NR667 Chamberlain CEA week 8 exit exam questions with actual answers {100% correct} rated a+ 100% distinction guarantee.

Blood Flow Lungs ® Pulmonary Veins ® Left Atrium ® Aorta ® Body Tissues ® Vena Cava ® Right Atrium ® Right Ventricle ® Pulmonary Arteries ® Lungs Symptoms with right vs left side heart blockage · Blockage on the left side of the heart backs up and causes lung symptoms · Blockage on the right side of the heart backs up and causes body symptoms (peripheral edema) HNC8 HTN Guidelines Defined as 140/90 Treatment algorithm: Less than 60 years old - 140/90 60 years old - Defined as 150/90 (more leniency b/c we do not want to drop their BP too low) What hypertension medication should someone with DM and/or CKD be on? ACE or ARB (protects kidneys) What HTN medication should an African American pt be on? CCB What HTN medications should be used in patients with heart failure? Carvediolol and Thiazide diuretics Common side effects from ACE inhibitors cough, angioedema What HTN medication is contraindicated if an ACE inhibitor caused angioedema? ARB What HTN medication should a heart failure pt NEVER be on? CCB (These cause the heart to "relax" which is not good in HF pts) 2 types of CCBs Dihydropyridines & Non-dihydropyridines What are dihydropyridine CCBs used for? BP control Example of a dihydropyridine CCB and side effects Amlodipine Bradycardic side effects, peripheral edema, constipation What are non-dihydropyridine CCBs used for? arrhythmias Example of a non-dihydropyridine CCB and side effects cardizem Tachycardic side effects/palpitations - these meds were peripherally and have a rebound tachycardia The atria (top chambers of the heart) work on which electrolytes? K+ (potassium) and Ca (calcium) The ventricles (bottom chambers of the heart) work on which electrolytes? Na (sodium) and K+ (potassium) Conditions in the atria needs medications that work on K+ or Ca such as .. Cardizem (CCB) or Amiodarone (potassium channel blocker) Conditions in the ventricles needs medications that work on K+ or Na such as .. Amiodarone (potassium channel blocker) What class of medications could be used for atrial and ventricular conditions? Beta-blockers or potassium channel blocker (Amiodarone) What is the percentage of EF for someone with HF with reduced EF? 40% What is the percentage of EF for someone with HF with preserved EF? 40 or greater HF patients with reduced EF need to be on what medications? Carvedilol, loop diuretic, ACE, or ARB What type of diuretics are more potent? Loop diuretics Which hypertensive medications are "cardio-protective"? ACEs and ARBs Functional classes of HF (NYHA): I: No sx II: Sx w/ moderate exertion III: Sx w ADLs IV: Sx at rest What is the ASCVD risk score? measurement of a pt's 10 yr risk of an adverse cardiac event What are the high-intensity statins? Atorvastatin 40-80 mg Rosuvastatin 20-40 mg What happens during S1 heart sounds? mitral valve closes and aortic valve opens Which structural heart condition can cause syncope or near-syncope? Aortic stenosis Which structural heart condition cause a harsh, high-pitches sound that can be heard in the neck or on the right side of the chest near the 2nd intercostal space? Aortic regurgitation/insufficiency Which structural heart condition is very loud and can be heard on the lower left side of the chest? Mitral regurgitation/insufficiency What are the 2 most common places for a AAA? infra-renal and ascending aorta Which aortic aneurysm requires surgery right away? Stanford A (ascending) Which aortic aneurysm is often treated medically or with a possible graft (but does not often need surgery)? Stanford B (descending) What is a medical intervention that should be done for a patient with a Stanford B aneurysm? Keep BP low What class medication should NEVER be given to a patient with an aneurysm or any sort of connective tissue disorder? flouroquinolones (end in "floxicin") What are the 4 fat-soluble vitamins? (stay in the body for a long time) ADEK What percentage of pulmonary emboli or DVTs are provoked? 70% How long should a patient with a provoked PE or DVT be treated with an anticoagulant? at least 3 months How long should a patient with a non-provoked PE or DVT be treated with an anticoagulant? at least 3 months, but could be lifelong if any recurrence What is the Virchow's triad? 