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NP Family > Cardiac > Flashcards

Cardiac Flashcards

1
Q

What does an S3 sound indcate?

A

CHF or pregnancy

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2
Q

What is S4 a sign of? Sounds like Tennessee.

A

LVH or elderly with stiff arteries

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3
Q

Murmur heard moderately loud with stethoscope plus a thrill.

A

Grade 4 murmur

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4
Q

A loud murmur heard without a stethoscope.

A

Grade 6 murmur.

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5
Q

Aortic stenosis is a _____ murmur that radiates to the ____.

A

systolic, neck

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6
Q

Mitral regurgitation is a _____ murmur that radiates to the ______.

A

systolic, axilla

best heard at apex during S1

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7
Q

What is the gold standard to rule out AAA in 65 and older who smokes.

A

Ultrasound.

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8
Q

What do you prescribe for HTN in someone who also has osteoporosis.

A

thiazide

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9
Q

HTN drug for a diabetic with neuropathy

A

ACE or ARB

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10
Q

AV nicking is a sign of ______.

A

hypertension

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11
Q

Elderly patient with an isolated systolic hypertension BP log. What medication do you start?

A

CCB.

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12
Q

What test is used for PAD?

A

brachial index

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13
Q

Edema, thick and discolored lower extremities describes what?

A

Chronic venous insufficiency.

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14
Q

What test is used for stable angina?

A

Stress test.

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15
Q

Moderately loud with stethoscope. No thrill. Is what grade murmur?

A

grade III murmur.

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16
Q

Patient with gradual onset fever, hemorrhages on nail beds (subungual hemorrhages), painful red raised nodules on fingers/feet (Osler nodes), tender, red spots on soles/palms (Janeway lesions).

A

Bacterial endocarditis.

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17
Q

A carotid bruit signifies what?

A

narrowing of the carotid.

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18
Q

amlodipine

A

CCB

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19
Q

diltiazem (Cardizem)

A

CCB

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20
Q

verapamil

A

CCB

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21
Q

nifedipine (Procardia)

A

CCB

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22
Q

chlorthalidone

A

thiazide diuretic

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23
Q

hydrocholorthiazide

A

thiazide diuretic

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24
Q 
atenolol
labetalol
metoprolol
bisoprolol
carvedilol
propranolol
Beta Blocker or Alpha-Beta blocker?
A 
atenolol- BB
labetalol- Alpha
metoprolol- BB
bisoprolol- BB
carvedilol- Alpha
propranolol- BB
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25
Q

enalapril

A

Ace inhibitor

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26
Q

lisinopril

A

Ace Inhibitor

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27
Q

captopril

A

Ace Inhibitor

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28
Q

losartan

A

ARB

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29
Q

valsartan

A

ARB

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30
Q

candesartan

A

ARB

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31
Q

hydralazine

A

vasodilator

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32
Q

What hypertension medication can cause a dry, hacking cough?

A

Ace inhibitors

33
Q

What HTN medication class is avoided in CHF?

A

CCB

34
Q

What HTN med class is avoided in asthma or COPD patients?

A

Beta Blockers

35
Q

What does a positive Homan’s sign indicate?

A

DVT

(+) test with lower leg pain with dorsiflexion of foot

36
Q

pain worse on ambulation (intermittent claudication), pain relieved by rest, shiny and hyperpigmented ankles that are hairless and cool, decreased pedal pulse
venous insufficiency or arterial insufficiency?

A

Peripheral arterial disease symptoms

37
Q

S2 click with late systolic murmur

A

mitral valve prolapse (MVP)

38
Q

normal LDL levels

A

< 100

39
Q

normal HDL level

A

> 50

40
Q

normal triglyceride level

A

<150

41
Q

When to start Niacin or Fibrate?

A

when triglycerides over 500

42
Q

Start statin if ASCVD risk over _____%
LDL > _____
diabetic with LDL ____-_____.

