Cardiology CE 2

Question 1

CCB and HF

Answer 1

Calcium makes muscles contract and the heart is a muscle. We do no want HF patients on a CCB bc it will decrease the force of contraction and the heart is already failing - d/c this medication

Question 2

HF and NSAIDs

Answer 2

NSAIDs increase water retention. We don’t want HF patients to have extra water on board.

Question 3

HF clinical s/sx
7

Answer 3

1. resting tachycardia
2. abnormal EKG
3. tachypnea
4. crackles
5. diaphoresis
6. S3 and/or S4
7. peripheral edema may be present

Question 4

HF - fluid fills where first

Answer 4

thorax so first s/sx are usually thorax related - listen to the heart and lungs

Question 5

HF - BLE edema is a ___ response

Answer 5

late response

Question 6

AAA is diagnosed when what

Answer 6

the aortic diameter exceeds 3.0 cm (usually about 2 cm)

Question 7

ruptured AAA is estimated to cause what percent of sudden deaths

Answer 7

4-5%

Question 8

AAA - how to assess
3

Answer 8

listen to lower abd for bruit
palpate for mass with pulsation
get an US

Question 9

pulsatile mass in the abd in asymptomatic cases =

Answer 9

AAA

Question 10

age to screen for AAA regardless of family history or smoking

Answer 10

65-75

Question 11

AAA risk factors include
5

Answer 11

1. 65 or older
2. smoking history
3. male
4. white
5. family history

Question 12

which valves cause most adult murmurs

Answer 12

aortic and mitral valves

Question 13

which valves cause most childhood murmurs

Answer 13

pulmonic and tricuspid

Question 14

stenotic valves

Answer 14

don’t open properly

Question 15

regurgitant valves

Answer 15

don’t close properly

Question 16

diastolic murmur always needs a ___

Answer 16

referral

Question 17

systolic murmurs
4

Answer 17

1. mitral regurgitation
2. physiologic murmur
3. aortic stenosis
4. MVP

Question 18

diastolic murmurs
2

Answer 18

1. aortic regurgitation
2. mitral stenosis

Question 19

aortic stenosis associated findings
3

Answer 19

Think ASC -
angina
syncope
CHF

Question 20

aortic stenosis - 2nd most common cause

Answer 20

rheumatic fever

Question 21

aortic stenosis heart sound

Answer 21

usually audible S4

Question 22

aortic regurgitation associated physical exam findings
4

Answer 22

angina
CHF
dizziness
CP

Question 23

aortic regurgitation most common causes
4

Answer 23

1. rheumatic heart disease
2. congenital deformity
3. aortic root abnormalities
4. syphilis

Question 24

aortic stenosis PP

Answer 24

narrow PP

Question 25

aortic regurgitation PP

Answer 25

very wide

Question 26

mitral stenosis associated findings
2

Answer 26

dyspnea
a fib

Question 27

murmur - a fib think

Answer 27

mitral stenosis

Question 28

mitral stenosis etiology

Answer 28

rheumatic fever

Question 29

mitral stenosis physical exam includes
2

Answer 29

1. loud S1
2. apical diastolic murmur radiating toward axilla

Question 30

mitral regurgitation associated findings
3

Answer 30

SOB
fatigue
HF

Question 31

mitral regurgitation etiology
5

Answer 31

1. usually congenital condition
2. rheumatic heart disease
3. acute endocarditis
4. MVP
5. calcified annulus

Question 32

MVP associated physical exam findings
3

Answer 32

palpitations
chest pain
CLICK

Question 33

murmur - CLICK, think?

Answer 33

MVP

Question 34

MVP etiology - most common in who

Answer 34

women 14-30 years

Question 35

MVP heard best where

Answer 35

click heard best at the apex and left sternal border

Question 36

murmur - accentuated with standing, quieter with squatting

Answer 36

MVP

Question 37

Ankle brachial index (ABI) compares what

Answer 37

BP at ankle and at arm

Question 38

ABI normal range

Answer 38

1-1.4

Question 39

ABI >1.4 suggest

Answer 39

noncompressible calcified vessel

Question 40

ABI < 0.9 suggest

Answer 40

PAD

Question 41

ABI <0.5 suggests

Answer 41

severe PAD

Question 42

murmur you hear when the heart is growing and stretching such as in a young adult

Answer 42

physiologic murmur