ACNP 1 Test Questions and Answers
Pt presenting with Acute Pulm Edema or Cardio Shock after MI Correct Ans-DDX: Acute
MR, VSD, Rupture ventricle wall
Right Side Heart Valves Correct Ans-RA - Tricuspid - Ventricle -Pulmonary - LA - Mitral -
Left Vent - Aortic
Mitral Valve Correct Ans-MVS - Dias mur 4/5 ics low pitch apex, decubitus
S+S MVS- afib, sob, lvhf, pulm edema
cause- rheumatic heart dis, atrial myxoma
MVI - Holosystolic mur radiate Axillae, s3 if CHF pres
S+S MVI - arrhythmias, tachy/tachypnea, Pulm edema, fatigue sob
cause- ICM, acute pap muscle rupture after MI, endocard, torn chordae
Aortic Valve Correct Ans-AS- Sys mur @ base, radiate carotid, S4 gallop
S+S- delay carotid upstrk, angina, ST depr, twave inv
AI- Dias mur @ 2/3 ics w/ pt Lean Forwd
S+S- Wide PP, Bounding apical w/ PMI displc, "Water Hammer"
- LV overld/fail, DOE, Pulm edema + congestion
Common- Congent bicuspid, AO root dz, endo, Type a disctn
,Tricuspid Valve Correct Ans-TVI- Holo mur L/mid Lwr sternl bordr while sitting up or stand
S+S- Fatigue, Palps, abd distention, early satiety, abnrl LFT's JVD, peripheral edema
AS treatment Correct Ans-AVR - ACE/ARB
*Do NOT give BB + caution with diuretics*
AI treat Correct Ans-Manage HF
AVR
*CANNOT USE IABP*
MVS TREAT Correct Ans-MVR
manage afib/HF syptoms
MVI- Diuresis for preload / Vasodilate Afterload
daily wts
Most common organism for ENDO Correct Ans-Staph
Strep
Entero
HACEK organsms
, HACEK orgnsms` Correct Ans-Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella
Dukes Criteria Correct Ans-2 major
1 major and 3 minor
5 minor
Major - Coxiella Burnetti, +BC x 2 / Veg seen ECHO or new valve regurg/ Bacteremia
Minor- Fever, Septic emboli, IVDA (heart cond), ICH, Janeway lesion, Osler Nodes, Roth spots,
rheumatoid factor, non major BC+, conjunctiva hemorrhage
Duke's criteria Correct Ans-infective endocarditis diagnostic criteria
Major - sustained bacteremia, endocardial involvement by echo, new valvular regurgitation
Minor - predisposing condition, fever,
septic or pulm emboli, mycotic aneurysm, intracranial hemorrhage, janeway lesions
immune phenomenon - glomerulonephritis, osler's nodes, roth spots, rheumatoid factor
non major blood culture/echo
Endo risk factors Correct Ans-IVDU
Pt presenting with Acute Pulm Edema or Cardio Shock after MI Correct Ans-DDX: Acute
MR, VSD, Rupture ventricle wall
Right Side Heart Valves Correct Ans-RA - Tricuspid - Ventricle -Pulmonary - LA - Mitral -
Left Vent - Aortic
Mitral Valve Correct Ans-MVS - Dias mur 4/5 ics low pitch apex, decubitus
S+S MVS- afib, sob, lvhf, pulm edema
cause- rheumatic heart dis, atrial myxoma
MVI - Holosystolic mur radiate Axillae, s3 if CHF pres
S+S MVI - arrhythmias, tachy/tachypnea, Pulm edema, fatigue sob
cause- ICM, acute pap muscle rupture after MI, endocard, torn chordae
Aortic Valve Correct Ans-AS- Sys mur @ base, radiate carotid, S4 gallop
S+S- delay carotid upstrk, angina, ST depr, twave inv
AI- Dias mur @ 2/3 ics w/ pt Lean Forwd
S+S- Wide PP, Bounding apical w/ PMI displc, "Water Hammer"
- LV overld/fail, DOE, Pulm edema + congestion
Common- Congent bicuspid, AO root dz, endo, Type a disctn
,Tricuspid Valve Correct Ans-TVI- Holo mur L/mid Lwr sternl bordr while sitting up or stand
S+S- Fatigue, Palps, abd distention, early satiety, abnrl LFT's JVD, peripheral edema
AS treatment Correct Ans-AVR - ACE/ARB
*Do NOT give BB + caution with diuretics*
AI treat Correct Ans-Manage HF
AVR
*CANNOT USE IABP*
MVS TREAT Correct Ans-MVR
manage afib/HF syptoms
MVI- Diuresis for preload / Vasodilate Afterload
daily wts
Most common organism for ENDO Correct Ans-Staph
Strep
Entero
HACEK organsms
, HACEK orgnsms` Correct Ans-Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella
Dukes Criteria Correct Ans-2 major
1 major and 3 minor
5 minor
Major - Coxiella Burnetti, +BC x 2 / Veg seen ECHO or new valve regurg/ Bacteremia
Minor- Fever, Septic emboli, IVDA (heart cond), ICH, Janeway lesion, Osler Nodes, Roth spots,
rheumatoid factor, non major BC+, conjunctiva hemorrhage
Duke's criteria Correct Ans-infective endocarditis diagnostic criteria
Major - sustained bacteremia, endocardial involvement by echo, new valvular regurgitation
Minor - predisposing condition, fever,
septic or pulm emboli, mycotic aneurysm, intracranial hemorrhage, janeway lesions
immune phenomenon - glomerulonephritis, osler's nodes, roth spots, rheumatoid factor
non major blood culture/echo
Endo risk factors Correct Ans-IVDU
