Cardio Hell 1

Front 1

____________of its mass lays to the left of the body’s midline

Back 1

2/3rds

Front 2

__________is formed by the tip of the left ventricle, a lower chamber of the heart and rests on the diaphragm

Back 2

Apex

Front 3

______ of the heart is its posterior surface

Back 3

The BASE

Front 4

The largest portion of the heart is the _________

Back 4

Left Atria

Front 5

The four pulmonary veins open into_______

Back 5

Left Atrium

Front 6

__________ receives the inferior and superior vena cava

Back 6

Right atrium

Front 7

__________surrounds and protects it AND holds the heart in place

Back 7

The Pericardium

Front 8

WHat are the two parts of the pericardium

Back 8

Fibrous and Serous

Front 9

This is the tough inelastic and outer connective tissue (outer)
1. This prevents overstretching of the heart
2. Provides Protection
3. Anchors the heart in place

Back 9

Fibrous Pericardium

Front 10

___________ is the thinner, delicate and forms double layer around the heart

Back 10

Serous Pericardium

Front 11

What are the two layers of the Serous Pericardium?

Back 11

Parital
Viseral

Front 12

This is the outer layer of the Serous Pericardium and it fused to the fibrous pericardium

Back 12

Partial Layer

Front 13

This is the Inner later of the serous pericardium (aka epicardium) adheres tightly to the surface of the heart

Back 13

Visercal Layer

Front 14

lays Between the Parietal and Viseral Layers of the heart and reduces friction between the membranes as the heart moves

Back 14

Pericardial Fluid

Front 15

___________ is the space that contains the pericardial fluid

Back 15

Pericardial Cavity

Front 16

What are the 3 layers of the heart?

Back 16

Epicardium (Viseral Layer)
Myocardium
Endocardium

Front 17

This is the visceral layer of the serous pericardium)-
i. is the thin transparent outer layer of the wall
ii. it is composed of mesothelium and connective tissue

Back 17

Epicardium

Front 18

i. consists of cardiac muscle tissue
ii. constitutes the BULK of the heart.
iii. This tissue is only found in the heart and is specialized in structure and function
iv. Responsible for the pumping action of the heart
v. Cardiac muscle fibers are involuntary, striated, branched and the tissue is arranged in inter lacing bundles of fibers

Back 18

Myocardium

Front 19

i. Thin layer of simple squamous epithelium that lines the inside of the myocardium.
ii. Covers the valves of the heart and the tendons attached to the valves
iii. It is continuous with the epithelial lining of the large blood vessels

Back 19

Endocardium

Front 20

a. Superior Vena Cava-brings back blood mainly from parts of the body above the heart
b. Inferior Vena Cava-brings back blood mostly from parts of the body below the heart
c. Coronary Sinus-drains blood from most of the vessels supplying the wall of the heart

Back 20

Veins that return blood to the heart

Front 21

These are abnormalities in cardiac rhythm and conduction and they are differentiated by rate

Back 21

Cardiac Arrhythmias

Front 22

_____________ can be dangerous because they decrease cardiac output and in turn they decrease brain and myocardial profusion

Back 22

Cardiac Arrhythmias

Front 23

Cardiac Arrhythmias can be differentiated by rate explain this:

Back 23

a. Tachy vs brady
b. QRS Duration can be wide or narrow

Front 24

These can cause sudden cardiac death and can be asymptomatic or symptomatic
A. syncope
b. Dizziness
c. Palpatations

Back 24

Cardiac Arrhythmias

Front 25

__________ is the gold standard for cardiac arrhythmias

Back 25

ECG

Front 26

Definitive diagnosis for a cardiac arrhythmias is _______

Back 26

Catheter Ablation

Front 27

This Rhythm originates in the SA Node and follows appropriate conduction pathways. HR is 60-80 bpm

Back 27

Normal Sinus Rhythm

Front 28

This heart rate is slower than 60 bpm, this is due to increased vagal tone or normal pacemaker or organic disease of the sinus node

Back 28

Sinus Bradycardia

Front 29

This is < 45 bpm
and can cause:
weakness
syncope
confusion

Back 29

Severe Bradycardia

Front 30

This rate can increase with exercise or aministration of atropine

Back 30

Bradycardia

Front 31

If a patient presents with a heart rate of < 50 bpm, what do they have and how would you treat it?

