Cardiac Disorders

Front 1

Total cholesterol values

Back 1

Desireable: <200 mg/dL

Borderline high: 200- 239 mg/dL

High: >200 mg/ dL

Front 2

LDL lab values

Back 2

Optimal: <100mg/dL

Normal: 100 - 129 mg/dL

Borderline High: 130- 159 mg/dL

High: 160- 189 mg/dL

Very High: >190 mg/dL

Front 3

JNC7 Blood Pressure Guidelines

Back 3

Normal systolic 120- 139 diastolic <80

Prehypertension S: 140- 159 D: 80-89

Hypretension Stage 1 S: 140-159 D: 90-99

Hypertension Stage 2 S: >160 D: >100

Front 4

HDL Lab Values

Back 4

Low level, High risk: <40 men <50 women

Average risk: 40-50 men 50-60 women

High level, low risk : >60 men and women

Front 5

Which organs are commonly affected by longterm uncontrolled hypertension

Back 5

Brain (stroke)

Eyes (retinoaty, AV nicking, bleeding, blindness)

Heart (heart disease, left ventricular hypertrophy, MI, CHF)

Kidneys (renal failure, proteinuria)

Front 6

Statins

Back 6

atovastatin (Lipitor)

rosurvastatin (Crestor)

simvastatin (Zocor)

Front 7

Hypertension Treatment

Back 7

1. Thiazide Diuretic "-ide"

2. ACE "prils"

3. ARB "sartan"

4. BB "lol"

5. CCB "pine"

Front 8

Cozaar interactions

Back 8

Tagamet increase serum levels

Diflucan decreases efficacy of Cozaar

oxipurinol increase risk of enal calculi

grapefrut delays absorption

Front 9

S2 heart sound

Back 9

Closing of aortic and pulmonic valve

systole to diastole

"lub dub"

Front 10

S1 heart sound

Back 10

Closing of mitral and tricuspid valves

diastole to systole

Front 11

Clinical Signs and symptoms of heart failure

Back 11

resting tachycardia

narrow pulse pressure <25

tachypnea

crackles

diaphoretic

S3 and/or S4 heart sound

peripheral edema (late sign)

Front 12

Systolic Murmurs

Back 12

Mr. Peyton Manning as MVP

Mr. - Mitral Regurgitation

Peyton Manning- Physiologic Murmur

As- Aortic Stenosis

MVP- Mitral Valve Polapse

Front 13

Diastolic murmurs characteristically begin with ___ heart sounds and terminate with or before ___ heart sound

Back 13

Begin with S2

Terminate with or before S1

Front 14

Palpations and chest pain

"Click" heard at mitral listening point

Back 14

Mitral Valve Prolapse

Front 15

Middle age older adult male complains of midsternal chest pain that feels like heavy pressure on chest. Numbness and tingling felt in left jaw and arm. Diaphoretic, cool, clammy skin.

Back 15

Acute Myocardial Infarction

Front 16

Eldely white male complains of pulsating type senation in abdomen and low back. Pain becomes sharp and excrutiating

History of smoking and hypertention

Back 16

Dissecting Abdominal Aortic Aneruysm (AAA)

Front 17

Elderly patient complains of acute onset of dyspnea, fatigue, dry cough, and swollen feet and ankles with gradual weight gain. Lung exam reveals crackles. S3 heart sound heard. History of CAD and prior MI

Back 17

Congestive Heart Failure (CHF)

Front 18

Patient presents with fever, chills, malaise that is asociated with new murmur and absupt onset of CHF. Subunual hemorrhages on nailbeds, petachiae on palate, painful violet colored nodes on fingers and feet tender spots on palms/ soles

Back 18

Bacterial endocarditis

Front 19

Diastolic Murmurs

Back 19

Ms. ART

Ms. - Mitral Stenosis (low pitched rumbling)

AR- Aortic regurgitation (high pitched)

