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ACNP Test 1 – Cardiology: Questions With A+ Solutions
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ACNP Test 1 – Cardiology: Questions With A+ Solutions
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ACNP Test 1 – Cardiology: Questions With A+ SolutionsNYHA classifications heart failure Right Ans - Stage 1: no limitations, no
SXS
Stage 2: Slight limitations of activity but comfortable at rest
Stage 3: Marked limitations of activity but comfortable at rest
Stage 4: Severe inability for activity without discomfort, SXS at rest
AHA heart failure Right Ans - Stage A: patients at risk for the development
of HF but have no structural abnormality of the heart
Stage B: patients who have structural abnormality but remain free of
symptoms
Stage C: patients who have structural abnormality and previous or current
symptoms
Stage D: patients with end-stage disease refractory to standard treatment
Management for heart failure Right Ans - ACE- (--pril names)
ARB (2nd to ACE due to intolerance, names with -sartan) Intolerance:
angioedema or cough
Beta blocker- Metoprolol most heart specific, coreg non selective and works
on B1 B2 and A1. ( ending in -lol). in addition to ace if class II or III
HF with Preserved EF (>50%) Right Ans - pEF → diuresis + treatment for
pt's other comorbids, no digoxin
If murmur is heard at 5th intercostal space Right Ans - Mirtal
If murmur is heard at 2-3rd intercostal space Right Ans - Aortic
Mitral Stenosis Aortic Regurg Right Ans - Diastolic
Mitral Regurg Aortic Stenosis Right Ans - Systolic
Mitral Stenosis Right Ans - Loud S1 murmur, low pitched, mid diastolic
following an opening snap: apical crescendo rumble. Best heard in L lateral
decubitus position
Almost always due to rheumatic & in women. Hemoptysis is s/s Right Ans -
Mitral Stenosis
, Mitral Regurg Right Ans - S3 with systolic murmur at 5th ICS MCL, may
radiate to base or left axilla, musical, blowing or high pitched
Aortic Stenosis Right Ans - Systolic blowing, rough harsh murmur at 2nd
ICS usually radiating to neck
Aortic Stenosis grades Right Ans - Mild-effective valve area of > 1.5cm
Moderate_effective valve area >1-1.5cm
Severe-effective valve area < 1cm
Aortic regurg Right Ans - Diastolic, blowing murmur at 2nd Left ICS
S3 Right Ans - Ken-tucky, heard in increased fluid states ( CHF, pregnancy)
S4 Right Ans - Ten-ne-see, stiff ventricular wall ( MI, L vent hypertrophy,
chronic HTN)
Gold standard to valvular problems Right Ans - Echo
Management for valvular problem Right Ans - Avoid strenuous activity,
sodium restriction, Diuretics and digitalis aminoglycosides, Nitroglycerin,
HMG-CoA reductase inhibitors
Follow-up are for valve Right Ans - Antiplatelet therapy: Plavix, ASA
Anticoagulant: Coumadin
Beta blocker: slow heart rate, decrease BP and demand for oxygen
BP goal of People >60 Right Ans - 150 or 90
Goal for people with DM or CKD Right Ans - 140 or 90
Treatment with blood pressure for african american Right Ans - thiazide
diuretic and CCB
Treatment for non- black people HTN treatment Right Ans - thiazide
diuretic, ace, or arb, CCB
If patient has HTN and CKD (all ages and all races) Right Ans - ACE or ARB
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