Back 31

1.Bradycardia
2. Start ACLS
3. Identify and treat the underlying causes of bradycardia

Front 32

If the patient has bradycardia and you also notice four indicative s/s that make the patient unstable and are _________ how would you treat it?

Back 32

Unstable patient would have s/s
1. Hypotension
2. Acute mental status change
3. Signs of Shock
4. Acute Heart Failure
Treat with Atropine 05mg bolus
Repeat q 3-5 mins
Max dose is 3mg

Front 33

If you are treating bradycardia with medication because the patient is unstable and you have already administered Atropine and it did not work...what do you do next?

Back 33

1. Prepare for transcutaneous pacing
2. Use Dopemine IV 2-10 mg/kg min
3. Use Epinephrine
2-10 MCG/min
1:10,000 solution

Front 34

If a heart rate is faster than 100 bmp it is considered______

Back 34

Tachycardia

Front 35

This is caused by a RAPID impulse from the SA node, the rhythm is generally regular but may vary with changes in position

Back 35

Sinus Tachycardia

Front 36

___________ occurs with:
Fever
Dehydration
Stimulants
Infection
Alcohol Withdrawl

Back 36

Tachycardia

Front 37

If a patient with Tachycardia presents with Tachycardia but does not have:
Fever
Dehydration
Stimulants
Infection
Alcohol
What should you consider?

Back 37

Consider starting ACLS Protocol

Front 38

Paroxysmal Supraventricular Tachycardia means what

Back 38

Paroxymal= sudden
Supreventricular= above the ventricles

Front 39

__________ is the most common cardiac arrhythmia and it often occurs in patients without structural heart disease. The most common reason for this to happen is reentry

Back 39

Paroxysmal Supraventricular Tachycardia

Front 40

This usually has an ECG rate of 160-220 bmp heart rate of ABOVE 150 and has a regular rhythm. The P wave may be buried in the narrow QRS because the rate is so rapid

Back 40

PSVT

Front 41

This can be ASYMPTOMATIC but is frequently associated with:
Palpitations
Rapid Heart Rate
Mild Chest Pain
Shortness of breath

Back 41

PSVT

Front 42

This is the most common CHRONIC arrhythmia and the prevalence increases with age.

Back 42

A Fib

Front 43

With this Cardiac Arrhythmia multiple areas of the atrial myocardium are continuously discharging and the pattern is irregularly irregular

Back 43

A fib

Front 44

This Cardiac Arrhythmia is rarely life threatening unless the ventricular rate is rapid enough to cause
1. Hypotension
2. Myocardial Ischemia
3. Dysfunction

Back 44

A-fib

Front 45

This rhythm is irregularly irregular (R-R is irregular) and has an Atrial rate of 400/min presenting as fibrillation waves (wavy baseline)
Ventricular rate is around 170-180 bpm

Back 45

AFIB

Front 46

The ventricular rate is 170-180 bpm and the arial rate is approx. 400/min. What am I?

Back 46

A-Fib

Front 47

Up to 2/3 of patients experiencing their first episode of _______ will spontaneously revert to Sinus Rhythm within 24 hours

Back 47

A-Fib

Front 48

If a patient is stable with A-Fib and it is their first episode and it has been less than 24 hours how should you treat them?

Back 48

Just monitor/IV/o2/No meds or pacing

Front 49

The goal of treatment for A-fib should be to focus on _________

Back 49

ventricular rate control

Front 50

Patients with A-Fib >48 hours are at risk for _________

Back 50

Cardioembolic events

Front 51

If a patient has had A-Fib for >48 hours and are at risk for cardioembolic events how should you treat the patient?

Back 51

These patients should not be cardioverted until anti coagulated * UNLESS they are unstable. Because they are at risk for an emboli

Front 52

IF a patient is unstable and has A-Fib you should follow ACLS protocol and do what?

Back 52

Prepare for cardioversion from 100-200J

Front 53

If the patient is stable and has A-Fib the therapy is aimed at what?

Back 53

Rate control and anti coagulation

Front 54

If a patient is stable and has A-fib what medication do you not give underway?

Back 54

Warfarin (Coumadin)

Front 55

Embolitic event, rapid ventricular rate that could lead to myocardial dysfunction are all complication of what?

