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ACNP REVIEW > cardiology > Flashcards

cardiology Flashcards

(66 cards)

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1
Q

Systolic murmurs

A

Mitral Regurg Aortic Stenosis Systolic murmurs Mitral Valve Prolapse

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2
Q

Diastolic murmurs

A

Mitral Stenosis Aortic Regurg Diastolic murmurs

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3
Q

Medication class best in patients with CAD and MI

A

Beta Blockers

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4
Q

Medication class best in patients with Diabetes and renal failure

A

ACE-I and ARBs

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5
Q

PE EKG changes

A

S1: deep S wave in lead I Q3: Q wave in lead III T3: ST elevation and T wave inversion in Lead III

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6
Q

Global ST elevation and treatment

A

Pericarditis and treatment with NSAIDs (Toradol)

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7
Q

NASPE pacing codes

A

chambers paced chambers sensed response to sensing programmability and rate modulation

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8
Q

Stage 1 HTN

A

Systolic BP 140-159 or Diastolic BP 90-99

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9
Q

Stage 2 HTN

A

Systolic BP > 160 or Diastolic BP > 100

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10
Q

Prehypertension

A

Systolic BP 120-139 or Diastolic BP 80-89

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11
Q

S3 heart sound

A

ventricular gallop resistance to ventricular filling due to fluid overload, CHF, and cardiomyopathy Sounds like “Ken-tuc’-ky”

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12
Q

S4 heart sound

A

atrial or presystolic gallop caused by increased ventricular diastole due to MI, HTN, and ventricular hypertrophy

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13
Q

Grade 1 murmur

A

barely audible

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14
Q

Grade 2 murmur

A

clearly audible but faint

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15
Q

Grade 3 murmur

A

moderately loud, easily heard

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16
Q

Grade 4 murmur

A

loud, associated with thrill on palpation

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17
Q

Grade 5 murmur

A

very loud; heard with one corner of stethoscope off chest wall

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18
Q

Grade 6 murmur

A

loudest; no stethoscope needed

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19
Q

Hypercalcemia can cause what rhythm abnormalities

A

AV blocks and bundle branch blocks due to increased contractility of heart and shortening of depolarization

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20
Q

What electrolyte imbalances cause U waves

A

hypomagnesemia and hypokalemia

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21
Q

To be diagnosed with HTN the pt. must have

A

3 elevated pressures on 2 separate occasions

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22
Q

Target BP for pts. with CKD, DM, or < 60 years old

A

< 140/90

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23
Q

Hypertensive urgency treatment

A

ORAL treatment with any short-acting agent Not Nifedipine

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24
Q

S/S of hypertensive urgency

A

upper level stage II HTN disc edema microalbuminuria LVH hair loss severe perioperative HTN

