Exam (elaborations)
PAEA EMERGENCY MEDICINE EOR TOPICS 1/475 QUESTIONS AND ANSWERS (A+)
- Course
- Institution
PAEA EMERGENCY MEDICINE EOR TOPICS 1/475 QUESTIONS AND ANSWERS (A+)
[Show more]
Seller
Follow
HELLENAH
Reviews received
Content preview
PAEA EMERGENCY MEDICINE EORTOPICS 1/475 QUESTIONS AND
ANSWERS (A+)
what is the most common cause of heart failure?
specifically left sided? right sided? - √Answer :-MC is
CAD (coronary artery disease)
-L sided: *CAD* & HTN
-R sided: *L sided HF* & pulmonary dz
Quiz :decreased ejection fraction, thin ventricular walls,
dilated LV chamber, and an S3 gallop (filling of dilated
ventricle) is associated with systolic or diastolic heart
failure? - √Answer :systolic (MC form of CHF)
*(the sound is actually heard in the diastole though)
-memory trick: "sys-to-lic" 3 consonants = S3
Quiz :normal ejection fraction, thick ventricular walls,
narrowed LV chamber, and an S4 gallop (atrial
contraction into a stiff ventricle) is associated with
systolic or diastolic heart failure? - √Answer :diastolic
-memory trick: "di-a-sto-lic" 4 consonants = S4
Quiz :what are the causes of systolic vs diastolic heart
failure? - √Answer :-systolic: post *MI*, *dilated
cardiomyopathy*, myocarditis
-diastolic: *HTN*, *LVH*, *elderly*, valvular heart dz,
hypertrophic or restrictive cardiomyopathy, constrictive
pericarditis
,Quiz :when the metabolic demands of the body exceed
normal cardiac function (d/t thyrotoxicosis, wet beriberi,
severe anemia, AV shunting, Paget's disease of the
bone) this is termed ________ heart failure -
√Answer :high-output
*fairly uncommon
-low-output HF is just d/t problem w/ myocardial
contraction, ischemia, or chronic HTN
Quiz :what are some causes of acute vs chronic heart
failure? - √Answer :-acute: *largely systolic*;
hypertensive crisis, acute MI, papillary muscle rupture
-chronic: dilated cardiomyopathy (systolic), valvular dz
(diastolic)
Quiz :explain class I-IV New York Heart Association
functional classes - √Answer :-class I: *no sx's*, *no
limitation* during ordinary physical activity
-class II: *mild sx's* (dyspnea or angina), *slight
limitation* during ordinary activity
-class III: *comfortable only at rest* (sx's caused maked
limitation in activity even with minimal exertion
-class IV: *sx's even while at rest*, severe limitations,
inability to carry out physical activity
Quiz :what compensations does the body make when
heart failure (can be due to something that causes
either inc pre/afterload or dec contractility) begins? -
√Answer :1. sympathetic nervous system activation
2. myocyte hypertrophy/remodeling
3. RAAS activation: fluid overload
,Quiz :the following are signs/sx's of what sided heart
failure?
inc pulmonary venous pressure, dyspnea, orthopnea,
rales/rhonchi, chronic non-productive cough with pink
frothy sputum, HTN, Cheyne-Stokes breathing, S3 or
S4, pale skin/cool extremities, sinus tachy, fatigue -
√Answer :L-sided HF
Quiz :the following are signs/sx's of what sided heart
failure?
inc systemic venous pressure, peripheral edema, JVD,
anorexia, N/V, hepatosplenomegaly, RUQ tenderness,
hepatojugular reflex (inc JVP with liver palpation) -
√Answer :R-sided HF
Quiz :-CXR showing Kerley B lines (alternate flow
tracts), cardiomegaly, pleural effusion, pulmonary
edema
-echo with dec EF
-inc BNP on labs
are all signs of? - √Answer :heart failure
*BNP released from atrium with preload too high
(volume overload)
Quiz :what drugs have shown to decrease mortality
rates in pts with heart failure? - √Answer :*ACE
inhibitors* (-prils), ARBs, *beta-blockers* (-lols),
hydralazine + nitrates, spironolactone
, Quiz :in pts who experience the following common side
effects of an ACE inhibitor to treat heart failure, what is
the alternative medication?
-1st dose hypotension, renal insufficiency,
hyperkalemia, cough, angioedema - √Answer :ARBs (-
sartans)
Quiz :what vasodilators are often used to treat heart
failure? - √Answer :hydralazine + nitrates
-good for african americans
-safe in pregnancy
-acts to dec pre/afterload
-used if pt not able to tolerate ACEi/ARBs/BB or if more
control needed
Quiz :what is the most effective treatment for symptoms
of heart failure? - √Answer :diuretics
-loop diuretics (-semides) act on inc excretion of Na, Cl,
K, H2O (so can go hypo on these electrolytes), other
s/e: hyperglycemia, hyperuricemia
-K-sparing diuretics (spironolactone, eplerenone)
aldosterone antagonists; s/e: hyperkalemia,
gynecomastia with spirono
-HCTZ or metolazone (thiazide like diuretic)- s/e:
hyponatremia/kalemia, hyperuricemia, hyperglycemia
Quiz :what medications are used to treat acute severe
heart failure? - √Answer :*sympathomimetics* (positive
inotropes to inc contractility)
-*digoxin*: but has a narrow therapeutic index (can
cause arrhythmias, seizures, dizziness, GI upset, visual
disturbances, gynecomastia); toxicity = downsloping ST
segment; antidote: Digoxin Immune Fab
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller HELLENAH. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
85651 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now