AG-ACNP – Cardiovascular Questions &
Answers
What is the reversal agent for coumadin? Correct Ans-Vitamin K
What is the treatment for endocarditis? Correct Ans-PCN G IV q4hrs in combination with
gent
What is the treatment goal for HTN management? Correct Ans-Within 1 month
1. Increase dose or add second drug
2. Assess MONTHLY until goal is reached
3. Refer to HTN specialist if >3 drugs are needed
What is usually the first symptom of PVD? Correct Ans-Complaints of calf pain
(claudication)
What lab diagnostic is indicated in HTN as a rule out? Correct Ans-AM/PM cortisol levels to
rule out Cushings
What major physiological complication is associated with pericarditis? Correct Ans-Cardiac
tamponade. AMB muffled heart sounds and decreased cardiac output
,What medication is indicated for low cardiac output with pulmonary edema? Correct Ans-
Dobutamine 2.5-20 ug/kg/min
What medication regiment would you initiate for a patient s/p AMI with reduced LV function of
EF 10%? Correct Ans-Coumadin - indicated for EF <30%
ACE Inhibitor - prevent remodeling
Beta Blocker - prevent remodeling
What routine lab monitoring is indicated with use of statins? Correct Ans-LFT - 3-6 months
r/t ARF hepatic toxicity with statins
What signifies a NYHA Class IV Heart Failure score? Correct Ans-Inability to carry out any
physical activity without discomfort. S/S at REST
What three groups present differently with AMI? Correct Ans-Women - fatigue, epigastric
pain
Elderly and Diabetic - no pain r/t diabetic neuropathy
What two cardiac enzymes are cardioselective? Correct Ans-Troponin I
CK-MB
What two classic EKG findings are highly suggestive of pericarditis? Correct Ans-ST
segment elevation in ALL leads
,PR depression - highly significant for pericarditis
When do most AMI occur? Correct Ans-At rest
When is it contraindicated to administer tPA in regard to BP? Correct Ans-SBP >180/>100.
Which heart sound is best associated with CHF? Correct Ans-S3 - atrial gallop. FVE states.
Which heart sound is best associated with LVH? Correct Ans-S4 - ventricular gallop. Stiff
ventricular wall - MI, HTN, LVH
Which heart sound is common in angina and AMI? Correct Ans-S4 - ventricular wall stiffness
Which murmur is associated with S3, systolic murmur at 5th ICS MCL that radiates to L axilla?
Correct Ans-Mitral Regurgitation
Which of the following lipid panels has 3 of the 4 values abnormal, warranting attention from the
AG-ACNP?
a. cholesterol 170, LDL 80, TG 240, HDL 20
b. cholesterol 180, LDL 136, TG 160, HDL 29
c. cholesterol 210, LDL 182, TG 160, HDL 34 Correct Ans-B. Cholesterol 180, LDL 136,
TG 160, HDL 29
, Which of the following patients are most likely to develop a DVT:
a. 45 yo. liver failure pt
b. 30 yo. s/p ORIF R tib/fib
c. 59 yo. parapalegic, bedridden
d. 24 yo. F PO contraceptives Correct Ans-a. 45 yo. liver failure pt r/t high risk for bleeding
Your obese 38 yo. patient has the following lipid panel:
Total Cholesterol 270
HDL 28
LDL 168
What is the most appropriate intervention at this time? Correct Ans-Start a statin
Your patient has a history of coagulapathy and is scheduled to go to the OR. What is the most
appropriate intervention for this patient? Correct Ans-Pneumatic stockings. NOT Heparin,
coumadin, or lovenox
Your patient is a 45 yo. F with new onset atrial fibrillation. PMH is unremarkable. What
medication would you start this patient on? Correct Ans-ASA
43 yo. M presents to ED with complaints of substernal chest pain that increases with inspiration,
coughing and swallowing and decreases when he leans forward. He recently had fever, chills and
loss of appetite. What is your primary differential? Correct Ans-Pericarditis