Back 55

A-Fib

Front 56

This is usually associated with heart disease or COPD

Back 56

Atrial Flutter

Front 57

This originates from a localized area in the atria and looks like saw tooth flutter waves on the ECG. The atrial rate is 250-350 bpm

Back 57

Atrial Flutter

Front 58

Commonly _________has a flutter wave of 4:1. 4 flutter waves per 1 QRS

Back 58

Atrial flutter

Front 59

Synchronized cardioversion of (25J-50J) is very effective in converting up to 90 % of patients

Back 59

Atrial Flutter

Front 60

Chemical cardioversion with Ibutilide 1-2mg IV is 50-70% successful within 60-90 minutes for ________

Back 60

Atrial Flutter

Front 61

Anticoagulation is not necessary for patients with A-flutter _______

Back 61

< 48 hours

Front 62

Embolitic event in chronic______ is the same as chronic atrial fibrillation

Back 62

a-flutter

Front 63

________ are due to impulses originating from the ventricles

Back 63

PVC

Front 64

______ are very common, even in patients without heart disease BUT occur most in patients with
1. Ischemic Disease
2. Post-MI

Back 64

PVC's

Front 65

Hypoxia
CHF
Digoxin Toxicity
Electrolyte abnormalities are the common causes of ______

Back 65

PVC's

Front 66

Patients with______ are at an increased risk of development of ventricular fibrillation, especially after AMI

Back 66

PVC's

Front 67

With this you would see a premature or WIDE QRS with a preceding P-wave

Back 67

PVC

Front 68

When you have a _____ the complications could be progression to V-tach or V-Fib

Back 68

PVC

Front 69

If this person is asymptomatic and has no organic heart disease, no treatment is necessary but you should send for med advice and if symptomatic MEDEVAC

Back 69

PVC

Front 70

This is 3 or more consecutive ventricular beats lasting < 30 seconds and terminating spontaneously

Back 70

Non-Sustained V-tach

Front 71

This type of ventricular tachycardia is there to stay and is continuous and severe

Back 71

Sustained V-tach

Front 72

This cardiac arrhythmia can be life threatening because it could lead to pulseless V-tach, V-Fib, rupture of ventricular wall, and death

Back 72

V-Tach

Front 73

With this cardiac arrhythemia you should check electrolytes because it can occur in patients with hypokalemia and hypomagnesemia

Back 73

V-tach

Front 74

With this cardiac Arrhythmia you should treat patients with Amioderone 150mg over 10 min DO NOT BOLUS, repeat as needed if it returns, then 1mg/min 6 hours maintenance

Back 74

V-tach

Front 75

With this rhythm you should R/O Dehydration and drug use

Back 75

V-tach

Front 76

Amioderone may cause cardioversion back to NSR with this rhythm

Back 76

V-tach

Front 77

This is totally disorganized depolarization of small areas of ventricular myocardium, no effective ventricular pumping, LIFE threatening

Back 77

V-Fib

Front 78

This is seen most commonly with severe ischemic disease

Back 78

Ventricular Fibrillation

Front 79

On this ECG you will find a zig zag pattern without P waves or QRS complexes and the protocol for treatment of this is ACLS for cardiac arrest

Back 79

V-Fib

Front 80

This is a generalized disease of the arteries leading to narrowing and occlusion

Back 80

Atherosclerotic Disease

Front 81

This disease puts you at risk for having:
Coronary Artery Diease
Peripheral Artery Disease
Stroke
Aortic Disection

Back 81

Atherosclerotic Disease

Front 82

This is the leading cause of death in the United States

Back 82

CAD Coronary Artery Disease

Front 83

Hypercholesterolemia and other lipid abnormalities provide important risk factors for this disease

Back 83

CAD

Front 84

Risk of getttng_____CAD increases with higher levels of low density lipoprotein (LDL) Cholesterol and decreases with higher levels of high density lipoprotein (HDL) cholesterol. It is also important to check blood gluclose

Back 84

CAD

Front 85

If a patient is diagnosed with CAD what advice should you give your patient?

Back 85

Advice them on lifestyle changes and increase activity and exercise, low fat diet high in fruits and vegetables

Front 86

If a patient is diagnosed with ______ you should treat them with anti hyperlipidemic agents such as Statins: Simvistatin (Zocor)

Back 86

CAD

Front 87

If medication and diet do not help with CAD what is the other option?

