Adam Olsen Review Flashcards
(128 cards)
1
Q
Walking briskly for 30 mins every days of the week can lower systolic bp by how much?
A
4-9
2
Q
Weight loss of 10kg can decrease systolic bp by how much
A
5-20
3
Q
Most common type of htn
A
essential or idiopathic
4
Q
MCC of secondary htn
A
Renal disease
5
Q
What demographic has more signifigant htn at a younger age
A
AA males
6
Q
Dash diet alone can decrease the the bp by how much
A
8-14
7
Q
Sodium restiction can decrease systolic bp by how much
A
2-8
8
Q
A new onset HTN what is the tx
A
lifestye modifications
9
Q
Lifestyle modifications for how long
A
6-12 months
10
Q
What do you need to be careful of with a young female and ACE
A
Pregnancy - highly teratogenic
11
Q
Pt with HTN and proteinuria
A
ACE
12
Q
Raynauds and HTN?
A
CCB
13
Q
Name some CCB’s
A
Amlodipine, Nifedipine, Diltiazem (non-d), verapamil (non-d)
14
Q
Which CCB can slow AV conduction
A
Non- Dihydro
15
Q
You are asked to give a med for anti-anginal
A
Nifedipine
16
Q
Side effects of CCB
A
Constipation, peripheral edema
17
Q
Name some loop diuretics
A
Furosimide, bumix
18
Q
Name some thiazide diuretics
A
HCTZ
19
Q
S/E of loops
A
hypokalemia, hypercalcemia, hypomagnesemia, ototoxicity
20
Q
A patient has an elevated Ca with normal PTH?
1) Thizide induced
2) Hyperparathyroid
3) Dehydration
A
Thiazide diuretic
21
Q
A pt has nephrotic syndrome – med>
A
Loop
22
Q
I am an AA with LV dysfunction give me a med
A
Nitrates and hydralazine
23
Q
I am a white with LV dysfunction give me a med
A
BB, ACE or ARB and diurtic
24
Q
Example of ace
A
Lisinopril, enalapril, captopril
25
ACE s/e
angioedema, cough
26
I have CKD give me a med
ACE, ARB
27
Htn urgency - what is the % of bp you want to decrease in the first 24 hours
No more than 25%
28
Why decrease the bp slow in htn urgency
decrease profusion to kidneys, possible heart and
29
When do you use Nitropressidue
HTN emergency (only comes in IV)
30
Why use labetolol
short acting
31
What are IV anti-hypertensives that you can use for HTN
hydralazine (10-20mg IV push), Labetolol, nitropressidue,
32
You think I have a secondary cause of HTN and I have low K and HTN
Primary hyeroaldosteronism
33
Primary hyperaldosteronism
Low potassium and HTN
34
you think I have a pheo what labs do you order
24 hour urine
35
Ihave elevated Ca and Htn and am not on any meds what secondary cause could we have
hyperparathyroid
36
I take HCTZ and have elevated Ca what could be the cause
HCTZ
37
What medication can you not be on if you are testing for hyperaldosteronism
Spiranolactone
38
Aldosterone is release from the
Adrenal gland
39
Why does the kdney release aldosterone
decreased flow to the kidney
40
Does aldosterone retain water or excrete it
retain
41
You think I may have hyperaldosteronism what labs do you order
renin and aldosterone (1:20 or greater)
42
I have central obesity and striae with Htn
cushings
43
I have htn and decreased femoral pulses
Coarctation of aorta
44
Halmark of pheo
elevated catacholamines (metanephrines)
45
I have tachycardia, nervousness,sweating and htn,
pheo
46
I am obese and have a hard time sleeping at night and I have Htn -- what may i develop
uncontrolled HTN
47
I have sleep apnea what am I at risk for
arrythmias
48
What BB do we not give those cocaine peeps
Cardioselective (Lopressor, metoprolol)
49
I am in actue Pulmonary Edema what med should you give me
Lasix- then nitro
50
I had an MI and now I am in severe CHF you do an echo and I have severe MR--why?
Ruptured Papilary muscle
51
What are thesystolic murmurs
AS, PS, MR, TR
52
What is the S1
closure of Mitral and tricuspid valve
53
What is the s2
closure of aortic and pulmonic
54
S3 and S4 systolic or diastolic
diastolic
55
S3 signifies whay
LV dysfunction, cardiomyopathy, CHF, volume overlad
56
S3 is heaard best by what side of the stethescope
bell
57
when is S3 in diastole
early
58
when is S4 in diastole
late
59
What is S4 associaed with
Stiff ventricle, enlarged LV, Long standing HTN,
60
Can you have an S4 gallop in A fib?
