APEA Predictor Remediation Study Set
1. AFIB/ EKG finding Abnormal atrial depolarization w/ normal ventricular depolarization
CHAOS IN THE ATRIUM
NO P waves
2. Types of AFIB Controlled- <100 bpm
Uncontrolled- >100 bpm
3. Management & Rate control: Metoprolol (BBS) or Diltiazem (CCBs) rhythm
Meds ( rate con- control w/ antiarrhythmics ( Amiodarone) Anticoags-
trol, rhythm con- Warfarin - ASSESS CHADS-VASC score
trol, anticoags)
4. CHADS-VASC Stroke risk tool used for AFIB
score CHF, HTN, >/= 75 yo, DM, prior stroke/ TIA/Thromboembolism
5. Amiodarone prevents conduction of unwanted cardiac impulses Test tip:
(MOA, LONG assess chest x-ray & PFTs prior to initiation
TERM USE Long term use can lead to hypothyroidism, pulmonary toxicity & optic neuropathy
CAUSES?)
6. Warfarin normal:1 goal:2-3,
Tx: if <2 increase dose; antidote: Vitamin K
INR 2-9: hold & drop dose
INR >10 (- BLEEDING): Oral Vit K INR >10
(+ BLEEDING_): IV vit K
7. Things to avoid Green leafy vegs, mayo, canola oil, beef liver,
with Wafarin
8. Drug to drug ABX, antifungal, antidepressants, alternative (St. Johns wort, Gingko), antiplatelet, and anti-
interaction (War- inflammatories, amiodarone, acetaminophen
farin) 8 A'S
, APEA Predictor Remediation Study Set
9. HTN (goal) <140/90 in pts <60 and past hx of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries get stiff)
JNC <130/80; If ACVSD risk >10 initiate HTN meds
10. TX HTN (1ST) Lifestyle modifications, herbal ( COQ10)
11. ACE Inhibitors ( "PRIL" Captopril, Enalapril, Afosiopril
slow down how
much AT2 your Antihypertensive. Blocks ACE ( angiotension converting enzyme) lungs from con- verting
body makes) angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased Aldosterone
secretions, Sodium and fluid loss. Heart and renal pro- tective for DM
*Orthostatic Hypotension, cough, angioedema, HYPERKALEMIA RISK
12. ARB (Angiotensin -Sartan (losartan
Receptor Block- antagonizes action of aldosterone Heart
er) ( blocks the and renal protective for DM
re- ceptors that Hyperkalemia risk, dizziness
use AT2 use to
nar- row the
blood vessels)
13. THIAZIDE HCTZ or chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of the kidney(
decrease sodium reabsorption and therefore decreases fluid reabsorption) preferred in
osteoporosis & AA pts.
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in uric acid, glucose,
triglycerides, and calcium
14. Calcium channel agents that inhibit the entry of calcium ions into heart muscle cells, causing a slowing of the
blockers heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing of the smooth
muscle cells of the blood vessels to cause dilation; used to prevent or treat angina pectoris,
some arrhythmias, and hypertension
, APEA Predictor Remediation Study Set
Preferred in >65 yo & AA pts SE:
ankle edema, headaches
AVOID IN PTS WITH GERD- WEAKENS GASTRIC SPHINCTER
15. Idiopathic sys- Caused by stiff arteries; overactive thyroid, DM, seen in pts >60; bp goal: <150 systolic
tolic HTN TX: CCB
16. Kawaski (CREAM) Acute febrile illness of unknown cause resulting in vascular inflammation leading
cause of heart disease in < 5 yo
high fever (up to 104 greater than 5 days), strawberry tongue, peripheral ede- ma,
conjunctival redness, peeling polymorphic rash over trunk, cervical lym- phadenopathy
(Often unilateral) dry lips, hand/foot swelling
17. TX of Kawasaki Aspirin & IVIG
Resolves in 4-8 weeks; f/u w. cardiology
18. Murmurs s3 & s4 S3- Gallop- heard @ the end of diastole, heard in HF or pregnancy
S4- Atrial kick- heard right before systole caused by uncontrolled HTN or LV
hypertrophy; benign finding in elderly
19. Systolic murmur ( Mitral regurgitation- mitral valve doesn't close properly and causes blood to flow backward
MR PASS MVP) into left atrium of the heart; radiates to the axillae; can cause circulation issues
physiological- innocent murmur; turbulent blood flow
aortic stenosis- narrowing of the aortic valve, can cause dyspnea, syncope and angina on
exertion
systolic mitral valve prolapse- mitral valve's flaps bulge into the left atrium of the heart during
contraction phase of the heart.