Back 87

Surgery: Coronary artery Bypass grafting
Percutaneous Coronary Intervention (ballon angio plasty and coronary stenting)

Front 88

This is a symptom of a systemic atherosclerosis process

Back 88

Lower Extremity Occlusive Disease (atherosclerotic Peripheral Vascular Disease)

Front 89

There is a high correlation with patients who smoke and patients with diabetes that have ________

Back 89

Lower Extremity Occlusive Disease (atherosclerotic Peripheral Vascular Disease)

Front 90

A patient would present with Claudication: cramping pain or tiredness in the thigh, calf, foot, with walking or exercise and is relieved by rest

Back 90

Lower Extremity Occlusive Disease (atherosclerotic Peripheral Vascular Disease)

Front 91

Patients with this are at a high risk for amputation if the pain is unrelieved with rest.

Back 91

Lower Extremity Occlusive Disease (atherosclerotic Peripheral Vascular Disease)

Front 92

If a patient presents with loss of hair, thinning and cool skin, atophy of muscles and diminished pulses they may have _________

Back 92

Lower Extremity Occlusive Disease (atherosclerotic Peripheral Vascular Disease)

Front 93

This is a acute occlusion due to emboli or thrombus

Back 93

Acute Arterial Occlusion of a Limb

Front 94

Atrial Fibrillation is the MOST common cause and it can also be caused by valvular heart disease

Back 94

Acute Arterial Occlusion of a Limb

Front 95

When you have this disease and it is not caused from atrial fibrillation, emboli are predominantly due to emboli from the proximal internal carotid artery

Back 95

Occlusive Cerebral Vascular Disease

Front 96

If a patient has Occlusive Cerebral Vascular Disease do not treat with ________

Back 96

Vagal Maneuvers or carotid massage

Front 97

_________ is classified based on ECG findings as ST-segment elevated MI (STEMI) or non-ST segment elevation (NSTEMI) along with cardiac biomarkers (CK-MB and troponins)

Back 97

Acute myocardial Infarction

Front 98

_________ represents tissues ischemia without infarction

Back 98

NSTEMI

Front 99

AMI or _______ results from an occlusive coronary thrombus at the site of preexisting arthrosclerotic plaque

Back 99

ST-segment elevated MI

Front 100

Less commonly a, infarction can occur from ________ coronary vasospasms, hypotension, or excessive metabolic demand

Back 100

Coronary Vasospasm

Front 101

In young individuals with no risk factors you should consider cocaine use if a patient presents with an infarction caused by _______

Back 101

coronary vasospasm

Front 102

The sum of total ST-Segment elevation is a good indicator of the extent of the infarction and risk of subsequent events for _______

Back 102

ACS- Acute Coronary Syndrome

Front 103

_______ covers the spectrum of unstable cardiac ischemia from unstable patients angina to acute myocardial infarction. It is caused by hypo-perfusion of cardiac tissue

Back 103

ACS-Acute Coronary Syndrome

Front 104

Elevated Cardiac Enzymes may indicate_________ it may take 4-12 hours to become elevated

Back 104

MI

Front 105

what should you do if a patient is is dyspneic, hypoxic, has signs of heart failure or O2 sat < 94%. Maintain 02 sats ≥ 94%

Back 105

– Oxygen 4L/min

Front 106

The goal of treatment is to prevent further cardiac damage, during ACS. What must you do to achieve this?

Back 106

Monitor and support ABC's
Get vitals and O2 Sat
Cardiac Rhythm
IV Access
MONA-Oxygen, Aspirin, Nitroglycerin, Morphine

Front 107

Do not give patients with ACS – Aspirin (Acetylsalicylic Acid) 160-325mg to chew if:

Back 107

Contraindicated in patients with ASA allergy or GI bleed

Front 108

the 3rd step in preventing further cardiac damage medication wise would be to administer what?

Back 108

Nitroglycerin (Glyceryl Trinitrate) 1 sublingual tablet/spray q3-5 for ongoing symptoms. Max dose 3 tablets.

Front 109

If a patient is suffering from ACS ______ is contraindicated if they have hypotension SBP<90, marked bradycardia (<50) or tachcardia

Back 109

Nitroglycerin

Front 110

You would administer ________ for chest discomfort unresponsive to sublingual nitroglycerin

Back 110

Morphine 4-8 mg

Front 111

If hypotension develops after the use of morphine with patients that have ACS you should administer what as your FIRST line of therapy?

