Final_Week2

Question 1

Risk factors for angina pectoris

Answer 1

Male
increased age
HL
HTN
smoker
DM
obese

Question 2

Treatment of STEMI

Answer 2

• MONA
• BB (not in cardiogenic shock, blocks, dec. CO)
• Reperfusion tx (30-60min. from arrival)
• PCI (90m from arrival)
• CABG

Question 3

Treatment of UA/NSTEMI

Answer 3

Goal directed tx: decr. o2 demand, limit thrombus formation

• Bed rest, O2, analgesia, BB, CCB
• ASA, clopidogrel, prasugrel, or tricagrelor
• heparin
• thrombolytic therapy is NOT indicated

Question 4

Heart failure classifications

Answer 4

Class I: Asymptomatic
Class II: Symptomatic with moderate activity
Class III: Symptomatic with mild activity
Class IV: Symptomatic at rest

Question 5

Bioprosthetic valve

Answer 5

Lasts ~ 10 yrs, no LTAC, preferred for older

Question 6

mechanical/bioprosthetic valve - anesthetic considerations

Answer 6

Biggest concern: anticoagulation

-assess valve function

Question 7

MS - key points

Answer 7

• symptomatic: valve < 1.5cm2
• increased LA volume/pressure
• increased pulmonary venous pressure

Question 8

MS - diagnosis

Answer 8

Echo - calculate valve area

-opening snap early in diastole

Question 9

MS - Tx

Answer 9

• diuretics, BB, anticoag

- surgery: pHTN

Question 10

MS - goal

Answer 10

avoid tachycardia (reduces SV)

Question 11

MS - goal

Answer 11

avoid tachycardia (reduces SV)
*full, slow, constricted

Question 12

MR - goal

Answer 12

increased HR, decreased SVR

Question 13

AS - key points

Answer 13

bicuspid valve (seen in younger pts)
rheumatic dx, infective endocarditis
-systolic murmur: mimics carotid bruit, RU sternal border 
-pulsus parvus
-chest compressions: won't work

Question 14

Critical AS

Answer 14

Valve area < 0.8 cm2

SAD: angina, syncope, DOE

Question 15

AS - goal

Answer 15

prevention of HOTN/decreased CO

NSR 70-80

Question 16

AS - goal

Answer 16

prevention of HOTN/decreased CO

NSR 70-80

Question 17

AR - key points

Answer 17

• widened pulse pressure

- LVH

Question 18

AR- goal

Answer 18

full, fast, forward (HR >80)

-avoid bradycardia, HTN

Question 19

TR- key points

Answer 19

• high pitched, holosystolic murmur, LL sternal border

- may be d/t pHTN

Question 20

TR - goals

Answer 20

• maintain IV fluid volume at norm/high level

- avoid N2O (pulm vasoconstrictor)