2 condx that may be indicated by Diastolic murmors

A

Aortic regurgitation, Mitral stenosis

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24
Q

If a murmur is found in a child, what is your next step?

A

Refer to cardiology

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25
Q

What type of holosystolic atrial murmur radiates to the axilla?

A

MR

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26
Q

A PT with Afib requires what type of TX?

A

Anticoagulation

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27
Q

Where is Aortic Regurgitation heard the loudest?

A

2nd ICS to right of sternum

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28
Q

What condx is characterized by a long asymptomatic period followed by exercise intolerance.

A

Aortic Regurgitation

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29
Q

What is a common early finding in a PT with AR?

A

Hypertrophied left ventricle

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30
Q

What murmur presents as a high pitched, diastolic that radiates toward the cardiac apex?

A

AR

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31
Q

Where is Mitral Stenosis murmur best heard?

A

Loudest Near cardiac apex

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32
Q

What GRADE is a murmur that is easily audible, associated with a thrill?

A

IV/VI

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33
Q

HTN is defined as BP above what levels?

A

130/80

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34
Q

A correlation between BP and age > 60 years exists. As age increases DBP decreases

A

TRUE

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35
Q

Naproxen has a FAVORABLE effect on HTN (Na + & K+). T/F

A

FALSE. Naproxen may have an UNFAVORABLE effect on HTN (Na + & K+).

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36
Q

Pt on Thiazide should have what levels monitored?

A

K+ Levels

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37
Q

Pt on Thiazide may experience what symptoms due to hypokalemia?

A

weakness, fatigue, muscle cramps, ED

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38
Q

A PT treated with candesartan (ARB) should avoid what supplement?

A

Potassium

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39
Q

What is one side effect of Lisinopril?

A

dry cough

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40
Q

Lisinopril is what type of enzyme inhibitor?

A

ACE

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41
Q

A 35 YO Caucasian male using lisinopril may have an increase in what?

A

K+ (Potassium)

42
Q

What is The most common indicator of end organ damage in adolescents with hypertension

A

left ventricular hypertrophy

43
Q

A low sodium diet is considered to be intake of less than how much sodium/day?

A

Less than 1.5g/day

44
Q

What type of diet is considered low sodium?

A

Mediterranean

45
Q

What is a diet you can recommend to PTs who need a low-sodium diet?

A

Dash

46
Q

Name 2 labs that can be ordered to check kidney function

A

Creatinine, eGFR, UA

47
Q

Name 2 labs that can check endocrine levels

A

TSH, Fasting blood glucose

48
Q

What lab checks for K+. NA+, CA+ etc/

A

Electrolyte panel

49
Q

Name 3 labs that can be ordered to check heart function

A

Chol, HDL, LDL, Trig (complete lipid panel)

50
Q

What lab can be ordered to check for anemia?

A

cbc

51
Q

What is considered an elevated BP?

A

120-129 / 80

52
Q

What is considered Stage 1 HTN

A

130-139 / 80-89

53
Q

What is considered Stage 2 HTN

A

> = 140 / >= 90

54
Q

TX for PT with Stage 1 HTN?

A

Start lifestyle changes and reassess

55
Q

PT with Stage 2 HTN should be making lifestyle changes and prescribed with medication. How often should the patient be reassessed?

A

Reassess in 1 month. If goal met, reassess in 3
to 6 months.

56
Q

If a PT with Stage 2 HTN is making lifestyle changes and prescribed medication but not meeting goals, what should be done?

A

If goal not met, consider different medication/ titration and recheck monthly.

57
Q

What tx should be given to children with secondary HTN?

A

Pharmacologic treatement

58
Q

R/t renal (Kidney failure), endocrine (hepatomegaly), respiratory disorders (bibasilar crackles), and damage to the retina (AV nicking) can be caused by …

A

Secondary HTN

59
Q

Isolated Systolic HTN is caused by loss of recoil in the arteries (atherosclerosis), which increases PVR. T/F

A

TRUE

60
Q

What is the TX for isolated systolic HTN?

A

Treatment: Low dose thiazide diuretic or a calcium channel blocker

61
Q

Name a common CCB used to treat Isolated systolic HTN

A

AMLODIPINE

62
Q

Amlodipine may cause urinary incontinence. Why?

A

CCBs weaken muscle contraction

63
Q

Amlodipine requires K+ monitoring. T/F

A

FALSE. Amlodipine DOES NOT require K+ monitoring.

64
Q

PT with Pain that improves when dangling foot (elevation makes it worse) may have what dz?