Back 111

Fluids

Front 112

________ is common post MI

Back 112

Cardiac Arrhythmias

Front 113

Pain relief with ______ is significant because its a vasodialator and it will show you that your coronart arteries are blocked, this wont work if is completely blocked

Back 113

Nitroglycerin

Front 114

__________ is defined as circulatory insufficiency that creates an imbalance between tissue oxygen supply and demand resulting in global tissue hypoperfusion. This leads to hypoxia, acidosis and eventual end organ damage and failure.

Back 114

Shock

Front 115

This leads to hypoxia, acidosis and eventual end organ damage and failure.

Back 115

Shock

Front 116

• Hypovolemic
• Cardiogenic
• Distributive
• Obstructive

Back 116

Categories of shock

Front 117

Dobutamine a Beta Adrenergic agonist is 1st line choice for __________
Initial dose is 0.5-1mcg/kg/min titrate to effect

Back 117

cardiogenic shock.

Front 118

Distributive shock has three Categories, what are they?

Back 118

Sepsis, Anaphalaxis, and Neurogenic

Front 119

This type of shock is caused from an over whelming infection with a massive release of bacterial endotoxins causing inability to maintain perfusion

Back 119

Sepsis (type of Distributive shock)

Front 120

This is a severe systemic hypersensitivity reaction where there is a massive release of histamine and other vasoconstrictive substances causing vasodilation, and POTENTIAL AIRWAY COMPROMISE due to edema and bronchospasm

Back 120

Anaphylaxis (type of distributive shock)

Front 121

This is caused by a spinal cord injury resulting in loss of sympathetic stimulation, fluids are no help for this, massive vasodialation happens during a spinal cord injury

Back 121

Neurogenic (type of distributive shock)

Front 122

If a patient is experiencing anaphylaxis what is the main treatment?

Back 122

ABCs, secure Airway
Epinephrine (epipen) 0.3 mg SC/IM repeat q 10-15 mins
Epipen delivers dose of 1:10,000 0.3mg
IV fluid LR or NS bolus

Front 123

what are the 3 ancillary treatments for anaphylaxis?

Back 123

Benedryl IV 50mg
Solumederol 125 mg IV
Zantac 50mg IV

Front 124

This is broadly defined as inflammation of the heart muscle

Back 124

Acute Myocarditis

Front 125

With _________ one of the physical findings would be a pericardial friction rub

Back 125

Acute Myocarditis

Front 126

With this the ECG may show signs of pericarditis and you would see diffuse ST-segment elevations

Back 126

Acute Myocarditis

Front 127

With _________ Pericardial Friction run is the MOST COMMON sign, sounds like snow crunching or velcro

Back 127

Acute Inflammatory Pericarditis

Front 128

While using and EKG to diagnose Acute inflammatory Pericarditis you would see diffuse ST segments and the DDx will always be a heart attack

Back 128

Acute Inflammatory Pericarditis

Front 129

ECHO is the gold standard for Dx___________

Back 129

Valvular Heart Disease

Front 130

AMI/UA
PE
Pericardial Temponade
Esophageal Tamponade
Esophageal Rupture
Tension Pneumo/Pneumo
Aortic Dissection/Rupture
Acute Pneumonia
These are all what?

Back 130

Big 7 life threating causes of chest pain

Front 131

Costrochondritis, herpes zosterm and trauma are all considered non-emergent causes of __________

Back 131

chest pain

Front 132

Anxiety, depression, somatoform disorder are all considered non-emergent causes of __________

Back 132

chest pain

Front 133

esophageal reflux, pancreatitis, bilary choledocolithiasis, peptic ulcers are all considered non-emergent causes of __________

Back 133

chest pain

Front 134

Chest pain with exertion relived by rest is called______

Back 134

Stable angina

Front 135

If you patient is experiencing chest pain while resting you should consider it to be___________

Back 135

Unstable Angina

Front 136

if you patient presents with Chest pain behind left sternum described as squeezing, burning, pressing, or aching. Often characterized as a fist over the mid-chest with radiation to left shoulder or arm, back, neck or jaw. (pain and discomfort is much more severe with an MI)