3 broad categories of factors that are thought to contribute to thrombosis What are things that could contribute to a provoked PE or DVT? Anesthesia, immobility, pregnancy, hypercoagulable state, DVT, cancer, hormone replacement What are the 3 things that make up the Virchow's triad? Venous stasis Hypercoagulability Endothelial injury What testing should be done first to look for peripheral artery disease? ankle-brachial index (BP will be lower on the ankles vs arms) What test will confirm a diagnosis of PAD? angiography Symptoms of PAD pale, waxy, hairless legs pain with ambulation that improves with cessation of ambulation Treatment for PAD stents of bypass of vessels Anti-platelet medications Statins for lipid management Lifestyle modifications and management of co-morbidities (diabetes) -smoking cessation -daily ambulation Treatment of intermittent claudication Anti-platelet/aspirin Lifestyle modifications and management of co-morbidities (diabetes, HTN, hyperlipidemia) -smoking cessation Exercise (walking through the pain) Symptoms of acute tamponade narrowed pulse pressures, tachycardia, JVD, muffled heart tones What cardiac arrhythmia has an irregularly, irregular rhythm with no visible P waves? Atrial fibrillation What cardiac arrhythmia is characterized by a "saw-tooth" pattern? Atrial flutter intrinsic vs extrinsic clotting pathway Intrinsic factors: 12 - 11 - 9 - 10 Extrinsic factors: 7 - 10 Thrombin - 2 What is the natural anti-coagulant? Protein C/S (once you start warfarin, protein c/s stops working) What anti-coagulant does a patient need to be on for valvular diseases? Warfarin Bridging for anti-coagulants are only required for which medication? Warfarin Mnemonic for landmarks on an EKG "I See All Leads" II, III, & eVF: Inferior V1 & V2: Septal V3 & V4: Anterior V5 & V6: Lateral What procedure is commonly done for A-fib patients? Ablation When ordering imaging studies, when is contrast needed? When looking for anything vascular What are the 5 traits of metabolic syndrome? (Need to have 3 for a diagnosis) -Male waist 40in or female waist 35 in -HTN: BP 130/80 -Trigylcerides 150 -Serum HDL 40 in males or 50 in females -Hyperglycemia: fasting glucose 100 What is the BP goal for patients with diabetes? 130/80 (to protect the kidneys) What condition causes a blood sugar 600 (600-1200), hyperosmolality, and often causes neuro impairment? Hyperglycemia Hyperosmolar State (HHS) What A1C reading indicates diabetes? 6.5% or greater When a patient has diabetes, what should their A1C be to be considered "well controlled"? 7.0% What should the A1C be before adding a second medication? 8.0% What is the first-line treatment (medication) for a patient with Type 2 diabetes? Biguanides (Metformin) Which diabetic medication class is often used as a 2nd line treatment but causes hypoglyccemia? Sulfonylureas (glupizide, glyburide, glimepiride) What class of diabetic medication is contra-indicated with a personal or family history of thyroid carcinoma? GLP-1 Which class of diabetic medications cause glucose to be excreted through the bladder and has a side effect of frequent UTIs and yeast infections? SGLT2 inhibitors (end in "gliflozin") What insulin is long acting? Lantus (20-24 + hours) S/S of hypothyroidism fatigue, difficulty losing weight, constipation, cold intolerance, menorrhagia, coarse nails, brittle hair, delayed relaxation phase of DTRs, hypothermia, goiter What will labs look like for hypothyroidism? Elevated TSH and decreased T4 Treatment of hypothyroidism Levothyroxine Therapeutic/starting doses of levothyroxine Therapeutic is typically 1mcg/kg/day Start low (25-50mcg) and increase as needed When should thyroid levels be checked after starting levothyroxine? 6-8 weeks What lab is checked to check for autoimmune hypothyroidism/Hashimoto's? Anti-PTO S/S of hyperthyroidism fatigue, insomnia, anxiety, nervousness, weight loss, palpitations, diarrhea, heat intolerance, menorrhagia, coarse nails, brittle hair, brisk reflexes, hyperthermia, tachycardia, tremors, eye sx (exophthalmos), diaphoresis, goiter, new onset a-fib What will labs look for hyperthyroidism? Low TSH, elevated T4 What should you do if both TSH and T4 are elevated? Scan the brain (brain tumor, etc) Treatment for hyperthyroidism methimazole, PTU, radioactive iodine ablation, surgery/thyroidectomy (rare) What medication can be used to manage the symptoms/tachycardia in hyperthyroid patients? propanolol Longstanding, untreated hyperthyroid can lead to: Thyroid storm Sx of thyroid storm high fever, CNS dysfunction (presents a lot like serotonin synd