Dental prophylaxis not necessary for MVP
20. Diastolic mur-
murs (ARMS
1. AFIB/ EKG finding Abnormal atrial depolarization w/ normal ventricular depolarization
CHAOS IN THE ATRIUM
NO P waves
2. Types of AFIB Controlled- <100 bpm
Uncontrolled- >100 bpm
3. Management & Rate control: Metoprolol (BBS) or Diltiazem (CCBs) rhythm
Meds ( rate con- control w/ antiarrhythmics ( Amiodarone) Anticoags-
trol, rhythm con- Warfarin - ASSESS CHADS-VASC score
trol, anticoags)
4. CHADS-VASC Stroke risk tool used for AFIB
score CHF, HTN, >/= 75 yo, DM, prior stroke/ TIA/Thromboembolism
5. Amiodarone prevents conduction of unwanted cardiac impulses Test tip:
(MOA, LONG assess chest x-ray & PFTs prior to initiation
TERM USE Long term use can lead to hypothyroidism, pulmonary toxicity & optic neuropathy
CAUSES?)
6. Warfarin normal:1 goal:2-3,
Tx: if <2 increase dose; antidote: Vitamin K
INR 2-9: hold & drop dose
INR >10 (- BLEEDING): Oral Vit K INR >10
(+ BLEEDING_): IV vit K
7. Things to avoid Green leafy vegs, mayo, canola oil, beef liver,
with Wafarin
8. Drug to drug ABX, antifungal, antidepressants, alternative (St. Johns wort, Gingko), antiplatelet, and anti-
interaction (War- inflammatories, amiodarone, acetaminophen
farin) 8 A'S
, APEA Predictor Remediation Study Set
9. HTN (goal) <140/90 in pts <60 and past hx of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries get stiff)
JNC <130/80; If ACVSD risk >10 initiate HTN meds
10. TX HTN (1ST) Lifestyle modifications, herbal ( COQ10)
11. ACE Inhibitors ( "PRIL" Captopril, Enalapril, Afosiopril
slow down how
much AT2 your Antihypertensive. Blocks ACE ( angiotension converting enzyme) lungs from con- verting
body makes) angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased Aldosterone
secretions, Sodium and fluid loss. Heart and renal pro- tective for DM
*Orthostatic Hypotension, cough, angioedema, HYPERKALEMIA RISK
12. ARB (Angiotensin -Sartan (losartan
Receptor Block- antagonizes action of aldosterone Heart
er) ( blocks the and renal protective for DM
re- ceptors that Hyperkalemia risk, dizziness
use AT2 use to
nar- row the
blood vessels)
13. THIAZIDE HCTZ or chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of the kidney(
decrease sodium reabsorption and therefore decreases fluid reabsorption) preferred in
osteoporosis & AA pts.
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in uric acid, glucose,
triglycerides, and calcium
14. Calcium channel agents that inhibit the entry of calcium ions into heart muscle cells, causing a slowing of the
blockers heart rate, a lessening of the demand for oxygen and nutrients, and a relaxing of the smooth
muscle cells of the blood vessels to cause dilation; used to prevent or treat angina pectoris,
some arrhythmias, and hypertension
, APEA Predictor Remediation Study Set
Preferred in >65 yo & AA pts SE:
ankle edema, headaches
AVOID IN PTS WITH GERD- WEAKENS GASTRIC SPHINCTER
15. Idiopathic sys- Caused by stiff arteries; overactive thyroid, DM, seen in pts >60; bp goal: <150 systolic
tolic HTN TX: CCB
16. Kawaski (CREAM) Acute febrile illness of unknown cause resulting in vascular inflammation leading
cause of heart disease in < 5 yo
high fever (up to 104 greater than 5 days), strawberry tongue, peripheral ede- ma,
conjunctival redness, peeling polymorphic rash over trunk, cervical lym- phadenopathy
(Often unilateral) dry lips, hand/foot swelling
17. TX of Kawasaki Aspirin & IVIG
Resolves in 4-8 weeks; f/u w. cardiology
18. Murmurs s3 & s4 S3- Gallop- heard @ the end of diastole, heard in HF or pregnancy
S4- Atrial kick- heard right before systole caused by uncontrolled HTN or LV
hypertrophy; benign finding in elderly
19. Systolic murmur ( Mitral regurgitation- mitral valve doesn't close properly and causes blood to flow backward
MR PASS MVP) into left atrium of the heart; radiates to the axillae; can cause circulation issues
physiological- innocent murmur; turbulent blood flow
aortic stenosis- narrowing of the aortic valve, can cause dyspnea, syncope and angina on
exertion
systolic mitral valve prolapse- mitral valve's flaps bulge into the left atrium of the heart during
contraction phase of the heart.
Dental prophylaxis not necessary for MVP
20. Diastolic mur-
murs (ARMS