No- you need atrial contraction to have an S4
61
I have a crescendo- decrescendo radiating to my neck
AS
62
I have a diastolic blowing murmur
AR
63
Waterhammer pulse is associated with
AR
64
Corrigans sign is associated with
AR
65
Quinkes pulse is associated with
AR
66
Traubes sign is associates with
AR
67
Holosystolic in apex radiating to axilla
MR
68
opening snap with diastolic rumble
MS
69
I had rheumatic heart disease what valvular problem do I have
MS
70
Rheumatic heart disease and what criteria
Jones
71
Mid systolic click
MVP
72
I have a loud crescendo decrescendo murmur that increasess with valsalva
HCM
73
Valsalval ___________ preload
Decreases (you are underfilling the heart)
74
Hand grip ___________________ preload
increases
75
Cardiomyopathy definition?
Disease process of the heart
76
Most common cause of restrictive cardiomyopathy
Amylodosis
77
Dilated cardiomyopathy causes
alcohol, uncontrolled htn, valvular disease, CAD, MI, Cocaine, pregnancy, hyperthyroidism, iatrogenic, viral (most common- cowasaki)
78
Hypertrophic cardiomyopathy examples
genetic (most common), athletes, long standing
79
Restricted cardiomyopathy causes
Sarcoid, amyloid, hemachromatosis
80
secondary outcome of HCM
Ventricular arrhythmias
81
MCC of sudden cardiac death
v fib
82
What medication should you treat someone with HCM
BB
83
I have high levels of monoclonal light chains in my blood- differentials please
Multiple myloma or amyloidosis
84
What is the MC type of cardiomyopathy
Dialated
85
What is the least common type of cardiomyopathy
restrictive
86
If you see Right axis deviation what type of disease states should you think of
Pulmonary
87
Left heart failure symptoms
pulmonary edema, orthopnea and PND
88
Right heart failure
Peripheral edema, anasarca, ascites, JVD, hepatomegaly
89
can you have right and left sided yeart failure
yes---bad question
90
class 1 NYHA
No limitations to physical activity, no symptoms
91
Class 2 NYHA
slight symptoms with activity
92
Class 3 NYHA
Symptomatic with limtited activities
93
Class 4 NYHA
Symptomatic at rest
94
Systolic dysfunction is classified as
EF< 40%
95
What is the EF
Amount of blood left at the end of diastole following systole--- or rather the % of blood pumped out of the left ventricle
96
MCC of CHF
Ischemic heart disease of MI
97
Diastolic dysfunction
increase in ventricular stiffness - normal EF
98
Fluid with protein < 0.6 what is the type of fluid
transudatice
99
Causes of transudative
CHF (MC), Chiirrosis, low albumin, low nutitional status
100
cause of exudative fluid
Infection (MC), cancer
101
You give an elderly patient levothyroxine and they are having SOB....why could that be
Highoutput CHF caused by too much T4
102
I have CHF with normal LV function and i am not fluid overload what is the best bedication for me to start now?
Metoprolol- always a BB
103
A patient has angina that lasts 15 mins and is resolved he has negative tests (trop and ekg) what next
Serial Trops
104
What do you do after serial troponins is a patient if they are all neagative and the patient is still asymptomatic
stress test
105
Stress test shows mild area of ischemia what do you do
Medical therapy
106
Stress test shows a large area of ischemia what do you do
cath them
107
Pharmaolical stress testing is done with what 3 agents
dypridamole(persantine), adenosine, dobutimine
108
contraindications for adenosine and persantine?
bronchospasm, phulmonary disease, heart block (use dobutimine)
109
ACS includes
unstable angina
Non ST elevation MI
STEMI
110
Is demand ischemia classified as an ACS
NO- it is a type 2 MI.
111
When does trop I begin to rise
4-8 hours and lasts 10-14 days
112
What test is good to test for re-infarct?
CK and CK MB
113
You want to use the earliest test to ssee if there is an MI what do you use
CKMB- rises within 4-6 hours so a little quicker
114
Immediate tx for ACS
MONA (morphine, oxygen, nitro, asprin)
115
I have an inferior wall infact what should you not give
Nitro
116
Should you chew or swollow asprin? Why?
Chew, faster absorbed
117
What is the drug that decreases mortality in patients at the time of infarct
Asprin- always give asprin first!!!!!!!
118
What else should you give patients with ACS besides MONA initially
BB, Heparin, Clopidogrel (plavix)
119
When should you give TPA
STEMI with no access to cath lab
| STEMI with contraindication to surgery or cath for some reason
120
I have cp after a recent MI- my EKG shows PR depressions what do I probably have
Dresslers syndrome (remember PR depressions are as important as ST elevations)
121
Pericarditis treatment
NSAIDS
steroids
Colchecine (sorry for bad spelling)
122
What is nicotinic acid
Niacin
123
What do you use to lower tiglicerides
fibric acid derivitives (genofibrozil, fenofibrate)
124
What is the perferred therapy for someone with low HDL high LDL and High Tigs?
HMG-CoAreductase inhibitor
125
I have a bad reaction to a statin what do you give me next
bile acid sequestrant
126
What is the only cholesterol lowering medication to decrease morbidity and mortality
STATIN
127
What are 2 s/e of statins
HYPERGLYCEMIAS, and rhabdomyolisis
128
Most common congenital defect
VSD