A

Peripheral artery dz

65
Q

What ABI value is specific to PAD

A

< 0.9

66
Q

HOw is ankle brachial index (ABI) measured?

A

Divide highest SBP by Highest SBP in ankle

67
Q

Name 2 signs of Peripheral Vascular dz

A

Dull/ achy pain, Edema, yellow slough/ ruddy skin

68
Q

Name 2 symptoms of Chronic Venous Insufficiency

A

swelling/ heaviness, pain, itchiness, varicose veins, reddish/brown looking skin, scattered telangiectasias, & ulcers.

69
Q

MVP is usually benign. T/F

A

TRUE

70
Q

MVP often presents by a late systolic murmur and what type of click?

A

Mid systolic click

71
Q

Best test for MVP?

A

Echocardiography

72
Q

S/S of Abdominal aortic aneurysm includes:
Acute/ sudden onset of tearing, severe low back pain/ abd. Pain. May have pustule abd. T/F

A

TRUE

73
Q

What is the most cost effective screen for Abdominal aortic aneurysm?

A

Abd ultrasound

74
Q

Complication of aortic dissection includes left/right pleural effusion:

A

LEFT (NOT RIGHT)

75
Q

When treating Hyperlipidemia Statins are most beneficial when taken in conjunction with what?

A

Diet & Exercise

76
Q

Alcoholic drinks should be avoided in PTs with Hyperlipidemia. T/F

A

TRUE

77
Q

How long do PTs need to fast for Hyperlipidemia lab?

A

12-14 hours

78
Q

Triglycerides require PT to fast how long?

A

x 12 hours

79
Q

What is normal total cholesterol

A

< 200

80
Q

What is the value of optimal LDL?

A

< 100 MG/DL

81
Q

Name 2 agents that are best for lowering triglycerides

A

Niacin, Fibrates

82
Q

Name 1 fibrate used to lower triglycerides

A

Fenofibrate (Tricor). ALSO: gemfibrozil (Lopid), &
benzafibrate (Bezalip).

83
Q

What 2 meds are strong statins that can reduce triglycerides by 33 to 50%

A

Atorvastatin (Lipitor) & rosuvastatin (Crestor)

84
Q

Auscultation of ….. is indicated to assess for generalized atherosclerosis.

A

carotid bruits

85
Q

A PT with c/o pain in lower legs with ambulation (resolution with rest), reports pain in calf muscle (intermittent claudication). This may be caused by what condx?

A

atherosclerosis

86
Q

Lipid measurements should be repeated how often after initiating statin/dose adjustment?

A

4 to 12 weeks after initiating statin/dose adjustment.

87
Q

What dz is a connective tissue dz that leads to autoimmune driven vascular dz & diffuse fibrosis affecting the skin of the hands & face, joints, GI tract, & lungs.

A

Systemic sclerosis

88
Q

What is the TX for systemic sclerosis

A

Tx: Sildenafil, endothelin antagonists & prostacyclin agonists.

89
Q

PT reports acute onset (3 days) of unilateral swelling, pain, & discoloration (Red) in lower extremity from impaired blood flow, pain NOT
relieved by walking. What is your diagnosis?

A

DVT

90
Q

Why is DVT an increased risk in pregnancy?

A

Inferior vena caba & pelvic vein compression by enlarging uterus

91
Q

Holman’s Sign (lower leg pain with dorsiflexion) indicates the PT has what condx?

A

DVT

92
Q

What can a PT use to help relieve DVT?

A

compression stockings

93
Q

What is a condition caused by blockage in the lymphatic system, part of the immune & circulatory system ?

A

Lymphedema

94
Q

What can a PT use to help relieve lymphedema?

A

Compression stockings

95
Q

Name 2 medications that can exacerbate heart failure

A

Metoprolol, Naproxen

96
Q

What are Typical heart sounds associated with CHF

A

S1, S2, S3

97
Q

The presence of S3 ventricular gallop acompanied by anasarca, dyspnea, dry cough, fatigue, SOB, wt. gain, audible bibasilar rales, is associated with what condx

A

CHF

98
Q

Crackles, bibasilar rales lower lobes, cough, mild dyspnea, decreased breath sounds, dullness to percussion are s/s of what type of heart failure?

A

Left ventricular failure

99
Q

Anorexia, nausea, RUQ pain, and lower extremity edema with cool skin HTN are s/s of what type of heart failure?

A

Right ventricular failure

100
Q

What CHF class is described by a patient whose ordinary physical activity results in fatigue, exertional dyspnea?

A

CLASS II

AANP EXAM (8 decks)

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