Back 136

Angina

Front 137

Treat Angina with _________ because it is a potent vasodilator

Back 137

Nitroglycerin 0.4mg SL q 5 mins max 3 doses

Front 138

This is related to the presence of at least 1 of Virchows Triad

Back 138

DVT

Front 139

Venous Stasis
Hypercoaguable State
Injury to the vessel wall

Back 139

Virchows Triad

Front 140

If you have:
Recently traveled
Use recreational IV Drugs
older than 60
use birth control
obese
smoke
immobilized
or are on hyoercoaguable hormones then you are at risk for a __________

Back 140

DVT

Front 141

if you have unilateral leg swelling then you must rule out ________

Back 141

DVT

Front 142

IF you have s/s of DVT you must undergo __________

Back 142

ultrasonography

Front 143

The primary goal of treating________ is prevention of a PE

Back 143

DVT

Front 144

You would treat _______ with aggressive anticoagulation with Heparin 80 units/kg IV loading dose then initiate continuous infusion of 18mg/kg/hour
or use lovenox 1mg/kg SC q 12 hours

Back 144

DVT

Front 145

Complications from ______ are pulmonary embolism and death

Back 145

DVT

Front 146

this is __________Muffled heart sounds, Jugular venous distension, Hypotension unresponsive to fluid challenge

Back 146

Becks triad

Front 147

Complications of procedure to treat _______ include RV and coronary artery perforation. Dysrhythmias.

Back 147

Pericardial Tamonade

Front 148

When trying to diagnose ________Helical CT pulmonary angiography is the imaging study of choice. You can also do a CXR and an ultrasound

Back 148

Pulmonary Embolism

Front 149

The goal of treatment for ________ is to prevent further PE

Back 149

PE

Front 150

If you have S/S of DVT it is dx as a_________ until proven otherwise

Back 150

PE

Front 151

You would treat _______ with aggressive anticoagulation with Heparin 80 units/kg IV loading dose then initiate continuous infusion of 18mg/kg/hour
or use lovenox 1mg/kg SC q 12 hours

Back 151

PE and DVT

Front 152

This is the primary disease of the aging, 75% of cases are in people who are 65 or older

Back 152

CHF

Front 153

This heart issue can be right or left sided

Back 153

Congestive Heart Failure

Front 154

With ______ you would find Paroxymal Nocturnal Dyspnea (PND) as one of your physical findings
(PND- attacks of sever shortness of breath and coughing that generally occurs at night)

Back 154

CHF

Front 155

When diagnosing CHF ______ is the gold standard for diagnosis

Back 155

ECG

Front 156

If you saw a patient that had sudden severe chest pain that radiates through to the back, described as ripping or tearing pain your
DX and TX would be what?

Back 156

Dx Aortic Dissection
CXR
CT scan
DDx Acute MI
PE
TX Goal is to lower b/p to SBP 100-120 until surgery
Pain control: Morphine Sulfate 4-8mg IV
Surgery is definitive therapy

Front 157

What is the definite therapy or treatment for Aortic dissection?

Back 157

Surgery

Front 158

What is the treatment goal for aortic dissection?

Back 158

Lower B/p SBP 100-120 until surgery

Front 159

What is the pain control that you would use for a patient DX with an aortic dissection

Back 159

Morphine 4-8 mg IV

Front 160

this is a bacterial or fungal infection of the valvular or endocardial surface of the heart

Back 160

Endocarditis

Front 161

While examining a patient that has a fever, cough, back or flank pain and pain in the abdomen you notice petechiea on the palate, conjunctiva and beneth the finger nails. You also notice Spilinter hemmorragaes: red lineal streak under the nail plate and within the nail bed. You also observe that the patient has janeway lesions which were painless, erythematous lesion on palms or soles and while doing an eye exam you notice exudative lesions in the retnia which normally only occurs inn 25% of patients. While during the heart exam you note a new heart murmur?
What is the DX?
What is the Tx?

