Cardiovascular Flashcards Preview

Boards > Cardiovascular > Flashcards

Flashcards in Cardiovascular Deck (186):
1

s/s of MI in women

dyspnea, fatigue, back pain, nausea

2

s/s of AAA

pulsating-type sensation in abd or lower back

3

risk factors for AAA

elderly white male, hx of HTN, smoker

4

s/s of CHF

dyspnea, fatigue, swollen feet/ankles, lung crackles, S3 heart sound

5

painful violet-colored nodes on the fingers or feet in those with bacterial endocarditis

Osler nodes

6

tender red spots on the palms/soles in those with bacterial endocarditis

Janeway lesions

7

where is the apical pulse

5th intercostal space at midclavicular line

8

flow of blood in the heart

vena cava--> right ventricle --> tricuspid valve --> right ventricle --> AV valve --> pulmonary artery --> the lungs --> pulmonary veins --> left atrium --> mitral valve --> left ventricle --> aorta

9

S1 is the

closure of the mitral and tricuspid valves

10

S2 is the

closure of the pulmonic and aortic valves

11

mneumonic to remember type of valves

MOTIVATED APPLES:
Mitral
Tricuscpid
AV valves (3 leaflets)

Aortic
Pulmonic
Semilunar valves (2 leaflets)

12

S3 sounds like

KENTUCKY

13

S3 is only abnormal in those

greater than 35

14

S4 is caused by

stiff left ventricle

15

Sign of left ventricular hypertrophy

S4

16

atrial gallop or atrial kick

S4

17

ventricular gallop

S3

18

S4 sounds like

Tennessee

19

the bell of the stethoscope is to hear for

extra heart sounds (S3 or S4), mitral stenosis

20

heart sound that can be normal in the elderly

S4

21

Mnemonic for systolic murmurs

Mr. Peyton Manning AS MVP (Mitral regurgitation, Physiologic murmurs, aortic stenosis, mitral valve prolapse)

22

Mnemonic for diastolic murmurs

ARMS (aortic regurgitation, mitral stenosis)

23

These murmurs are ALWAYS indicative of heart disease

diastolic murmur

24

Also called the "opening snap" and is best heard with ___

mitral stenosis; bell of stethescope

25

murmur grade where a thrill is first heard

grade IV

26

____ murmurs are always abnormal; whereas ____ murmurs are usually benign

diastolic; systolic

27

mitral regurgitation murmur radiates to the

axilla

28

aortic stenosis murmur radiates to the

neck

29

A split S2 is best heard at the

pulmonic area

30

When afib is intermittent and terminates in 7 days or less; asymptomatic

paroxysmal afib

31

amiodarone has a black box warning for

pulmonary and liver damage

32

simvastatin and amiodarone together can cause

rhabdomyolysis

33

INR for those with prosthetic valves

2.5-3.5

34

diet teaching for those on coumadin

only one serving per day of foods high in vitamin K ("greens": kale, collards, mustard, turnip, spinach, romaine lettuce, brussel sprouts)

35

treatment for paroxysmal atrial tachycardia (PSVT)

Valsalva, carotid massage, splashing cold water on face

36

what is paradoxical pulse

when the apical pulse is still heard but no radial pulse can be palpated

37

If INR is between 3-5, then

skip one dose, may need to decrease maintenance dose, recheck every 1-2 days until normal

38

If INR is between 5-9, then

hold dose and give either small dose of oral vitamin K OR skip the next 1-2 doses. Recheck INR daily until normal.

39

screening in BP for those with normal BP

every 2 years

40

screening in BP for those with prehypertension

every year

41

Prehypertension

SBP 120-139, DBP 80-89

42

Stage I HTN

SBP 140-159, DBP 90-99

43

Stage II HTN

SBP greater than 160, DBP greater than 100

44

eye changes in those with HTN

copper and silver arterioles; AV nicking; papilledema

45

can cause HTN in young adults

renal artery stenosis

46

how to check for coarctation of the aorta

check radial and femoral pulse at same time

47

Goal BP for those greater than 60 without hx of DM or CKD

less than 150/90

48

Goal BP for those less than 60 without hx of DM or CKD

less than 140/90

49

Goal BP for those with DM or CKD

less than 140/90

50

first line of trx in those with HTN and CAD

ACE or ARB

51

first line of trx in those with HTN post-MI

beta blocker

52

first line of trx in those with HTN with hx of heart failure or CHF

thiazide

53

dietary source of magnesium

dried beans, whole grains, nuts

54

where loop diuretics have effect

Loop of Henle

55

ex of loop diuretics

furosemide (Lasix), bumetanide (Bumex)

56

ex of aldosterone receptor antagonist diuretics

spironolactone

57

MOA of spironolactone

antagonizes effect of aldosterone --> increase water elimination and conserves potassium