Answers
What is the reversal agent for coumadin? Correct Ans-Vitamin K
What is the treatment for endocarditis? Correct Ans-PCN G IV q4hrs in combination with
gent
What is the treatment goal for HTN management? Correct Ans-Within 1 month
1. Increase dose or add second drug
2. Assess MONTHLY until goal is reached
3. Refer to HTN specialist if >3 drugs are needed
What is usually the first symptom of PVD? Correct Ans-Complaints of calf pain
(claudication)
What lab diagnostic is indicated in HTN as a rule out? Correct Ans-AM/PM cortisol levels to
rule out Cushings
What major physiological complication is associated with pericarditis? Correct Ans-Cardiac
tamponade. AMB muffled heart sounds and decreased cardiac output
,What medication is indicated for low cardiac output with pulmonary edema? Correct Ans-
Dobutamine 2.5-20 ug/kg/min
What medication regiment would you initiate for a patient s/p AMI with reduced LV function of
EF 10%? Correct Ans-Coumadin - indicated for EF <30%
ACE Inhibitor - prevent remodeling
Beta Blocker - prevent remodeling
What routine lab monitoring is indicated with use of statins? Correct Ans-LFT - 3-6 months
r/t ARF hepatic toxicity with statins
What signifies a NYHA Class IV Heart Failure score? Correct Ans-Inability to carry out any
physical activity without discomfort. S/S at REST
What three groups present differently with AMI? Correct Ans-Women - fatigue, epigastric
pain
Elderly and Diabetic - no pain r/t diabetic neuropathy
What two cardiac enzymes are cardioselective? Correct Ans-Troponin I
CK-MB
What two classic EKG findings are highly suggestive of pericarditis? Correct Ans-ST
segment elevation in ALL leads
,PR depression - highly significant for pericarditis
When do most AMI occur? Correct Ans-At rest
When is it contraindicated to administer tPA in regard to BP? Correct Ans-SBP >180/>100.
Which heart sound is best associated with CHF? Correct Ans-S3 - atrial gallop. FVE states.
Which heart sound is best associated with LVH? Correct Ans-S4 - ventricular gallop. Stiff
ventricular wall - MI, HTN, LVH
Which heart sound is common in angina and AMI? Correct Ans-S4 - ventricular wall stiffness
Which murmur is associated with S3, systolic murmur at 5th ICS MCL that radiates to L axilla?
Correct Ans-Mitral Regurgitation
Which of the following lipid panels has 3 of the 4 values abnormal, warranting attention from the
AG-ACNP?
a. cholesterol 170, LDL 80, TG 240, HDL 20
b. cholesterol 180, LDL 136, TG 160, HDL 29
c. cholesterol 210, LDL 182, TG 160, HDL 34 Correct Ans-B. Cholesterol 180, LDL 136,
TG 160, HDL 29
, Which of the following patients are most likely to develop a DVT:
a. 45 yo. liver failure pt
b. 30 yo. s/p ORIF R tib/fib
c. 59 yo. parapalegic, bedridden
d. 24 yo. F PO contraceptives Correct Ans-a. 45 yo. liver failure pt r/t high risk for bleeding
Your obese 38 yo. patient has the following lipid panel:
Total Cholesterol 270
HDL 28
LDL 168
What is the most appropriate intervention at this time? Correct Ans-Start a statin
Your patient has a history of coagulapathy and is scheduled to go to the OR. What is the most
appropriate intervention for this patient? Correct Ans-Pneumatic stockings. NOT Heparin,
coumadin, or lovenox
Your patient is a 45 yo. F with new onset atrial fibrillation. PMH is unremarkable. What
medication would you start this patient on? Correct Ans-ASA
43 yo. M presents to ED with complaints of substernal chest pain that increases with inspiration,
coughing and swallowing and decreases when he leans forward. He recently had fever, chills and
loss of appetite. What is your primary differential? Correct Ans-Pericarditis