ALWAYS indicative of heart disease

Front 20

Sudden palpitations with weakness, dizziness, syncope, and dyspnea

Back 20

Cardiac arrythmias- atrial fibrillation

Front 21

Patient complains of abrupt onset of palpitations, rapid pulse, lightheadedness, shortness of breath, anxiety

Pulse: 200 BPM

EKG: Peaked QRS with P waves present

Back 21

Paroxysmal Atrial Tachycardia

Front 22

Paroxysmal Atrial Tachycardia causes

Back 22

digitalis

toxicity

alcohol

hyperthyroidism

caffeine

illegal drugs

Front 23

Paroxysmal Atrial Tachycardia treatment

Back 23

Tell patient to hold breath and strain hard

Carotid massage

Splash ice on face (valsalva maneuver)

Front 24

Left Ventricular Heart Failure Symptoms

Back 24

crackles, rales, cough, dyspnea, diminished breath sounds, dullness to percussion

paroxysmal nocturnal dyspnea, othopnea, nocturnal nonproductive cough, wheezing

HINT: LEFT for LUNG

Front 25

Right Ventricular Heart Failure Symptoms

Back 25

jugular vein distention

enlarged spleen, enlarged liver

extreme edema

HINT: RIGHT for GI

Front 26

CHF treatment

Back 26

Lasix 20mg- 320 mg daily

Nitroglycerin

ACE, ARB, BB, Digoxin

Front 27

Older patient with history of smoking and hyperlipidemia complains of worsening pain on ambulation that is relieved by rest. Overtime symptoms worse until walking is limited.

Back 27

Peripheral vascular disease

Front 28

Diagnostic Tests for Peripheral Vascular Disease

Back 28

Initial: ankle and bradial BP before and after exercise

Doppler flow study

Angiography- gold standard

Front 29

Adult, tall and thin female patient complains of fatigue, palpations, and lightheadedness that is aggravated by heavy exertion. S2 click followed by systolic murmur

Back 29

Mitral valve prolapse

Front 30

Mitral valve prolapse treatment

Back 30

asymptomatic- no treatment, monitor

symtomatic-

Betablockers

avoid caffeine

avoid alcohol and cigarettes

Front 31

No P Wave present on EKG

Back 31

atrial fibrillation

Front 32

Pathologic Q waves present on EKG

Back 32

Myocardial Infarction

Front 33

ST segment elevation with tall peaked T wave on EKG

Back 33

Myocardial Injury

Front 34

Low frequency sound heard late in diastole

Rare in children and infacnts

Always pathological and seen in conditions with decreased in ventricular compliance

Back 34

S4 heart sound

Front 35

High pitched diastolic murmure which is best heard at the second intercostal space at the right side of the sternum. Harsh and noisy murmur that radiate to neck

Back 35

aortic regurgitation

Front 36

Murmur Grades

Back 36

II / VI - Quite but hear as soon as stethoscope is placed on chest

III / VI - Moderately loud

IV/ VI - Loud with palpable trill

V/ VI - Very loud and heard with stethoscope partially off chest

Front 37

First line treatment for essential tremors

Back 37

betablockers - prolanolol

Front 38

What is the significance of the S4 heart sound

Back 38

it is a marker of poor diastolic function, most often in poorly controlled hypertension or recurrent myocardia ischemia

Front 39

elevated calcium level causes

Back 39

hyperparathyroidism

Front 40

medical history risk factors associated with CHF

Back 40

CAD

renal disease

COPD

hypertension

previous MI

vascular disease

severe anemias

Front 41

low frequency heart sound heard late in diastole

Back 41

S3

Front 42

cyanotic heart defects

Back 42

truncus arteriosus

Front 43

acyanotic heart defect

Back 43

aortic valvular lesions

patent ductus arteriosus

atrial septal defect

Front 44

parasystolic murmur that is best heard at the apex or apical area, radiates to axilla and is loud-blowing and high pitched

Back 44

mitral regurgitation