Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/24

Click to flip

24 Cards in this Set

  • Front
  • Back
What is the most commonly seen early sign of right CHF, which is not seen in early left CHF?
JVD
What are the systolic dysfunctions of CHF? (EF, Preload, LVEDP, contractility)
Ejection Fraction < 40%
Preload and LVEDP: Inc
Contractility: Dec

(leads to LV hypertrophy)
What causes CHF exacerbation in previously stable patients? (10)
FAILURE:
Forgot medication;
Arrhythmia, Anemia;
Ischemia, Infection;
Lifestyle (Inc sodium);
Upregulation (Inc cardiac output--pregnancy or hyperthyroidism);
Renal failure w/ fluid overload;
Emboli (pulmonary); Endocarditis
What are the diastolic dysfunctions of CHF? (compliance, contraction, recoil, stiffness, LVEDP, CO, EF)
Compliance: Dec
Contraction: Nml
Recoil: Dec
Stiffness: Inc
LVEDP: Inc
CO: Nml
EF: Nml to high
Which type of CHF dysfunction--systolic or diastolic has a normal ejection fraction and is more common in women?
dyastolic
What related heart conditions are seen in the systolic dysfunction of CHF that deals w/ decreased contractility? (4)
Ischemia (most common);
Dilated Cardiomyopathy;
HTN;
Valvular dz
What related conditions are seen in the systolic dysfunction of CHF that deals w/ Inc afterload? (3)
Hypertension;
Aortic stenosis;
Aortic regurg
What related conditions are seen in the diastolic dysfunction of CHF that deals w/ abnormal active relaxation? (2)
Ischemia;
Hypertrophic cardiomyopathy
(from disorders causing LVH)
What related conditions are seen in the diastolic dysfunction of CHF that deals w/ abnormal passive filling? (2)
Restrictive cardiomyopathy;
Concentric hypertrophy from HTN
What are the early signs of Left-sided CHF? (2)
Dyspnea on exertion;
Dec exercise tolerance
What are the late sx of Left-sided CHF? (8)
PORNS DD Tits:
Paroxysmal Nocturnal Dyspnea;
Orthopnea;
Rales and crackles;
Nocturia;
S-3 gallop;
Diaphoresis;
Displaced PMI (laterally);
Tachycardia
What are the early signs of Right-sided CHF? (6)
A Juicy CHERry:
Anorexia
JVD*
Cyanosis
Hepatomegaly
Edema in periphery
RUQ pain
What are the late sx of Right-sided CHF? (2)
abnormal Hepatojugular reflex;
Ascites
What force causes the pulmonary congestion in diastolic dysfunction?
Increased hydrostatic pressure
what (3) ways can CHF be diagnosed by a CXR?
Enlargement of cardiac silhouette;
Pulmonary vascular congestion;
Kerley-B lines
(3) lab methods of diagnosing CHF
CXR;
Echocardiogram (function of ventricles);
Basic Natriuretic Peptide (BNP elevation)
AHA staging guidelines for CHF (stages A-D)
A: at risk but w/o structural heart disorder

B: no sx, w/ structural disorder

C: prior or current sx + structure disorder

D: end-stage dz
NY Heart Assoc Functional Classes of Heart Failure (I-IV)
[measures pt activity limitation]
I: No limitation

II: slight limitation

III: Sx w/ minimal effort, ok at rest

IV: Sx at rest
SOB while lying flat
Orthopnea
What drug classes are good versus CHF? (3)

Which ones are only helpful if patient has a diastolic dysfunction? (2)
Systolic or Diastolic dysfunction:
ACEIs/ARBs
Beta-blockers
diuretics

Diastolic dysfunction only:
Calcium channel blockers
Nitroglycerin
Name the diuretic used for mild CHF and the 2 for significant CHF
Mild:
Thiazides

Significant CHF:
Loop diuretics
Spirolactone
What is the difference in the signs/sx of people w/ right CHF and cirrhosis? (2)
Right CHF also has:

1. JVD

2. Orthopnea
what are the (5) Tx for Acute Pulmonary Edema and Paroxysmal Nocturnal Dyspnea?
NOMAD:
Nitroglycerin
Oxygen
Morphine
Aspirin
Diuretic
What is the rule for prescribing beta-blockers for CHF?
never give during active CHF--add beta-blockers once the patient is diuresed to dry weight and on stable doses of other medications