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Internal Med Rotation > Cardiovascular > Flashcards

Flashcards in Cardiovascular Deck (35):
1

what is isolated systolic hypertension?

systolic pressure >160 with a diastolic pressure <90

2

what initial labs should be drawn with a hypertensive patient

serum creatinine
postassium
glucose
fasting lipid profile
UA
electrocardiogram

3

A ratio of aldosterone to plasma reinin activity (PRA) greater than what is suggestive of primary aldosteronism.

20

4

if a patient presents w/ HTN, hypokalemia and difficult to control BP what should they be evaluated for?

primary aldosteronism

5

how are aldosterone levels attempted to be suppressed?

high sodium diet

6

If a patient has difficult to control BP, spells of palpitations, HA and marked elevated BP what should be suspected?

pheochromocytoma

7

What test is highly sensitive for pheochromocytomas?

plasma metanephrines

8

What are diastolic pressures <65 associated with?

increased stroke risk

9

IV meds for hypertensive emergencies

labetalol (alpha/ beta blocker)
nicardipine (CCB)
fenoldopam (dopamine-1 agonist)

10

when should antihypertensive meds be started in patients who don't attain BP goals w/ lifestyle changes?

after 6-12 months of nonpharm therapy

11

ADR of diuretics

urinary frequency
muscle cramps

12

ADRs of ACE inhibitors

cough
angioedema

13

ADR of beta blockers?

bradycardia sexual dysfunction

14

what is an alpha-2 agonist used for BP?

clonidine

15

what are alpha-1 antagonists?

doxazosin, terazosin

16

what is used to treat primary aldosteronism?

aldosterone antagonist (sprionolactone)

17

most commonly affected valvues for valvular heart disease

aortic and mitral

18

aortic valvue disease is more common in what sex?

male

19

most common cause of valvular heart disease?

rheumatic fever

20

do stenotic valvular lesions lead to pressure overload or volume overload?

pressure

21

symptoms seen with aortic stenosis

exertional angina
effort-related syncope
dysnpea (from LV systolic/ diastolic dysfunction)

22

symptoms seen w/ aortic regurgitation

foreceful heartbeat/ palpitations (increased LV stroke volume)
angina
exertional dyspnea

23

what valvular condition can present w/ exertional dyspnea, palpitations, hemoptysis

mitral stenosis

24

what valvular disease present with a systolic, crescendo-decresendo at upper sternal border?

aortic stenosis

25

what valvular problems presents with a diastolic rumbe at LV apex?

mitral stenosis

26

what valvular condition presents w/ holosytolic murmur at LV apex that radiates to axilla?

mitral regurgitation

27

what type of valvular problems presents with a decrescendo diastolic "blow" parasteneral

aortic regurgitation

28

what are some peripheral manifestations of increased pulse pressure (associated w/ aortic regurgitation)

pulsatile flow in nail beds
head bobbing
rapidly rising falling carotid pulse
bobbing uvula

29

Diagnostic studies for valvular heart diseases

EKG
chest x-ray
echo

30

treatment for mitral stenosis

heart rate control (beta blockers or CCB)

31

treatment for acutely symptomatic mitral regurg

afterload reduction- nitroprusside or hydralazine
diuretics

32

treatment for aortic regurgitation

afterload reduceion w/ ACEI or CCB

33

what signals the development of tight mitral stenosis

short S2 to OS interval, prolonged diastolic murmur, left arterial enlargement

34

what toxicity should be considered in patients presenting w/ a-fib w/ regular ventricular response?

digoxin

35

bradyarrythmias w/ progressively increasing PR intervals before a dropped QRS complex

Type-1 second degree block (Wenckebach)