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cardio Flashcards

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1
Q

How often should adults aged 18 and older with no identifiable risk factors be screened for hypertension?

A

Every 3-5 years

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2
Q

What is the recommended annual screening for adults aged 40 or older?

A

Screen annually

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3
Q

What is the official diagnosis for hypertension based on BP readings?

A

2 readings on 2 occasions

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4
Q

What is the BP classification for Stage 1 hypertension?

A

130-139 OR 80-89

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5
Q

What is the BP classification for Stage 2 hypertension?

A

> /= 140 OR >/= 90

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6
Q

What are the four main drug classes used to treat hypertension?

A
  • ACE inhibitors
  • ARBs
  • CCBs
  • Thiazide diuretics
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7
Q

What side effect is associated with ACE inhibitors?

A

Cough and angioedema

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8
Q

What are the two types of calcium channel blockers (CCBs)?

A
  • DHP (-pines) - more selective for vascular smooth muscle (minimal impact on heart contractability)
  • Non-DHP (verapamil and diltiazem) - effect both heart and blood vessels which decrease heart contractility
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9
Q

What is a common side effect of thiazide diuretics?

A

Increases glucose, uric acid, and triglycerides - protective from osteoporosis

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10
Q

What are the medications recommended for hypertension in pregnancy?

A
  • Nifedipine
  • Labetalol
  • Methyldopa
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11
Q

What indicates a suspicion of secondary hypertension?

A

Onset < 30 years, abrupt onset, or needing >/= 3 medications for BP

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12
Q

What is considered a hypertension emergency?

A

BP 180 and/or 120 + signs of organ damage

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13
Q

What is the cutoff for ASCVD risk for primary prevention with statins?

A

7.5%

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14
Q

What is the LDL level that necessitates high statin therapy?

A

LDL >/= 190

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15
Q

What is the normal level for total cholesterol?

A

< 200

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16
Q

What are signs of hyperlipidemia?

A
  • Xanthelasma
  • Arcus senilis
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17
Q

What is the risk associated with hypertriglyceridemia levels over 500?

A

Increased risk for acute pancreatitis

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18
Q

What are the components of metabolic syndrome?

A
  • Increased waist circumference
  • BP >/= 130/85
  • Fasting glucose >/= 100
  • Elevated triglycerides >150
  • Low HDL level
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19
Q

What is the reference lead for an ECG?

A

Lead II

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20
Q

What is depolarization in the cardiac conduction system?

A

Negative to positive charge; transition from rest to contraction

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21
Q

What does the P wave represent in an ECG?

A

Atrial contraction (atria depolarization)

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22
Q

What is the clinical presentation of atrial fibrillation?

A
  • Fatigue
  • Shortness of breath
  • Lightheadedness
  • Dizziness
  • Palpitations
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23
Q

What anticoagulants are used for atrial fibrillation?

A
  • Apixaban (Eliquis)
  • Rivaroxaban (Xarelto)
  • Warfarin
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24
Q

What characterizes Mobitz type 1 heart block?

