2
Adult Primary Care Exam 2 with verified detailed answers
|| || || || || || || ||
Best lab test to rule out MI - ✔✔Cardiac-specific troponin I and T (rise within the first 2-4
|| || || || || || || || || || || || || || || || || ||
hrs after MI and remain elevated for 7-10 days)
|| || || || || || || ||
What should you do for the patient experiencing ACS? - ✔✔ASA, nitroglycerin and transfer
|| || || || || || || || || || || || || ||
to ED (preferably at a hospital with a cath lab)
|| || || || || || || || ||
Number one symptom of CAD - ✔✔Angina
|| || || || || ||
Characteristics of metabolic syndrome - ✔✔1) HTN || || || || || ||
2) Obesity
||
3) Dyslipidemia
||
4) DM
||
CV risk factors - ✔✔1) HTN
|| || || || ||
2) Obesity
||
3) Dyslipidemia
||
4) DM
||
5) Cigarette smoking
|| ||
6) Physical inactivity
|| ||
7) Microalbuminuria
||
What manometers are best? - ✔✔Mercury bulb (if using digital, make sure they are
|| || || || || || || || || || || || || ||
periodically recalibrated) ||
,2
What are you listening for when measuring BP? - ✔✔1st and 5th Korotkoff sound
|| || || || || || || || || || || || ||
What factors can transiently elevate BP? - ✔✔1) Anxiety
|| || || || || || || ||
2) Cold
||
3) A full bladder
|| || ||
4) Exercise, smoking or caffeine within the previous 30 minutes
|| || || || || || || || ||
Essential HTN risk factors - ✔✔1) Age (arteries stiffen with age)
|| || || || || || || || || ||
2) Gender (male until age 60)
|| || || || ||
3) Race (AAs have higher rates than whites)
|| || || || || || ||
4) Obesity (10# wt loss can make a big difference; meds work better in conjunction with wt
|| || || || || || || || || || || || || || || || ||
loss)
5) Family history
|| ||
6) Alcohol intake (>2 oz per day)
|| || || || || ||
7) Cigarette smoking
|| ||
Physiologically what causes primary HTN - ✔✔Increased CO which results in increased || || || || || || || || || || || ||
peripheral arterial resistance || ||
Typical presentation of secondary HTN - ✔✔-Presentation is usually abrupt and severe
|| || || || || || || || || || ||
-Usually < 35 y/o || || ||
-Negative family hx || ||
-Failure to respond to empirical therapy despite compliance
|| || || || || || ||
#1 cause of secondary HTN - ✔✔Renal artery stenosis
|| || || || || || || ||
,2
Other causes of secondary HTN - ✔✔Pheochromocytoma, primary hyperaldosteronism,
|| || || || || || || || ||
coarctation of the aorta, Cushing's, Renal Parenchymal Disease, alcohol, medication
|| || || || || || || || ||
How would you diagnose Cushing's? - ✔✔24 urine to see if cortisol levels are elevated
|| || || || || || || || || || || || || ||
Questions to ask about HTN - ✔✔1) When were they initially diagnosed?
|| || || || || || || || || || ||
2) Highest reading ever obtained
|| || || ||
3) Have they been on any other anti-hypertensive meds previously? (If yes, why did they
|| || || || || || || || || || || || || || ||
stop taking them?)
|| ||
Factors from chest pain article - ✔✔1) >55 in men; >65 in women
|| || || || || || || || || || || ||
2) Known CAD or cerebrovascular disease
|| || || || ||
3) Pain not reproducible by palpation
|| || || || ||
4) Pain worse during exercise
|| || || ||
5) Pt assumes pain is cardiogenic
|| || || || ||
(For scores of 2-5 order EKG; for scores of 4 and 5 give O2 and ASA -- arrange for ED
|| || || || || || || || || || || || || || || || || || || ||
transport)
What medications should you ask about when concerned about HTN? - ✔✔1) NSAIDs
|| || || || || || || || || || || ||
2) OTC cold remedies
|| || ||
3) Oral contraceptives
|| ||
4) Anabolic steroids
|| ||
5) MOAIs
||
6) Tricyclic antidepressants
|| ||
7) Diet pills
|| ||
, 2
What candy (in excess) can elevate BP? - ✔✔Licorice
|| || || || || || || ||
What are abnormal fundoscopic findings that are possible w/HTN? - ✔✔1) Abnormal blood
|| || || || || || || || || || || ||
vessels
||
2) Vitreous hemorrhage
|| ||
3) Flame hemorrhage
|| ||
4) Cotton wool sports
|| || ||
5) Hard exudates
|| ||
Why would you draw a CBC w/HTN? - ✔✔HTN drugs can cause anemia/polycythemia
|| || || || || || || || || || || ||
Why would you draw a uric acid level w/HTN? - ✔✔Thiazide diuretics can increase uric
|| || || || || || || || || || || || || || ||
acid levels
||
Why would you draw a calcium level w/HTN? - ✔✔Low calcium intake in the diet can
|| || || || || || || || || || || || || || || ||
increase BP ||
HTN differentials - ✔✔1) White coat syndrome
|| || || || || ||
2) Isolated systolic HTN
|| || ||
3) Any one of the secondary causes
|| || || || || ||
4) Cocaine use
|| ||
Recommended lifestyle modifications w/HTN - ✔✔1) Weight loss || || || || || || ||
2) Reduction of sodium intake (DASH diet)
|| || || || || ||
3) Regular exercise (3-5x per week)
|| || || || ||
4) Reduce ETOH intake to no more than 2 oz. daily
|| || || || || || || || || ||