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25
Hypertensive emergency treatment
Hospitalized, A line, IV therapy Goal is to reduce MAP by no more than 25% within 2 hours, then toward 160/100 within 2-6 hours Drug of choice: Nipride
26
S/S of Hypertensive emergency
HA, confusion, irritability (hypertensive encephalopathy) hematuria, proteinuria (hypertensive nephropathy) unstable angina, MI, aortic disection, PE, preeclampsia
27
leading cause of mortality and morbidity in US
CAD 4:1 men:women Age \>70 1:1
28
Lead II, III, aVf represents
inferior wall; 90% RCA, 10% Circumflex
29
Lead I, aVL, V5, V6 represent
Lateral wall
30
Lead V1-V6 represent
Anterior wall
31
Indications for thrombolytics
ST segment elevation \>0.1 in 2 or more leads CP and ST elevation not relieved by SL NTG \<80 pt. is A/O and knows medical hx
32
Absolute contraindications for thrombolytics
Hx of CVA, cranial or spinal trauma, severe uncontrolled HTN, known bleeding tendencies, trauma or surgery within 10 days, known or suspected pregnancy
33
Relative contraindications for thrombolytics
puncture or non compressible vessel \< 10 days ago Poorly controlled HTN Hemorrhagic opthalmic condition PT \>15 secs
34
Systolic heart failure
results from inability to expel blood normally d/t depressed LV contraction ACE-I and BB is standard of therapy
35
Diastolic heart failure
inability of heart to relax Treatment is to prevent tachy, reduce LV filling, reduce BP and improve exercise tolerance and quality of life Treatment: BB, ARBs, ACE-I, Digoxin reserved fro diastolic HF with afib
36
Acute left sided heart failure S/S
Manifested in the lungs: dyspnea at rest coarse rales S3 heard
37
Chronic right sided heart failure S/S
Manifested in periphery: Dyspnea with exertion JVD Peripheral edema Abdominal discomfort Fine, diffuse rales
38
First line management for CHF
ACE-I and BB Then add: diuretic, aldosterone antagonists, MSO4, and O2 Identify underlying cause
39
Osler's nodes
on the tips of fingers and toes Caused by septic emboli from infected heart valve Painful
40
Best way to diagnose AAA
spiral CT
41
This type of angina occurs more in woman that in men
Printzmetal- vasospasm not secondary to atherosclerosis Occurs more often in early morning hours
42
Causes of secondary HTN
CKD, Coarc of Aorta, Cushing's, pheochromocytoma, aldosteronism, sleep apnea, thyroid/parathyroid disease Most common cause is Renal Artery Stenosis
43
Drug class for HTN in African Americans
Ca Channel Blockers
44
Post MI drugs
ASA, Statin, BB, ACE-I (for first 6 weeks post-MI)
45
Goal INR for pts. with afib on coumadin
2.0-3.0
46
Goal INR for pts. with artificial valve on coumadin
2.5-3.5
47
Chads-2 score
CHF, HTN, Age \>75, DM, Hx of stroke
48
Duke criteria for endocarditis
Two major or one major and 3 minor or 5 minor: Major: positive cultures consistent with IE organisms,evidence of cardiac involvement (echo, new regurg) Minor criteria: Predisposing heart condition or IV drug use, Fever \> 38.0, vascular phenomena: major arterial emboli septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjuncitval hemorrhages, and Janeway lesions Immunologic phenomena: glomerulonephritis, Osler's nodes, Roth spots and rheumatoid factor Microbiological evidence: positive blood culture but does not meet a major criterion as noted above or serological evidence of active infection with organism consistent with IE Echocardiographic findings: consistent with IE but do not meet major criterion
49
Assess patients prior to administering SL NTG about what medication
phosphodiesterases (sildenafil or Viagra class)
50
Hepatojugular reflux
Have patient positioned at 45 degrees and press on liver, if JVP rises \>3 is a positive test Indications: Tricuspid regurg, congestive heart failure
51
Jugular Venous Pressure
Normal \< 8 cm Measure with patient at 45 degrees and measure highest impulse of jugular vein from angle of Louis on sternum. Then add 5 cm (measurement from RA to sternum)
52
Critical Aortic Stenosis Triad
Angina, Heart failure, and exertional syncope
53
V1- V4 represent
V1 & V2 septum V3 & V4 anterior Left anterior descending
54
Normal RA pressure
0-7
55
Normal RV pressure
20-30/0-5
56
Normal PA pressure
20-30/8-12 Mean \< 20
57
SvO2 range
60-80% Mixed venous oxygen saturation
58
SVR
resistance of blood flow by systemic vasculature 900-1300
59
Cardiac output range
4.8-6.4 L per minute
60
Cardiac Index (CI)
Cardiac output/ Body surface area
61
62
Drug class used for DM and HTN should use
ACE inhibitor
63
Pts. with CAD and HTN should use what class
Beta-blocker
64
Drug class used for HTN in African Americans
Calcium Channel Blocker
65
Hydrostatic pressure
Pushes water out of the vessel The PCWP is a measure of hydrostatic pressure
66
Oncotic pressure
pulls water into the vessel

ACNP REVIEW (32 decks)

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