58

Side effect of spironolactone

gynecomastia, hyperkalemia, vomiting/diarrhea

59

contraindications to spironolactone

high K+, renal insufficiency, DM with microalbuminuria

60

avoid abrupt discontinuation of this BP med

beta blockers: can cause rebound HTN

61

Beta1 receptors are specific to the ____ ; and beta2 receptors are specific to the ____

heart; lungs and peripheral vasculature

62

contraindications to beta blocker use

asthma, COPD, second/third degree block

63

Do not use this beta blocker to treat HTN as it has a short half-life

propranolol (Inderal)

64

side effects of CCB

headaches, ankle edema, bradycardia

65

one side of effect of nifedipine is

reflex tachycardia

66

The nondihydropyridine CCBs MOA

Decrease HR, a little BP

67

The dihydropyridine CCBs MOA

Decrease BP, doesn't hurt pulse

68

ex of nondihydropyridine CCB

verapamil and diltiazem

69

ex of dihydropyridine CCB

nifedipine and amlodipine

70

MOA of ACEI and ARBS

block conversion of angiotensin I to II (a potent vasoconstrictor)

71

BP med that is contraindicated in pregnancy

ACEI and ARB

72

side effects of ACEI and ARB

dry hacking cough, hyperkalemia, angioedema

73

This med is contraindicated in renal artery stenosis

ACEI or ARB

74

ex of ARB

losartan

75

MOA of alpha-adrenergic blockers

vasodilation

76

common side effects of alpha-adrenergic blockers

dizziness and hypotension

77

first dose orthostatic hypotension is common in this medication

alpha-adrenergic blocker

78

administration of alpha-adrenergic blockers

give a bedtime, start at low doses and titrate slowly

79

first choice medication for a male with HTN and BPH

alpha-adrenergic blockers

80

MOA of diuretics

decrease volume and preload

81

This BP medication has a sulfa component and should be avoided in patients with sulfa allergy

thiazide diuretics

82

Has a favorable effect for those with HTN and osteopenia/osteoporosis

thiazide diuretics

83

side effects of thiazide diuretics

hyperglycemia, hyperuricemia, high cholesterol, hypokalemia, hyponatremia

84

examples of thiazide diuretics

HCTZ, chlorthalidone

85

these two BP med combinations can increase risk of hyperkalemia

ACEI and spironolactone

86

CHF is an EF less than

40%

87

normal JVD is less than

4 cm

88

If a patient with CHF has no limitations of physical activity, they are classified as

Class I

89

If a patient with CHF has ordinary physical activity that results in fatigue, and exertional dyspnea, then they are classified as

Class II

90

If a patient with CHF has marked limitation in physical activity, then they are classified as

Class III

91

If a patient with CHF has symptoms at rest with or without physical activity, then they are classified as

Class IV

92

risk factors of DVT

oral contraception use, inactivity for more than 3 hours, CHF, pregnancy, bone fx in long bones, trauma, recent surgery

93

s/s of DVT

swelling of extremity that is painful, red, and warm.

94

gold standard to diagnose DVT/PE

contrast venography

95

Trx for DVT/PE

heparin IV, then warfarin PO for at least 3-6 mo

96

risk factors for superficial thrombophlebitis

catheter, IV potassium, Staph aureus infection

97

s/s of superficial thrombophlebitis

indurated, cordlike vein that is warm, red, and tender to touch

98

trx for superficial thrombophlebitis

NSAIDS (ibuprofen, Anaprox DS/naproxen), warm compresses

99

intermittent claudication

worsening pain on ambulation that is relieved by rest

100

golden standard for dx of peripheral vascular/arterial disease

angiography

101

Pentoxifylline (Trental) is indicated for

peripheral vascular/arterial disease

102

reversible vasospasm of the peripheral arterioles on fingers and toes

Raynaud's

103

s/s of Raynaud's

color changes that occur symmetrically in hands and feet, numbness/tingling with cold temperatures.

104

treatment for Raynaud's

nifedipine or amlodipine

105

important not to use these drugs in those with Raynaud's

Imitrex, decongestants, amphetamines

106

subungual hemorrhages

splinter hemorrhages on nailbed

107

s/s of endocarditis

subungual hemorrhages, Osler nodes, Janeway lesions, fever/chills

108

endocarditis prophylaxis is given to those with

prosthetic valves, heart transplant, invasive dental procedures

109

endocarditis prophylaxis is NO longer given to those with

mitral valve prolapse, GU/GI invasive procedures

110

endocarditis prophylaxis medication

amoxicillin 2 g PO x 1 (adults); amox 50 mg/kg (children) one hour before procedure;

111

treatment for MVP with symptoms

beta blockers, avoid caffeine/alcohol/smoking

112

normal cholesterol is less than

200

113

normal HDL is

greater than 40

114

normal triglycerides

less than 150

115

high risk of pancreatitis

triglycerides greater than 500

116

simvastatin drug interactions

grapefruit juice, antifungals, macrolides, amiodarone

117

serious complication of statins

rhabdomyolosis and drug-induced hepatitits

118

MOA of statins

decrease LDL and raise HDL

119

MOA of fibrates and nicotinic acid

reduces triglycerides and increases HDL

120

SE of fibrates

dyspepsia, gallstones

121

patient education for those with high triglycerides

reduce simple carbs, "junk food" and fried foods

122

patient education for those with low HDL

increase exercise, trial of OTC niacin

123

gemfibrozil (Lopid), Tricor

fibrate

124

Cholestyramine (Questran)

bile acid sequestrant

125

work on the small intestine and interfere with fat absorption (including fat-soluble vitamins A, D, E, and K).