A

PR interval becomes longer until the AV node blocks the impulse

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25
What is the hallmark sign of a myocardial infarction?
ST elevation in at least 2 leads
26
What is hypokalemia?
Potassium level < 3.5
27
What is the normal range for magnesium?
1.5-2.4
28
What is pulsus paradoxus?
10 point drop in systolic BP upon inspiration
29
What does the acronym 'ALL PEOPLE TAKE MONEY' represent?
Heart valve anatomy: Aortic, Pulmonic, Tricuspid, Mitral
30
What is the difference between diastolic and systolic heart failure?
* Diastolic: preserved ejection fraction, r/t impaired ventricle relaxation and increased stiffness. The ventricle has hypertrophy. caused by HTN, DM, obesity and aging. * Systolic: reduced ejection fraction (<40%), poor pumping - left ventricle loses ability to contract effectively. most commonly r/t ischemic heart disease
31
What are common symptoms of right-sided heart failure?
* JVD * Edema of legs and ankles * Ascites * Hepatomegaly
32
What are common symptoms of left-sided heart failure?
* Shortness of breath (SOB) * Wheezing * Coughing * Pink frothy sputum * Orthopnea
33
What is the most common cause of right-sided heart failure?
Related to left-sided heart failure and fluid backing up to the right side
34
List symptoms associated with right-sided heart failure.
* Jugular venous distention (JVD) * Edema of legs and ankles * Ascites * Hepatomegaly
35
What tests are included in the diagnosis of heart failure?
* CBC * CMP * Hepatic panel * B-type natriuretic peptide (BNP) * Echocardiogram (ECC)
36
What ejection fraction percentage is definitive for diastolic left-sided heart failure?
<40%
37
What is the mainstay treatment for heart failure?
Diuretics, with Lasix being the most common
38
What should be monitored when using diuretics?
Potassium levels (K+)
39
What are key pharmacological treatments for heart failure?
* Potassium-sparing diuretics (e.g., spironolactone) * Angiotensin receptor-neprilysin inhibitors (ARNIs) - provides extra benefit for HF patients * Beta-blockers (BB) * SGLT2 inhibitors - BS control and also are proven to decrease CV events and hospitalizations for HF pts
40
What medications should be avoided in heart failure?
* NSAIDs - prostaglandin inhibition leading to water retention * Thiazolidinediones - r/t fluid retention. This med is used for DM2 the increase insulin sensitivity * Non-DHP calcium channel blockers (e.g., verapamil, diltiazem) - can depress myocardial contractility
41
What is the classic symptom of stable angina?
Occurs with activity and is relieved with rest and medication
42
What populations may exhibit vague symptoms of acute coronary syndrome?
* Diabetics * Older adults * Females
43
What is the dual antiplatelet therapy (DAPT) after stent placement?
* Aspirin * P2Y12 inhibitor (e.g., Plavix)
44
What is endocarditis?
Inflammation of the inner lining of the heart
45
What are the most common causes of infective endocarditis?
* Streptococcus * Staphylococcus
46
What are the risk factors for endocarditis?
* Dental disease * IV drug use * Cardiac devices * Preexisting diseases and defects of the heart and valves
47
List classic findings of chronic venous insufficiency (CVI).
* Edema * Varicose veins * Skin changes * Ulcers
48
What is a major risk factor for peripheral artery disease (PAD)?
Smoking
49
What is the classic symptom of intermittent claudication?
Lower extremity muscle pain relieved by rest
50
What is the diagnosis criteria for PAD?
Ankle-brachial index (ABI) is less than 0.9
51
What is the treatment for hyperlipidemia?
* HMG-CoA reductase inhibitors (statins) #1 choice * PCSK9 inhibitors - #3, can add to ezetimibe * Ezetimibe - #2 choice * Bile acid sequestrants * Fibrates - used more for high triglycerides
52
What are the side effects of statins?
* Rhabdomyolysis * Drug-induced hepatitis
53
What is the mechanism of action of direct oral anticoagulants (DOACs)?
Disrupt part of the clotting cascade to prevent new clots from forming or growing
54
What is the preferred anticoagulant for patients with mechanical heart valves?
Warfarin
55
What is the average lifespan of a platelet?
7-10 days
56
What are the side effects of ACE inhibitors?
* Dry hacking cough * Angioedema
57
What should be monitored when using ACE inhibitors?
Kidney function and potassium levels (K+)
58
What is the contraindication for ARBs?
Pregnancy
59
What is the treatment of choice for Raynaud phenomenon?
Calcium channel blockers (CCB)
60
What is the mechanism of action of fibrates?
Lower triglyceride levels
61
What should be avoided when taking statins?
Grapefruit juice
62
What is the antidote for digoxin toxicity?
Digoxin-specific antibody fragments (digifab)
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