CV 2

Question 1

renin in olders adults

Answer 1

older adults tend to produce less renin - ACE-Is are effective HTN first line meds in pts who produce a lot of renin, so maybe go with CCB first in older adults

Question 2

common early finding in pts who have chronic AR is

Answer 2

hypertrophied left ventricle

Question 3

BP in patients with AR

Answer 3

elevated SBP and decreased DBP - termed wide pulse pressure

Question 4

most common adult murmur

Answer 4

MVP

Question 5

measure what while on warfarin

Answer 5

INR

Question 6

how long to hold warfarin when high

Answer 6

generally one or two doses may be omitted before rechecking INR and resuming warfarin or decreasing the dose

Question 7

ED is associated with what BP med

Answer 7

thiazide diuretics - specifically chlorthalidone

Question 8

metoprolol is a ___ beta blocker

Answer 8

cardioselective

Question 9

natural course of AR

Answer 9

long asymptomatic period with slowing of activities but remains essentially asymptomatic then SOB with activity and finally SOB at rest

Question 10

an immune response to group A strep infection involving the heart is

Answer 10

rheumatic fever

Question 11

preferred initial HTN med for non-black pt

Answer 11

ace

Question 12

which HTN med is not preferred in DM patients and why

Answer 12

BB as they may mask the s/sx of hypoyglycemia

Question 13

NSAIDs and HF

Answer 13

NSAIDs cause sodium retention and thus water retention - one dose may not cause issues but repeated doses are likely to produce water retention

Question 14

after a myocardial event what meds should be started daily
4

Answer 14

ASA
ACE I
BB
statin

Question 15

cough from an ACE usually occurs when

Answer 15

within two weeks of starting therapy

Question 16

if a patient’s lipids are elevated, what should be performed and why

Answer 16

TSH is evaluated - if the TSH is elevated, it may be secondary cause of hyperlipidemia. It is considered safe practice to NOT treat elevated lipids until the TSH level has decreased to at least 10 mU/L. If lipids are still elevated then you treat them.

Question 17

two groups of people that have adverse effects of Na consumption > 2G day

Answer 17

African Americans
Older adults

Question 18

BP meds that can cause urinary incontinence and why

Answer 18

CCB - CCBs block the up-take of calcium into cells which is needed for muscle contraction. This can decrease muscle contraction of urinary muscles leading to urinary incontinence. If this is occurring, you can lower the CCB dose, try a different class of medication, or use incontinence products

Question 19

most common ailments in older adults
2

Answer 19

HTN
arthritis

Question 20

BP should be screened how often

Answer 20

annually

Question 21

two meds recommended for starting tx in patients with ISH

Answer 21

long-acting CCB, specifically those that end in -pine and thiazide diuretics

Question 22

thiazide-type diuretics produce an average decrease of how many points in SBP

Answer 22

2-8

Question 23

when to check K after starting ACE I

Answer 23

1 month

Question 24

classic symptoms of DVT
3

Answer 24

swelling
pain
discoloration in lower leg

Question 25

BP trends with age

Answer 25

as age increase > 60 years, SBP increases and DBP decreases

Question 26

pulse pressure measurement greater than 60-70 points indicate what

Answer 26

stiffening of the vessels

Question 27

the usual course of MVP is ___

Answer 27

benign

Question 28

mitral valve issue that usually results in HF

Answer 28

MR

Question 29

what age for HR 60-100 in child

Answer 29

age 10

Question 30

age to start screening BP

Answer 30

3

Question 31

when two or more risk factors for GI bleed are present (> 75 yrs old, hx of GI bleed, warfarin use, daily NSAID use, chronic steroid use), ASA should not be added without what

Answer 31

some form of protection for the GI tract - misoprostol or daily PPI

Question 32

Echo is best for evaluating what
4

Answer 32

valves
chamber size
cardiac output
overall function of myocardium

Question 33

3 dx that indicate starting ACE-I

Answer 33

HTN
DM with proteinuria
HF