CARDIO

Question 1

If a patient has lower extremity pain that is worse with prolonged standing or sitting & better with leg elevation and walking what dx? Tx?

Answer 1

Venous insufficiency

Tx with compression, leg elevation, and exercise

Question 2

If a patient has lower extremity pain that is wore with walking and relieved with rest what dx? Tx?

Answer 2

Peripheral artery disease

Tx with colpidogrel and Aspirin

Question 3

Who should be treated with a high dose statin?

Answer 3

Atherosclerotic disease, LDL >190 + family Hx, Diabetic + LDL>190

Question 4

Side effect of statin therapy?

Answer 4

Rhabdo!!

Question 5

How do you treat rheumatic fever?

Answer 5

PCN (or cephalosporin)

Question 6

What are the sxs of pericarditis? Tx?

Answer 6

P’s! Persistent, pleuritic, postural, and pericardial friction rub

Tx with NSAID & ASA

Question 7

How do we distinguish pericarditis from tamponade and MI’s?

Answer 7

Echo! If you see wall motion tenderness think Tamponade

Question 8

How do you tx tamponade?

Answer 8

Pericardiocentesis

Question 9

What cardiomyopathy involves systolic dysfunction? Tx?

Answer 9

Dilated

Tx with ACE & Diuretics

Question 10

What cardiomyopathy is associated with sudden cardiac death?

Answer 10

Hypertrophic

Question 11

What cardiomyopathy is associated with diastolic dysfunction?

Answer 11

Hypertrophic (Septum is enlarged)

Question 12

When would you see pulsus alternans?

Answer 12

dilated cardiomyopathy

Question 13

When would you see bisferens carotid pulse?

Answer 13

Hypertrophic cardiomyopathy

Question 14

If a patient has continuous PVC’s for longer than 30 seconds at a rate greater than 100 and they are stable – what Dx? Tx?

Answer 14

Ventricular tachycardia

Tx with Amiodarone

Question 15

What if your patient is in vtach and they are unstable but have a pulse?

Answer 15

Synchronized cardiovert

Question 16

What if your patient is in vtach and they are unstable without a pulse?

Answer 16

Defibrillate/CPR (like Vfib)

Question 17

How can you treat torsades?

Answer 17

IV Magnesium

Question 18

If a patient is stable and has a sudden onset of a racing heart and EKG shows HR >100 that’s regular and narrow – what dx? Tx?

Answer 18

PSVT

Tx with Valsalva or carotid massage or ADENOSINE

Question 19

What if your patient in PSVT is unstable? What must you ALWAYS rule out with PSVT?

Answer 19

Unstable = cardiovert

MUST rule out WPW

Question 20

How do you tx WPW?

Answer 20

Amiodarone

Question 21

How do you treat Aflutter?

Answer 21

CCB – ablation is definitive

Question 22

If the PR interval is progressively lengthening until the heart fails to produce a p wave or QRS complex – what Dx?

Answer 22

Mobitz 1

Question 23

Continuously dropped beats without PR interval lengthening – what dx?

Answer 23

Mobitz 2

Question 24

What is Rate control for Afib?

Answer 24

CCB (Diltiazem or Verapamil)

Question 25

What is rhythm for Afib?

Answer 25

DC cardiovert – but NOT IF IT HAS BEEN LONGER THAN 48 HOURS

Question 26

What medication reduces afterload in HF?

Answer 26

ACE inhibitors

Question 27

What medication reduceds preload in HF?

Answer 27

Diuretics

Question 28

Side effect of Lisinopril? Alternative medication?

Answer 28

Cough! Can try an ARB

Question 29

Side effect of diuretics? Alternative med?

Answer 29

Drop in K levels | Can switch to spironolactone or eplernone

Question 30

A diabetic with HTN should be placed on what kind of med?

Answer 30

ACE/ARB

Question 31

A patient with heart failure, ischemia, or CAD + HTN should be placed on what kind of medications?

Answer 31

Beta blocker or ACE

Question 32

A patient with Angina or hyperthyroidism + HTN should be placed on?

Answer 32

Beta blockers

Question 33

A patient with raynauds with HTN should use what kind of med?

Answer 33

CCB

Question 34

At what levels do patients become stage 2 HTN? What does that mean?

Answer 34

160+/100+ They will most likely need 2 meds to treat their HTN. ONE WILL BE A DIURETIC

Question 35

What is the drug of choice for HTN?

Answer 35

Hydrochlorothiazide

Question 36

Can you use a dihydropyridine (verapamil and diltiazem) with a statin?

Answer 36

NO

Question 37

What’s the DOC for HTN in pregnancy?

Answer 37

Methyldopa

Question 38

When would we not use a thiazide?

Answer 38

someone with an MI, pregnant women, CKD

Question 39

When would we use a BB for HTN treatment?

Answer 39

MI, CAD, and diabetes