bile acid sequestrant

126

side effects of bile acid sequestrant

bloating, gas, abd pain

127

labs for cholesterol meds

baseline LFTs

128

triad of rhabdomyolosis

muscle pain, weakness, red-brown urine

129

labs in rhabdomyolosis

high CK, proteinuria

130

high waist circumference in males

greater than 40 in

131

high waist circumference in females

greater than 35

132

criteria for metabolic syndrome

abdominal obesity, HTN, HLD

133

fatty liver or nonalcoholic fatty liver disease is caused by

triglyceride deposits in the liver

134

labs for fatty liver

elevated ALT and AST; Hep A, B, and C negative

135

treatment for fatty liver

weight loss, avoid hepatotoxic drugs (statins, tylenol), vaccination for Hep A&B

136

BMI calculation

weight/height2

137

when to screen for lipid disorders

men: 35, women: 45

138

normal BP in children

both systolic and diastolic are less than 90th percentile for gender, age, and height

139

when should BP meds be started in children

if lifestyle modifications fail in 6 months

140

management for statin therapy

baseline LFTs, CK does not need to be routinely measured

141

normal cholesterol in children is

below 75th percentile

142

abnormal cholesterol values in children

above 95th percentile

143

when to screen for dyslipidemia in children

age 9-11 and again at 17-21

144

systemic inflammatory illness that particularly affects medium-sized arteries, especially the coronary arteries

Kawasaki disease

145

s/s of Kawasaki disease

fever, conjunctivitis, strawberry tongue, rash, swelling of hands and feet

146

diagnostic for kawasaki disease

high ESR/CRP, thrombocytosis, leukocytosis.

147

screening for AAA

one time screening for all men 65-75 who have smoked

148

outpatient trx for DVT

LMWH then add warfarin for at least 5 days, can d/c LMWH once INR is therapeutic for at least 2 consecutive days

149

management of DVT

compression stockings after anticoagulant therapy initiated; early ambulation

150

s/s of arterial ulcers

painful; mostly on toes; necrotic

151

abnormal ABI

less than 0.90

152

s/s of venous ulcers

located between knee and ankle; mild pain; scaling, weeping, erythema

153

aortic regurgitation is best heard when

leaning forward or during Valsalva

154

location best heard for venous hum

under right clavicle

155

quality of venous hum

continuous murmur

156

location best heard for stills murmur

2-4th left ICS

157

quality of stills murmur

musical

158

characteristic of hypertropic cardiomyopathy

systolic murmur that gets louder when the patient stands

159

therapeutic range for digoxin

0.5-2.0

160

s/s of digoxin overdose

anorexia, N/V, abd pain, confusion, visual changes

161

examples of potassium sparing diuretics

triamterene, amiloride

162

adverse effects of beta blockers

bronchospasm, blunts hypoglycemic response, depression

163

med choices for african american with HTN

thiazide or CCB

164

med choices for non-black person with HTN

thiazide, CCB, ACEI, ARB

165

thiazide diuretic is good to treat

mild HTN

166

these people are known to have high renin states causing HTN

young white males

167

First line treatment for isolated systolic HTN

CCB

168

Side effect of HCTZ

erectile dysfunction

169

-pine drugs are

DHP CCB

170

DHP Calcium channel blockers decrease ____ and not the _____.

BP; pulse (Don't Hurt Pulse)

171

These people should be placed on a moderate to high statin

Hx of CHD or stroke;
LDL greater than 190;
DM, age 40-75;
10-year risk score greater than 7.5%

172

High potency statins

atorvastatin (Lipitor), rosuvastatin (Crestor)

173

Moderate potency statins

simvastatin (Zocor), pravastatin (Pravachol)

174

med contraindicated to give in heart failure

TZDs, CCB, naproxen

175

Areas of heart valves

Aortic;
Pulmonic;
Tricuspid;
Mitral

176

These valves don't open properly

stenotic valves

177

these valves don't close properly

regurgitant valves

178

s/s of aortic stenosis

syncope, angina, HF

179

murmur with an audible "click"

mitral valve prolapse

180

mitral valve prolapse can be common in

pregnant women; women 15-30.

181

causes of peripheral artery disease

diabetic, smoker, dyslipidemia, no exercise

182

trx for kawasaki disease

aspirin daily x 2 months to prevent MI

183

innocent murmur clues

less than grade II, softer when sitting than lying, musical quality

184

pathologic murmur clues

grade III or higher, harsh quality, increased intensity when standing

185

foods high in folic acid

spinach, liver, whole wheat bread

186

this BP med can increase blood sugars

thiazide diuretics