A

ASCVD risk over 7.5%
LDL > 190
DM + LDL 70-189

43
Q

definition of coarctation of aorta

A

congenital defect, aorta is narrower than usual

DX: echo

44
Q

symptoms of coarctation of aorta

A

HTN, lower extremities pulses are weak compared to upper pulses, murmur present

45
Q

where do you best hear a split S2 sound?

A

pulmonic area

2nd ICS, left sternal border

46
Q

What BP med should you wean off to avoid rebound HTN?

A

Beta blockers

47
Q

Xanthelasma

A

lesions of the eyelids assoc. with high cholesterol

48
Q

What is an abnormal ankle-brachial index score? And what does it screen for?

A

less than 1.0

Peripheral artery disease

49
Q

What two HTN meds would you choose to start an 90 year old woman on?

A

CCB or thiazide diuretics

50
Q

Pulsus paradoxus is the _______ in _______ pressure during __spiration.

A

decrease in systolic pressure during inspiration

51
Q

closing of the semilunar valves is S1 or S2?

A

S2

S1 is atrioventricular valves closing

52
Q

HTN meds preferred for Af Americans

A

CCB or thiazides

53
Q

BP goal for all races/ages under 60?

Or if they’re over 60 with DM or CKD.

A

140/90

54
Q

BP goal for over 60 y.o.

A

150/90

55
Q

Arteriovenous nicking– on examination of the eye, a small ______ is seen crossing a small ______, which results in the compression of the _____ with bulging on either side of the crossing.

A

artery, vein, vein

56
Q

What HTN med would you prescribe a person with HTN and osteoporosis?

A

thiazide diuretic

57
Q

What is there an increased risk of when triglycerides are over 500?

A

pancreatitis

58
Q

A carotid bruit is cause by carotid ______.

A

stenosis (plaque accumulation)

59
Q

Where do you hear aortic stenosis best?

A

2nd ICS, R side

60
Q

Rule out ______ ________ in females with mitral valve prolapse.

A

Marfan’s Syndrome

61
Q

What grade murmur is the first time a thrill is felt?

A

Grade 4

62
Q

T/F:

Do not mix statins with grapefruit juice.

A

true

63
Q 
Which two are high intensity statins?
Rosuvastatin
Simvastatin
Atorvastatin
Pravastatin
A

Rosuvastatin

Atorvastatin

64
Q

What labs should be monitored while on statins?

A

LFTs

65
Q

What effects do thiazides have on…

  • blood sugar
  • triglycerides
  • potassium
  • gout
A

elevates sugar
elevates triglycerides
lowers potassium
elevates uric acid

66
Q

what can pulses paradoxus lead to?

A

asthma, emphysema, pericarditis, cardiac effusion

67
Q

What are the starting doses of warfarin (Coumadin) for Afib in people under and over age 70?

A

under age 70 start at 5mg

over age 70 start at 2.5mg

68
Q

When do give Vitamin K?

A

INR over 5.0

69
Q

Goal INR for Afib?

Goal INR for prosthetic valves?

A

2-3

2.5-3.5

70
Q

What is the gold standard for diagnosis of PAD?

A

angiography

71
Q

low ext. edema, ruddy colored, dull and achy, ulcers, warm to the touch, with pedal pulses present is PAD or PVD?

A

PVD

72
Q

test for PVD?

A

ultrasound

73
Q

Who and what do you screen for AAA?

A
  • men aged 65-75 who have ever smoked

- abdominal ultrasound

74
Q

Heart block as a prolonged _____ interval.

A

PR interval

75
Q

HTN meds ok for 1st degree heart block

A

BB and CCB

only for 1st degree though

76
Q

Is right or left side HF caused by pulmonary hypertension and results in edema and/or ascites?

A

Right HF

77
Q

Which side HF (R or L) has symptoms of SOB, fatigue, weakness, rapid or irregular heartbeat, reduced ability to exercise, persistent cough or wheezing with white or pink blood-tinged phlegm?

A 
Left HF
(left = lung)
78
Q

treatment for Left heart failure?

A

ACEi & Lasix

79
Q

What med is used for CAD prevention in the elderly?

A

aspirin

NP Family (19 decks)

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