Adult Primary Care Exam 2 with verified detailed answers
|| || || || || || || ||
Best lab test to rule out MI - ✔✔Cardiac-specific troponin I and T (rise within the first 2-4
|| || || || || || || || || || || || || || || || || ||
hrs after MI and remain elevated for 7-10 days)
|| || || || || || || ||
What should you do for the patient experiencing ACS? - ✔✔ASA, nitroglycerin and transfer
|| || || || || || || || || || || || || ||
to ED (preferably at a hospital with a cath lab)
|| || || || || || || || ||
Number one symptom of CAD - ✔✔Angina
|| || || || || ||
Characteristics of metabolic syndrome - ✔✔1) HTN || || || || || ||
2) Obesity
||
3) Dyslipidemia
||
4) DM
||
CV risk factors - ✔✔1) HTN
|| || || || ||
2) Obesity
||
3) Dyslipidemia
||
4) DM
||
5) Cigarette smoking
|| ||
6) Physical inactivity
|| ||
7) Microalbuminuria
||
What manometers are best? - ✔✔Mercury bulb (if using digital, make sure they are
|| || || || || || || || || || || || || ||
periodically recalibrated) ||
,2
What are you listening for when measuring BP? - ✔✔1st and 5th Korotkoff sound
|| || || || || || || || || || || || ||
What factors can transiently elevate BP? - ✔✔1) Anxiety
|| || || || || || || ||
2) Cold
||
3) A full bladder
|| || ||
4) Exercise, smoking or caffeine within the previous 30 minutes
|| || || || || || || || ||
Essential HTN risk factors - ✔✔1) Age (arteries stiffen with age)
|| || || || || || || || || ||
2) Gender (male until age 60)
|| || || || ||
3) Race (AAs have higher rates than whites)
|| || || || || || ||
4) Obesity (10# wt loss can make a big difference; meds work better in conjunction with wt
|| || || || || || || || || || || || || || || || ||
loss)
5) Family history
|| ||
6) Alcohol intake (>2 oz per day)
|| || || || || ||
7) Cigarette smoking
|| ||
Physiologically what causes primary HTN - ✔✔Increased CO which results in increased || || || || || || || || || || || ||
peripheral arterial resistance || ||
Typical presentation of secondary HTN - ✔✔-Presentation is usually abrupt and severe
|| || || || || || || || || || ||
-Usually < 35 y/o || || ||
-Negative family hx || ||
-Failure to respond to empirical therapy despite compliance
|| || || || || || ||
#1 cause of secondary HTN - ✔✔Renal artery stenosis
|| || || || || || || ||
,2
Other causes of secondary HTN - ✔✔Pheochromocytoma, primary hyperaldosteronism,
|| || || || || || || || ||
coarctation of the aorta, Cushing's, Renal Parenchymal Disease, alcohol, medication
|| || || || || || || || ||
How would you diagnose Cushing's? - ✔✔24 urine to see if cortisol levels are elevated
|| || || || || || || || || || || || || ||
Questions to ask about HTN - ✔✔1) When were they initially diagnosed?
|| || || || || || || || || || ||
2) Highest reading ever obtained
|| || || ||
3) Have they been on any other anti-hypertensive meds previously? (If yes, why did they
|| || || || || || || || || || || || || || ||
stop taking them?)
|| ||
Factors from chest pain article - ✔✔1) >55 in men; >65 in women
|| || || || || || || || || || || ||
2) Known CAD or cerebrovascular disease
|| || || || ||
3) Pain not reproducible by palpation
|| || || || ||
4) Pain worse during exercise
|| || || ||
5) Pt assumes pain is cardiogenic
|| || || || ||
(For scores of 2-5 order EKG; for scores of 4 and 5 give O2 and ASA -- arrange for ED
|| || || || || || || || || || || || || || || || || || || ||
transport)
What medications should you ask about when concerned about HTN? - ✔✔1) NSAIDs
|| || || || || || || || || || || ||
2) OTC cold remedies
|| || ||
3) Oral contraceptives
|| ||
4) Anabolic steroids
|| ||
5) MOAIs
||
6) Tricyclic antidepressants
|| ||
7) Diet pills
|| ||
, 2
What candy (in excess) can elevate BP? - ✔✔Licorice
|| || || || || || || ||
What are abnormal fundoscopic findings that are possible w/HTN? - ✔✔1) Abnormal blood
|| || || || || || || || || || || ||
vessels
||
2) Vitreous hemorrhage
|| ||
3) Flame hemorrhage
|| ||
4) Cotton wool sports
|| || ||
5) Hard exudates
|| ||
Why would you draw a CBC w/HTN? - ✔✔HTN drugs can cause anemia/polycythemia
|| || || || || || || || || || || ||
Why would you draw a uric acid level w/HTN? - ✔✔Thiazide diuretics can increase uric
|| || || || || || || || || || || || || || ||
acid levels
||
Why would you draw a calcium level w/HTN? - ✔✔Low calcium intake in the diet can
|| || || || || || || || || || || || || || || ||
increase BP ||
HTN differentials - ✔✔1) White coat syndrome
|| || || || || ||
2) Isolated systolic HTN
|| || ||
3) Any one of the secondary causes
|| || || || || ||
4) Cocaine use
|| ||
Recommended lifestyle modifications w/HTN - ✔✔1) Weight loss || || || || || || ||
2) Reduction of sodium intake (DASH diet)
|| || || || || ||
3) Regular exercise (3-5x per week)
|| || || || ||
4) Reduce ETOH intake to no more than 2 oz. daily
|| || || || || || || || || ||