Back 161

Dx: Endocarditis
Tx: Unasyn and nafcillin and gentamicin

or you can use vancomycin 1gm IV q 12 plus ceftriaxone 2 gm IV qd

Front 162

________ is the term applied to 95% of hypertensive patients when know single cause can be identified, it is a mix of genetic and environmental factors. Onset between 25-55 years of age. This is made worse by excessive alcohol, smoking and obesity

Back 162

Essential Hyertension

Front 163

_________ has an identifiable cause, this is suspected in patients with HTN at an early age or when the first symptoms appear after age 50

Back 163

Secondary Hypertension

Front 164

a Patient that presents with a blood pressure of <120/80 would be considered to have _______

Back 164

Normal B/P

Front 165

a Patient that presents with a blood pressure of 120/139 - 80/89 would be considered to have _______

Back 165

Pre-hypertension

Front 166

a Patient that presents with a blood pressure of SBP140-159/DBP 90-99 would be considered to have _______

Back 166

Stage 1 hypertension

Front 167

a Patient that presents with a blood pressure of SBP >160 and a DBP of > 100 would be considered to have _______

Back 167

Stage 2 hypertension

Front 168

A patient presents with renal disease, renal artery stenosis and is pregnant. This person will most likely have what abnormality in their vital signs?

Back 168

High blood pressure

Front 169

If a patient has pheochromocytoma, crushing syndrome and hyperthyroidism then this person will most likely have what abnormality in their vital signs?

Back 169

High blood pressure

Front 170

Patients using drugs or taking certain drugs and estrogen may be_______

Back 170

hypertensive

Front 171

________hypertension is usually asymptomatic

Back 171

Essential

Front 172

Blood pressure must be elevated on > 3 separate occasions and measured on separate days in order to be considered as this

Back 172

hypertension

Front 173

If a patient has hypertension what medication should you put them on in order to treat it? This is the first line.

Back 173

HCTZ Hydrochorothiazide 12.5-25mg PO daily

Front 174

A hypertensive urgency is blood pressure that must be reduced within a few hours, where as _________ requires a substantial reduction in blood pressure within 1 hour to prevent serious morbidity or death

Back 174

Hypertensive Emergency

Front 175

This blood pressure is usually strikingly elevated with the DBP > 130 mmHG but correlation between pressure and end organ damage is poor

Back 175

Hypertensive emergency

Front 176

If patient present with a SBP of 220 and diastolic BP of 130 what is happening with this patient?
220/130

Back 176

Patient is having a hypertensive emergency

Front 177

The complications of end organ damage due to a hypertensive emergency would damage what organs?

Back 177

Kidney, brain, heart, retina

Front 178

Use _______ to reduce hypertensive urgency DBP ,110 over 24 hours. If the patient is already on an antihypertensive agent, reinitiate that hypertensive agent

Back 178

PO medications

Front 179

For ______ you would not use PO meds, you would use IV medication such a Labetolol 20mg IV and start Metroprolol 25-50mg PO BID

Back 179

Hypertensive Emergency

Front 180

This is blunt trauma to the chest causing a myocardial contusion and necrosis, commonly caused by high speed MVA and the steering wheel in MVA's

Back 180

Cardiac Contusion

Front 181

This is commonly asymptomatic except for chest wall pain, sometimes you may find anterior chest injuries such as broken ribs and a chest wall contusion. Tachycardia is disproportionate to the degree of trauma. What is the DX?

Back 181

Cardiac Contusion

Front 182

This is a sudden transient loss of consciousness associated with inability to maintain postural tone

Back 182

Cardiac Syncope

Front 183

The most common causes are vasovagal reflex from pain or fear and uncompensated drop in cardiac output when assuming upright posture

Back 183

Cardiac Syncope

Front 184

_________ is divided into structural cardiopulmonary lesion vs dysrhythmias

Back 184

Cardiac Syncope

Front 185

__________ cardiac syncope can be caused by valvular issues, hypertropic cardiomyopathy, AMI and PE

Back 185

Structural

Front 186

Dysrhythmias that cause ________would be
bradycardia, AV block, V-tach, A-Fib and PSVT, this would indicate an electrical problem

Back 186

cardiac syncope

Front 187

When a patient goes into cardio pulmonary arrest one of the very first things that you should do is_______

Back 187

Maintain airway patency

Front 188

If a patient is in PEA or asystole what treatment should you render?

Back 188

CPR for 2 mins
IV access
Epi 1 mg q3-5mins
Rhythm NOT shockable
CPR for 2 mins
Epi 1 mg q3-5mins
Repeat

Front 189

For a patient with _______ reduce B/P by 25% within 2 hours then 160/100 in 2-6 hours

Back 189

Hypertensive Emergency

Front 190

If a patient presents with a new onset heart murmur and a fever then it is _____ until proven otherwise

Back 190

Endocarditis